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in customer relationship management. Generally, that doesn't exist in healthcare. It certainly doesn't exist in most of those individual practices because the records are primary clinical. But things like, well, here comes John, and we know that John has already told us that he can't have an appointment with us on Tuesdays and Wednesdays.
Okay, because he has other obligations at work. Well, we don't need to ask him that question every time he calls for an appointment. We should know that. That should be in the system that says John doesn't want Tuesdays and Wednesdays. Or it would be time of day. Or we know that John needs some assistance with transportation. Or we know all those kinds of things. We should know those things. And as it turns out, all of that information is generally exchanged in some fashion between the patient and the provider. It's just not captured.
Welcome to Passion Struck. Hi, I'm your host, John R. Miles. And on the show, we decipher the secrets, tips, and guidance of the world's most inspiring people and turn their wisdom into practical advice for you and those around you. Our mission is to help you unlock the power
power of intentionality so that you can become the best version of yourself. If you're new to the show, I offer advice and answer listener questions on Fridays. We have long form interviews the rest of the week with guests ranging from astronauts to authors, CEOs, creators, innovators, scientists, military leaders, visionaries, and athletes. Now, let's go out there and become
PassionStruck. Hello, everyone, and welcome back to episode 476 of PassionStruck. Ranked is one of the top five most inspirational podcasts worldwide. A heartfelt thank you to each and every one of you who return to the show every week eager to listen, learn, and discover new ways to live better, to be better, and to make a meaningful impact in the world.
If you're new to the show, thank you so much for being here. Or you simply want to introduce this to a friend or a family member, and we so appreciate it when you do that. We have episode starter packs, which are collections of our fans' favorite episodes that we organize into convenient playlists that give any new listener a great way to get acclimated to everything we do here on the show. Either go to Spotify or PassionStruck.com
dot com slash starter packs to get started. I am so excited to announce that my book Passion Struck won Best Nonfiction Book at the International Book Awards. It's also won the Eric Hoffer Book Awards, was awarded the Best Business Minds Book Awards, and won the gold medal at the Nonfiction Book Awards. In addition to being selected as a must read by the Next Big Idea Club, you can purchase it on Amazon or go to passionstruck.com.
In case you missed it earlier this week, I interviewed Amy Lee McCree. In our episode, we explore her latest insights on developing innate intuition, harnessing universal energy and enhancing personal well-being. You'll discover in this episode's practical tips from her new book, Aura Alchemy, and learn how to transform your life from the inside out. Don't miss this enlightening conversation with Amy Lee McCree.
crate. And if you like Amy's episode or today's, we would truly appreciate a five-star rating and review and sharing the show with your friends and family. I know these reviews go such a long way in bringing more people into the PassionStruck community, and we and our guests love to hear from our listeners. In today's episode, I am delighted to have Dr. Peter Yesowicz, Chairman of Hospital Healthcare Partners and Vice Chairman Emeritus of MMGY Global. Peter, alongside Stowe Shoemaker, co-authored the groundbreaking book, Hospital Health Care, which delves deep
into a fascinating concept what if healthcare providers serve their patients in the same way that hospitality providers serve guests in hotels resorts and restaurants it's a thought-provoking question given that both industries share many common service touch points can principles of hospitality be adopted to enhance the patient experience hospital healthcare provides a resounding yes as they answer in this interview peter is going to share with us the secrets and principles from the hospitality industry that can revolutionize the way
healthcare providers engage with their patients. We will explore Peter's innovative payer model, which stands for prepare, anticipate, engage, evaluate, reward, and learn how it addresses current trends impacting the healthcare landscape. This episode promises to be an enlightening journey as we unravel the reasons behind the hospitality deficit in healthcare and how adopting a
hospitality oriented approach can significantly enhance patient satisfaction and overall experience. So get ready for an eye opening conversation that will challenge your perceptions and unveil a new horizon where the worlds of healthcare and hospitality converge to create an extraordinary patient experience. Thank you for choosing PassionStruck and choosing me to be your host and guide on your journey to create an intentional life. Now let that journey begin.
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Always Night Pads will do their up to 100% leak protection thing. Shop for Always in-store or online, wherever you get your pads. I'm so excited today to welcome Dr. Peter Yesowich, PassionStruck. Welcome, Peter. Thank you, John. Delighted to be here.
Today, we're going to be exploring your brand new book, Hospitable Healthcare. Love the title of it. But before we get into that, I thought it was good to dive into your background because you have an extensive one in marketing and communications in the travel and hospitality industry. But can you explain how with that background, it led you down what I consider to be an unusual path of becoming a board member at the Cancer Treatment Centers of America?
Wonderful question. I'll try to do this briefly for your audience, but going back to my school days, I have a doctorate in psychology, but I never pursued that with the idea of practicing clinically. I did it with the understanding of applying the principles of psychology really in marketing communication. So for about a 35-year period, I built a business that ultimately became, I think, the largest in the hospitality category, certainly in this part of the world.
where we created marketing communications programs for brands that you and your listeners would recognize. Back in the late 90s, however, I received an inquiry from then the chairman of a company by the name of Cancer Treatment Centers of America, CTCA to express it briefly. And the chairman had found me because one of the board members of the company at that time was the president of the Ritz-Carlton Hotel Company.
