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3/8/2014
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PATIENT CARE IN THE ERA OF “EXPERIENCE ECONOMY”
JASON BABCOCK, MBA CMPE
CREATED WITH FRANCISCO ARREDONDO, MD MPH
JASON B. BABCOCK, MBA, CMPE
21 years medical practice management experience
Certified Medical Practice Executive (CMPE)
CEO of Fertility Treatment Center (2010+)
Partner & General Manager of Arizona Medical Exchange (2005‐2010)
Practice Administrator of Arizona Institute of Hand & Shoulder Specialists (1993 to 2004)
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OVERVIEW
Why is the experience economy relevant?
What is the experience economy?
How you design a memorable experience?
Other pearls
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WHY IS THE EXPERIENCE ECONOMY RELEVANT?
STATUS OF CUSTOMER EXPERIENCE
Bain and Company Consulting surveyed customers from 362 companies:
80%
believed their experience provided was superior
8%
of customers described their experience as superior
PATIENT EXPERIENCE
“You can say what you want about who you are, or who you think you are, but people believe what they experience.”
Jack Mackey, Vice PresidentService Management Group
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BUSINESS VALUE DISCIPLINES
“Operational Excellence” COST
“Product Leadership” CONSTANT INNOVATION
“Customer Intimacy” CUSTOMIZED OFFERING
Price
Patient Outcome
Patient Experience
M. Treacy and F.Wierserma, The Discipline of Market Leaders 1995
IVF
Process Outcome
Experience Results
60
310
2
71
5547
2518 11
9 630
10
20
30
40
50
60
70
80
Dropout Reasons in Fertility Care
Patient
Physician
Brandes et al. When and why do subfertile couples discontinue their fertility care? Human Reproduction 2009;24:3127
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WHAT ARE THE ROOT CAUSES OF DROPOUT?
Psychological / emotional factorsPsychological stressUncertainty of successDepression / anxiety pre‐treatment
“I’ve just had enough”
Financial / cost issues >50% of insurance‐covered IVF patients drop out before using benefits
Domar AD. Impact of psychosocial factors on dropout rates in insured infertility patients. Fertil Steril 2004;81:271‐3.
IMPROVE THE EXPERIENCE
It is not just thinking about the service we deliver, but also thinking
about the experience
WHAT IS THE EXPERIENCE ECONOMY?
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WELCOME TO THE EXPERIENCE ECONOMY
“As goods and services become commoditized, the customer experiences that companies create will matter most.”
Pine & Gilmore, HBR
THE PROGRESSION OF ECONOMIC VALUE
Pine BJ, Gilmore JH. Welcome to the experience economy. Health Forum J Sept‐Oct 2001 pg 10‐17
“Certainly, competitors can duplicate specific diagnoses, experiences, and follow‐through devices, but no one can commoditize the most important aspect of a transformation: the unique relationship formed between the guided and the guide. It is the tie that binds.”
THE PROGRESSION OF ECONOMIC VALUE
Pine BJ, Gilmore JH. Welcome to the experience economy. Health Forum J Sept‐Oct 2001 pg 10‐17
1. Commodities are raw materials for the goods they make
2. Goods are physical embodiments of the services they deliver
3. Services are intangible operations for the experiences they stage
4. Experiences are memorable events for the transformations they guide
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THE PROGRESSION OF ECONOMIC VALUE
Pine BJ, Gilmore JH. Welcome to the experience economy. Health Forum J Sept‐Oct 2001 pg 10‐17
THE PROGRESSION OF ECONOMIC VALUE
Pine BJ, Gilmore JH. Welcome to the experience economy. Health Forum J Sept‐Oct 2001 pg 10‐17
THE PROGRESSION OF ECONOMIC VALUE
4. Patient experiences are memorable events for the transformations they guide
5. Final progression is transformation. A belief that the patient will “purchase” transformations according to the set of eternal principles the practitioner seeks to embrace – what together they believe will last.”
Pine BJ, Gilmore JH. Welcome to the experience economy. Health Forum J Sept‐Oct 2001 pg 10‐17
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GUMBALL ANYONE?
Patients will forget that you said “Your tubes are blocked and you need IVF,” patients will forget how many blood draws they’ve done, but patients will never forget how you made them feel.
