An Open Letter to Alaskan Medical Community: We Can Do Better

AN OPEN LETTER TO THE ALASKAN MEDICAL COMMUNITY: WE CAN DO BETTER - Bradison Management Group AKLet me start by saying, I LOVE Alaskan businesses. My heart is in the success of privately owned businesses throughout Alaska, and I especially have a soft spot for surgeons in private practice. The pressures they endure to take excellent care of patients (and they do) in the exam room, provide full-time employment and benefits for on average 3.5 employees per doctor, keep abreast on regulatory requirements of at least a dozen government agencies and then try to have a home life — well it’s next to impossible. I empathize as a small business owner and appreciate their effort to improve healthcare for fellow Alaskans.

From a business perspective, however, I do struggle with the standard of business practice throughout the medical industry. So many physicians host a desire to embrace entrepreneurial efforts. Yet, in many, if not most practices, this effort is in direct conflict with best business practices and quality of the patient experience. Simply put, you just can’t be good at everything. Physicians are often referred to as “the worst business” people next to well — attorneys. The need to grow, gain market share and increase profitability are often malaligned with strategic vision. The idea of managing a business from inside the exam room is riddled with a challenge. This, coupled with an extremely shallow hiring population, has lead us to creating a less than a favorable work environment. Ultimately, we end up with frustrated workflows resulting in a frustrated workforce and the ones that lose out are the patients.

When polled, our patient population from several different socio-economic sectors agree UNANIMOUSLY that “McY D’s” offers far superior customer service than the majority of their physician practices.

Attributing to this are:
  • Lack of clarity in billing practices
  • Inconsistent, extremely high cost of service versus value
  • Friendliness of front desk staff
  • Accuracy in record keeping
  • Timeliness in returned phone calls

Where is the competition in excellent patient service? What has happened to pride of ownership? What the results of our survey indicate to us as business consultants are that the market is wide open for competition. We see several new physicians, dentists and various practitioners relocating to Alaska and pretty quickly out performing legacy competition by offering immediate access, and streamlined billing practices. In some cases, their clinical outcomes are not monitored so we can’t even be sure that their actual clinical services are better or worse than the competition.

So what do patrons expect when they order a Big Mac? It’s pretty simple. There are employee competencies and industry standards that they expect. They expect a clean and fairly modern facility. They expect the person at the counter to smile, and provide a courteous experience. When there is a delay or a variance in service, they expect an apology and corrective action. Consistently. If I have a poor experience, there is a phone number right on the window asking “How did we do?” with the owner’s direct phone number. Accountability, accessibility, courtesy and consistency are at the root of their training.

In a recent activity conducted by BMG, our secret shopper attended an appointment at a well respected medical practice. The physician was not available, so our patient saw a Advanced Nurse Practitioner. While the office was beautiful, staff attentive, the visit lasted 15 minutes. Arguably our patient was paying for expertise in diagnosis and condition, not necessarily for the time involved. Now call me silly, but with at least 7 years of less training than the board certified MD — I would expect a different level of expertise or at least an enhanced service. So did our patient. Our shopper confirmed that (his) basic expectations for diagnosis of a sinus infection was met, however, the value to the appointment did not match the out of pocket expense. The net result is that he will not return. Ever.

So pricing aside, one of the key drivers of healthcare are the employees outside of the examination room. As an industry, the climate in many medical offices include entitled and angry employees. Commonly when evaluating employee engagement we hear comments such as “you don’t understand the patients are angry, we are understaffed, and we have so much to do.” Further complicating the issue of quality customer service, staff are far more focused on pleasing the provider versus pleasing the patient.

Let me offer this comparative: The airline industry has many of the same challenges such as pricing inconsistencies, delays in service and forces beyond the control of the front counter. Yet competition is fierce. As an industry airlines onboard employees with competency training, and solicited customer feedback forms the foundation of their set expectations. They monitor customer retention by offering mileage incentives, published pricing, and friendly customer service.

As business owners, physicians too should be mindful of competition not by concentrating on the practice across town but by concentrating on the patient. To do so, business practices must be actively managed in areas including accountability, marketing, business development, employee engagement, and standard of service. These should all be monitored and checked on. If you REALLY think you’re offering excellent patient care — how do you know? Just last night I was at Table 6 (a local restaurant here in Anchorage) and 3 patrons were pretty animated in providing a good summary of their experience at one of the three largest clinics in Anchorage. And let me tell you, the feedback was timely, specific and understandable. It definitely wasn’t positive. As a community, we can do better.

So, here is my plea. Physicians, as business owners you require excellent customer service. Measure it. Reward it. By embracing a competitive spirit you can measure success in all aspects of your business from customer satisfaction to clinical outcomes. By doing so you embrace an entrepreneurial mindset, set care standards according to the community, and then exceed them. Understand the impact of your roles as an Owner, as a Practitioner and as a Leader. Embrace holding your staff accountable, while encouraging excellent standards of performance. The change comes at a cost, but so does losing to the competition.