And he had been recruited to the board because the chairman wanted more hospitable kinds of care delivered to his cancer patients. And he was aware of my work in service marketing, so he persuaded me to attend a board meeting as an observer one day, which was fascinating for me. I knew nothing about oncology. I knew nothing about the business of medicine.
And I sat in the meeting and I marveled at the fact that the board meeting began with an unprompted recitation from a patient. And the chairman said, we're going to turn the floor to the patient. We're going to allow the patient to tell us the good, bad, and ugly on his or her experience. And we're not going to start this meeting until he or she is finished.
And it was a fascinating kind of recitation for me. And I looked around the room and there was some really impressive people on the board. And I thought, wow, this is an organization that is committed to that kind of patient centricity. There's a lot of merit here. He had asked me because of my knowledge of service marketing to join the board, which I did. I sat on the board for, I think it was about 16 years, but between 2010 and 2020, I
He actually asked me to take the reins of the marketing communications for the company. So I became the chief growth officer for CTCA. And for those of your listeners who don't know that company, back in when I exited, we had five destination hospitals. I say destination hospitals because the majority of patients would travel locally.
from their hometown to seek care there, primarily as a result of really the complexity of their diagnosis. And 10 clinics. We were treating roughly about 15,000 patients annually. We had, at one point in my career there, we had all five hospitals achieve five-star HCAHPS ratings. We were one of two hospital systems in the country to do that.
We were consistently rated at 95 plus percent in terms of likelihood to recommend it. That always amazed me because we're talking about cancer. We're not talking about broken bones and other kinds of maladies, but many times with a diagnosis of cancer, the outcome is very sad.
Yet we would continue to get these remarkable ratings. What I observed there is I looked at the hospitality elements of the care delivery, and that's a long answer to a great question, but that basically is what then inspired me and my co-author to write this book. And that is we had one foot in hospitality and one foot in health care, and it became very obvious to us
that the healthcare business could be, the healthcare experience, the patient experience could be improved immensely through the adoption of certain principles of hospitality. Well, we're going to explore that in a second, but I wanted to go back to your marketing and communications background just for a second. I have a similar background in some ways. My side of the house was more on the technology aspect of it, but I joined a company called
called Catalina Marketing. I'm sure you're familiar with them, but based here in the Tampa Bay area, we had two sides of our business. One was Catalina and the other was Catalina Health. So Catalina, what we did was personalized promotions in the form of both paper coupons that you would get when you would check out plus digital
advertisements or coupons that were tailored to you. And it was a really interesting business model. Unfortunately, the company isn't what it was a decade ago, but we had three years of data on pretty much every single person in the United States, France, the UK, and Japan, and their shopping habits across all large box retailers, grocery retailers, and pharmacies.
and therefore could really personalize the offers that we were giving them. And then the other side, we had this business, Catalina Health, where we were doing basically promotions for big pharma companies. And what we were trying to do was unite the front and back of house and pharmacies. But then we developed a capability called total patient management, where we wanted to be able to provide different messages to a patient
both before they would enter a caregiver's location, but then afterwards or when they would go to a pharmacy to enlighten them to remember to take supplements or do these lifestyle interventions, et cetera. Does any of that ring a bell with any of the work that you had done? Yes. One of the things that I think we highlight in the book
is the sophistication in the hospitality business that has evolved over time in terms of understanding the preferences and the behaviors of customers, and then translating that into how you anticipate and serve patients in healthcare. Whether it's the kind of thing you've described, which is profiling previous behavior to, I don't want to digress, but it's one of my favorite topics, loyalty. Let me cite a statistic for you that I think very few people in healthcare know, and that is
If you look at the percentage of adults who seek a treatment of any kind from a hospital or hospital system in this country and the percentage who return to that system or hospital within a five-year period for any other type of service, that's about 42, 43 percent of the population of patients. That means that there's a 60 percent attrition rate from year one to year five in health care.
That would never happen in hospitality. And the reason for that is exactly what you just described. And that is they track behavior, they track preferences, they act upon those preferences, and they reward that behavior. Again, not to digress, but one of the things we have fun with in the book is we ask the question, why do health care providers not have loyalty programs and frequency programs? Why do we...
And now you've read the book. We open with this fictitious patient who is told to get a colonoscopy by his PCP. And we chronicle all the challenges he has in getting that done. And then six weeks later, he and his wife decide to go to Vegas for a weekend. And we chronicle that whole experience.
And at the end of that, we disclose the fact that when he looks at his visa bill after he gets back from Vegas, he discovers he got 2,500 reward points. And we ask the question, why didn't he get reward points for his colonoscopy?
And when I say that to clinicians, they all work and you get these wild expressions and some are offended by that. But I say, no, think about that. Why would you not create programs that advance loyalty? To your point, John, those techniques came from hospitality. That's where frequency programs were born, was in the airline business, was United Airlines and ultimately American Airlines.
My car wash down the street has a frequency program. Why is it? Anyway, you get the point. So those techniques were born in hospitality and have yet to infiltrate health care. It's interesting. This past year, I've had on two distinguished people from the hospitality arena. One was Will Godera, and he's published a new book this past year called Unreasonable Hospitality. And I had on Jeremy Fall.
who opened up 14 restaurants. And one of the things that they both described to me in their interviews was that there's only so much you can do within the four walls of a restaurant. The most important thing that you can bring to life is the experience that someone has when they're there. And it's an interesting way to think about health care because you typically don't walk into your doctor thinking about
having an experience because most of us have not had a pleasant one when we visit our doctors, so to speak. An interesting point, and I love to start this conversation with people who are interested in the topic by asking them a question, and that is, have you personally ever had a healthcare experience that went wrong? And everybody has a story. Most of us have multiple stories, but then I stop them and I say, well, think about
What caused that, and rarely is it the clinical outcome, that's not what went wrong. It's the way the health care service was provided.
