Ask any kid who they would list as heroes and role models and my guess is that pilots are on that list. I bet doctors are too. Ask any adult what they think about traveling or going to see a healthcare provider and their reaction may not be as awe inspiring.


If you had asked me two weeks ago if I was excited for vacation, I probably would have given a reluctant "yes". That reluctance would have had nothing to do with how the week turned out (knee injury). The stress in my voice would have everything to do with the travel. I will admit it, six years of crisscrossing the company consulting for hospitals left me a little discontented with the airline industry. Here is the kicker, there are a lot of similarities between the airline industry and healthcare and its not because of the fares.

I am convinced, but hopefully not jaded, that airlines will always drop the ball in some regard. It may be lost luggage, a botched seat request, delayed flight, or more than likely ornery crew. Seats are littered with trash and crumbs from the previous flight. Ever walked up to a gate agent who is too busy typing to look up? Its become a cliche! What about flight attendants who roll their eyes at passengers trying to lift bags into the bins? In short, it is not an industry where many people expect world class service. A lot of the issues are surrounding the belief that airfare is the number one determining factor in how passengers pick an airline. To race to the bottom means cutting a lot of employee benefits. The Gallup organization will attest, that employee satisfaction is the key driver in providing good service.

The airline industry has had a lot of pressures that have resulted in over stressed and overworked employees. Fuel costs, decreased volumes (following 9/11) and telecommuting technology mean less people are traveling. To cut costs, some airlines have merged, filed bankruptcy and restructured. Restructuring often allows them to work employees longer hours and on less wages; not the kind of thing that makes anyone happy to serve customers. As an example, some airlines have dropped contracts with cleaning crews in favor of having flight attendants clean the cabins- all the while doing so on wage cuts. I do not offer that as an excuse for poor service, but only to shed some light on the surly attitude of the front line staff.

Ask any kid who they would list as heroes and role models and my guess is that pilots are on that list. I bet doctors are too.

What does that have to do with healthcare? If doctors really are still our healthcare heroes, what does that make the rest of the the professionals in the healthcare industry? We have reservations, thats the scheduling department. We also have ticketing agents, we call them Patient Access. From there, it may be a little more nebulous but I suspect readers can find appropriate analogies for flight attendants, luggage handlers, mechanics and executives.

Most patients interact with the front line staff - patient access, nurses, etc- far more than they see the doctor. Frequently the interaction we get with the 'hero' is not much different than the overhead announcement and the casual goodbye while you deplane. That means that our front line teams hold the entire experience in their hands. Botch the reservation or roll your eyes at check-in and you have ruined the patients entire 'flight'.

Healthcare has very similar stresses. While it may not be fuel costs, providers are struggling with lower reimbursement. In many markets Medicare pays less than the cost of procedures. The industry has built a business around group health plans making up that difference, a hidden tax on employers and patients. Other markets are facing the threat of unions who's contracts limit what someone can and cannot do as part of their job. Ask a union nurse to take away the tray of food and you may be surprised to hear that he cannot, he has to call dietary services. Of course dietary services cannot clean up the mess, that is the role of house keeping. Not exactly a seamless service experience but probably something that sounds very familiar to unionized airlines.

How do we change course?

Barack Obama has set the tone for this generation - a time of change. His campaign may have been one of the greatest grass roots efforts in our democratic history. One of President Obama's clearly stated goals has been healthcare reform. While I personally believe that the administration's focus is on the payor side of the industry it does not recuse providers from examining their owe practices. (It is also worth noting that during the election Obama was the number 1 twitter user, with the most followers.)

If providers do not own their image and cultivate a service culture, then they will find themselves in the same position as the airlines. Patients may come through the doors, but they only praise they will be singing are about the 'heroes', the physicians. The only way to change that future is to take the reigns and effect change in how the organization presents itself. It starts with employees who want to come to work and represent you on the front line. Ask them what they need to in oder to do that for the organization.

James Gillmore and Joseph Pine, in their work The Experience Economy assert that good service is tantamount to success. Experience Economy spells out the importance that front line staff plays in giving the customer a seamlessly wonderful encounter. Like the Ritz-Carlton's goal, providers should strive to fulfill every customers desires, spoken or unspoken. When we see someone who looks lost, stop and offer to help. Do not be the flight attendant that watches the elderly man who cannot lift his bag. If you are a physician do not be late. When passengers hear 'weather delay' and see blue skies, it does not matter what the true cause is; they are not getting where they want to be. This is the time, as has been discussed here before, to start connecting with all of the healthcare constituents outside of your physical walls. The tools are free, all it takes is the willingness to use them. Lets ask ourselves how we would want to be cared for, then do that!