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“Building a good customer experience does not happen by accident. It happens by design.” — Clare Muscutt
Most service industries, such as hospitality, are crafted to center customer experience. Between paying Rs 200 for a glass of watermelon juice in a five-star restaurant versus paying Rs 20 on the street, the difference lies within the customer experience, not the product, i.e., the watermelon juice itself. Consumers will pay for the services they value. You’d think customer experience would be at the core in designing any service, but this isn’t the case. Consider the healthcare industry in India.
First, easy access to healthcare is not even available to every Indian, as has been especially evident over the past few weeks. Next, the accessible healthcare services are definitely not centered around viewing the patient as a customer, as I discovered during my recent experiences with the healthcare industry that accompanied my mother’s diagnosis of cancer.
My first thought-exposure to cancer came about a decade ago, as I read Siddhartha Mukherjee’s Emperor of Maladies. Another book that really got me thinking about aging was Atul Gawande’s Being Mortal, which I read in 2015. Ironically gifted to me by my then 20-something-year-old daughter, this book made me aware of aging and consideration of the quality of life over continuity of life. We must allow individual choice when it comes to one’s health directive, and I must be the captain of my own fate and master of my own soul in this regard.
These thoughts resurfaced in the wake of my mother’s diagnosis of cancer last year. I got the call from the doctor while I was in a board meeting, and was told that my mother had Stage 3, if not Stage 4 cancer. I needed time to process and try to figure out what to do. Those accompanying thoughts from my earlier readings helped me decide that my mom, although not college-educated, has always been strong and smart, and the only thing to do in this situation was to tell her the truth. I knew that she had to be the first person that I would tell, and that, most importantly, she would have to make the decision about the next steps to take.
This decision was completely justified when my mother, with her years of wisdom, just accepted the diagnosis stoically and courageously with faith in its divine karmic purpose within her journey in life. Now cancer is a disease that requires one to spend a lot of time in hospitals. Not typically designed around being customer-centric, the focus in this healthcare experience is solely placed on medical competence and patient-centricity. The patient is rarely seen as a customer. In fact, most doctors would talk to me and ignore her, even when I tried to keep myself in the background.
For example, the first step in the case of any major illness like cancer is to take a number of diagnostic tests. In my mother’s case, this was a whole day, from 7 am-5 pm, spent on various tests. I encountered no less than nine separate instances of billing, each involving a 10–20 minute process of standing in a queue. Each of the tests was conducted in different locations within the center, requiring a repetitive back and forth from billing to testing. This seemed like a broken operational process and felt akin to the madness of Alice’s Wonderland. There is an obvious gap in operational efficiency and customer service when there are proven ways to solve it in any industry if customer convenience was taken into account! I spent about 1 lakh solely on these diagnostic tests, and let’s be clear — if I had spent 1 lakh in any other business on a single day, the service that I would expect and experience would be much more streamlined, organized, and overall superior. Healthcare is a business too, one where the customer has very little influence!
After this experience, I did some research — every health tech solution online at most gives you some sort of a rating for the doctor. What I’ve understood to be true is that while the doctor you have is important, they’re not the sum of your healthcare experience. Most big hospitals employ reasonably competent doctors. When it comes to cancer, the doctor creates the protocol of treatment and then spends about 3–5 minutes with you during each session of chemotherapy (which lasts 4–5 hours on average). They have little to no say on the service that you receive. And as a customer, you have no choice but to experience the broken administrational processes while gritting your teeth. In my opinion, the quality of the doctor is over-emphasized with no bearing on the patients’ overall experience, anxiety, and recovery. Do you choose a school for your kids based on a single teacher or for the pedagogy of the entire school?
In other businesses, like retail or e-commerce, you would take the net promoter score (NPS), deep science algorithms that measure customer satisfaction and predict business growth. You take into account the speed of a website, reduce the time for the payment gateway, cart abandonment analysis, etc., and continually improve the product for better customer engagement. Millions of dollars are spent on trying to create the best possible customer experience. Why then is healthcare any different? Is it because of the inherent power/knowledge leverage between healthcare professionals and laypeople? Additionally, the public healthcare system in India offers 0.08 doctors per 1000 people, thereby providing no real choice for most customers in this space.
All of this to say that if you are ever in need to find good healthcare, it is important to consider it as a service and choose an option that is the best fit for you. When it came to my mother’s treatment, I visited different hospitals all over Bangalore and decided on Cytecare. Everything that they did was set up around reducing both inconveniences to the patient as well as the time spent in hospital. For example, while most hospitals take an average of 5–8 hours to administer chemotherapy and discharge the patient, Cytecare took 2–2.5 hours. When this is a weekly activity over an extended period, which chemotherapy is, it adds up. This reduction in time is solely caused by operational improvement. Everything else in the treatment remains the same. If a difference in time as drastic as this can be caused by only streamlining operational processes, isn’t it important to focus on efficiencies in Indian healthcare services? There is a tremendous opportunity to build customer-centric healthcare services In India. The advent of e-commerce changed retail forever by making the customer the king. I am intrigued if technology in healthcare can change business models radically to center on service and satisfaction. We need inclusive and affordable care solutions for India.
Tony Hsieh once said, “customer service shouldn’t just be a department, it should be the entire company”.
There is no other industry for which this matters more than healthcare. A special shout out to the team at Cytecare who did just this and consistently took the effort to personalize my mother’s experience and make her as comfortable as possible. They offered her empathy and compassion in each interaction, and I am very grateful for their support during this difficult time.
If you’re building a health tech startup, please reach out to us at email@example.com.