IVF PATIENT EXPERIENCE
PATIENT EXPERIENCE
Let’s focus internally first
Impacting the lives of your team members has a genuine positive result on the patient experience
Love your teammates and help them grow or lose them to another who will
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DNA IS MADE UP OF FOUR CHEMICAL BASES: ADENINE (A), CYTOSINE (C), THYMINE (T), AND GUANINE (G).
DNA of FTC is made up of…
Infertility treatments
SusanSerena
Sheila
Renae
Michella
MaggieLisa VP
Lisa F.
JessicaJennifer
Jason
Dr. Tao
Dr. Craig
Dr. Behera
Desheng
Daina
Casey
ChristaBrenda
Ashley Audrianna
Amberlee
AlexisLab tests
Blood draws
Scans
TLC
Injections
ICSI IVFOutpatient Surgery
Financial Consults
SonohystogramsHSG
Donor program
Tracy
BethTamara
TammyMiao
PATIENT EXPERIENCE
The ripple that you create with your positive actions goes on and on!
IF YOU OWN THE PROBLEM, YOU OWN THE PATIENT
Is it our fault that despite requesting records from our competition or referral physicians they do not send them on time?
NO Is it our problem? YESIs it our fault that the patient ran out of medication and it is a weekend and nothing is open? NO
Is it our problem? YES
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PATIENT EXPERIENCETHE BEST PART OF THEIR JOURNEY
ALWAYS
Be enthusiastic
Use active listening
Use patients name
Find out
Make it right
Use secret service
Own it
NEVER
Sound too busy
Act or sound distracted
Say “no”
Say “I don’t know”
Make excuses
Say “The provider is running behind”
TYPICAL CLINIC EXPERIENCE
Reliable, fuel efficient with easy to use interior controls
Dull driving experience
Aging interior
Underpowered engine
Dated automatic transmission
Few standard interior features
The Ferrari sweeps through broad emotional extremes ‐soft and sweet now, hard and fast when provoked ‐revealing the wild Italian temptress within," writes Automobile Magazine.
"The amazing thing is how the car is able to embrace every situation with an astute blend of confidence and competence.”
PATIENT EXPERIENCE THAT YOU PROVIDE!!
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PATIENT CARE STANDARDS
Non‐Negotiable Standards
Point
Never do a blind transfer
Never say “not a problem”
Never pass by a patient without engaging them
Never show frustration in public
Never make the customer wrong
Always Standards
Take them there
Warm transfers
Genuinely say: “certainly,” “absolutely,” “my pleasure”
10 feet rule, genuine smile is part of the uniform
Focus on what you can do, not what you can’t do
Own it even if its not your fault
PATIENT CARE STANDARDS
Non‐Negotiable Standards
Never say how old are you?
Never criticize competitors
Over share with a guest
Never ask, “Why are you here?”
Never put down other team members
Always Standards
How young are you?
Respect your competitors
Make a casual genuine conversation
Anticipate patient needs
Anticipate team mate needs
WORK IS THEATRE:A MODEL NOT A METAPHOR!
Performance: “An activity done by an individual or group in the presence of and for another individual or group”–Richard Schechner, Performance Theory 1986
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WORK IS THEATRE:A MODEL NOT A METAPHOR!
• You can’t bring a bad day to the office
• Remember, it’s not the patients fault
• Every expression, word, pose, look, smile, frown, body language will be a
memorable event
Success depends on how well you act each day
ACTING IN MEDICAL PRACTICE
“… If a provider does not possess the necessary skills to assess a patient’s emotional needs and to display clear and effective responses to these needs, the job is not done.”
Hillel M. Finestone, David B. Conter. Lancet 1994 Sept 17;334(8925):801‐2
ACTING IN MEDICAL PRACTICE
“Consequently, we believe that medical training should include an acting curriculum, focused on the conveying of appropriate, beneficial responses to those emotional needs…”
Hillel M. Finestone, David B. Conter. Lancet 1994 Sept 17;334(8925):801‐2
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MANY: PA’S ACTING IN FRONT OF THEIR PATIENTS WILL BE OFFENSIVE & NOT AUTHENTIC
“Control, connection, economy, variety, filling, timing, pointing: these are all necessary skills which… communicate the shape of the appropriate gesture to the audience”
Harrop J. Acting with Style, London 3rd ed: Routledge, 1999.
and will likewise for the audience of one, the patient.