And that takes us back into the realm of hospitality. And in the book, we introduce a model that we've created called the payer model. Now, you'll get a chuckle out of that as you're listening as well, because when you say payer to people in healthcare, heads turn. But our payer is P-A-E-R, and it stands for prepare, anticipate, engage, prepare.
evaluate and reward. And those are the five steps in hospitality that we, and we actually provide very actionable kinds of recommendations in the book, whether it's a PCP, a multi-practice office, whether it's a hospital system, where they can actually import those techniques. Because we know that in the hospitality business, one of the things they do exceedingly well is they prepare for arrival.
So they know more about you. They know your room preference. They know your seat preference. They know your pillow preference. All those kinds of things. And one of the things that frustrates consumers of healthcare so much is the requirement of the clipboard and filling out all the information. And they say, well, gee, I was just here three months ago. Why do I have to do this again? Well, I realize that there are reasons for that, but there are also reasons to circumvent that and to do this in a way that is a little more consumer-friendly. But I guess the point I'm making is
that our model has been crafted around the idea of taking demonstrated principles of hospitality in those areas. How do you prepare, anticipate, engage, and so forth? And for each of those, demonstrate a typical experience that a healthcare patient has and how they could really improve the patient experience. Now, the one thing I would mention, too, is
is one of the objections I hear appropriately from people, clinicians in particular who read the book, who say, well, this is great, but hospitality is a need service and we're in the, excuse me, is a want service and we're in the need service, right? So that you don't come to the hospital out of choice.
Well, that may or may not be true, depending on the reason for visit, but there's so many elective procedures. And if we talk about all the other kinds of procedures that are non-emergency in nature, where there is an element of choice for patients, all of these principles, we believe, apply.
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Always Night Pads will do their up to 100% leak protection thing. Shop for Always in-store or online, wherever you get your pads. Well, let's dig into that a little bit more deeply because you said in the book that you had conversations with 25 leading hospitality and healthcare professionals.
Were there any insights from these conversations that particularly stood out to you or shaped your approach? Yes. And let me give you the kind of the grand perspective. The insight that came from those interviews, and by the way, I purposely attended multiple patient experience conferences since we started this process, just as an observer to listen to the luminaries in that discipline. And here's the big insight.
Everybody agrees it's a problem. The patient experiences a problem. There is no agreement on the solution to the problem.
And so what happens is the dialogue tends to focus on, well, we know that people are upset with surprise billing, and we know that we're upset with wait times, and we know that they're, and the list goes on and on. But rarely did we hear in our interviews, or have I heard in my attendance at these conferences, a very specific list of actionable steps that a healthcare provider could take
provide to go ahead and address those. Let me give you one example, if I may, because in the book we talk about the hospitality deficits, and that's the term that we use to describe the problem. And the way we calculated that, as we went out, I think it's John, and we did, rather than have two guys with an opinion, we went out and we did a national survey of 1,200 adults
And it was the insights that came from that survey that fed the content of the book. But in the survey, we identified 22 points of service contact that are common to both healthcare and hospitality. Examples would be how easy or difficult it is to get an appointment, for example. Another example would be whether or not you know the cost of the service before it's rendered. Those kinds of things. We have 22 points of engagement, and we looked at those for hospitals,
We looked at those for walk-in clinics, physicians' offices, lodging, and dining in restaurants. So the way to think about this is we have a 5 by 22 matrix study, and we had 1,200 observations in each cell. We do all the analytics, and we come up with this concept of deficits. So here's the example. The number one source of dissatisfaction in the hospitality deficit for adults in America, according to our work today,
is not knowing or understanding the cost of the service before it's provided. So we all have examples of that, whether it's going to the local dentist, where you're not made aware of the cost of the treatment, whether it's, and I'm talking about non-emergency procedures. Certainly it applies to many emergency procedures. How about things like an annual physical?
I mean, we all have many examples, but we have no idea what the cost of the service is going to be in health care. We certainly know what it's going to be in hospitality. So the question is, what do you do with that insight? Well, I was giving a presentation a couple of weeks ago, and a CEO of a large health system in New York came up to me and said, OK, smart guy, tell me what we should be doing to address that, because we know it's a problem. People complain about that all the time. I said, well, let me give you this idea.
I said, next week, if you have to take your car to the repair shop, are they going to give you an estimate? They said, well, sure they are. I said, you're going to have to approve that estimate before they do the work, right? When you check the cost of a flight from New York to San Francisco, are you going to know the cost of that? Of course you are. Anyway, you get the point. I said, why don't you do this? When you confirm an appointment, this is not emergency procedures. When you confirm an appointment for a patient,
Why don't you give them, with that confirmation, a pro forma estimate of the cost of the treatment or service that's going to be provided with the disclaimer that that may be adjusted based on the examination, the tests that are going to be performed, and so forth.
