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Would You Like Fries With That?

April 17, 2015

Glancing through the latest issue of  Anesthesiology News, the independent newsletter for anesthesiologists, I was yawning through subjects like Enhanced Recovery After Surgery, aspirin for cardiac surgery, and stellate ganglion blocks for PTSD (?!) when I turned to page 30 and there, luminous on their glossy paper, two articles about “customer value”.  Here’s how one of them starts:

“Like all workers, anesthesiologists must determine the best way to serve their ‘customers’ – the hospital, surgeons, patients and bill payors.” (Crist, C.  Marketing 101 for Anesthesiologists: show your value. Anesthesiology News, 41(4), April 2015, p30).

(The italics around the word customers was not added by me.)

“Anesthesiologists should follow age-old marketing advice: Identify customer needs, develop products to meet those needs, and communicate those products to the consumer.”

(The need for marketing might have to do with the ongoing CRNA-MD war being fought between the ASA and the AANA.  Maybe.)

“Show that you can get it done.  Be a hard worker, facilitator and collaborator.”

The authors suggest that instead of sitting by our anesthesia machines we should be helping the surgeon tie his gown, answer phones for the nurses, and open sterile packaging for the scrub techs.  This is how we prove our value to our customers, the surgeons and OR nurses.  Sort of a generally nice, helpful guy.  Like a waiter.  This kind of behavior is, incidentally, what is recommended to medical students to prove that their presence in the OR is not just a hindrance and/or nuisance.

Then, on the very same page, a lawyer by the name of Mark Weiss tells us that our real value is measured by our ability to create an “experience monopoly”.  The EM, or E +Phe+PQenv = strength of unique experience, is “providing such a valuable experience to patients, referral sources and facilities that they deem you their preferred partner, one that they can’t see themselves doing without.” (Weiss, M.  Do you make this mistake concerning customer value? Anesthesiology News, 41(4), April 2015, p30-31).

Mr. Weiss points out that people have preferred dry cleaners or restaurants because of the personal and environmental touches that give customers a good experience and thus keep them coming back.  In medicine, this lawyer suggests, an EM has three components: expertise, physical environment, and relationship environment.  And expertise is the least important.

“Of course, the goal is for you to increase the level of performance within your medical group across each of the components.  Note especially that you must focus on the human experience and environmental factors – all physicians understand the importance of medical expertise, yet that expertise alone, and certainly, that expertise tamped down by the impact of a poor environment and an even poorer experience is worthless in terms of creating relationships with patients, referral sources and facilities that over a career will prove extremely valuable.”

Expertise worthless, waiterly obsequiousness priceless.  Got it.

So I’ve got my order book and my pen, my apron, my black running shoes, and a big wide grin.  I went to waiter school, and I’m ready to serve.  But there’s a problem.  Nobody in my restaurant wants the same thing.  Everyone wants it their way.  If I make suggestions based on my experience with the food I’m told to stay out of it and bring me what is requested.  One guy says he wants cheap food and doesn’t care much about quality.  Another customer says quality is his highest value, and you “can’t put a price on quality, am I right?”  The lady at table 8 insists on putting ketchup on her tacos even though I know it is not standard of care for tacos and might even be harmful to her.  But I am a waiter, here to please, so I bring the ketchup.  Soon after, the cook comes to me complaining that I am overusing ketchup for unnecessary and frivolous uses and must refuse ketchup for all tacos in the future.  My boss tells me to hurry up with my orders, then gives me three more tables.  Now the food is coming out quickly, but the dishes aren’t being cleared and the aesthetic experience in the restaurant is tarnished.  I’m still smiling, but I’m now I’m confused.  Why did I go to waiter school if no one takes my advice?  Why is the guy who wants cheap food sitting with the oil baron for whom price is no object?  How can I please the lady who wants ketchup on her tacos, and who will give me a good or bad evaluation in the form of a tip, and the cook who considers ketchup on tacos to be wasteful at best and malpractice at worst?  And where’s the bus boy?



From → Healthcare

  1. Josh permalink

    I love this post!
    As an ICU nurse i have to hear about the importance of patient satisfaction from management while at the same time trying to take care of sick people.
    It’s impossible to make everyone (different docs, family, patients, departments, hospital employees, etc) happy. And ketchup on tacos is what some desire even if it is verboten.

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