We Need More Customer Service In Medicine

Customer service in medicine is important. I know many people don’t want to hear that, but it’s not going away. Patients are talking to each other more than ever. They’re leaving comments on Facebook, Twitter, and numerous physician review websites. Get a few bad reviews, and watch your patient volume drop. Your revenue won’t be far behind.

However, I believe the current focus on customer service is actually too narrow. Yep, that’s right. I think medicine needs more customer service, not less.

While much of the physician lounge discussion and staff meeting arguments stem from external customer service, medicine actually needs a larger focus on internal customer service.

The business world is already well versed in both internal and external customer service. Talk with any businessperson and you will hear them talk about their internal and external customers. It’s considered standard practice to extend the same level of customer service to your internal customers as your external customers.

The reason for this is simple. To best achieve your organization’s mission, everyone in your organization has to work together. Team work makes the dream work as we like to say.

Unfortunately, I have witnessed a lot of colleague interactions that were downright scary. Many times, they look something like this:

(video courtesy of Youtube and ZdoggMD.com)

While that video might be hilarious (this one is even better), these types of negative interactions not only throw a wet blanket on a everyone’s day, but they hamper patient care.

In my mind, there are three reasons that medicine, and physicians in particular, should focus on improving our collective internal customer service skills. Allow me to explain.

The Patient Is Still Sick


I use this phrase all the time when embroiled in some type of specialty turf war or argument. While we’re sitting here arguing about “whose problem” this should be, the patient is still sick. Think about the poor patient in the middle of this confrontation:

(video courtesy of Youtube)

I don’t know what the mission of each of your organizations is, but I’m willing to bet that taking care of patients is an integral part of it. As a profession that generally prides itself on caring for others, arguing and negative interactions takes the focus off the patient and onto ourselves. We should view this as countercultural and unacceptable.

I fully recognize that legitimate conflicts arise that need to be solved. However, my rule in my personal practice and those whom I supervise is to take care of the patient first, period. We will deal with the system issue, but step one is always to care for the patient in front of you.

By flexing our internal customer service skills, we can make these occurrences few and far between. I was involved in a great conversation on Twitter discussing the role of radiology and pathology in patient care, and specifically how both specialties desire to be more directly involved in the care of the patient. Here is one quote I think is poignant:

“Cannot tell you how many times I’ve gotten “I’m just covering” when calling back to ask more questions about a study.”

Good internal customer service recognizes that these types of conversations cannot happen and our relationships with our colleagues are essential to achieving our overall mission of caring for the patient. “I’m just covering” turns into “how can I help our patient today,” and the patients benefit at the end of the day.

Conflict Increases Your Workload


Can you afford to add more tasks to your day? Do you really want that routine case to take double the amount of time it should? No, right? Your day is already slammed.

Negative interactions with your colleagues not only hamper patient care, but they waste your time. First, there is the obvious. If you’re like me and you have an argument with a colleague, then its going to take you a few minutes to cool down. Are you going to do much productive during that time? Nope. Time wasted.

Second, are you going to work with that colleague in the near future if you need to? You might hesitate if you have a poor interaction with a radiologist and then need a quick chest x-ray interpretation. Might just wait for the report, right?

My previously mentioned Twitter conversation had someone that probably has lived out this reality. Check out this quote:

“Surgeons at my old institution referred to radiologists as “possums”. They lived in the dark and would bite if approached/provoked.”

Pretty sure you’re just going to wait for the report if you think the radiologists you work with are “possums.” Waiting for that report is probably going to cost you some time in the care of that patient. Instead of having the information you need and moving on, you’re going waste time because no one is practicing good internal customer service.


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Frustration Leads To Mistakes


Now its time for the rubber to meet the road. It’s one thing to have your schedule inconvenienced or to feel upset. It’s quite another to put patient safety at risk. Unfortunately, practicing poor internal customer service does just that.

Remember that example I just gave, where a physician and radiologist don’t want to talk because of a poor interaction? That lack of communication endangers patient safety. The patient safety literature already supports the idea that lack of communication amongst teams leads to medical errors.

