Can Medicine Learn A Lesson From Sprint?

I read an article on Business Week’s web site about how Sprint is getting a “wake up call” after so many customers and employees have left due to poor working conditions and poor customer service. I couldn’t help thinking about the eerie similarities between Sprint’s former philosophy and the philosophy that some in the medical industry currently hold.

“A numbers-driven management approach implemented after the [merger] led to poor morale and deteriorating customer service.”

Patient volumes. What code can the billing company use? Did you attach the correct modifier? What did you document? How often did you check vital signs? What was the pain scale? Right now medicine is all about the data. Patients aren’t people any more — they’re disease codes, check boxes, and billing sheets.

“Customer service call centers began to be measured and viewed primarily as cost centers, rather than opportunities for strategic advantage. Customer service ended up a secondary priority.”

Replace the term “customer service” with “emergency department” in the above sentence. That’s the way most emergency departments are viewed.

Projections of cost savings after the Sprint/NexTel merger “boosted pressures to find cost savings throughout the company.”

Many hospitals are pressured to stay afloat with declining reimbursements and more uninsured patients. How do they save costs? Hire less staff. Increase high-paying procedures. Read on.

There was “pressure to keep customer calls short.” At Nextel, she was judged only on the number of customer problems she solved each month, however long they took, and she would occasionally spend 30 minutes to resolve a thorny issue. But after the merger, speed was the priority, she says. “They would say, Your calls need to be shortened.’”

Substitute the term “patient visits” for “customer calls.” See a similarity?

“After the merger, unhappy customers defected in droves, and profits evaporated.”

What’s happening in medicine now? Unhappy paying patients are leaving traditional medical practices and hospitals in droves. Where are the patients going? To concierge clinics and specialty centers where they get more “customer service” from their health care providers. To be fair, profits are also evaporating due to funding cuts in medicine - something that Sprint didn’t have to worry about.

“They would micromanage us like children,” said one Sprint employee who was fired after taking time off when her father died.

Are you listening, Joint Commission? Are you listening, CMS?

One manager told employees “If you don’t think you can handle this, I hear McDonald’s is hiring.” “Everyone was scared.”

Great attitude. One problem with this approach in medicine. Some people are taking the managers up on their threats. Funny how McDonalds is fully staffed but how I see a lot of hospitals begging to hire nurses and other health care providers. In fact I read about hospitals that will pay huge signing bonuses for nurses to come on staff. Then, once the nurses start working, they get treated like crap. They stay just long enough to keep the signing bonus, then leave and tell everyone else how miserable it is to work at the hospital. End result? Hospital has less money. No one wants to work there. More staff attrition.
Another unintended outcome: The staff that is loyal enough to continue working at the hospital has less and less help because of more and more job vacancies. Yet these loyal employees are expected to do more and more with less and less, creating a dangerous environment for patient care. More adverse outcomes. Lower staff satisfaction. More staff attrition.

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The result of the “business as usual” approach with Sprint:
Sprint’s stock price is down 66% since it merged with NexTel. “Poor service is a central reason.”
“The toll on Sprint’s reputation has been dear. The company has ranked last among the country’s five major wireless carriers in customer service every year since the merger in 2005.”
“The new policies hurt Sprint’s ability to build its customer base. In the third quarter of 2007, [customer turnover] stayed high, and Sprint saw its subscriber numbers remain flat, at 54 million, while rivals AT&T and Verizon added millions.”

Now Sprint’s current CEO is “reversing course on several fronts, hoping to salvage what he can from the troubled merger.”

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The result of the “business as usual” approach with medicine?
Patient satisfaction with their medical care sucks. Staff satisfaction isn’t much better.
Providers are getting fed up and leaving medicine.
Lawsuits for less than adequate medical care are abundant. Save a few bucks by hiring less staff, lose a few million when there’s a bad outcome.
Things aren’t getting better, they’re getting worse.
The medical industry in this country is heading full speed toward the tip of a ginormous iceberg. Be afraid of the collision. Be very afraid.

George Santayana once said that “Those who cannot remember the past are condemned to repeat it.“

Lets see if some government agencies are smart enough to read the history books.

Maybe they could just click on the Business Week article instead.