But at least, and by the way, you know what that's going to be because the insurance company, you've already negotiated the contract and you know what the reimbursement is going to be for that. So why don't you go ahead and just give me that range estimate.
And even if it's going to, if the actual cost is going to vary slightly, which will disclose the reason why, what you've done immediately, and by the way, the copay requirement of the patient, what you've done immediately is you've diminished that hospitality deficit dramatically. So now people go, oh, it's going to cost me between $600 and $800. So then they can decide what it is they'd like to do with that information.
So he said, it's interesting. I said, well, you can have all of that information. And obviously it requires some software and some discipline to do that. I said, why don't you do that? He said, we never thought about doing that.
And anyway, there's an example of kind of thing I'm talking about. And that's the number one source of this deficit. Now, naturally, it can be the system would have some complications and debugged and so forth. But I offer that up as a practical example. It's funny, John, a number of these podcast interviews that I've done with hosts such as yourself, they all say, you know what? I got a bill the other day from my
dermatologists that I didn't expect. I got a bill that everybody got a bill they didn't expect. Now, I'm not talking about surprise billing. That's a whole other discussion. But I'm talking about unexpected bills. And I guess you get my point. And that is, I think the way to manage that in our payer model is go ahead and give a pro forma estimate the time the appointment is confirmed.
I thought maybe an interesting way, Peter, to go about demonstrating your pair model was for me to give you a real life example. We've got a fictional one, Roger, in your book, but I thought maybe we could give you one from my life. Love it. Then you could go through, after you hear what happened to me, how if they applied the pair model, it could have been a different experience. Good.
So I get most of my services through the VA since I'm a veteran. However, oftentimes they don't have the capacity to do everything in routine services that they need to do for us. So they give us something called community care. So I was sent to community care for a neurology department. So what ends up happening is the VA sends over a fax.
to the clinic. This one happened to be a place called St. Anthony's Neurological Clinic here in St. Petersburg. And then that clinic is then supposed to receive that information and then contact the patient so that they can do an intake. In my case, I was told by Community Care that they had sent the information and I waited one week, waited two weeks,
Didn't hear anything. Went back, called Community Care again, and they said, well, it sounds like you're going to have to initiate the process with St. Anthony's. So then the only way to initiate that process is to call them. So the first 15 times I called,
I could not get through to a human person because it would hang up on me before the human even answered the phone. Then when I finally did get through, I waited for over an hour to talk to a human who said that they hadn't received anything from the VA and that I needed to have them resend it again. So after playing this game for a bit, I found out that
If you call in the morning, you have basically no chance of getting a human on the phone. But if you call later in the day, between 3 to 5, you've got a much better opportunity. So after going through this cycle multiple times, I eventually got the appointment set up. Once you get into the system, I found it to be very straightforward. The doctor was great. The treatment was actually provided much better than the VA did it and a much more efficient
advantageous and quick way for me because I'm in and out of the office with about 20 minutes, which was great. Where this takes an hour to an hour and a half at the VA. But then about three, four weeks later, I get the bill in the mail and luckily the VA is paying for it. But this is a procedure that if you would go to most places would probably run you
$700, maybe at tops, $1,000. And they were charging the VA $3,800 for it. Obviously, the VA is only accepting a fraction of that. The price tag was just shocking to me. But interestingly enough, after I had gotten the bill, I actually got a satisfaction survey about the whole procedure and it outlined the experience and then never received any feedback from it. That's just...
my personal example, in your reader model, what interventions,
Could you have done across the prepare, anticipate, engage, evaluate, reward? Oh, I could give you many. And we probably don't have enough time on your show to go through even past the P in the mock. But no, I mean, your comments, John, unfortunately are not atypical. The kinds of experiences that many of us, myself included, by the way, have had seeking health care.
And I'll go back to my comment earlier when I said, when I asked people, can you think of a health care experience gone wrong? It's not the clinical outcome. I mean, you just confirmed that in your experience, if I heard you correctly, you were pleased with the clinical intervention and presumably with the clinical outcome. It was all of the elements that surrounded that, which is the delivery of care, which are hospitality elements.
that produced the kind of horrific experience that you had and the frustration that you had. And every step of the way, those are manageable.
And as I say in the book, for each of those, we have probably four or five very specific actions that a healthcare provider could take to prepare, to anticipate, to engage in scope work. Really, I'm pleased to hear that you were asked for some feedback. I'm dismayed to hear that you never heard back from them. But in our book, you may recall that one of the things that we asked the 1,200 respondents was,
Do providers in healthcare ask for feedback? And the majority don't, which is also very interesting. And the contrast with hospitality is vivid. Last night, again, when we had dinner with some friends and I booked a reservation on Open Table two days ago. This morning, before I even got out of bed, I have an email. Open Table says, tell us about your dining experience. The same is true with many service providers that are relentless
We just took a vacation a couple of weeks ago. TripAdvisor has sent me multiple emails requesting feedback on the same trip because I haven't responded yet. Now, again, to the point where we say, okay, enough's enough.
