The Net Promoter System Podcast
Host Rob Markey welcomes back Maurice FitzGerald, retired vice president of customer experience at HP Software and author of Net Promoter—Implement the System. Together, Rob and Maurice discuss the unique customer experience challenges that healthcare providers and organizations face, and how the Net Promoter System can help.
In this excerpt, Rob and Maurice discuss the importance of communication and empathy in medical care:
ROB MARKEY: You can look at medical outcomes and you can compare that to patient NPS or a version of patient satisfaction. What's fascinating is that medical outcome and patient satisfaction are not highly correlated. In fact, the strongest correlation between some component of the medical experience and NPS is the patient’s set of ratings of the communication that they received from the medical staff.
MAURICE FITZGERALD: Wow.
ROB MARKEY: There are dimensions of it that matter. Was the messaging consistent? Was it empathetic, delivered in an empathetic way? Did they feel fully informed? All of those things mattered more for the way that the patient perceived their care than the medical outcome.
There isn't a fully objective way to judge the medical outcome. So a lot of it has to do with the patient's self-reported function. Still, the patient's evaluation of medical outcome was a less significant statistical driver of their Net Promoter Score, meaning their likelihood to recommend that doctor and that hospital, than was the quality of communication about the procedure and about the care that was being provided.
MAURICE FITZGERALD: Wow. That's fascinating. It does remind me of the time when my sister got extensive teaching or training on what I can only call malpractice case reduction. And the training, they said that your likelihood of facing a malpractice suit has nothing at all to do with the medical outcome. It has to do with only one thing, which is empathy—the patient's perception that you're relating to them. So surgeons with no people skills, but with sensational medical outcomes, still are more likely to have malpractice suits.
ROB MARKEY: Well, this is a really common thing. Now, I'll caution you that the way that the training was positioned falls into the same category of danger as Martin Makary has talked about. And that is, saying, “This is the only thing that matters.” That's not true. All things being equal, it's better to have better medical outcomes.
MAURICE FITZGERALD: Yes, even if the patient is unhappy.
ROB MARKEY: Right. And at any given level of medical outcome, it's much better to demonstrate significant empathy. So what we're talking about really is back to this idea—it's systems thinking. You need to balance all of this together.
And unfortunately, the world is a complicated place, and you cannot reduce medical care to one metric, whether it's an outcome metric, or a patient satisfaction metric, or NPS, or anything else. That would be a mistake.
So the argument that I would make is that what we need in health care, globally, and one of the most important things that is being developed today is a set of standards around what constitutes a positive medical outcome and a systematic way of measuring that, along with a set of standards regarding what it costs to achieve that outcome and what the patient's perception of the experience was, whether that's NPS, HCAHPS, or some other crazy way of measuring the feedback.
Now I will also make the argument, of course, that if you are managing a large provider network, or even a modest sized provider network, again, all things being equal, you're better off creating closed-loop feedback between your patients and the people who provide the service and the people who support them than you are simply measuring and holding them accountable to some number.
You want individual patients providing individual pieces of feedback about what happened in their experience, and how that individual nurse, doctor, orderly, pharmacist or accountant impacted that customer's experience, so that those people can learn how to demonstrate more empathy and how to create an experience that is more pleasant for patients going through a medical procedure.