What Do You Tolerate?

January 10, 2021
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You get what you expect and you deserve what you tolerate.”

-Mark GrabanLean Hospitals: Improving Quality, Patient Safety, and Employee Satisfaction

 The word “tolerate” evokes disappointment.  If you “tolerate” something, it means that you are accepting something less than you truly want.

 I wholeheartedly agree with the statement; “you deserve what you tolerate.” As for expectations, I would modify the first part of the sentence to; you get up to the level of what you expect.

Experience teaches that expectations are rarely met 100% and even more rarely exceeded.  And so, why not set expectations high with the realization that should they fall a bit short, you’d be satisfied?

The greater danger for most of us lies not in setting our aim too high and falling short; but in setting our aim too low, and achieving our mark.
-Michelangelo di Lodovico Buonarroti Simoni 

Nowhere is this more apparent than in hospitals and doctors’ offices, where customer service seems to have seriously lagged behind the times.  Even before the Pandemic, barriers of all sorts were put up between patients and care facilitators.

 Think of the typical doctor’s reception areas, which are appropriately called “waiting” rooms.  There is usually a significant barrier, sometimes of clear Plexiglas with a small opening, behind which is seated a person who often goes to extraordinary lengths to ignore the people on the other side.

 Even the title of Mark Graban’s book acknowledges the fact that customer satisfaction is not on most hospitals’ radar screens.  They are concerned with “patient safety” and “employee satisfaction” as if those are greater goals than patient satisfaction.  Is that what he means by “lean”.  Or, is that just “mean”?

Are people to be considered as cars?  Does “lean” mean adapting Toyota’s assembly line and production efficiency principles over patient comfort and satisfaction.  Does it mean cost efficiency at the expense of the patient experience?

And, there might even be some confusion, which equates a successful outcome with patient satisfaction with the process.  In my mind, the 2 issues are quite different, though a pleasant process has a positive impact on the former.

 There are few places where tolerance for poor customer service is more apparent than in the healthcare industry.  During the current Pandemic, with healthcare workers working behind even greater barriers, garbed in PPE and stressed themselves, patient service is in danger of moving even further towards back of the bus.

 Patients themselves have come to expect poor customer service.  During the Pandemic, even that low bar of expectation has been lowered.

 I bring this up because this confluence of tolerance and expectations presents an opportunity.

 People still crave attention and desire good service.  Now is the time to step up and evaluate your patient experience, your team’s patient service and look at what you and they (patients) have been tolerating.

 People want to be seen and listened to.  They hate being ignored.  They hate “waiting,” in either waiting rooms or for results.  People more than ever crave attention, connection and respect.

 Where can YOU improve your patient experience?

Could your “waiting room” be replaced with a virtual one?  
Could you have patients texted with an updated time when the doctor will actually see them?  
Could you text them when their results are available?  

Are there apps for that?  Yes, there are!

 As an employer, what do YOU expect from your employees?  

Do they know it?  

Are behaviors clearly defined?  

Are outcomes of such behaviors clearly defined?  

Are they measured?  

Is performance regularly reviewed?  

How is underperformance mitigated?  

Or, is underperformance just tolerated?


 The Pandemic has presented yet another opportunity.  One of the victims of this Pandemic has been the Hospitality Industry.  This industry, in general, attracts people who are people-pleasers.  Moreover, many companies in the industry have excellent customer service training programs.

 I personally have sent dental practice employees to the Ritz Carlton training programs.  Today, there are graduates of such programs looking for employment. Such people can be taught the nuances of healthcare, a far easier task in my opinion than trying to make a non-people pleaser into one.

 Just dealing with people who truly care about others can dramatically change the patient experience.  And, as the “placebo effect” is real and the positive impact of the “doctor-patient relationship” on outcomes has been well documented, we now have a tremendous opportunity to reshape our clinics, offices and practices in ways that will also improve both patient satisfaction and health.

 To you excellent success and wellness,

Michael, Laurie, Merideth and the PPS Team

 P.S.  If you would like to discuss how you could improve your HR process, schedule a complimentary 20-minute strategy session: Schedule HERE\

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Dr. Michael Goldberg is one of the leading educators on dental practice management in the United States.

Michael ran and sold a prestigious group practice in Manhattan and has been on Faculty at Columbia University and New York-Presbyterian Medical Center for 30 years including Director of the GPR program and Director of the course on Practice Management.

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