One of the issues of deep interest to us is that of managing patient expectations. This week I bought new spectacles from Tesco – a very minor health care intervention, admittedly – but one which is useful to hold up to the light. We should look at together at how my expectations were set, whether they were realised and most importantly whether there was any mismatch between what I expected and what actually transpired. It is the latter that leads to either a satisfied customer, Mr Angry or a ‘raving fan’.
The first thing to say is that I had a good experience – better than expected. What did I expect? Not a great deal, in point of fact. I had hoped for a combination of:
– prompt turnaround (I needed the glasses before going away on holiday)
– good value for money
– real world customer care (previous experiences with buying spectacles online had been unsatisfactory)
– a wide choice of products
– spectacles that fitted me and corrected my vision.
So let us think about how I set these expectations. I had seen some in-store advertising offering a ‘two for one’ deal (with a free eye test to boot!). I had browsed the selection of frames available in-store and seen some frames I liked. I had had an eye test at the branch a few years ago and been impressed by the set up and professionalism. When I rang to book an appointment they offered me a same-day appointment, so it seemed very possible that I could get the prompt turnaround that I needed.I also had confidence that if the glasses were not satisfactory in any way I could take them back to the shop and get some real world customer care.
The first thing that struck me is how powerful ‘friction points’ are – what Carlzon refers to as ‘Moments Of Truth’.These are moments when the customer decides whether or not the provider is what he claims to be. Humans measure each Moment Of Truth against against a number of variables, including reliability, responsiveness, assurance, empathy and tangible outcomes. We all experience Moments of Truth when we purchase goods or services.Typically they are occasions when we note something is not quite right and (less commonly) when something has gone well. I am personally finely attuned to things going wrong, and I suspect this is the default setting for most of us. For example, I had not got straight through to the opticians department on the phone on two occasions, there was a minor mix up with my surname and previous records.There was a slight sense of being ‘sold’ optional extras. On the other hand, when I was handed my glasses the assistant made the comment ‘they look nice’ which was reassuring. Our overall impression of whether our expectations are met is highly (and possibly disproportionately) coloured by these Moments Of Truth.
The overall experience however was very good and in fact exceeded my expectations. I was seen promptly at the appointed time. The optician was courteous and professional, immediately engendering trust. The opticians was well-staffed and there was an excellent sense of team work in evidence – my experience was made as frictionless as possible. The consulting room was well appointed and clean, with a full complement of ‘machines that go bing’. The offer was excellent value for money (a second pair free and tinted lenses at no extra cost) and the glasses arrived within two days, well within my desired time frame.I was also pleased with the actual glasses, which did exactly what it says on the tin. Overall, then, my expectations were more than fulfilled and here I am recounting my experience as a ‘raving fan’.
The real issue of course, is whether we can or should apply this thinking to having a facelift, or indeed any type of cosmetic surgery. Having a facelift is in many ways fundamentally different to buying spectacles (or indeed any other consumer purchase):
– a facelift is usually a ‘one off’ – there is no previous experience and therefore we set our expectations in a very different way (personal recommendation, media hype, information gleaned from the internet etc)
– a facelift is not a frivolous purchase – the worst that could happen if I was unhappy with my spectacles is that I could have demanded my money back and bought another pair elsewhere
– a facelift is irreversible – once done, the die is cast
– the financial outlay is very significant for a facelift
– having any kind of cosmetic surgery is a profound emotional adventure for the majority of patients
– having a successful facelift is not a simple linear process – there are an almost unimagineable number of possible confounding factors, both biological and emotional.
Take home message – think deeply about your expectations and whether they are realistic if you are considering having a facelift. Most cosmetic surgeons are commercially oriented and know how to play the game.