Managing an Adverse Experience by Ending on A High Note

Larry Benz

Perspectives from Larry Benz, DPT, MBA

Written by Kristen Wilson, PT, DPT

Our patients experience many versions of customer service in their daily lives ranging from extraordinary to lackluster and, as a result, have become effective evaluators of quality, and demand more from their providers than ever before.

Access to information regarding the caliber of service is easy, thanks to online reviews and comment boards, leaving the provider exposed to consumer opinion. In an environment where an isolated, negative impression could lead to a backlash of online criticism, how can the provider best manage an adverse customer experience to mitigate fallout?

Through his years as a physical therapist, CEO of Confluent Health, researcher, and educator Dr. Larry Benz recognized that the patient experience can be shaped by several key tenets to improve the provider/patient connection and create a more compassionate relationship to yield improved patient outcomes. Moved to share his lessons learned, he outlines these principles in his book Called to Care: A Medical Provider’s Guide for Humanizing Healthcare.1 Implementation of his suggestions help create patients who are engaged and satisfied, and as a result, become champions of your brand, rather than critics.

One strategy offered by Benz is to create an environment where a patient experience always ends on a high note. Based on research by psychologist Daniel Kahneman, Benz highlights that a person’s remembrance of a past experience is based on two things2:

  • The average of how the experience felt at its peak
  • How the experience felt when it ended

These two components are unaffected by duration of the experience and can be easily shaped by initiatives to create summative positive experiences along the way.

Consider an event where a patient arrives for therapy and has to wait an extra half hour before his session starts as the result of a prior patient situation that required the attention of the treating therapist. The irritated patient expresses his discontent with the therapist who can proceed with two options. One, apologize and start the session. Or two, apologize, start the session, and follow up with a handwritten apology note with a $5 coffee gift card sent the same day to the patient’s address. Certainly, the therapist isn’t to blame for having to handle the other patient’s condition, however, how the therapist handles the apology will directly shift how the affected patient remembers the situation, thus creating a lasting overall impression of the quality of customer service. Creating a positive experience or memory out of a negative episode will reduce the potential for the patient to remember the entire episode of care in a negative light. As a result, when the plan of care ends, likely the patient will leave a positive review touting the quality of customer service, and the previously negative issue will be a distant and irrelevant memory.

As you create processes in your clinic for handling adverse patient events, reflect on the importance of ending on a high note. Develop processes to ensure your patients feel engaged and appreciated so that when the time comes for them to recall their experience, it is a summation of positive experiences and any negative consequences were turned positive. Your efforts will not only create brand ambassadors, but yield positive online reviews and cultivate effective word of mouth referrals. 


1Benz L. Called to Care: A Medical Provider’s Guide for Humanizing Healthcare. Australia: Lioncrest Publishers; 2020.

2Kahneman D, Fredrickson BL, Schreiber CA, Redelmeier DA. When More Pain Is Preferred to Less: Adding a Better End. Psychological Science. 1993;4(6):401-405. doi:10.1111/j.1467-9280.1993.tb00589.x

Kristen Wilson

Kristen Wilson, PT, DPT, is a PPS member, Impact editor, and owner of Action Potential in Glen Mills, Pennsylvania. She can be reached at

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