Patient Experience Happens on Two Clocks. Health Systems Need to Pay Attention to Both.

Patients rarely think about healthcare in terms of operational metrics.  

They think about whether they got the care they needed when they needed it, and whether the experience felt worth their time. 

A recent Becker’s Healthcare Podcast episode explored that idea through NRC Health’s nSight report, The Currency of Time.  

The conversation featured William England, Ph.D., Strategic Advisor of Research for NRC Health and author of the report, alongside Casey Arends, Director of Experience Strategy at Fairview. Together, they explored a challenge that every patient experience leader recognizes: improving access matters, but loyalty depends on what happens after the patient arrives. 

Key Takeaways: 

• Patients evaluate healthcare through two lenses: time saved and time well spent 
• Younger consumers report far more access barriers than older consumers 
• Efficiency improvements alone have diminishing returns on loyalty 
• Trust, communication, reassurance, and clarity are stronger loyalty drivers than speed 
• Friction compounds across multiple touchpoints, even when individual issues seem minor 

The research begins with a simple observation. Healthcare organizations have spent years trying to improve speed, efficiency, and convenience, and those efforts matter—but they don’t tell the whole story. 

England explained that patients effectively use two different “clocks” when evaluating their experiences. One clock measures convenience: “How long did it take me to get an appointment? Was scheduling easy? How long did I have to wait when I got there?” The second measures the quality of the encounter itself: “What did you do with my time when you had it?” 

That second type of question includes whether clinicians listened, explained what was happening, and helped patients feel reassured. 

For patient experience leaders, this distinction matters, because it reframes how loyalty is created. Operational efficiency gets patients into the system. Human connection determines how they remember the experience afterward. 

“If you hurry up and get more people into a poor experience, it’s probably not going to produce the long-term results that you’re looking for,” said Arends.

One finding stood out during the discussion. According to the research, 59% of older consumers reported no access barriers, compared with 37% of Gen Z and Millennial consumers. That’s a 22-point gap. 

England described the finding as “striking.” 

“The takeaway is not that young people are impatient,” he said. Instead, expectations have evolved because consumers can book a flight and change a hotel reservation, order dinner, and complete countless other tasks whenever they want. 

Healthcare increasingly competes against those experiences, which means patient experience leaders must think beyond traditional access measures. 

Arends said part of the response is ensuring digital tools and virtual experiences are “as seamless as possible” while helping consumers understand what to expect from their care journey.

Healthcare leaders often focus on access because it feels measurable. Wait times can be tracked. Scheduling delays can be quantified. Capacity challenges can be documented. 

But the discussion suggests there is a limit to how much loyalty organizations can earn through efficiency improvements alone. 

“If I can’t get you through the front door, I don’t have much of an opportunity to create loyalty with you,” England said. Yet, as he emphasizes, the research also found that “we did find diminishing returns to efficiency alone.” 

When NRC Health analyzed what distinguishes loyal consumers, a different set of factors emerged: confidence and trust, clarity and understanding, reassurance, and communication. 

Those findings point to something fundamentally human. 

“People are willing to forgive, to a degree, some delay, as long as they know they’re in good hands afterwards,” said England. 

For patient experience leaders, that’s a useful reminder. Patients don’t expect perfect access; they expect confidence that the care they receive is worth their time.

Many loyalty problems don’t begin with a major failure. They begin with a series of small frustrations. 

England described how friction often accumulates across the patient journey: 

“I couldn’t get an appointment when I wanted,” he said. “Then I had trouble finding where to go when I got there. Then I waited a long time in the waiting room. Then I had to repeat the information that I’d already provided.” 

None of these issues, England notes, are severe on their own. “None of those are individually catastrophic,” he said. “But piece that together and hang it together in the mind of the person experiencing this care journey.” 

That accumulation of friction is often invisible inside organizations, because different departments own different pieces of the experience. 

Arends said many organizations still separate experiences that patients see as connected. “We don’t do a good job of tying those things together,” he said, noting that healthcare often treats scheduling, billing, and care delivery as distinct experiences rather than as parts of a single journey.

The podcast closed with an important question: Who owns this work? 

The answer is complicated, because healthcare delivery spans access teams, digital teams, clinicians, nurses, and operational leaders. 

But patients see something much simpler. 

“The patient doesn’t say, ‘My access-center experience was a seven, but my clinical experience was a nine,’” England said. “They say, ‘This was my experience with this health system.’” 

Arends brought the discussion back to the people delivering care. “You’re the ones delivering this experience,” he said, emphasizing the importance of helping leaders and teams see themselves in the data used to evaluate experience. 

Patient experience is not owned by a single department. It is the sum of every interaction, every handoff, every explanation, and every moment a person spends deciding whether their time was respected. 

The organizations that succeed will improve both clocks: the time patients save and the time they spend. 

Want to learn more? Read NRC Health’s nSight report, The Currency of Time, and listen to the full Becker’s Healthcare Podcast conversation to explore how leading health systems are rethinking patient experience through the lens of time.