When your staff disappoint you and the patient

“I recently had the opportunity to hear author, speaker and customer experience coach Elizabeth Dixon share something with business leaders last month something that every Doctor should keep top-of-mind as well. She said ‘the customer experience will never be better than the employee experience.’ For every Physician out there who owns your own practice and struggles with staff resentment, staff morale and poor customer service reviews that can be reframed to say … ‘the Patient experience [at your practice] will never be better than your employees experience!’

By Michael Tetreault, Editor-in-Chief, Concierge Medicine Today, Host, Concierge Medicine Forum

We’ve all been there. We’ve all experienced it. It’s a right of passage it appears in order to have permission at the dinner table to lament about how mistreated you were recently when ‘going to the doctor’s office.’

It’s not the Doctor’s fault either, usually.

Stories get told around each our kitchen islands or living rooms about how when your mother or your Uncle last went to the doctor or specialist and wh

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at they experienced. You’ll know these phrases when you hear things like “You think your last Doctor’s office visit was bad … well, let me tell you about mine!”

Top 10 hospitality tips for Doctors

This is sadly not the first, nor the last time this will happen.

So, I’ll start this article off today with a story. It is unfortunately a true story. Even more unfortunate and unfair is that, it is happening inside thousands of medical offices multiple times a day across the U.S. and very little is being taught to combat this problem.

“I drove across town, took the morning off of work and found childcare for our two kids for a 5-minute visit with the Doctor,” says the Office Manager we spoke to. “On top of that I was held in contempt by the staff for just showing up and giving them my business? That’s absurd. And, as someone who knows medical billing codes myself, I noticed the Doctor billed me for a 30-minute visit when I only saw the Doctor for 5-minutes. I wasn’t a walk-in patient either.”

This is also not the first, nor the last time this will happen to a patient, you or me.

Your front-line, medical office employees have incredible power. Metaphorically, they wield giant swords and can leave a wake of destruction in their path. Conversely, in a few medical offices today, they also set the tone for the Patient-Physician visit and relish in serving people with a smile. These are the rare medical offices you and I encounter that are the diamonds in the rough.

Sometimes however, employees themselves can forget this.

As a Physician, you know that these interactions directly impact your Patients. Whether you like it or not, these interactions are a bright and shiny reflection of your good or poor leadership skills.

Thomas Edison said “The reason most people do not recognize an opportunity when they meet it is because it usually goes around wearing overalls and looking like hard work.”

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If your team does not have an appreciation for their position, their role and their status in your practice and moreover, FOR the Patient, the patient experience will never be better than the employee experience.

Simply stated, the Patient experience is an overflow of the employee experience.

Do your employees enjoy their work? Do you allow them to interrupt you when your seeing patients? Do they know precisely when to give you bad news or purposely hide it until you’re in a better mood? Do you dismiss their ideas because they’re not your ideas?

Author, speaker and business coach Elizabeth Dixon wrote a new book I highly recommend every Doctor get. It’s called The Customer Experience. For some context, she currently leads Strategy and Research and Development for Service & Hospitality at Chick-fil-A and has been blessed to work for incredible brands including Disney World, the Gap, YMCA, and Cooper Aerobics Center. She has been mentored by some of the greatest including Dan Cathy and Horst Schulze. She has learned from the greats of Southwest Airlines, Drury Hotels, Walmart & Zappos. In her book she writes “… whether you’re the boss calling the shots, the employee making it happen, or the intern just starting out in your field, I believe you’re uniquely positioned right where you are to make an impact in the place you spend so much of your time: your job!”

This may not describe your office culture, but you probably can think of at least three medical offices this does describe.


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Your employees and your front-line administrative staff should understand their purpose beyond their paycheck. This best on display when your employees view Patients through the lens of necessary vs. nuisance. In today’s healthcare environments, Patients are abandoning their primary care, family medicine and specialists at a rapid rate. This continued erosion of the patient experience is eroding a patient’s trust in the healthcare community.

We can all agree that every single day each Patient will leave your practice and tell a story about you to someone they meet. What are you celebrating about the Patient during your visit with them? What are the stories that Patient will share with others about you? About your team? About your staff? If you truly want to cultivate new patient referrals, you have to become a raving fan of your patients and your employees.

