Healthcare branding and the law of expectations
The other day, I took my daughter to the dermatologist for a follow-up treatment for a minor skin ailment, her fourth visit. Her mom had taken her on the previous trips and had warned me that it could take awhile. Not the treatment, which included a quick evaluation by the doctor and a five-minute spray application. The wait.
The entire visit took an hour from start to finish, almost all of it waiting. “How could a dermatology practice afford such poor service?” I thought, especially given the multitude of options available to us in our area and the commodity level of care we needed.
Much of the revenue generated by dermatology groups is from elective cosmetic services – botox, microdermabrasions, etc. – and dermatology could be considered one of the surest forms of retail offerings in healthcare. Meaning price, convenience, service and experience all (should) play a significant role in customer choice.
Alas, despite the fact we were 10 minutes early, we waited in the reception area 25 minutes past our scheduled appointment, and after we were called back, waited another 20 minutes in the exam room. At that point, I told my daughter to put her shoes and socks back on, and we proceeded to leave. Coming out of the room we walked smack into the doctor coming in, who apologized for the delay, and we went back into the exam room for the 10 minute visit.
This whole experience amazed me given the elective nature of the dermatology business, and what I would assume is an understanding that serving customers right would be a key to success. But the kicker was the sign posted on the waiting room wall: “If you have been waiting 30 minutes past your appointment time please inform the receptionist.”
Nearly every doctor’s office, lab and waiting room has a sign similar to this, and typically they provide timeframes of 15 or 20 minutes. These signs are meant to acknowledge and allow for the variability inherent in many care encounters. Sometimes physicians or other caregivers need more time, and a delay can’t be helped. Depending on the situation, twenty minutes is either no big deal (the ED) or fairly annoying (scheduled lab visit). But I’d never seen one allowing for 30 minutes in a clinic setting like this. What this sign conveyed to me was that the clinic has accepted the fact that they can’t see patients on time, and they wanted patients to accept that fact as well.
The sign reminded me of one of my favorite business books, “The Feiner Points of Leadership,” by Michael Feiner. The author, a professor at the Columbia University Graduate School of Business, talks about management strategies using real-life stories from his own executive career at Pepsi, and his style is as down-to-earth and cuttingly honest as I’ve read anywhere. In his book, the first “law of leadership” is called the Law of Expectations, where he states:
“People live up to their perception of our expectations of their performance. More simply, people respond to the level of confidence you show in them.”
Now consider that sign again, and the impact it’s having on this dermatology group’s brand. From a brand experience perspective, it’s literally giving staff and physicians a pass on improving service and efficiency, solidifying as policy the idea that a 30-minute wait is not only acceptable, it’s likely the norm. Now consider it from a brand perception angle: How do I feel as a customer of this practice, knowing that I’m pretty much guaranteed to wait, possibly 30 minutes (or more) past my appointment time? Annoyed, angry, irritated, and itching to tell others — feelings the practice will have to work hard to help me forget if it wants me to recommend it to anyone else.
In this case, the brand perception became the brand reality, and when it came time to schedule the next appointment, I walked straight out of the office.
When it comes to your brand messaging, what expectations are you setting? It’s one thing to ensure your brand promise and values are grounded in reality – puffery and exaggeration have their own dangers. But it’s quite another to set brand experience expectations so low that they allow for an unacceptable reality. Doing so will not only assure a poor experience, it will assure your customers will seek a more respectful and satisfying alternative.
Brilliant observations. Those of us who provide marketing for physician practices need to ensure that the messages being sent by the office are not counterproductive to our efforts. As a health care marketer and health care consumer, I find a big disconnect in many areas of service between what is promoted and what actually happens.
Bravo for helping to raise the level of awareness on the patient experience and its connection to marketing.
Nice article. For comic relief, it reminds me of the Seinfeld episode where Jerry gives his clothes to the laundry mat, and when he returns, the money he had in his hamper is missing, and the laundry mat owner points to the sign that says: “Not responsible for lost or stolen items.” Just like the laundry mat as a license to steal, the doctor offices have a license to steal our time with those signs.
Nice post, Chris. This is one reason I make the gas-face (sorry, bad 1991 reference) when I hear that ‘employees don’t own the brand.’ I heard this again recently at a conference, and promptly pulled out the face. I do think that consumers own the brand perception, but employees are so important to creating the experience that shapes that perception. The only positive out of your experience is that the clinic, for better or worse, is honest about their brand promise (“chances are you’re going to sit a long time”). Not very aspirational, as you refer to in your post. A more egregious offense is if the clinic gave the illusion that you are important to them and you shouldn’t wait for more than 10 minutes, and failed miserably (think any Taco Bell TV spot related to your actual experience). Every employee owns the brand (our hospital’s CEO says we are all caregivers, no matter our role, and we firmly believe that), and at the point of intersection with the consumer is where you blow them away, or keep them away.
Hi Chris, nice post. I’m going over to the clinic to remove that (^*#($* sign immediately.
It’s interesting to change the cultural chasm between changing consumer expectations and the provider-focused culture.
We’ve gotten great feedback on this post, both here in the comments section and offline. (So thank you Valerie, Randy and Tom). It’s of course one thing to point out a poor brand touchpoint such as the “wait 30 minutes” sign, and something altogether different to address the problems behind it. Those could be an organizational indifference to or misunderstanding of the importance of customer service and brand building. Or an inability to change embedded cultures, or any other number of ingrained issues.
But wouldn’t it be great if we started seeing the signs come down, just to start? What if we had a “wait 30 minute” sign bonfire, to cleanse ourselves of these symbols of indifference or inefficiency? Ahh, we can dare to dream.
Keep the comments coming. Is there anyone who has taken this step, who has eliminated the waiting signs? What was the impact? Was is it positive or negative from a consumer perception perspective? Did it impact at all the actual wait-times?
I liked this post very much, Chris.
I agree that medical offices are coming very late to the game of customer service and good business practices. Office visits are very difficult to keep on time for lots of reasons, but the biggest one is that many patients refuse to keep their issues and discussions to a 10-minute slot (tongue-in-cheek). No question that the traditional practice doesn’t worry about running late as it’s the way medicine has always been. No question that the consumerist patient is here and as you did, they will vote with their feet. Patients need to speak up and discuss their concerns with their physician’s manager and open a dialogue. Believe me, managers are struggling as hard with the fix to the problem as you are dealing with it as a patient.
By the way, most practices that have the sign you speak of tell me that it originated years ago when patients did not check in and they just sat down, expecting the staff to know them. They put up the sign to encourage patients to come to the front desk!
Best wishes,
Mary Pat