Systems for Success


Improving customer service in your practice: Three main areas of focus.

By Doug Schumann, MA, PMP, SSBB*

You say you want to provide exceptional customer service, but do you know what that takes? You must be willing to take an unflinching and objective look at the way you are providing service to your customers currently, and make it a priority to improve your performance going forward. In a recent Bain & Company survey, most folks reported they are providing better service than they actually are. In fact, when they surveyed 362 firms, 80 percent of the companies believed they were delivering a “superior experience.” Of those companies, only 8 percent of their customers agreed that they were delivering that same “superior experience.”1 This is a significant disconnect!

The Stakes Are High in Today’s Market

Today’s customers have more choices, are better connected, informed, and have higher service expectations. Consider these statistics:

  • Customers are 25 percent more likely to share bad news than good news.
  • 88 percent of consumers trust online reviews as much as personal recommendations.
  • 89 percent of customers are likely to go to a competitor after a bad experience. In most of those cases, you won’t get a second chance once you make a mistake.2

On the bright side, improving your customer service will help your business grow and thrive. American Express found that 7 in 10 Americans are willing to spend more with companies they believe provide excellent customer service, and Bain & Company found that a 10 percent increase in customer retention levels results in a 30 percent increase in the value of a company.3 Talk about a great return on investment!

So now, are you sure you’re up for the job to provide exceptional service? Are you really sure? If so, let’s jump in…

Creating a Baseline

How good is the service you are providing? In order to truly know, it is important to create a baseline. You may feel that you are already providing great service, but unless you are asking your patients, your guess is simply your opinion. In order to develop a plan, you will want to create a baseline for both your Customer Satisfaction rating and your Net Promoter Score.

As a business, it is critical to gather a baseline from both a tactical and strategic perspective. From a tactical perspective, most organizations measure their Customer Satisfaction (CSAT). The measurement of how the business is performing from a strategic perspective is typically referred to as Net Promoter Score (NPS).

CSAT refers to how you are performing in regard to your day-to-day interactions with clients, according to your clients. This information provides you with specific feedback in regard to how your practice is running, and helps you determine how specific team members (individuals) are performing. Some common CSAT questions include the following:

  • How would you rate the experience of your interactions with our front desk staff?
  • How would you rate the experience of your interactions with your therapist?
  • How knowledgeable was the therapist you worked with?
  • Overall, how would you rate the quality of your service experience?

NPS provides a measure of the perception of your overall brand and will help you understand how loyal your customers are. NPS surveys center around one very specific and important question: On a scale of 0 to 10, how likely is it that you would recommend X brand to a friend or colleague? The answers to the NPS question are divided into three categories:

  • Promoters (who love your business–they responded with a 9-10)
  • Neutrals (who are “meh” about your business–they responded with a 7-8)
  • Detractors (they are very upset with your business and are not afraid to tell anyone who will listen–they responded with a 0-6).

The NPS question provides context regarding how likely it is that your practice will grow, or contract, based on how your patients feel about the practice. It’s also a good alternative to traditional CSAT questions, and there are many studies pointing it to be correlated to revenue growth. While specific employees can have a significant impact on your NPS, it provides more context regarding how your business is perceived overall.

Here is an example that may help you understand the difference and importance of both. I once worked in an organization that was only tracking CSAT. We constantly got praise on the performance of an individual staff member. Everyone loved “Skippy.” That’s why we couldn’t understand why some of the clients who were working with him began to terminate their relationship with our organization. It wasn’t until we began to also measure NPS that we realized the difference. One of our clients provided us with a 5 out of 5 on their CSAT survey, while providing us with a 1 out of 10 on our NPS survey and provided us with notice that they were about to terminate their contract. How could they both love us and hate us at the same time?

When we followed up with the client, here’s what we heard: “Skippy is fantastic! He is so great! But we hate the rest of your organization. Skippy continues to tell us how he’s trying to do as much as possible for us, but you won’t let him get anything done.”