But my point is that the whole hospitality culture is tell us more about how we did, which, by the way, cascades into another aspect of the payer model and how consumers are seeking information about providers. We're all going online and looking at position ratings and hospital ratings and so forth. And what's really interesting is that
The amount of ratings and the quality of ratings available in healthcare, particularly on providers, individual providers, is very limited compared to what it is in hospitality. The example we give is if you have an anniversary dinner booked in a restaurant in Tampa and
and the entree is cold or the service is lousy or whatever, and you complain about that, immediately they fix it on the spot typically. But you might go home that night, go online, and erupt in terms of how you would critique that restaurant experience. That doesn't happen in health care. People don't diss their providers. They don't diss the physicians and the clinicians.
and we have a whole section of the book where we explore that psychology because it's a very interesting psychology and and i think we understand why but what that does is that it really diminishes the amount of kind of objective information that's out there for consumers to help make those choices but anyway long answer to a great question but we could deconstruct your whole experience and i could give you very specific action items for the payer model that would be
that the VA, unfortunately, the VA has a reputation for being less than responsive. And I know that they're working diligently to try to improve that and applaud that. In fact, I had the pleasure of meeting the gentleman who's in charge of the patient experience at the VA a couple of weeks ago, and I can tell you that he is absolutely focused on trying to improve that. But it's like turning a cruise ship. It's a Herculean effort. Well, I think the problem at the VA is
And I think it's the same problem that you have in the civilian world is that the whole way that the system, at least in the United States, works is everything is protocol-based. Meaning the way the whole system treats you is instead of looking at the tree and the trunk, they look at all the leaves and the branches. And I think it would be a much different experience if you had
It was akin to functional medicine, someone looking at the whole person. This is what the primary care provider is supposed to be in the VA, but they're so overwhelmed they can't do it. So you end up going to all these different providers that they send you to, and unfortunately there isn't an interconnected system, and from an IT standpoint, master data system that's tracking this so that providers understand
who are providing these other services are prompted to not only prepare for you, but to anticipate what the visit is going to do and then to adequately engage in it. And I think having looked at this from a lot of my experience in Fortune 50 companies is part of the issue
With the healthcare system and where it differs from a lot of the major businesses that people are familiar with is when people think about Lowe's, they think about Lowe's as a retailer. Well, actually, Lowe's is a big data company.
If you would ask Lowe's, what is the one thing that differentiates them from True Value or Ace Hardware, Menard's, Home Depot, it is the underlying data that they have, not only on the products that they carry, but most importantly, on the individual shopper who comes in the store and or visits the website or calls up the call center. I think that is an extremely critical factor that these hospital systems
health care centers, individual offices don't think about
the data that they had at their disposal. It's the same thing that Amazon does. Amazon has all these different capabilities, but at its core, it's a data company. Yeah, you've also got, obviously, regulatory issues you have to deal with, too, in healthcare that make it a little more complicated, not to the extent that it's not possible, but it does add a layer of complexity when you start to profile preferences for patients. But you're absolutely right.
And then there's the interconnectivity because the healthcare business is firewalled by provider. And that is most providers are not national in scope as they are in hospitality. They don't have a common database. So if you travel from Tampa to Atlanta and you stay in a Marriott, the people there are going to know you as well as people in San Diego at the Marriott. They have the database that informs them. That doesn't exist in the healthcare. I
Again, there's some regulatory reasons, but another reason is the structure of the industry right now. And one of the guys that we interviewed in our book was a gentleman by the name of Mike Levin, who was legendary in hospitality as the guy who grew the Holiday Inn brand. And he grew that into a brand that I think eventually had 4,000 units or something across the world.
And it was master franchising and understanding how to standardize service delivery throughout the system. And the point he made to me, which I agree with, is that there is a wonderful opportunity for franchise development in health care that really hasn't been explored.
because there's some wonderful brands that have reputations that would be highly franchisable. Now, the concern, and we did this at CTCA, by the way, we had many inquiries from individual health systems that wanted to import CTCA clinics for quality care into a hospital or even create a hospital. And the biggest challenge that we had was ensuring the quality and the consistency of the care delivery.
And I realize that in health care, that's a lot more difficult than it is in hospitality. But the principle's still there. The principle's the same. And so one of the things that we state in the book is we think this is going to change because we think that one of the destinies in health care is there will be more franchising. There will be more national systems. And there's a consolidation that will be underway driven by cross-sector
containment in the clarion physicians and all the other things. But anyway, the parallels to us are very obvious. Well, if you just look at a company, Chick-fil-A, who my brother works for, the amount of data that they have on the stores and the ability for them to understand when a
individual stores performing well or when it's not is amazing to me. They have, as you did, they have so many points of service that they look at to examine how well a particular store is doing and then they have all kinds of interventions that they can do. So in a franchise model, I think there are a lot of advantages where in share numbers you could have
much more sophisticated systems that could add value to how a franchisee would need to operate so that it was done in a uniform way across all the different branches. So I think there are some great opportunities for that. But when you're talking about small one-off primary care physicians, or maybe you go to an orthopedic center that's got maybe four or five partners in it, how do you
take that model where in a franchise you could blow this out and how would you see this working for these individual providers who are much of what the healthcare system is in the United States? Yeah, I would say that the example you've given, let's say a practice with four or five clinicians that is not affiliated with some kind of regional or national provider brand,
There are so many specific suggestions in the payer model in the book that practice could adopt.
that would have a very positive impact on the patient experience. So again, going back to the five steps, how do you prepare in terms of exactly what we were talking about a moment ago? In the marketing world, there's a tremendous amount of focus over the last 25, 30 years in customer relationship management, CRM, database development, looking at preferences, the kind of things you talked about before.