Designing a culture of gratitude starts with appreciation for the Patient and ends with celebration of the Patient by both you and your staff. Plain and simple.

Designing A Culture of Gratitude In Your Practice

There’s quite a few research and studies on the effects of gratitude on our moods, our mental health and well-being. We’ve included half-a-dozen or so in the citations below. I encourage you to read each one of them. They’re actually pretty good.

Patient referrals don’t happen simply because you happen to have done a thing or two right in the patient experience department. Patient referrals happen because you (and your staff) did a lot of things right and you had a plan to recover when you things went wrong and needed to manage the tension and frustration.”

I’m a student of customer service in healthcare, or should I say, customer no service in healthcare. From the bill for $21 sent to collections to the exam room and the bathroom, every little thing in healthcare communicates.

Leadership training companies like the Ritz Carlton and the Disney Institute train people on the importance of a warm greeting, a smile and eye contact? They train and incorporate these ideals into their courses because for far too long companies and leaders of companies have made it all about trying to make customers become fans of their brand, not the other way around.

Author and John Maxwell Leadership Communicator, Jeff Henderson, author of the book Know What You Are FOR writes “If a business was a person, many businesses would be considered narcissists. And, narcissism is bad for business.”

Drape that statement like a wet blanket over the healthcare culture you and I work, live, practice and participate in and it hits to the core of what’s wrong with healthcare and customer service. Or should we say, customer-no-service?

It’s why you and I see so many Doctors chasing reviews. What about the search result services and getting rid of negative reviews? Patient referrals don’t happen simply because you happen to have done a thing or two right in the patient experience department. Patient referrals happen because you (and your staff) did a lot of things right and you had a plan to recover when you things went wrong and needed to manage the tension and frustration.

That seems counter-intuitive in healthcare because it is. You see, I’m not a Physician. I’m a Patient. And, I know what it is like to sit on the other side of the exam room from you. I know what it is like to brag about my Doctor to my friends and tell everyone who will listen about how amazing healthcare could be and should be because I want them to experience the same thing too!

For many Patients, they hear more from their Doctor about what’s going wrong with them than what’s going right. In fact, Patients usually think ‘Oh no, what’s wrong?’

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Every Doctor we have ever interviewed in the past 20+ years echos the sentiment you probably do every single day you enter the doors of your practice.

That is, “Do my Patients know that I truly care about them?”

This is the number one question each Patient right now is thinking about you. It’s the only thing they are concerned about when they book an appointment with your staff. It’s why they are willing to take a half a day off of work to see you!

Henderson goes on to add “The pathway to creating raving fans in a highly competitive, ever-changing business world isn’t easy. Winning organizations of tomorrow will be more concerned with becoming fans of their customers instead of convincing customers to become fans of the organization.”

A lot of medical offices, teams and even Doctor’s will argue that they already know this. I’d counter that by saying “Knowing and doing are two different things.”

I won’t keep coming back if I believe you don’t care about me.

It is in fact quite rare to see a medical office, team and Doctor spotlight the Patient and celebrate their achievements. Whether it be weight-loss or blood level results, Patient love to be appreciated and celebrated. They want to be seen, heard and recognized. They want to impress you in many cases. However, a lot of medical office cultures and your peers are too busy talking about negative results and instead of talking with the Patient, they talk to the Patient and leave little room for relationship and questions.

“I’m not a Physician, but I am a Patient … and I can discern in just a few seconds if the Doctor entering the exam room gives a rip about me. I observe their body posture, facial expressions and eye contact.”
~Editor, Michael Tetreault, Concierge Medicine Today

When was the last time you celebrated with a Patient their weight loss or lifestyle change with a handwritten note? Aren’t these the most precious moments in their life? Aren’t those the most memorable Doctor-Patient encounters you recall when you think back on your long career of helping Patients?

Every Patient is going to tell a story about you. I want it to be a great one!

With all of that said, what is gratitude’s effect on the culture of your medical practice? Gratitude puts you and your team in a position to flourish. It breaths new life into friendships and is attractive to Patients. Here are few research studies, articles and perspectives from a more scientific vantage point that you may want to read and consider as we walk through this course together.

Articles, Citations, Links & Studies About How Gratitude Impacts Healthcare Workers and The Patient-Physician Experience

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