The case for customer loyalty

Healthcare Financial Management, Sept, 2004 by Arthur C. Sturm, Jr.

Originally my son was seen in the ED by a very compassionate physician who moved my son's case to the top of the priority list. During the course of his tests, that physician's shift changed and his replacement was not only impersonal but invisible. Also, our pediatrician (Doctor A) never responded to the ED pages, and at discharge the nurse did not know, among other things, whether our son's condition was communicable (it wasn't). We were given a prescription for pain management and some discharge instructions to read on our own.

To our surprise, the ED physician who had first treated our son called the next day to check on his condition. We were greatly buoyed by this act of concern and felt the worst was behind us. Doctor A never did call us.

As it turns out, the discharge instructions proved to be incomplete, omitting the all important requirement for complete bed rest in a dark room for at least 48 hours.

Three days later our son's symptoms reappeared with a demonic vengeance. Had we received the correct instructions, that painful episode could have been avoided. Had Doctor A called, we could have reviewed his activity after discharge. We found that in the end, we were taking care of ourselves rather than being taken care of. We had been given a choice of hospitals and now believe that we chose poorly.

And to keep our comparisons consistent, our value as a customer was about $4,000 for that six-hour visit.

The Point: Become Loyal to Your Customers

In case there are any readers asking, "So what's your point?":

* Marriott understands my value to it as a consistent user over time, a "lifetime" customer versus an annual performance. In a sense, Marriott has become loyal to me. The company continues to be a market leader in its finances and customer loyalty.

* United keeps asking me to demonstrate my loyalty to it, and dismisses me when I miss its threshold. The company cannot find a way out of bankruptcy.

* Hertz pushes the idea of service. The attendants didn't just retrieve my briefcase--they got me to my flight. Hertz has secured a point of difference, not in the cars it offers but in understanding the traveling executive's most precious currency: time.

* Doctor A and Hospital X exemplify the theory of "word of mouth" advertising. My family's negative experience with that pediatrician and that hospital is now the topic of every social encounter I have, demonstrating once again that we communicate our bad experiences to nine other people.

One interesting follow-up point: We asked Doctor A, our pediatrician of 13 years, why he didn't respond to the ED page. He got pretty huffy and said that it came in on his day off and he didn't take pages on that day. "It was the hospital's fault. They knew I wasn't in and should have paged someone else."

The one element common to all these examples is that I derived satisfaction not from the organizations' core competencies but from the experience around them. I never mentioned the Marriott rooms, the United flights, the Hertz ears, or the accuracy of the diagnosis at the hospital. As these companies search for revenue, Marriott and Hertz will see my loyalty increase. United Airlines and Hospital X will not.