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Kinky Boots, Swedish Dialysis and Demanding Customers

Market Corner Commentary for August 26, 2015-Kinky Boots, Swedish Dialysis and Demanding Customers

The oldest and best advice in business is “give customers what they want.”  From Broadway to Sweden, demanding customers make companies better.  The more health companies strive to meet customer needs, the better healthcare will become.

Wisdom in Boots

demanding customersBusiness wisdom was the last thing I expected from Kinky Boots, the raucous Broadway show about drag queens and an English shoe factory.

Here’s the plot in a nutshell.  After making quality men’s shoes for generations, Price & Sons Shoes is failing.  The owner, Charlie Price, needs a strategy to keep the company alive.

A chance encounter with a flamboyant cabaret singer (Lola) reveals that drag queens suffer mightily wearing women’s boots.  While fashionable, women’s boots hurt male feet.

A niche market is born.  Charlie offers to make a sample boot for Lola.  Lola agrees as long as the boots are red.

The proto-type is a bust – burgundy isn’t red.  Lola takes over product design and creates Kinky Boots.  They’re fabulous.  Customers rave.  Sales skyrocket.  Price & Sons thrives.  Beliefs change.  Boy gets girl.  Lots of singing and dancing.

Here’s the “moral of the story”: giving customers (drag queens) what they want (fashionable and functional boots) creates wealth and sustainability for successful companies (Price & Sons).

Beyond HCAPHS

There are no Broadway musicals celebrating exceptional healthcare services, but there could be.

Providers execute most transactions with limited patient involvement.  The system pays providers for treatments, not outcomes or happy customers.  Often the patient/customer experience is lousy.   Long wait times for short appointments with stressed caregivers is routine in most primary care settings.

Recognizing healthcare’s patient experience deficiencies, Medicare developed the Hospital Consumer Assessment of Healthcare Providers and Systems survey tool (HCAHPS) to measure patients’ perspectives on their care.  Medicare pays bonuses to providers with higher scores and penalizes providers with lower scores.

HCAPHS has thirty-two questions and employs a standardized methodology for collecting and analyzing survey results.  Providers have adjusted operations to improve their scores and outcomes have improved in the measured areas.

Kudos to Medicare.  CMS saw a problem and is addressing it through their payment formularies.  However, no other industry relies on the government to measure customer satisfaction.  Centrally-administered surveys can raise average performance, but they never inspire exceptional performance.  They’re not Broadway-worthy.

Providers must look to themselves and their patients/customers to differentiate in an increasingly consumer-driven marketplace.   Partnering with patients promotes innovation.

Remarkable outcomes occur when caregivers engage customers.  A hospital dialysis center in Ryhov, Sweden illustrates how.

Climb Every Mountain, The Musical

demanding customersHere’s a story that could excite Broadway producers.

Christian Farman was a Saab Avionics mechanic and an amateur athlete when he contracted serious kidney disease.  His treatment required dialysis three times a week at Ryhov Hospital.   Debilitating side effects (nausea, fatigue, thirst) made Christian believe that dialysis was taking over his life.

After conducting research, Christian approached his nurse, Britt-Mari Banck, about self-administering his dialysis.  Christian believed that shorter, more frequent treatments would lessen his side effects.  Administering the treatments himself would free him from the hospital’s regimented dialysis scheduling system.

The Hospital agreed to give Christian’s idea a try.  Britt-Mari trained him how to use the equipment and administer the medicines.  When he was ready, she gave him a key to the dialysis unit, so Christian could administer the treatments on his schedule (usually early mornings).

Within weeks, Christian’s side effects lessoned.  Most importantly, Christian regained control of his life.   He decided to become a registered nurse so he could help other people.  Today, he’s doing just that and genuinely happy.

Based on Christian’s success, Ryhov Hospital now encourages its dialysis patients to self-administer their treatments.  Over half of them do.  Remarkable.

Outcomes are better too.  Fewer complications translate into healthier patients and thirty-three percent lower operating costs.  Like Christian, most self-administering dialysis patients return to work and find renewed purpose as they take control of their treatment.

Demanding Customers are the Best!

demanding customersLola got what Lola wanted and saved Price and Sons.  Christian got what he wanted and transformed dialysis treatment at Ryhov Hospital.

Dialysis at Ryhov Hospital seems exceptional, but it isn’t.  Other industries routinely advance innovation by listening to and engaging customers.

Clothing merchant Sy Syms’ had a legendary tag line, “An educated consumer is our best customer.”  By definition, educated consumers have high standards and demand superior service.  They lead the way.

Health companies that find, cultivate and accommodate their most demanding customers will differentiate and thrive in post-reform healthcare.

A version of this article appeared in Academy 360 on August 20th

About the 4sight Health Author
David W. Johnson
David Johnson CEO 4sightHealth

David Johnson is the CEO of 4sight Health, a boutique healthcare advisory and investment firm. Dave wakes up every morning trying to fix America’s broken healthcare system. He is a frequent writer and speaker on market-driven healthcare reform. His expertise encompasses health policy, academic medicine, economics, statistics, behavioral finance, disruptive innovation, organizational change and complexity theory. Dave’s book, Market vs. Medicine: America’s Epic Fight for Better, Affordable Healthcare, is available on www.4sighthealth.com