ACTING IN MEDICAL PRACTICE
Everyone in contact with patients must find a role, characterize it, rehearse it, and perform it well in every interaction, whether you are a PA, medical assistant, manager, or physician,
Hillel M. Finestone, David B. Conter. Lancet 1994 Sept 17;334(8925):801‐2
the patient healthcare experience depends on how well you act.
HOW TO DESIGN A MEMORABLE EXPERIENCE
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HOW TO DESIGN THE MEMORABLE EXPERIENCE
Theme of the Experience
Harmonize (+) Cues
Eliminate (‐) Cues
Mix in Memorabilia
Engage 5 Senses
THEME OF THE PATIENT’S EXPERIENCE
A dominant idea, an underlying concept or organizing principle around which you organize the entire experience that you stage.
THEME OF THE PATIENT’S EXPERIENCE
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CONSISTENT THEME FOR THE EXPERIENCE
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HARMONIZE IMPRESSIONS WITH POSITIVE CUES
Create unforgettable impressions by introducing cues that affirm the nature of the experience to the patient.
Memories = Education
They are the residue, take away after they have spent some time with you
HARMONIZE IMPRESSIONS WITH POSITIVE CUES
On Caring by Milton Mayeroff. 1971.
Create a Caring Environment, not just patient care
Professional caring presents special challenges. Effective carers are able to understand and explore the boundary and interaction between the professional and the personal aspects of care and to achieve a balance between the two.
HARMONIZE IMPRESSIONS WITH POSITIVE CUES
On Caring by Milton Mayeroff. 1971. Painting by Carmen Martinez‐Jover.
Patience Trust Honesty Hope
Humility Knowing Courage Alternating rhythms
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ELIMINATE NEGATIVE VISUAL CUES
Dirty office?
Stained ceiling tiles?
Baseboards have “dust bunnies?”
Clutter or post‐its everywhere?
Loud / Noisy office and/or waiting room?
Odors?
Patient traffic congestion?
MA or NurseFertility Coach
ScanTransvaginal ultrasound
Guide
Catheter
Injection
Biller
Front Desk
Check in or Check Out
Welcoming Team
Pen
Financial CoordinatorPatient Facilitator
ELIMINATE NEGATIVE VERBAL CUES
ELIMINATE VISUAL NEGATIVE CUES
Baby Book
Why not a Patient IVF Journal
A Step‐by‐Step Emotional Workbook for Family Building
IVF Journal
Finding YOU In – Fertility
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MIX IN MEMORABILIA
MIX IN MEMORABILIA
ENGAGE ALL SENSES
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ENGAGE ALL SENSES
OTHER PEARLS
ABOVE & BEYOND OPPORTUNITIES
• Not having previous records available
• Making them wait excessivelyService Defects
• Counseling and normal physiology
• Diagnostic overview
• Discuss treatment options
Operational Standards
• Explain in their own words and make a connection
• Impeccable office
• PowerPoint available
Experiential Standards
• Give them a copy of the presentation
• Doctor comes to reception area to greet patient
• Tailored to expressed needs (history questionnaire)
Above & Beyond Opportunities
DiJulius John. What’s the secret? To providing a world‐class customer experience. 2008.
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Copy = get ideas from another clinic
Steal = get ideas from a totally different industry and apply them to your own
HYBRIDIZE
“Good artists copy, Great artists steal.”
Pablo Picasso
HYBRIDIZE: RESTAURANT INDUSTRY
Would you like to see how your meal is being prepared?
Nothing to hide: Why restaurants embrace the open kitchen? Transparency rather than mystery.
The sounds, the smells, and the sights of cooking can really help you work up an appetite – all create an experience
TRANSPARENCY RATHER THAN MYSTERY
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HYBRIDIZE: SPA INDUSTRY
How do you convert a negative cue into an advantage?
John Robert Spa
White Gowns vs. Black Gowns
to identify new customers vs. returning customers
HYBRIDIZE: SPA INDUSTRY
How do you convert a negative cue into an advantage?
• Cloth gowns versus paper
• Patient is anxious about treatment – spa music & a cup of tea
HYBRIDIZE: COUTURE INDUSTRY
Service/Experience Aptitude
Capacity to pinpoint opportunities to overdo patients expectations, irrespective of the circumstances.
