Rob Fromberg

A recent trip to the airport taught me several lessons in customer service.

I was escorting my younger brother, who is developmentally disabled, to the airport for his flight home from a visit.

The process began smoothly. After a short wait in line, we got his boarding pass and my pass to accompany him to the gate. We dropped his suitcase off at baggage screening and proceeded to the security checkpoint. I showed my gate pass and driver's license to a young man in a red vest and received a barely perceptible nod and the official scribble of approval on my pass.

My brother showed his boarding pass and state ID card. The young man looked at the pass and then the state ID. He looked at the pass again and the ID again. He looked at the back of the ID. He looked up at my brother and said, "This ID is expired."

Then came The Wait.

You know The Wait. It's the silence that says, "I have said what I need to say and will stare at you until the end of time and not volunteer one word to suggest how to resolve this situation."

A dozen examples of The Wait bounced through my mind: the contractor who said, "We can't put that door there." And waited. The registrar who said, "That class has been canceled." And waited. The insurance representative who said, "Your policy doesn't cover that treatment." And waited.

At the airport, after some extra screening for my brother, everything worked out fine. But the point is that the young man in the red vest didn't make the least effort to infer the question that anyone in our position would ask ("What should we do to get on the airplane?") much less answer that question. Instead, he chose to make the customer initiate the exchange.

Hospital revenue cycle leaders and staff face customer service challenges that dwarf those of most businesses. The encounters, even at their most benign, are charged with emotional and physical discomfort. The information that needs to be transmitted is complex, sometimes illogical, and frequently unwelcome. HFMA's PATIENT FRIENDLY BILLING® project provides the profession with guiding principles and tools to make this information exchange effective by looking at it from the patient's point of view. In addition, HFMA recently has released an excellent training program to improve revenue cycle customer service that includes video scenarios and role playing. In addition, "The Art of Customer Service," an article by Jeni Williams in this issue of hfm, contains insights and tips from providers on how they provide the very best customer service.

My airport experience reminded me that the core of good customer service is anticipating the customer's needs. I hope that your front-line representatives, after presenting patients or their families with information that is out of the ordinary, never use The Wait. I hope that your staffs are trained to anticipate the obvious question (usually "What do I do next?") and answer it.

Front-line staff are not the only ones with responsibility in a customer service transaction. Customers have a huge responsibility as well, especially in health care. In many ways, that responsibility is the root of consumerism.

The airport trip also reminded me of the customer's responsibilities. In one case, a woman in line ahead of me at the Dunkin' Donuts kiosk quizzed the attendant about the number of ounces each size cup held, whether they could make her latte with 2 percent milk, and--told they had only skim and whole milk--whether they could mix whole and skim milk. At that point I left. Customer responsibility: don't be unnecessarily picky. This was an airport Dunkin' Donuts for crying out loud. If she wanted that much coffee precision, she should have gone to the Starbucks kiosk across the hall.

More to the point, customers have a responsibility to be at least minimally informed about their transaction. The airplane had boarded, and I was the only non-employee left in the waiting area. The attendant made the final announcement, naming two passengers and telling them this was their final boarding call and the flight would be taking off immediately. A minute later, two laughing young women appeared at the gate, saying they didn't know how they had been confused about which gate the flight was leaving from and how it had gotten to be so late. The attendant smiled, took their passes, and let them through the door. I'm not sure I would have been so pleasant. Somehow every other passenger on the plane had managed to understand the gate location and the boarding time, neither of which had changed in the 90 minutes since my brother and I had arrived at the airport.

Healthcare professionals frequently find themselves working with patients who do not follow treatment regimens, who miss appointments, who do not bring necessary paperwork, and who do not understand their insurance. Although it may be tempting to grimace, gnash your teeth, and mutter under your breath when confronted with such situations, truly excellent customer service calls for a pleasant disposition (like that displayed by the airport attendant), an acceptance of the inevitability that some customers will not uphold their end of the transaction, and a hard look at how to do an even better job informing patients of their responsibilities.

Publication Date: Monday, October 01, 2007

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