"Patients come second..."

Paul Spiegelman and Britt Berrett wrote an interesting book called,"Patients Come Second: Leading Change by Changing the Way You Lead".  The premise of the book is fairly simple to understand - in this era of health care consumerism, when patient/family experience scores are being published on the Internet and will eventually be tied to payment, those of us in health care need to recognize a simple truth that is fundamental to service organizations.  You can't take of your customers if you don't take care of your employees. 

Let me be clear at the outset.  As a physician - indeed, as a physician who continues to practice - I completely recognize the personal bond between a patient and his or her physician as unique and distinct from that between a customer and a business owner.  However, like it or not, we also need to start to understanding the perspective of our patients and families as customers who have choices about where to go to seek care, because they do have a choice.  First and foremost, we should be treating our patients and families exactly how we would want to be treated.  But, the patient and family experience goes beyond that.  We need to recognize that patients and families deserve to be treated with respect, kindness, and compassion by every individual that they interact with during their health care experience - the physician, the nurse, the phlebotomist, the X-ray technician, the therapist, the front desk receptionist, the appointment clerk, etc., etc., etc.  Our hospitals and clinics should be clean, but they also should be warm and welcoming.  Rather than the bland, overly sterile environments of the past, hospitals and clinics should be happy, bright, and comforting (for a more in-depth explanation and potential suggestions on how to do this, check out "If Disney Ran Your Hospital" by Fred Lee). 

Back to Spiegelman and Berrett - happy, optimistic, energetic, and enthusiastic employees will lead to happy, optimistic, energetic, and enthusiastic customers!  So, if we really want to drive improvement in the patient and family experience, we have to start with the people who provide the care in our hospitals and clinics!  Improving the health care employee experience will significantly improve the patient and family experience (which will, if you believe all of the data out there - and I do - increase hospital revenue and decrease hospital costs!). 

Which brings me to another point.  Hospitals and health care systems must recognize that one of the best ways to become the "Best place to go for care" is to become the "Best place to work."  I recently read in a magazine that a major health care organization was considering cutting back on some of its employee benefits.  A representative from the hospital was trying to explain that the hospital was already "Best in Class" with respect to its benefits package, and by scaling back on some of the benefits, they could cut costs significantly and still remain near the top in their benefits package.  Those are definitely hard decisions to make.  However, I would argue the opposite point.  Cutting employee benefits is one of the quickest ways to lower employee satisfaction.

I am reminded of one of the stories that I read about in the two books by Howard Schultz, former CEO at Starbucks.  Schultz very early on decided to provide health care benefits to every employee at Starbucks - even the hourly employees!  Even when Starbucks was going through some of its most difficult times and even when the Board of Directors tried to convince him otherwise, Schultz remained firm that he would not cut this benefit.  He wrote, "Our first priority was to take care of our people, because they were the ones responsible for communicating our passion to our customers.  If we did that well, we'd accomplish our second priority, taking care of our customers."  He went on further, "I used to think that marketing was the most important department at Starbucks.  Today, I'd say, unequivocally, it's human resources.  Our success depends entirely on the people we hire, retain, and promote.  However outstanding our performance in marketing, design, real estate, manufacturing, store operations, new products, or R&D, it is ultimately interpreted and given life and meaning by the people of the company.  How well each function is carried out depends entirely on how they feel about one another and how much they care about Starbucks.”   In other words, at Starbucks, "Customers come second."