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1. From the following choose the best response to a patient if the provider is running late:
a) We know how valuable your time is, and regret any inconvenience this may cause you.
b) We do our best to always remain on schedule but unforeseen circumstances sometimes arise.
c) We are so sorry, but you can be certain that your appointment will not be rushed because of this and your provider will always spend your scheduled amount of time with you. We appreciate your patience – ask if there is anything we can do for her/him while waiting, or if she/he would like to see another provider (if possible)/reschedule if the delay has caused inconvenience.
d) I am sorry your provider is running behind, I can see if our other provider is available, or we can reschedule if it is more convenient for you.
OVERDO PATIENTS EXPECTATIONS, IRRESPECTIVE OF THE CIRCUMSTANCES
OVERDO PATIENTS EXPECTATIONS, IRRESPECTIVE OF THE CIRCUMSTANCES
2. A patient wants to speak directly with their provider and they refuse voicemail:
a) I would be happy to transfer you to their voicemail. They check it consistently throughout the day. I will also send them an email to let them know you called.
b) I am so sorry, when they are with a patient we don’t like to interrupt them. I’m sure you can appreciate that and I would be happy to tell him/her you called.
c) You apologize that he/she is not available, acknowledge that you understand that it is very important that they speak with them right away and you would be happy to personally hand deliver him/her the message
Treat others how they best like to be treated
GOLDEN VS. PLATINUM RULE
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HYBRIDIZE: RETAIL INDUSTRY
Nordstrom's
You go for the experience, not just to shop
HYBRIDIZE: AIRLINE INDUSTRY
How to deal with new patients no shows?
HYBRIDIZE: AIRLINE INDUSTRY
They oversell tickets and then give you an incentive to stay
How do airline companies fill most of their seats?
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HYBRIDIZE: AIRLINE INDUSTRY
Patient No Shows After doing a
root cause analysis, identify what percentage of patients do not show up W
hat to do? Overbook your
new patients more or less for that percentage
Result In event
everyone shows, compensate the delayed patient with movie tickets, a gift card or a handwritten note
HYBRIDIZE: HOTEL INDUSTRY
“A place where the genuine care and comfort of our guests is our highest mission…
… instills well‐being, and fulfills even the unexpressed wishes and needs of our guests.”
Create a experience!
HYBRIDIZE: HOTEL INDUSTRY
Three steps of service
1. Warm and sincere greeting Use the guests name, if and when possible
2. Anticipate guest needs
3. Fond Farewell Give them a warm goodbye and use their names, if and when possible.
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SECRET SERVICE
Any staff member adds personalized comments in the chart notes that are for internal review only – colored different.
“Patient is a dentist” “Graduated from culinary school” “Grandmother just died”
“Just gave a great presentation at work today”
“Scared to death of injections”
Reminds us that every interaction with a patient is a chance to create a remarkable experience
Create a moment
EVERY LIFE HAS A STORYIF WE BOTHER TO READ IT
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At FTC, we transform lives by helping individuals achieve their dream of a family
Individual Family
Creating a World Class
SERVICE VISION
We transform lives by helping individuals achieve their dream of wellness
Overweight Healthy
Depressed Uplifted
Fractured Healed
Creating a World Class
SERVICE VISION
TRAINING: ARE YOUR TEAM MEMBERS WILLING TO LEARN?
Employees probably treat your patients the same way you treat your employees.
SADNESS ‐‐‐> ANGER
Jantsch John. The Referral Engine: Teaching your business to market itself
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HIRING
A people hire A people
B people hire C people
DO NOT ACCEPT “FINE” OR “OKAY”
How was everything today?
When answer is not:
Great • Awesome • Fabulous • Excellent
Then instruct them to ask:
What about your experience today wasn’t excellent?
DO NOT ACCEPT “FINE” OR “OKAY”
A complaint is a gift… Why pay consultants to point out what your own patients
complain about…
This is free advice!
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COMMUNICATION
“I know what you believe you understand what you think I said, but, I’m not sure you realize that what you heard is not what I meant.”
Robert McCloskey, State Department Spokesman
“It is not what you say, it is what people
hear.”Dr. Frank Luntz, The Word Doctor
THE FTC DNA
Fertility Treatment Center… not limited to helping individuals
have babies.
We transform individuals into families.
THANK YOU
" The master of the art of living makes little distinction between his work and his play, her work and his leisure, his love and her religion. He simply pursues his vision of excellence in whatever he does, leaving others to decide whether he is working or playing. To him, he is always doing both“
‐Lao Tzu
