Over the last decade, healthcare delivery has transformed from a primarily transactional and unidirectional model to a more collaborative one. Today’s healthcare providers strive to embrace the concept of consumerism and deliver not only a satisfactory clinical outcome, but also an exceptional patient experience. Patients are now encouraged to be active participants in their care. In fact, patients demand that practitioners acknowledge and respect their expectations and wishes. This change has likely been driven by consumers’:
- ability to source information pertinent to their presenting symptoms, and
- desire to exert personal influence and control over their own wellbeing.
Healthcare consumers demand exceptional service and results.
Nowadays, healthcare providers preach a patient-first philosophy that not only addresses the clinical needs of each patient, but also embraces a level of service required to meet or exceed their expectations. Simple examples of service-level expectations in outpatient therapy include answering the telephone within a specified number of rings or scheduling an initial evaluation within 24 hours of referral.
Significant resources are dedicated to improving the level of service healthcare establishments and practitioners provide to their patients. However, I would argue that clinical excellence and high levels of service aren’t enough to truly drive growth. Otherwise, we would see higher utilization of therapy services, and those clinics that report upper-quartile clinical outcomes and Net Promoter Scores® would attract the vast majority of patient referrals.
And the perceived value of that service must justify the out-of-pocket cost.
I believe there is a third variable that is equally as important as clinical competency and customer service: perceived value. I define “perceived value” as, quite simply, the net worth of the service provided according to the patient. It is different from the other two variables. After all, a patient can achieve a good clinical outcome and be highly satisfied with the service—while simultaneously feeling the value received didn’t justify the cost. For instance, I can go out to dinner, eat food that is perfectly cooked, and receive a high level of service—yet feel the bill at the end is in excess of what I believe is reasonable. A clinical example of this is when a patient feels the amount of money they need to contribute toward their care is in excess of what they are prepared or want to pay—often resulting in an appointment cancelation or no-show.
Therapy providers must actively and positively influence their patients’ perceived value.
To blame the patient for undervaluing the service provided—or therapy in general—is unjust and unhelpful, as it is ultimately the responsibility of the clinician and the profession as a whole to educate and carefully explain to the consumer the tangible benefits of therapy. Only once the consumer is informed and fully understands the benefits received can they perceive sufficient value to justify the cost in terms of time and money. Until perceived value reaches a certain threshold—in combination with commensurate clinical and service levels—will patients fully commit to successfully completing the current episode of care and return for future therapy services.
The question then becomes: How do we influence the patient’s perceived value? The answer is communicating and reinforcing the value proposition throughout the entire patient experience—and via multiple channels. Clinicians must explain how every interaction, process, and procedure is helping the patient and providing a return on their investment of both time and money. Every touchpoint with potential and actual patients needs to underscore not only what therapy provides—and how—but also, more importantly, why. Society is prepared to invest significant resources on an ongoing basis into a product or service they believe provides sufficient return on investment (ROI). We need look no further than the Peloton® cycle to support this point!
The goal is to achieve not only patient loyalty, but also patient stickiness.
Only when the patient and therapist interaction includes all three variables in sufficient and appropriate amounts will the patient become a lifelong user and advocate of physical therapy. I define this as “patient stickiness”:
Patient Stickiness = Clinical Competency X Customer Service X Perceived Value
Patient stickiness is more than loyalty; it is the degree to which a patient not only associates themselves with a particular clinician and clinic but also the probability of utilizing therapy services over an extended period of time. Other industries quantify this concept as the lifetime financial value per customer, or LTV. The majority of our patients are, at best, episodic users of outpatient therapy services rather than long-term ongoing consumers (i.e., the kind of consumers we see accessing personal trainers, chiropractors, and massage therapists).
Going forward, healthcare providers—including physical therapists—must form collaborative relationships in which they strive to address the individual needs of the consumer while clearly communicating the perceived value. If they can do this successfully, consumers will increasingly turn to therapy as a solution to address their musculoskeletal issues, and providers can build stronger long-term customer relationships.