Demystifying Medicine One Month at a Time

You Want Fries With That?

Improving customer service in health care.

Hospitals are aiming for that top box.

Next month the Cleveland Clinic will host its second annual Patient Experience /Empathy and Innovation Summit.

If you’re a long time reader, you’ll remember some posts from last year’s first-ever summit. [Here, here and here.]

The Cleveland Clinic, always a newsmaker, is a world leader in this area because they have raised Patient Experience to the c-suite level: they have given one of their physician leaders the title Chief Experience Officer (“CXO”).

Imagine a huge three day gathering of doctors, nurses, designers, artists, and executives all intent on making things better for patients.

Wait, did he say designers and artists?

Yes. Medical facilities are taking the patient’s perspective into account more than ever in their architectural designs and renovations. And visual arts and music promote a healing environment-something hospitals have not usually been known for (can anyone say “sterile”?).

Why all the fuss? I mean, it’s nice that health care is entering the 21st century in terms of informatics (O.K., just call it computers) and other technologies. It’s not a big leap for competitive health care enterprises to compete on amenities, right?

This movement goes way beyond amenities, though. Here’s why:

Through a program called HCAHPS (pronounced “H-Caps”), the government is incentivizing hospitals to do their best on patient satisfaction surveys. And there’s money on the line. Under Medicare’s value-based purchasing plan (link warning: very boring reading), hospitals will start getting docked reimbursement money if they “underperform” in the domains of quality, safety, and patient satisfaction. No more business as usual.

Just like the issues of safety and quality, patient experience has come to the fore as an issue that hospitals and health care enterprises can no longer ignore. They don’t want to lose money. I call it a win-win. Do the right thing and get rewarded for it.

The thing is, most hospitals think they’re near the top in terms of patient satisfaction. This is an example of the Lake Wobegone effect. In the real world, not everyone is above average.

To really simplify the patient satisfaction scoring systems (there are many out there, but Press Ganey is the 800 lb. gorilla of the hospital performance measurment industry), ask yourself two questions about your doctor or hospital:

  1. Would you come back again?
  2. Would you recommend the service/facility/professional to a family member or friend?

If the answer is yes, would you be “highly likely to recommend” (i.e. 5/5 on a survey scale) in your enthusiasm? That’s the “top box” answer that hospitals are striving for.

Think of the power you’ll be wielding as this takes effect in the next 18-24 months.

If hospitals, doctors and nurses start thinking about your comfort first, health care will really be changed for the better. Let’s just hope that no one gets so bogged down with our new computer charting (informatics!) that we become even more emotionally (er, I mean professionally) distant.

Programming Note

Best Selling Stuff

If you’ll be anywhere near Iowa City April 21-23, check out “The Examined Life: Writing and the Art of Medicine” Conference. I’ll be on a panel Saturday morning with doctor-bloggers Michelle Au (“The Underwear Drawer” and author of the extremely soon-to-be released This Won’t Hurt a Bit (and Other White Lies) and Rob Lamberts (“Musings of a Distractible Mind“).

We’ll be talking doctor blogging: the whys the hows and the whatevers!


  1. Carolyn Thomas

    Thanks Dr. John for this provocative topic. As I read it, I could just picture some of the more burned-out docs I know rolling their eyes at the implication that somehow they have to now worry about patients enjoying a memorable “customer experience”! Might be a hard sell.

    But as a heart attack survivor, this makes eminent sense to me. When I first walked into Mayo Clinic’s Gonda Building and saw the 13 fantastic Dale Chihuly hand blown glass art installations floating two stories over the magnificent glass atrium, I was thunderstruck. I thought I’d died and gone to heaven. (Photo at: ) Mayo’s “Humanities In Medicine” program sounds similar to Cleveland’s. They are on to something.

    But you don’t have to be a world-class mega-hospital to incorporate some of these healing elements into every medical practice. Consider Fred Lee, former hospital administrator and Walt Disney exec who combined his two favourite passions into an innovative hospital employee training program called “IF DISNEY RAN YOUR HOSPITAL. He says: “Unlike traditional service organizations, Disney does NOT provide a service. Neither does your hospital.” What both do provide, according to Lee, is an “experience.” Hospitals would do well to emulate the most vital experiences that earn Disney the love of both guests and employees. More on this at:

    • glasshospital

      Carolyn-thanks for the comment and the links.

  2. Paul Dorio

    Thanks for great comments. Service service service. Between “customer service” and “communication” doctors would massively improve the collective patient experience if we all paid attention to just those two aspects of care. People must realize and accept the fact that patients will be satisfied if you are merely a good diagnostician if you are an excellent service-oriented person, but you will still lose patients and leave some dissatisfied if you have poor service but are the best diagnostician in the region.

    • glasshospital

      I agree. I’m mulling over a post about how in a doctor’s mind we could just check boxes and issue orders all day long–the real skill is in listening and communicating what we have internalized.

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