Whether they mean to or not, some of your best performers may be performing well in the eyes of your customers by throwing the rest of the organization “under the bus.” You will want to measure both CSAT and NPS to obtain both views. Make sure your team fully understands that while it is important for our clients to like them as individual performers, this can never come at the expense of the way they perceive the rest of the organization.

Once you have baselined your metrics, it’s time to build your plan to improve. A company’s foundation is its people and processes. Companies that provide excellent customer service employ staff who are happy and know what is expected of them. To improve your customer service, your plan should focus on three areas: Purpose, Systems, and Customer Focus.


A company’s purpose is its vision and core values. Think of a company as an extension of the humans who make up the company. Each company has a vision and core values, whether these have been officially developed or not. When a company doesn’t have a stated vision or values, the employees interpret the vision based on the attitude and behaviors of their leaders. This means they see what the leaders are doing, how they are acting, and take their cues from them. If the leaders are ethical and fair, the company will be ethical and fair. Unfortunately, the inverse of this is true as well. Leaders set the bar. Some set it high, but many set it low.

Exceptional companies have a lot of things in common. All exceptional companies have a stated vision and core values that align with that vision. I can assure you that companies that provide exceptional customer service do so because it is a pillar of their organization and core values. This may sound simple but it is true. If you don’t value exceptional customer service, you will never prioritize it in your business.

If you aren’t sure whether your company values excellent service, take the pulse of your company’s culture. Start by observing your staff on a day-to-day basis. In other words, observe what their body language says when they walk around the office. Are they smiling? Are they happy? Are they interacting with other staff?

If your team is “sleepwalking” through their day, or even worse, frowning and slumping through their days, you are not providing exceptional service to your customers. To further pinpoint how your company culture is doing, ask a simple question of your employees. The answer to the question will tell you everything you need to know about your company’s culture. The question is, “When you wake up in the morning, do you look forward to going in to work?”

If the answer for your employees is “yes,” then it is very likely that you have a healthy culture and are probably providing at least good customer service. If the answer is no, you will have to figure out how to turn that “no” into a “yes” for your team. For those that you determine will never look forward to coming in to work, you may want to have a different conversation with them. That conversation will center on helping them find a job somewhere else. Once you are confident that your staff is focused on the same purpose, values, and mission, it is time to focus on creating and improving systems.


Exceptional companies have developed and documented their systems. Systems are defined as a set of principles or procedures according to which something is done—an organized scheme or method. The best companies have developed systems for how they run their business and provide service. Having systems in place helps new employees onboard quicker and provides greater consistency for your employees. It helps ensure that everyone knows what they are supposed to do, and how they are supposed to do it. Some common systems include the following:

  • Core responsibilities (clearly defined responsibilities by role)
  • Playbooks or operational guidelines (a document or documents that outline the responsibilities of each role and how every department is expected to interact with each other)
  • Communications protocols (expectations regarding how staff will communicate with each other and with clients), which may include specific communication methodologies and protocols such as:
    • Active listening and speaking strategies
    • Positive and inclusive communication strategies
    • Standardized customer greetings and responses
    • Phone-answering protocols
  • Decision-making frameworks (what decisions staff can make, or how decisions are expected to be made)
  • Escalation processes (how customer concerns are escalated and to whom)
  • Key metrics (how the team knows that they are doing a good job)

Why “No Problem” Is a Problem

Most great companies have adopted some form of a communication playbook and have been very deliberate in determining a customer service communication standard. At Ritz-Carlton properties, whenever an employee is thanked they reply “my pleasure.” Why? Because they’ve determined that hearing “my pleasure” as a response is much nicer than hearing “no problem.” Showing gratitude in our industry in imperative—and so is the way you accept it. When you say “my pleasure” you are communicating that it was a pleasure for you to help them, and your own body language typically aligns with this message as well. If you have ever shopped at Nordstrom or eaten at a Chick-fil-A, you can see how providing a communication standard can improve the overall customer experience.

