How to Deliver Patient-Centered Care: Learn from Service Industries

Over the past decade, patient-centered care has become a mantra for high-quality health care.

Policymakers, researchers, physician-leaders, and patients have all cited the need for care to be tailored to patients’ unique needs and preferences. And there is solid evidence that patient-centered care can help improve care quality and reduce costs. However, in the rush to become more patient-centered, the health care system has misplaced its focus.

Current approaches to patient-centered care are based on aggregated preferences rather than individualized needs. Researchers and health systems deploy focus groups and surveys to assess general patient preferences in an effort to determine “what patients want.” But patients are a diverse group with diverse needs. Characterizing general beliefs and preferences alienates those whose needs and preferences do not align with the majority. The result has been a monolithic view of patients and their needs — a framework that prevents the delivery of truly patient-centered care.

All service industries share the challenge of providing tailored, individualized service. In response, leaders in customer service have developed tools and infrastructure to understand and respond to individual needs and preferences. Health care providers should leverage these approaches.

Tailored Service

For example, lessons from hospitality industry hold promise in helping physicians understand patient preferences and deliver tailored care. Consider New York City restaurateur Danny Meyer, who has built a restaurant empire on a relentless pursuit of hospitality and personalized service. People sitting down for a business dinner or anniversary at one of his restaurants might receive reserved, formal service. A group of eager tourists, on the other hand, may hear longer explanations of each dish and its provenance.

This type of service acumen is essential if physicians are going to respond to each patient’s unique needs and provide individualized care. However, medical education currently focuses on teaching standardized approaches to patient interaction. We were taught specific language that patients find helpful and specific actions and reactions such as placing a hand on patients if they begin to cry.

These strategies are well intentioned but stem from a misguided focus on the needs of the average patient. New servers at Meyer’s restaurants do not learn the preferences of the average diner. Instead, they are trained to quickly assess the preferences of the people at each table and tailor service to their unique needs. Medical schools should help students develop these same skills.

Consumer-Marketing Tools

Additionally, consumer-marketing tools, such as customer segmentation, can help providers deliver tailored care. Customer segmentation is ubiquitous across service and consumer product industries, but its application to health care has lagged. As health-care-delivery systems expand and more data is stored in electronic databases, there exists the potential to prospectively segment patients according to their needs and preferences.

Recently, researchers have used cluster analysis and data mining of large health databases to group patients according to preferences and measures of experience. Delivery systems could use these data to predict patient needs and expectations. For example, a practice could determine which patients are more likely to prefer being close partners in care decisions, be especially angered by lengthy wait times, or place a premium on warm, trusting relationships with staff.

Despite their broad applicability, these types of strategies and insights from service industries are underutilized by health care systems. One reason is providers have been reluctant to see health care as a service industry. Only by accepting the reality that it is one can providers learn from the successes of others in the field. And there is plenty to learn.

Brian Powers is an M.D. candidate at Harvard Medical School and previously worked at the Institute of Medicine’s Roundtable on Value & Science-Driven Health Care. Amol S. Navathe is a physician at Brigham and Women’s Hospital and is on the faculties of Harvard Medical School and the University of Pennsylvania’s Wharton School. Sachin H. Jain is chief medical Information and Innovation Officer at Merck, a lecturer in health care policy at Harvard Medical School, and an attending physician at the Boston VA Medical Center. This post originally appeared in the HBR Blog Network.

6 replies »

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  2. Good points. Danny Meyer actually talks at length about the fact that your first contact at a restaurant is often a reservationist on the phone, and how to move away from this person being a gatekeeper to someone who is trying to help you get a table. Subtle distinction, but it seems to work well at his restaurants.

    However, we were arguing more for helping physicians develop the type of service acumen that he inculcates within his wait staff. This comes down to reading patients and seeing what type of interactions they desire. Do they want a restrained, formal relationship with their physician? Or would they prefer the physician be more relaxed and chatty? These are the types of preferences that skilled waiters can draw out from a table within minutes with the proper training (as well as a base level of competence!).

    As for data, we envision something that goes deeper than age, risk, and complexity. A lot of health systems are already doing that with population health management. But those variables still come from the perspective of the health system rather than the patient. The exciting research we cite above – http://www.emeraldinsight.com/journals.htm?articleid=1780942&show=abstract – uses various health and demographic criteria to segment patients based on preferences and values for health system characteristics, communication styles, and dimensions of patient satisfaction and experience.

  3. Who could disagree with this advice? Would like to hear some specifics though. Going with the Danny Meyer example are you going to put a greeter at the door? This might work. One of our problems – it seems to me – is that the first point of contact is typically with someone who is responsible for billing/handling phones/dealing with insurers. I’d like to see a genius bar type set up. Perhaps some smart entrepreneur will come up with something …

    On data, give us more than “data will help.” How are you going to segment patients. By age? By risk? By complexity? Interested in knowing more.

  4. I think in today’s day and age, where almost everything is customizable, patients are looking for an experience at the doctors that suits their specific needs. Each patient is different, and learning to cater to their specific needs will ensure that they have a positive experience, and that they will come back. Nothing is more frustrating than dealing with a doctor who is spitting out the same old rhetoric. Their needs might not be unique, but treating them like they are shows the patient that they aren’t just a file to you. Customer satisfaction is extremely important to the success of a business.

  5. “Hold the pickle, hold the lettuce
    special orders don’t upset us.
    All we askk is that you let us
    serve it your way”

    or how about:

    “Have it your way,
    have it your way!
    Have it your way
    at Burger King”


    Each patients needs are not unique. There are only so many options available for eval and management. Most chronic disease patients need to do what they know they should do but don’t.

    Until the patient is writing the check there will be no patient oriented service. Someone else is making the rules and someone else has the gold. The patient and the doc are both chopped liver.

  6. A major factor in patient-centered care is also this trend in consumers being able to use technology to educate themselves and learn how to better manage their own health. Its true that the earlier you include the patient in the process the more likely that the appropriate treatment with be provided that is truly the best fit. Health care IS a service so the experience is just as important as the treatment itself. You see this in the sexual health arena, a sensitive topic to most but an issue needing much a attention. I had the pleasure of interviewing About.com’s STD writer and found how MD aren’t as proactive as they could be in encouraging their patients to take care of that part of their health:http://www.nytimes.com/2013/04/08/us/ban-on-free-condoms-jeopardizes-a-boston-college-group.html?pagewanted=all&_r=0