Generally, that doesn't exist in healthcare. It certainly doesn't exist in most of those individual practices because the records are primary clinical, but they, even though the data are there, but things like, well, here comes John, and we know that John had already told us that he can't get an appointment, have an appointment with us on Tuesdays and Wednesdays.
Okay, because he has other obligations at work. Well, we don't need to ask him that question every time he calls for an appointment. We should know that. That should be in the system that says John doesn't want Tuesdays and Wednesdays. Or it would be time of day. Or we know that John needs some assistance with transportation. Or we know all those kinds of things. We should know those things.
And as it turns out, all of that information is generally exchanged in some fashion between the patient and the provider. It's just not captured. It's not captured and recorded and analyzed and then used to, again, prepare. Again, the one that we all smile about, but it's very frustrating, is that the checklist is
and the, I say the checklist, you know what I'm talking about, the, what am I trying to say? The checkboard, where you have the clipboard, where you have to fill out the clipboard. You've filled that five times before. But I mean, even things like, here's another source of deficit for many patients, and that is they don't really have much knowledge about either the examination they're likely to have, the treatment they're likely to have, or the providers.
So what they do is they go online and they go to Dr. Google and they go to WebMD and they try to accumulate this information. Well, why wouldn't a small practice like the one that you've just described say, okay, along comes John, he has an appointment next Thursday at 2 p.m. and he's coming in for the following reasons. So what we should do is we send him with the confirmation, maybe a little 45-second video clip, and we can record these things in advance. And it might come from the clinician or come from the nurse.
that you're about to see. John, hi, my name is Sarah. I'm the lead nurse at the, and we're looking forward to seeing you next week. It takes 30 seconds to do that. Append that to the email and send that to you. So now all of a sudden you're matching a name and a face.
There's more of an element of personalization to that. And by the way, you can catalog all these too. So we say John's coming in for a physical. Well, rather than do a long email that says don't eat or drink anything from midnight prior, put that in a little video and just attach that to the confirmation, send that. Or maybe it's a little bio.
on one of the five clinicians that you're going to see. And here's Dr. Miles. Well, tell us, he paints for a hobby and he's got two kids and he's, you know where I'm going with that. All of that is very easy to do. You just need the systems.
And so when your appointment is confirmed, guess what? Now you feel a little better about what you're going to do, who you're going to see. And that's all hospitality. The best hospitality providers go so far as to contact you before you arrive. They send you an email and say, John, we're looking forward to your arrival on Tuesday. Is there anything we can do for you in advance?
Now, Holiday Inn doesn't do that. Some of the four-star and up providers do that as a matter of routine. Well, you would definitely thank your concierge doctor if you had one of those would be doing things like that. Not too many people do, but you're right. Yeah. Wouldn't it be nice if we all did? The whole premise behind that, John, is hospitality.
That's the premise behind concierge medicine. Obviously, the clinical aspect has to be superb, but it's all about access. It's about access, convenience. It's not being rushed in terms of the exchange. That's all hospitality. And it's funny because when we talk with a practitioner, it's an interesting idea, but that really doesn't work in health care. We say, well, think about it.
concierge medicine. Then they say, well, that's elitist. That's elitist. We're a not-for-profit system. And I say, wait a minute. Everything in our book applies equally to a patient on Medicare as it does to a patient with a Cadillac Blue Cross insurance. Everything.
And if you go through the book and you look at the recommendations, that's absolutely true. So what we're recommending is not elitist. It's not concierge medicine. But these are things that can be done for, say, patients who are on government insurance, Medicare or Medicaid. They still want to be greeted a certain way. They still want to know if there's a cost involved. Anyway, you get the idea that all of these principles apply the same way.
To me, if you were going to do something such as loyalty program, something like that, one of the ways I think you could make it work, thinking out loud here, is there are a number of companies who have worked with major corporations to help give employees an incentive to take advantage of wellness programs such as going to a gym. Definitely right. What I would see is you could have a way where
Since a lot of people, let's just go through the example that people are getting their medical care through a corporation. You could tie the two programs together and incentivize them either through a credit card they're using or through the company by if a person betters their health by doing wellness things and does wellness checkups or the standardized care, they could be given
point. That's absolutely right. Yeah. If you're aware, there's a company that's doing that right now by the name of ShareCare, S-H-A-R-E Care. And it was founded by the general founder WebMD.
and they're based out of Atlanta. And what they do is they sign up major corporations like I think Coke is a client and so forth. And they offer this program to their employees. And that's precisely the idea. And that is to the extent that they adopt more healthy lifestyle kinds of behaviors, what happens is they earn credits
rewards that in that example they're using travel by the way as an incentive okay so if you can demonstrate that you're on the right path to a healthier lifestyle the the one of the one of the currencies that you can use is travel redemption but that's that's probably a more the exception of the rule to your point it could be people who are offered complementary screenings in exchange for the certain behaviors so maybe it's lung cancer screenings prostate screens
a breast screening. It could be yoga, a couple of yoga classes. It could be cooking classes in the hospital kitchen to demonstrate how to enhance the nutrition of the food. All kinds of things that don't involve, you know, travel or some kind of illegal incentive because you can't have any cash equivalent or something like that.
but they can promote a healthy lifestyle and reward that. Very important given what I shared with you before, 60% attrition in terms of people going back to the same health system for another healthcare service.
