Physicians need to be more like the Ritz-Carlton to improve healthcare

There could not be anything more different than the experience one has between checking in at the doctor’s office and checking in to the Ritz-Carlton.

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When patients check in to a typical doctor’s office, they usually have to sign in and then wait to be called. Upon being summoned to the front desk, a clipboard is thrust in front of the patient upon which she must recall her entire medical history. Then, more often than not, she is asked to wait for an indeterminate amount of time, sitting on a hard, plastic chair with only a television blaring ads for prescription drugs or outdated magazines for distraction. Once led back to the exam room, the wait continues. When the doctor is finally ready, they might get 15 minutes together, and nowadays, doctors often need to spend more time staring at a computer screen inputting responses into the electronic health record system.

At a luxury hotel, it’s fair to say the experience is the opposite of that at a doctor’s office. Yet, that makes no sense, as health is more important than a vacation. And as any doctor will say, spending more meaningful time with a patient is essential for quality care.

Of course, there are concierge medical practices in which patients pay anywhere from $250 to $25,000 a year to get the “Ritz-Carlton” treatment in their medical care. But to truly reform our healthcare system, we need to bring concierge-level care to every patient.

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For a primary care doctor, establishing trust is critical. It means empowering patients to reach out at the first sign of a problem so they can receive treatment early before a condition becomes more serious. It means patients following recommendations to take medications on time and make lifestyle changes, like diet and exercise modifications.

Next: Building trust with patients

These things can help patients get healthy and stay that way, avoiding costly hospital visits. And that’s even more critical for physicians who serve seniors and those managing chronic conditions such as hypertension and diabetes.

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To build trust with patients, physicians need to take a page out of the hospitality industry’s playbook and do three things.

First, doctors must prioritize customer service and the patient experience. Like all customers, patients have some fundamental expectations. Customers expect the product to be free of defects. They expect timeliness. And they expect their interaction to be pleasant.

Indeed, a satisfied customer is one who walks away from an interaction that meets these expectations. But a loyal customer is one who walks away from an interaction that exceeds these expectations, because their interaction was not just nice, it was caring.

First impressions matter. Ritz-Carlton employees never greet guests with “hi.” Within nine feet of a guest approaching, they smile, look the guest in the eye, and say “Good afternoon, Mr. Smith.” This is not only welcoming; it shows all guests they are individually respected and valued. This warmth permeates all interactions.

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For doctors, that’s the key. The skills of diagnosing symptoms and offering treatments are not enough. Doctors should also make patients feel cared for, which would make diagnosis and treatment easier.

That’s why it’s unconscionable that the average time primary care doctors spend face-to-face with patients is 21 minutes annually. How can patients trust someone they only see for a few minutes? Good medicine requires more physician face-time with patients and services that help them overcome any obstacle they face accessing care-from dispensing medications on-site to providing courtesy transportation for those who need it.

Next: PCPs need to be more efficient

Second, primary care should operate efficiently. While this may seem contradictory, customer service and efficiency go hand in hand. True efficiency means eliminating mistakes to improve the product and reduce cost. Hotels are not more efficient when they reduce the number of linens, because that eventually requires the housekeeping staff to take more trips in the elevators, which slows down service for everyone.

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Similarly, doctors are not more efficient when they reduce time with patients or when they are paid to provide more costly tests and procedures. It only serves to undermine the patient-doctor relationship and ultimately, cause small problems to become bigger and costlier.

Finally, and perhaps most important, primary care practices should be driven by a mission that is communicated to all employees, from physicians to medical technicians to front-desk staff. When employees are motivated to provide extraordinary customer service every day, patients notice it, and will approach the whole visit and relationship with their provider differently. 

The good news is, while still rare, some practices are making this happen already. I've even joined the board of one of them because I believe in this approach. These practices are finding that when they go the extra mile, they have better health and financial outcomes because of it

Hopefully, this model of care will spread throughout the country, and in a few years, checking in to the doctor will feel like checking in to the Ritz-Carlton.

Horst Schulze was former COO of the Ritz-Carlton Hotel Company, and was a founding member of the company.  He currently serves as CEO of Capella Hotel Group, a luxury hotel management company, and as a board member of ChenMed.