Connecting The Dots of Healthcare

I was speaking at a practice management seminar today in Ohio and had the opportunity to listen in to a customer service program. The point was about “customers.” A primary care physician, (PCP), has one “customer,” his or her patient. When the patient is referred to a specialist, the specialist now has two customers. The patient being referred and the referring PCP. And when the specialist refers to a hospital, the hospital now has three customers, the patient, the PCP, and now the specialist. OK. Pretty basic stuff. But it was the discussion about “internal” and “external” customers that really got me. I didn’t speak up, because it wasn’t my show, but here’s what I wanted to say when physician or hospital staff talk about “everyone” being a “customer” and expecting to be treated as an “internal customer” like a business treats it’s “external customers.”

This is a set up for the predictable whining that goes like this: “You’ve got to be nice to me because I’m as important as any other ‘customer,’ you may have.”

It ain’t so, baby.

Sure, we’re all “customers.” And everyone has a right to be treated with respect and consideration. But debating whether or not you’re really a “customer”… “internal” or “external” is not the point.

The question is, are you producing revenue or costing revenue?

I’m about to get on a USAirways flight back to South Carolina and at the moment I’m eating at Max & Erma’s restaurant before you get through security at the Columbus Airport. (Don’t you just love the power of the internet?). While I’m waiting for my bacon and blue cheese burger, I’m reminded of an experience I had this winter. It was a cold, rainy, and dark night. OK…. so it’s cliched, but it was actually a bit of a mystery going on on the ramp before I boarded.

I had a big dark overcoat on, my carry-on bags could be mistaken for flight crew luggage, and I was late in getting on the flight. The baggage handler glanced up at me and said, “Are you a rev or non rev?”

“Excuse me?” I replied.

“Are you a revenue passenger or a non-revenue passenger?” he said. Noticing my confusion, he simplified his question. “Did you pay for a ticket of not?”

I told him I paid for the ticket but asked, just in case, could I fly for free since he was asking?

No humor from baggage handlers in the rain and I got on the plane, with my paid for ticket.

That’s really the issue about “internal” or “external” customers. It’s not about the “customer” as much as about are you producing revenue or costing revenue!

It’s great to be recognized as an “internal customer” but I’d rather be recognized as someone who is producing revenue, not costing a business money. If I’m a “rev,” I’ll be recognized for the value I provide more often and with more appreciation than a “non-rev.”

As an “internal customer,” of a business, everyone should actively create profit everyday to support the business that creates their income. It’s actually not something every employee should do, it’s something we all MUST DO.

There are internal customers who produce revenue and internal customers who cost money. There are external customers who produce revenue and external customers who cost money.

Running a profitable healthcare business , or any other business, for sustainable growth forces us to focus and cater to on revenue customers, regardless of “internal” or “external” designation. After the “rev-customers” are taken care of, we’ll worry about the “non-revs.”

Don’t get me wrong. I understand that to get “patient satisfaction” up, you’ve got to ensure “physician satisfaction,” and to do that you’ve got to get “staff satisfaction” up to a great level. But don’t lose sight of the fact that if you don’t please the “rev-customers,” you’re out of a job.

But, all things equal, be a rev.