As somebody who came out of hospitality, when you look at that attrition rate, you say, that's incredible, because that means they have to continue to find new patients. When I was at CTCA, we put as much emphasis on developing the relationships. Now, obviously, in cancer, the
Your goal is to cure the cancer, not necessarily to create repeat relationships. But through the relationships we had with family members and physicians who made referrals and so forth, they could see the progress that we would make with patients. That was very beneficial as opposed to treating every patient as a transaction, which is the way it happens, unfortunately, in a lot of places. So they go out and they spend more money on marketing to try to find a new patient as opposed to
In a less challenging disease, one of the things we know is when we get older, we require more health care. As a provider, wouldn't you want to have that relationship with somebody through their 40s and 50s and 60s? Anyway, that's the idea, but that doesn't happen in health care. Peter, I think I'd like to get you to go through some hypotheticals with me. So the first one would be, how could a provider use the principles of hospitable health care
to view a patient instead of treating them, serving them? Great question. Controversial question, by the way. And I appreciate you raising the question because we try to make that point in a responsible way in the book. And for the benefit of your listeners, let me just maybe elaborate on that. We say that
One of the reasons the hospitality industry enjoys so much higher guest satisfaction and so much higher loyalty than healthcare is they have discovered that as long as you treat guests equally, you can serve them differently. An example, if you're a member of a frequency program in a hotel chain, you might go to a special counter to register so it's a shorter line.
or you might get an upgrade on your accommodations when you check in. Same is true in the airline business. Same is true in the restaurant business. So everybody's treated the same way. It's just that they have identified different cohorts of their customers that they serve differently.
As a result of that, as consumers, we've come to acknowledge that's the way of the world, right? So we said, well, why is that guy in a different line than I'm in? And the answer is, well, he has a different relationship with the provider that affords him that privilege. And I accept that. Now, in health care, that's kind of an asthma, right? So you have that conversation with a hospital CEO or provider and they say, well, you can't do that.
And our assertion is you may not be doing that now, but you will be doing that in the future. And that is as long as you treat everyone clinically, this time, everybody has the same quality of clinical intervention, there is an opportunity to serve patients differently. So what does that mean? Less weight tolerance. I just finished an annual physical here at the Cleveland Clinic down in Weston, Fort Lauderdale.
and I go to their executive health program. I'm fortunate enough that I can afford that and I want to pay for that. And so when I go into the radiology waiting area to get my chest x-ray, and there are 30 other people seated there, I go right in. I don't wait for 45 minutes.
And I don't think anybody objects to that. No, they don't know why that happens necessarily. But the fact of the matter is that I paid for that privilege. I'm going to get the same quality of the scan. The person who's waited 45 minutes will get the same quality of the scan interpretation that I get. The only difference is that they've had to wait a little longer to get it.
That's a matter of choice, right? That's a matter of consumer choice. So the point I'm making is that I can give you multiple examples of that, but the point I'm making is that I think healthcare providers
And by the way, the best illustration of this is what we talked about a moment ago, concierge medicine. So some providers are going, wait a minute, as long as we treat everybody the same way, we can serve them differently. And they've carved that out and said, well, there's a cohort that we identified. And people can decide if they want to pay the premium for that privilege or not. That's a matter of choice.
We assert in the book that that is one of the fundamental principles that has been identified and refined in hospitality that has enabled them to maximize the financial performance of their service because people appear to pay for that privilege. And we know that's the case with concierge medicine where people pay a premium for that access.
So anyway, that's a great question. And so the question is, well, how do you do that? Well, let's say it's not concierge medicine. Example would be, let's say somebody has to return to the same clinic once a month for, I don't know, whatever treatment it might be.
Wouldn't it be better if you had maybe a different registration area for them where they don't have to stand behind six other people who may be first-time patients in the clinic who are going to get caught up in all the administrative requirements? And just that's a simple idea. So maybe you separate kind of registration areas where you have one that acknowledges returning patients and you have one that is for first-time patients, that kind of thing.
The same would apply to preferential appointments. So access to preferential appointments. And this gets to be a little complicated, but I'll give you the example because I think it's very relevant. One of the other great revelations in service marketing has been the concept of variable demand and yield management. And the best illustration of that is you go online and you check an airfare today, and it might be different tomorrow. Right.
And what's happened is the system has calculated the demand and said, well, we're going to sell these seats at this price and we're going to sell them at a different price tomorrow. You go on a website for a hotel and it says, well, if you want to come Tuesday night, we're going to charge you this. If you want to come Friday night, we're going to charge you that. So this whole concept of demand, variable pricing by demand doesn't exist in health care. We say, well, why not? I mean, shouldn't it?
So if I'm a patient, if I say the expression we use is in the airline business, we say, tell us what you want to pay. We'll tell you when you could fly. Same is true in the hotel business. Tell us what you want to pay. We'll tell you when you can come. And people go, that's great because maybe I really want to go on Friday night. I'm prepared to pay the premium. But then again, Tuesday's fine because I could save a hundred bucks.
Well, the same scan that I'm going to get in radiology, I mean, the cost of that is pretty much fixed. Would it make sense to think about pricing some of these services in health care such that you provide patients with an opportunity to be served differently? As long as we treat them all the same way. Yeah, so there's someone who says, I don't want to wait three weeks for an appointment. I want an appointment next week.
