When developing a premium patient experience, surgeons need to pay attention to four critical variables: price (what you charge); quality (as defined by the patient); experience (of your patient while under your care); and your staff (those individuals responsible for staging the experience). I intentionally use the word stage as the action verb used to describe the staff's behavior, as do the authors of The Experience Economy,1 which is a book I highly recommend to any surgeon who wants to thrive in the future. In my previous articles in Cataract & Refractive Surgery Today, I highlighted companies that established positions of market leadership via their superior customer experience, rather than the product itself, as their strategy for separating themselves from the competition. This demarcation is indeed a global phenomenon, as illustrated by a recent survey of 240 CEOs from around the world.2 The key finding of the report indicated that "the quality of customer service was often the only differentiator" in a world where products and services are increasingly similar. The concept works just as well in the practice of refractive surgery. Going forward, the patient's experience will become the key differentiator for a practice, especially when you consider that technology and surgical skills are not sustainable ways to make a surgeon and his practice stand out. That is, becoming "a great surgeon who uses the latest technology" is a position that can ultimately be matched by other providers.
How do you stage a great customer experience? Of the four variables listed earlier, the one that is perhaps most critical to your success is your staff, who interact with patients more than you do and thus must be given responsibility for staging the customer's experience in ways that are meaningful and personal.
KEEP YOUR CUSTOMERS
In the retail world, the number-one reason why companies lose customers has nothing to do with the product or its price. Customers choose to go elsewhere because employees conveyed an attitude of indifference (Figure 1).3 This longstanding truth about customer service often plays out in healthcare. A USA Today report on consumers' outlook on medicine showed that fewer than half (38) of those surveyed acknowledged that their doctor's front office team was courteous.4 When taken together, the aforementioned data points are a cause for concern in refractive surgery. Poor staff behavior can undercut all of your efforts to satisfy patients' needs and leave you wondering why a patient either never returned or did not refer others after achieving a successful clinical outcome. Because you do not often witness staff encounters with patients, you may have little awareness of any problems in your practice. Compounding matters is that, traditionally, only one out of every 25 unhappy customers actually complains; the other 24 go away angry.3
ATTITUDE IS EVERYTHING
Why do refractive practices experience problems with staffing? One reason stems from the selection criteria used to fill positions. Many practices hire based on technical competence, sometimes promoting someone from within (eg, "Mary was good at doing new patient workups; let us move her over to the refractive team"). Alternatively, practices will hire someone because of the experience gained while working for another refractive practice. In a medical retail environment, one should seek to hire for both passion and talent, with more weight being given to the former than the latter. Passion, seen in a person's natural enthusiasm, is part of what we think of as a great attitude. Talent, the skills brought to the role, can be taught and further refined. To find people with these invaluable attributes, one should look outside of ophthalmology or even medicine for skills and experience that can be applied to a practice. Retail sales, restaurants, and customer service centers are some examples of areas where one should seek refractive employees. Successful employees in those environments tend to have the right mindset to bring into your practice.
SINK OR SWIM
It is no accident when you experience superior service and a great customer experience from a business; these usually mean that employees have been formally trained, especially in terms of interaction (eg, greeting and educating customers as well as dealing with unhappy ones). Contrast this preparation with new refractive employees' typical training, which generally consists of pairing them with a current employee or sending them to an orientation within various parts of the clinic. These training tactics are okay but not sufficient. If you want employees to stage positive and memorable experiences for your customers, they need to receive equally excellent training. The antidote to the "sink or swim" mentality is to get professional help from outside firms or individuals that specialize in customer service training. You need only look as far as the manager of a great local business or hotel that delivers to its customers the type of experience you want to stage in your practice.
Formal training does not end with the honeymoon period of new employment, however. All staff who interact with customers should receive regularly scheduled "booster shots" of training, which help bolster morale as much as they do skill (see Exceptional Service Is Universal).
DEFINE THE EXPECTATIONS
In many service industries, a checklist replaces a job description. Employers provide employees with an operational checklist for every responsibility that defines a process for customer interaction, similar in concept to a surgical or examination protocol used daily in order to offer consistent levels of quality patient care. Customer service protocols are key in staging an excellent patient experience day in and day out.
ONSTAGE VERSUS BACKSTAGE
The subtitle to The Experience Economy, "Work is Theater & Every Business a Stage," is directly relevant to the staff's behavior in your practice. Is it not annoying when you encounter a retail employee discussing personal matters in your presence? Do you not feel "less than" when a hotel desk clerk does not acknowledge you in favor of paying attention to something else? These are examples of backstage behavior that have no legitimate role in the presence of customers. Staff should act as if they are onstage whenever they are in the presence of patients. As when watching a Broadway performance, the audience is never exposed to the activities that are behind the curtain or backstage. That would ruin the show. It is the same way in your practice.
IN SUMMARY
Your staff is the lifeblood of your practice, and I firmly believe that the quality of your employees can make or break your success as a refractive surgeon. The staff's performance requires leadership from the surgeon in the form of training, motivation, and a passion for taking care of customers. The end result is a customer experience that generates positive lasting memories that last long after the procedure.
Shareef Mahdavi is President of SM2 Strategic, a Pleasanton, California, firm helping medical manufacturers and providers create demand for new technologies. Mr. Mahdavi may be reached at (925) 425-9900; shareef@sm2strategic.com.
