Patient and customer experience often contain unnecessary friction. Two questions can identify the biggest problems.
getty
Would you prefer to scan and upload photos of your insurance cards that your doctor’s office already has, or navigate through a phone system that offers appointments in half-hour increments when you need to look two weeks ahead? Yesterday, I faced both challenges.
I needed to schedule a visit with a doctor I’ve seen for years. The office already has my medical history and insurance details. I usually choose to book appointments online to view all available slots and compare them with my calendar. So, I logged into the website, chose the appointment type and doctor, and picked a suitable date. Instead of a confirmation, I was met with a form demanding mandatory fields, including images of my insurance cards. Frustrated, I called the office.
The phone menu had an option to “make an appointment,” which I expected would connect me to a person. Instead, it led to another automated system. It asked for the appointment type and began suggesting times. With a two-week window when I couldn’t attend, the first option was within that period. I declined. It offered another time two days later, which also didn’t work. It continued offering times at 30-minute intervals. After multiple rounds, it became clear it intended to suggest all slots during my unavailable window before offering one that worked for me.
By shouting “human,” I escaped the automated system. A helpful scheduler quickly found a suitable appointment in a minute. Before that, I’d wasted about twenty minutes. When I mentioned the robot, she admitted, “We know, it’s terrible.”
What Patient Experience Data Says
The comment from the office staffer is telling. Those working directly with patients are aware of the process issues.
My experience is not unique. In a survey of 1,005 patients conducted for the scheduling vendor Notable, 70% reported trying to book a healthcare appointment online in the past year but were redirected to a phone call.
More concerning was the statistic that 61% of respondents had skipped seeing their doctor in the past year because “scheduling an appointment was too much of a hassle.”
Why Patient Experience Can Slip After Consolidation
The practice I was booking with was independent until it joined a larger group owned by private equity. The idea behind such deals is logical enough. Running a medical practice today is challenging, and most doctors prefer focusing on patient care over handling billing and insurance complexities. Consolidation aims to provide scale and expertise. It’s now more common than not: private equity-acquired practice sites grew from 816 in 2012 to 5,779 in 2021, expanding from 119 to 307 metro areas.
In theory, a group managing multiple practices can provide a better patient experience than a single office. In practice, I believe those selecting the technology don’t grasp what patients face. They might not test the systems themselves or deeply understand the patient experience. They rely on vendor promises and focus on efficiency and cost savings.
This is similar to the difference between professional managers and founders in the corporate world. Founders often prioritize customers and employees, while professional managers tend to focus on shareholder returns, as many corporate boards still uphold shareholder primacy. Except for some Certified B Corporations, PE firms aim to deliver financial returns for investors.
Another concern is that the metrics justifying a scheduling bot improve when patients abandon the process. Calls diverted from staff, cost per booked appointment, and average human handle time all look better when a patient gives up. If a patient completes the tedious process, it benefits the metrics too.
The issues might be invisible in the practice’s dashboard. Nudge authors Richard Thaler and Cass Sunstein describe this kind of unnecessary process burden as “sludge.” When I interviewed Sunstein, he noted that those most affected by it are often least able to overcome it. In healthcare, these are the patients you’d want to prioritize reaching.
Two Questions That Expose Friction In Any Customer Experience
I’ve emphasized this for years, and it was a central theme in my book Friction. Leaders should pose two questions to their frontline staff:
“What do our customers complain about?” Staff hear it directly from customers daily. My scheduler needed no encouragement to tell me the system was terrible.
“How can we make your job easier?” This may seem counterintuitive to managers aiming to maximize output from a stretched team, but frontline employees know precisely where their time is wasted. A poor customer experience often leads to a poor employee experience, as staff spend extra time with customers and fixing system-created issues.
Simply asking isn’t sufficient. Many managers dismiss complaints as whining or find reasons not to act. The software change is too costly, or the fix is on next year’s roadmap. When employees see their insights ignored, they stop sharing them. Some disengage entirely, joining the disengaged workforce.
My Own Confession
I’ve overlooked valuable feedback from customer-facing employees. When my company operated a small call center, the reps repeatedly complained about a software function that made a routine task unnecessarily time-consuming. It frustrated them and prolonged customer interactions, but I knew fixing it required our vendor to change their code. Since it only affected a minority of calls, I told our reps that was how the software worked.
Then I spent half a day on the phones and had to perform the task myself. That afternoon, I contacted the vendor, requested a fix, and asked them to bill us. In hindsight, I shouldn’t have needed to experience it firsthand. I failed to listen and act.
Here’s your task. Choose a process your customers frequently use, whether it’s booking an appointment, filing a claim, or checking out. Complete it yourself, from start to finish, as a customer would, without shortcuts or admin access. Then, ask the two questions to those handling the fallout. You’ll likely discover at least one change to streamline the customer experience.
