It’s not what you think – well, not exactly. I’m actually referring to the word “customer.” But within the healthcare industry, using it to describe patients is sacrilegious. We are perfectly comfortable using it to describe the folks that buy other goods and services, so why is it such a dirty word in healthcare? More importantly, what are the implications if patients are, in fact, customers?
A customer, by definition, is a recipient of a good, service, product or idea obtained from a seller, vendor or supplier for a monetary or other valuable consideration. When it comes to hospitality, retail, packaged goods, electronics and travel, we have gotten used to defining the individuals that purchase as customers. So why not healthcare? After all, a patient by definition is a person receiving or registered to receive medical treatment. A patient is someone that makes purchases in the healthcare space.
But in reality the word patient implies so much more, which is why we have yet to update the nomenclature and our thinking about what it means. Fundamentally, the term patient signals a relationship – a human element of care – that is not represented by the term “customer.” Customer implies transaction – something cold and empty, replete of human emotion.
By acknowledging that patients are customers of healthcare, we can start approaching the system in a different way. Rather than subjects of medicine, as customers, these individuals need to be served.
Customer is more than just a word; it’s a state of mind. A state of mind that has been slow-going in healthcare. Shifting the power from clinicians to customers has implications.
1. Customers have choice
Insight: According to the 2012 Census, there are nearly million practicing physicians in the US [PDF]. Most Americans choose from a selection of doctors, making a decision based on recommendation, insurance network, location, availability, certification and presumed quality. No different than shopping for a TV, as of 2012, consumers will also be looking at Consumer Reports: Health to facilitate the decision.
Implication: Quality is not enough. A friendly smile is not enough. The departure from the all-too traditional doctor-patient relationship model means that healthcare will need to step it up. No different than picking an airline, safety is considered tablestake, and customer service will be the way to differentiate and attract a new patient population.
2. Customers are resourceful and informed
Insight: This is the digital age. WebMD and Mayo Clinic Symptom Checker have enabled individuals to get smarter about their health. And while some medical professionals might find self-diagnosing irritating, it’s a reality. Patients are coming to their physicians with printed out diagnoses and skipping their general practitioner altogether (according to a study by the Archives of Internal Medicine, 41% of appointments are with specialists, for many of which as the first point of contact). Access to information has also created an excess of content, difficult to digest and even more difficult to navigate. At the end of the day, consumers are equally overwhelmed as they are (mis)informed.
Implication: No different than a concierge at a hotel, we need to curate the healthcare experience. Rather than fighting against the information, we need to empower. When I am buying a TV, I want someone to tell me which specs are important and which are not important. Healthcare providers will no longer be limited to diagnosing and treating, but extending their role in curating information
3. Customers seek value
Insight: I recently listened to a TedMed talk that disputes the idea of patients as customers, in part because they cannot discriminate on price. While it is mostly true that paying more does not imply better quality (few physicians charge a premium or choose not to accept certain forms of insurance in light of their credentials in a particular specialty), we forget that a majority of individuals aren’t just deciding on which doctor to go to, but whether they even need to go. A study conducted by American Physical Therapy Association found that 40% of the population that suffers from lower back pain never sees a medical professional! As patients – they are already in the door. As customers, they don’t always get to the door. Not every ailment is worth a doctor’s appointment, or rather, not every ailment is worth paying a co-pay. In fact, Americans are visiting the doctor much less frequently today, than they were a decade ago [PDF].
Implication: We need to reevaluate the value proposition for healthcare and re-imagine the delivery of care. This means making sure that customers are both getting what they pay for and understanding the value of what they are getting. Beyond that, it is also necessary to deliver more ‘a la-carte’ care, with choice-based services through a wider variety of access points. For example, if I can only afford $20, what can I get for that? On the flip side, if I am willing to pay more, what more can I get – can I get it digitally? Can I text a doctor? In other words, what is the business lounge of healthcare, versus the economy class fare?
4. Customers exist outside of healthcare
Insight: Unlike the word “patient,” which lives within the confines of healthcare, “customer” is a universal term. Recognizing patients as customers shines a light on the fact that individuals who seek care from a healthcare provider are also being served by hotels, restaurants, mobile carriers and airlines. As customers, they have developed a higher set of expectations.
Implication: Waiting an hour for an appointment is no longer acceptable, nor will it be rewarded with repeat business. Transparency will play a greater role in how consumers choose. I’ve heard the lack of transparency at a hospital being compared to that at a car mechanic – “It’ll cost $100 for me to take a look and I don’t know what it will cost to fix until I’m in there.”
It’s not about talking transactions – because at the end of the day, clinical care will always boil down to the little things a nurse does to make the experience better. But it is about embracing the fact that patients have more choices now more than ever. We need to not only anticipate their wants and needs, but also think outside the box.