Patient Perception is Reality.

(This is part II. Click here to go to part I. Click here to go to part III..)

I’m certain the doctor had an excellent “bedside manner” and exhibited professional competency to our friend.  However, I believe that due to the fact the doctor’s reputation was excellent, my friend expected and anticipated excellence (based simply on the reputation).  The positive reputation of the doctor made it far easier for him to satisfy the needs of the patient.

Reputations are the culmination of perceptions.  If there is no reputation, an organization has a “clean slate” to work from.  If the reputation is bad, the organization is already fighting an uphill battle with the customer (not to mention the internal morale and organizational issues).

It’s paramount for the health care provider to embrace the old adage that “first impressions are lasting impressions.”  Perceptions really begin to take shape the moment a patient, visitor, or family member walks through the front door of the facility.  The tone that a provider sets can make either a positive or negative lasting impression.

I have a few strikingly different yet lasting impressions from my role as family member (to the patients) when visiting various health care facilities.  Two quickly come to mind:

Our daughter was twelve and needed braces for her teeth.  She had already had the initial consultation with the orthodontist while my wife was present.  This particular orthodontist had a “policy” to meet face-to-face with the individual who had the ultimate financial responsibility (me) for the orthodontic care prior to the care actually commencing.

My wife re-confirmed the appointment and we arrived at the appropriate time.  I brought along a newspaper and a notebook. 

Strike one:  The reception area was cold and dark.  There was a lamp that did not work.  Not only was I chilled, I did not have enough light to read.

Strike two:  This particular office had no concept of managing time and no concept of managing relationships. 

After 27 minutes of waiting I approached the receptionist to find out what the delay could be and to hopefully get the meeting going.  The first words out of the receptionist’s mouth could have been “I apologize for the inconvenience, please let me try to give you an update of when we will be ready for you.” 

Instead, the receptionist made me feel like I was being rude for expecting an on-time consultation and questioning the wait.  Not only did she not try to give me an estimate of how much longer the wait would be, she didn’t attempt to make me feel like she cared. (Remember I did not initiate the meeting.)

I took a breath.  I looked the receptionist in the eyes and calmly stated, “Perhaps your organization doesn’t need our business.”

The receptionist, missing yet another opportunity to retain my family as customers, could not come up with anything polite to say to satisfy me.

On that note, I took my pride (and my wife) out the door.  My wife was absolutely furious with me.  (Apparently she had been preconditioned to accept that it was O.K. for medical offices to be tardy and unapologetic.)  In her defense, she was the one who had invested more time than I had by having a previous consultation with the doctor. 

Strike three:  In order to improve marital relations with my wife, I sat down that night and typed a letter dated 28 August 2007 (yes, I still have a copy) to the Orthodontist and sent it via fax, email, and US mail.


In the letter I relayed my unsatisfactory experience with the office and closed with the following paragraphs (please keep in mind that the subject of the meeting that never happened was payment from me to his offices for services that he allegedly hoped to render – In other words, I was a prospective customer at this point):

(Dear Doctor,)

“I value your time.  I also value my own time.  If you value our business and would like to reschedule, please call me to do so.  When and if you call, please give me an indication of what is a reasonable time we can expect to wait – If it is 30 minutes or an hour…. I will gladly bring in Golf Digest, a lap-top, banjo, etc. to amuse myself and I will wear a sweater to keep warm, etc.

“Another meeting option would be to simply come to our home.  We live only 5 minutes away.  If you would like to come by, you will be welcome… And we generally have beer in the fridge or coffee already made.”

I never heard back from the doctor or any of his staff.  (Our community is relatively small and this particular doctor and I definitely know several people in common.  I won’t elaborate our connections here as I have no intention of causing him or his staff embarrassment.)

On the brighter side, I’m pleased to report that we found another Orthodontist (Dr. Michael Cox) not too far away with a totally different customer service outlook that included friendly professional staff, free coffee, TVs, magazines, and even a Wii video game all within a very comfortable well-lit reception area.  (My wife eventually forgave me for leaving the office of the initial Orthodontist and my daughter now enjoys straight and healthy beautiful teeth since her braces have been removed.)

First impressions are lasting impressions.

Not all experiences have been negative.  One of the most positively memorable impressions I ever took with me from a health care facility was from our friends at Three Rivers Endoscopy in Pittsburgh, PA.

My daughter and I drove my wife to her colonoscopy appointment.  Our plan was to wait during the procedure and take her home to fully recover.  We didn’t know what to expect because we hadn’t yet seen the office.

We were greeted by a well-lit, comfortable open space.  The facility was clean and tidy and even boasted an aviary!  The aviary was roughly 6ft. wide by 7ft. high by 4ft. deep.  The birds were small and did not make noise.  They provided a comforting affect.  (The cage was clean and odorless.)

The most impressive feature of the waiting room to me may have been perhaps the simplest and most inexpensive touch.  There was a simple wooden box with stationary, envelopes, and pens with a small sign that read something to the effect, “In this day and age of emails and cell phones, the art of letter writing is often forgotten.  Why not take this time as you wait to write a loved one a letter?  Pens, paper and envelopes are provided.”

It has been years since my daughter and I sat in that waiting room while my wife was getting her colonoscopy.  It’s probably a safe bet that I didn’t get the words, that appeared on the sign inviting me to write a letter, exactly correct.

However, I’ve never forgotten the feeling that I received in the waiting room while my wife was going through the procedure.  I felt calm and comfortable.  More importantly, I felt that my wife was in good hands because I believed that the quality of the waiting room was indicative of the quality of care. 

Health care is a noble business.  But it is still a business. Read more...