Published: 16/09/2004, Volume II4, No. 5923 Page 17
Health service providers across the world are grappling with an issue that transcends national boundaries: are patients customers? At the same time, clinicians are asking: am I a doctor or a service provider?
So, are patients customers or patients? Customers buy things. They make purchases to sustain their lifestyle, enhance their lives, or acquire luxury goods. In this sense, patients are very similar to customers. But being a patient is a process of managed expectations, starting with diagnosis and ending, hopefully, in a cure.
However, from a customer point of view, returning is good; for a patient, returning is bad. So the health service will not naturally treat patients as if they were customers. Repeat business is bad news all round.
Yet patients are taxpayers. They are perceived to receive free treatment and this is often pointed out to them. But if one pays taxes, then healthcare is not truly 'free'. Patients buy their health services with taxes, insurance plans and so on.
And once patients begin to think of themselves as customers, we must become aware of what business already knows - that the customer is always right. Customers think irrationally and often select products based on criteria like lowest cost, or minimum effort.
What can we do to make a patient feel more like a customer: well treated, pampered, and given high-quality services at reasonable cost?
The key to understanding patients' experience is to manage their expectations proactively. The NHS has established many new channels for patient care which do not depend on the patient having to take time off to see the GP (NHS Direct and out-of-hours services, to name two). However, these services do not appear to provide extensive treatments: just a short-term 'someone there to help'.
It might be better to have fewer out-of-hours channels and a larger focus on longer appointments, the ability to visit to one's own doctor quicker, and less passing around of patients.
Providing a good service to patients also requires the development of an appropriate way to measure the patient experience.
The trouble with measures that bureaucracies create is that their criteria may not represent the reality of the local process of healthcare delivery, such as time to wait for an appointment, or to see a consultant.
But in the final analysis, patients are interested in one simple measurement: how long will it take to get better? So healthcare professionals need a small cluster of indicators that provide them with a relative indication of the patient's well-being and satisfaction during their journey through to a cure.
Patients need a single point of contact to guide them. After all, when taking a holiday, few people set out on a journey without first looking at a map and consulting an expert.
Joseph DiVanna is chief executive of Maris Strategies.