It’s kind of common parlance in the world of business that it’s important to listen to the “voice of the customer.” You hear it in large businesses that talk about listening to their customers as a why they became successful. Startups often focus on listening to potential customers as a way to build out their business plan. Development teams talk about shadowing their customer to know how they work so they can create better software.
I’m not here to disagree with the approach. Listening to the customer is essential to success in business. And yes, healthcare is a business. However, the challenge we face in healthcare is who is the customer?
One might naturally think that the patient is the customer. If it’s not for the patients, why are we even here? Ideally, this would be the case and I’d argue that healthcare would be so much better if we focused on patients as the ultimate customer. However, in the world of healthcare, the patient is often not seen as the customer. That’s right. The “customer” is really screwed up in healthcare.
If the patient isn’t the customer in healthcare, who is the customer?
We could look at the word “customer” in a lot of ways. In most industries, the person who pays for the product or service is the customer. In most cases, the person paying is also the person that’s going to use the product or service. This is often not the case in healthcare.
In healthcare, insurance companies are often paying for the healthcare services a patient receives. Does that make them the customer? They were for a long time. The view that insurance was going to pay for your healthcare was one that was perpetuated for a long time. These waters have been muddied lately as more and more patients have high deductible plans. Does this mean the patient and the insurance company are both the customer? If they’re going to listen to the “customer”, then should they listen to both the patient and the insurance company? What do you do if those customers disagree?
As if this wasn’t enough when it comes to healthcare organizations understanding who their customer is, employers are in on this action too. For a large majority of patients, employers are footing the bill for healthcare. Sure, it’s paid through the insurance company, but the employer is ultimately on the hook for the costs of healthcare. Insurance companies just pass the costs on to the employer. We’ve seen how much more interested employers are in healthcare as costs have gone through the roof. Does this indicate that the employer is actually the most important customer in healthcare?
Circling back to the patient, the patient often isn’t the real customer either. In many cases, a patient’s mom or child is the real customer. They’re the ones making the healthcare decisions because the child is too young to make a decision or the patient is too old, sick, or frail to make the decision. That means more cooks in the kitchen.
We shouldn’t leave out the government which is also the largest payer along with getting their hands into the mix as well with various government programs and regulations. We all know how what Medicare does influences so many things downstream in healthcare.
Instead of asking who is the customer in healthcare we may want to ask who isn’t the customer in healthcare?
Of course, if you’re a forward thinking healthcare leader, you know the patient is really the most important piece of healthcare. Yes, the healthcare system is tough to navigate, but the most forward looking and successful healthcare leaders I know make sure they always take care of the patient first. Sometimes that means lower profits in the short term, but generally results in long term success. However, it’s not hard to see why many healthcare organizations lose sight of the patient as customer with so many “customers” legitimately vying for their attention.