While it may sound counterintuitive, systems are actually freeing. How can this be? Good systems provide consistency and standards for your team to follow. Once your team knows what is expected of them and how they are supposed to do their job, the best systems are flexible enough to allow team members to know what they can take responsibility for themselves, and what types of issues should be escalated. The best systems also allow for continuous improvement. As your team becomes more competent they will be better able to provide suggestions for ways to improve the standards. Finally, systems must have corresponding metrics to ensure your results are improving. Reviewing those metrics on a regular basis will allow you to determine which systems are working and which ones need to be improved.

Customer Focus

Regardless of how good your systems are, nothing else will matter if you are not focused on your customers with the intention of helping them feel better. Keep things simple. If you truly want to improve your customer focus, know what your patients want. Put simply, your patients want you to:

  • Know them
  • Value them
  • Help them

Know Them

Do your therapists and front desk staff know your patients’ names? Do your patients have to tell several people the same thing over and over again? Do your therapists ask their patients what is important to them and what their goals are? I have seen many therapists who believe “they are the expert” but instead of listening to their patients, they dictate to patients what their plan of care will be because, again, “they are the expert.” You want your staff to understand what is important to your patients and to make sure they feel as though you really know them. Patients are loyal to practices that know who they are and why they have come to see them. Make sure your team looks all of your patients in the eye and is focused on them. Make sure they know their patients’ names and know what is important to them. You want them to be able to tell you something personal about each patient they work with.

Value Them

Are your patients greeted when they walk in the door or are they made to wait before someone greets them? When they set a time for an appointment, do you start on time or are you consistently late? Do your patients feel as though you really care about them? Make sure your staff is treating each other, and your patients, with respect and dignity. Start your appointments on time, and when you can’t, apologize and make sure it doesn’t become a pattern. Treat them as though they are important . . . because they are!

Help Them

Does your staff keep up with research- and evidence-based protocols? Are they considering the whole patient when working with them? Do they ask about their home environment and make sure the plan of care has been tailored to be achievable for them? Are you tracking how quickly and consistently your patients are getting better? Make sure you are measuring outcomes and encourage your team to remain up to date on the latest research and findings. Be sure they understand what works and what doesn’t, and that their treatments are based on evidence. If your patients aren’t getting better, they will go somewhere else!

If your patients believe that you know them, value them, and are helping them, they will remain loyal, and tell their friends and families all about you. Here are some final tips that can be leveraged to help improve the service you provide to your customers.

  • Utilize multiple surveys to ensure you are consistently focused on improving your service.
  • Utilize an outcomes tool to track patient improvement.
  • Create a checklist for each role at your practice to ensure folks know what is important and should be completed every day.
  • Make sure someone is responsible for responding to all calls in a timely manner.
  • Make it part of your initial evaluation to estimate the total cost of care so your patients fully understand what their out-of-pocket costs will be.
  • Verify benefits for all patients prior to starting treatment.
  • Make it a common practice for your staff to shadow each other and learn from each other’s approach. Listen to be sure your therapists are asking what is important to their patients and focusing their plans of care on those goals.
  • Encourage your entire staff to know how their role can help sell the value of the plan of care.
  • Create an appointment cancellation policy.
  • Leverage a “mystery shopper” on a regular basis to make sure your service is exceptional.
  • Develop an escalation process (What should you do if a patient becomes upset? How do you handle patients who aren’t willing to pay past due balances, etc.?)

Following the steps I outlined in this article will help you rise to the top of your industry and also help to make your patients feel taken care of and on track to reaching their goals. Now all you have to ask yourself is, are you ready to achieve your customer service goals?


1 Accessed March 2018.
2 Accessed March 2018.
3 Accessed March 2018.

Doug Schumann

Doug Schumann, MA, PMP, SSBB, is the vice president of Client Success at Clinicient in Portland, Oregon. He can be reached at

*This author has a vested interest in this subject.

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