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“Only in healthcare”: The case against exceptionalism in our industry Brian Wynne, VP and General Manager, NRC Health

Healthcare is an exceptional industry. No other sector of the economy functions quite like it.

It’s awash in contradictions. It’s a free market, with constricted choices; it’s tightly regulated, but difficult to control; and, while nobody wants to become a patient, nearly everyone will at some point.

That’s what makes healthcare truly unique—it’s the only indispensable industry. It’s also a textbook case of inelastic demand. When a health need arises, consumers become patients, whether they like it or not. Sometimes this even happens when consumers are not aware of it—or of anything else, for that matter. In what other industry can an organization convert and close a new customer while they’re unconscious?

Unfortunately, some segments of healthcare have come to take this market dynamic for granted. The unchecked demand for care services has lulled them into complacency.

We’ve said it before: many organizations operate with an “if you build it, they will come” mentality. We see daily examples of flaws in this reasoning. It also gives rise to another kind of exceptionalism, of which the healthcare industry should not be proud.


Only in healthcare do we let our web presence lapse.

For the most part, healthcare delivery is a decidedly brick-and-mortar business. But that doesn’t mean that healthcare organizations can give short shrift to their web presence. A healthcare provider’s website will dictate initial impressions and consumer assessment of usability, and in many cases, it acts as the front door to a health system. However, those on the forefront of digital presence—like consumer-goods brands—know that web properties are much more than a digital front door. Web properties are the product, and as such, they deserve the resources and strategic planning attention of a key service line.

94% of consumers report that they are more likely to trust businesses with well-designed and easily navigated websites. Social-media presence—especially in the form of star ratings and reviews—is an important driver of patient decision-making. Smart, attentive administrators can even use sites like Facebook for service improvement and recovery.

All too often, however, these lessons are lost on health systems. They stick with dated designs and fail to capitalize on clear and present opportunities.

Remember that your organization’s web properties will often be the first impression your organization makes on its consumers. Do what it takes to make sure it’s a good one.

Only in healthcare do we let our billing procedures become so confusing.

In any other industry, surprising bills are cause for outrage. In healthcare, they’re a matter of course.

61% of healthcare consumers find their bills confusing—and no wonder. Bills from health systems are often fragmented, incomplete, un-itemized and delayed.

This is not a new problem, but only now are serious solutions being vetted. CMS has proposed a rule for transparent pricing of hospital services, and startups like Amino are trying to market cost transparency to their customers.

Health systems are in danger of falling behind. Some hospitals make an admirable effort to inform patients about costs up front; however, that remains relatively rare. The writing on the wall is clear: price transparency is on the horizon.

Forward-thinking healthcare leaders should do their best to get ahead of it. Imagine the advantage a health system would enjoy if prices were easily found on their website, appointments could be booked and confirmed via an app, and payments could be made (in advance) online.

Only in healthcare do we still mail feedback forms out to customers.

Imagine if, when you bought something on Amazon, the only way you could give feedback was through a mail-in survey, which came weeks after your purchase. Would you even bother? Didn’t think so.

Long-form, mail-in feedback is inconceivable in other industries. It will only feel more archaic as time goes on and Millennials and Generation Z become healthcare’s biggest consumers.

Mail-in surveys are often an annoyance for customers, who prefer to give their feedback immediately after episodes of care. In fact, 74% of consumers would prefer to give feedback within minutes or days of their care event. They also shy away from lengthy written forms—which explains why digital formats like email, text and interactive electronic calls can seriously bolster response rates.

Only in healthcare do we settle for small amounts of feedback.

hile CAHPS surveys are an important source of patient feedback, only a fraction of patients respond to them. Most studies have response rates topping out around 28%.

With such scant feedback, providers and administrators typically view this data cynically. A lack of trust—or accurate representation—in the data works against teams organizing improvement efforts.

Data-skeptical clinical staff also point to survey delays as cause for skepticism. By the time mailed surveys are returned to healthcare organizations, weeks or months will have passed. Patients may have forgotten important details about their care experiences. As a result, clinicians can’t be sure of the feedback’s completeness or accuracy.

These flaws are not insurmountable—and eventually, CMS guidelines are likely to evolve to include digital-first survey modalities. But until that day comes, organizations should supplement their feedback operations with a viable, modern alternative.

Only in healthcare do we expect a pass for poor service.

From a consumer’s perspective, this may be the most grievous aspect of healthcare exceptionalism.

Healthcare providers rightly enjoy a prestigious position in society. Insofar as they represent healers, they’re revered as authoritative and trustworthy.

Sometimes, however, patients don’t receive the service they deserve or expect. They have to wait a long time for care. Their clinicians don’t listen, or seem condescending or unavailable. For patients, these pain points can be enough to sour them on an entire care experience. Perhaps that’s why up to 81% of patients report feeling unsatisfied with their providers.

Rather than taking a dismissive attitude toward customer concerns, health systems need a scalable way to identify lapses in service and triage for resolution. 84% of patients expect follow-up from a health system if they issue a complaint.

This is instructive. While it’s not always possible to prevent lapses in patient experience, service recovery provides a sizable opportunity to meet customer expectations after a less-than-favorable encounter.

is special. But not that special.

Don’t bank on loyalty from today’s healthcare consumer if you’re not committed to earning it. Non-traditional providers have carved out their place in the market, and their influence will only grow. The internet, meanwhile, has given patients a frictionless means to shop around, and patients’ growing share of responsibility for hospital bills means they won’t readily stomach sub-par service.

All this is to say: yes, healthcare is an exceptional industry. But as it has evolved and entered the modern era, it’s become more and more vulnerable to the market forces that govern every other business.

Health organizations, like any business, depend on their reputations. They’re subject to disruption from competition. Most importantly, and now more than ever before, they’re accountable to their customers.

That means patients need a reason to keep coming back to you. Don’t let an “only in healthcare” mentality keep your organization from giving it to them.