As a community, are we OK with that? As a patient yourself, do you want your medical team to avoid communicating with each other? No! You want your medical team working together to provide care for you because you know that anything less is going to result in substandard care. If your medical team doesn’t communicate, then your care might look like this:

(video courtesy of Youtube)

So the next time you are frustrated at that specialist who is giving you a hard time about a consult or you’re nervous that the pathologist is going to bite your head off on the phone, remember we need more customer service in medicine, not less. Even Mr. Bean can figure it out.

Hopefully, I have convinced you that customer service inside of healthcare is actually the most important form of customer service. At the very least, I hope you got a few laughs watching the videos.

Just like we have resolved to provide excellent service to our external customers, patients, in our efforts to provide the best care possible, we must equally resolve to provide excellent service to our internal customers, our colleagues, so we can all provide excellent care to our patients. As professionals, we should demand no less from ourselves.

What do you think? Is customer service a bad word or do you agree we need more? Have you ever been assaulted by a colleague dressed as Darth Vader? Leave a comment and let’s talk about it.

The Mission is the Answer

Its not often that a single phrase can be used to answer almost any question in any scenario. Today, however, we are in luck! For my inaugural post on the blog, I am going to talk about the most important thing in any organization, the mission.

This is Not a Mission

We should start about by discussing what a mission is not. A mission is not an overly generic phrase like “to make money” or “to help patients.” Any healthcare organization is going to try to help patients and will likely try to make money in some way.

An organization’s mission also should not be to simply to do whatever another entity tells it to do. I have seen this particular mistake made in numerous hospital owned physician networks. Phrases like “we just exist to generate referrals” run rampant in these places, and these types of phrases are toxic to culture.

This is a Mission

A mission should inspire employees. It should speak to a noble cause. It should be specific enough to define structure and function while simultaneously being broad enough to encompass ideals and principles, not just rote functions like “make money” or “help people.”

In healthy organizations, the mission statement is the driving force behind every action. Anyone unfamiliar with the mission is woefully unequipped to have any meaningful conversation about the work being conducted.

Inspired by a Mission

Physicians Don’t Know the Mission

I have met many physicians who have not put in the necessary time thinking about the mission of their organization, and it reliably leads to frustration and burn out.

It is impossible to find passion or joy while working towards a mission that you don’t know about or don’t care about.

The process of acclimating to the mission should begin before a physician even interviews with a company.

You should know the mission statement before you walk into an interview, and your opening question should be for the interviewer to explain the mission statement and how it informs operations. If the interviewer cannot answer that question, then that is a serious red flag.

If you are already part of a hospital system or network, then you should be incorporating the mission into everyday decisions. Let me give you a few basic examples.

Putting the Mission to Work

The Mayo Clinic has a lengthy mission statement, but the first part reads “To inspire hope…” Do you think that an organization aiming to “inspire hope” is going to have an extensive research component to their operations? Mayo certainly appears to think so.

Let’s get even more into the weeds. The last part of Mayo’s mission statement reads “Mayo Clinic will provide an unparalleled experience as the most trusted partner for health care.” Now, I can see all of the eye rolls happening here. The customer service surveys are coming! It’s true. If you put patient experience in your mission statement, then it will probably be extensively measured and emphasized on a day to day basis.

There are ways for you, the physician, to use this mission statement when you are interacting with administrators. Perhaps you work for Mayo and they are considering opening a new urgent care down the street. You’re not excited about this because that means your patients are going to be receiving healthcare from someone else, and thus, you are losing out on potential revenue.

Doctor Thinking About Applying Mission

By knowing the mission, you can seek to have a substantive discussion with the decision makers in the process. You can make the case that your patients should be seeing you for Mayo to remain the “most trusted partner” for patients since you are already their trusted physician, not some random person in an urgent care they have never met before.

If they respond with a comment about how you don’t have enough access in your schedule and access affects trust, then point out any number of options that could open up your access. Maybe an additional medical assistant or even a scribe. Point out how these options are cheaper than an entirely new urgent care clinic and better help the organization achieve its mission.

Remember the Answer

Any physician that follows this model can actually have a seat at the table where decisions are made that affect every day clinical practice. Better yet, physicians that speak the language of the mission are viewed as people that truly “get it,” not just employees trying to protect their own interests. All of this happened because you remembered the BossMD mantra…the mission is the answer.

What do you think? Are you excited about your mission at your workplace? Do you even know what it is? Does the mission affect your every day actions? Let me know in the comments below. To hear about my mission with this blog, visit the About Me section.