Okay, those are available and what happens is you adjust the cost
of the appointment accordingly. Now people say, well, wait a minute, that's not fair. Well, I'm not sure what's not fair about that. If the treatment is consistent regardless of how people seek it, but understanding that there are different cohorts of patients to be served differently. Now that's controversial, and I acknowledge that, but we think it's inevitable in health care that it will go that way for reasons that I think I've just hopefully articulated.
Peter, I've got a final question for you. You mentioned throughout the episode today that many of the recommendations in your book will be easy to implement, while others could be more difficult or even controversial like the one we just covered. Could you provide an example of a more challenging recommendation and why you would like the healthcare industry to consider it?
I think it goes back to the one that I mentioned earlier in our discussion, this issue of knowing the price of the service before it's rendered. It's the number one source of aggravation dissatisfaction for healthcare patients.
It's easily addressed. I'm not going to say it's completely solvable, but it's certainly addressable in a way that I think minimizes that frustration and anxiety that people have when they don't know the cost of the treatment, as demonstrated by the example I provided, and that is that health care providers...
Basically, no. I'm talking about non-emergency. They know, even for emergency, they know the cost of the service they're going to provide.
They know that. And for the most part, that's hidden from patients, which is one of the reasons why Trump back in '21 created that requirement for hospitals to post the cost of, I think it's now about 300 common procedures so consumers could shop for them online. And that's been a challenge to get compliance there. Anyway, so my answer is I think
That is the single greatest source of this frustration and aggravation. It is solvable. It's not going to be 100% accurate, but if I were to tell you, John, that the procedure you're going to come in for would cost you between $500 and $700 as opposed to not telling you anything, and then you get a bill for $680,
In those two scenarios, where are you going to be most comfortable? And I would submit that it's going to be with a general knowledge. Or maybe if the bill wasn't 7 or 6.88, it was 7.25, a little higher than the estimate. The fact of the matter is you had a little bit of a heads up and a bearing on what the cost is likely to be. And that diminishes a lot of the anxiety that people have. Plus, it helps them make a choice.
You know, because we've all heard stories of people shopping MRIs and they're all real. And if people had more access, transparent access to that kind of pricing, I think it would begin to diminish some of that frustration that they feel as a result of not having access to that pricing. Yeah, you could look at it just, if you do a car mechanic and getting multiple estimates on what it's going to cost to fix it. Exactly right.
Well, Peter, if a listener wanted to know more about you and the book, where is the best place for them to go? Go to our website, hospitablehealthcare.com. And it's not hospital health care, it's hospitable health care, if you pronounce it correctly. But I hear some people say, oh, it's hospital health care. No, no, no. It's hospitable health care. The reason for that is for most people, that's an oxymoron. They go, what?
And that's why we have, by the way, the subtitle, which is just as important, Hospitable Healthcare, Just What the Patient Ordered. We have a lot of fun with that because if they struggle with hospitable healthcare and they go, everybody's heard the expression was just what the doctor ordered. Well, this is just what the patient ordered. So they can go to hospitablehealthcare.com. Peter, thank you so much for taking the time with us today. It was such a great interview and I was so glad I could have it.
It's been fun, John, and I hope you and your listeners benefit from that, and I've appreciated the opportunity. Thank you. I thoroughly enjoyed that interview with Dr. Peter Yesowich, and I wanted to thank Smith Publicity and Peter for the honor of appearing on today's show. Links to all things Peter will be in the show notes at passionstruck.com. Please use our website links if you purchase any of the books from the guests that we feature here on the show. And if you like books, you can go to passionstruck.com under Passionstruck.
the Passion Struck podcast page, and you'll see a whole list of hundreds of my recommended books, each of which that I've read and recommend to my audience. Videos are on YouTube at both our main channel at John R. Miles and our Clips channel at Passion Struck Clips. Please go and join over a quarter million other subscribers. Advertiser deals and discount codes are in one convenient place at passionstruck.com slash deals. Please consider supporting those who support the show. I'm at John R. Miles.
on Twitter, Instagram, Facebook, and you can also connect with me on LinkedIn. Are you curious to find where you stand on the PassionStruck continuum? Then sign up for our new PassionStruck quiz, which you can find on passionstruck.com. It'll take you just 10 minutes to complete. It's only 20 questions, and you can find out where you are on your journey to becoming PassionStruck. You're about to hear a preview of the PassionStruck podcast interview that I did with speaker and executive coach, Finian Kelly, who reveals the transformative power
of intentionality, a feelings first approach to living and leadership. Learn how prioritizing feelings over outcomes can help you reconnect with yourself, reclaim your power and unlock infinite possibilities in both your personal and professional life. I really love the word grounded.
because it really connects to what happens when you don't live in the comparison world, you practice presence. And this is one of the key intentions of intentionality is practice presence over comparison. When we're present, we are now living here and now, we're grounded and we're not living in this fictitious world
story of the future or the past, which is where the ego hangs out. And the only place that our true divinity lives is here in this present moment. And when we drop into the present moment, we allow some intelligence and insights to start coming through us. And that's where the greatness really lies.
Remember that we rise by lifting others, so share this show with those that you love and care about. And if you found this episode today with Peter Yesowich useful, then definitely share it with somebody else who could use the words that he gave today. In the meantime, do your best to apply what you hear on the show so that you can live what you listen. Until next time, go out there and become Passion Strikes.
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