Why should the addiction treatment field and its practitioners be concerned about customer service? Because:
· 20 to 57% of outpatients do not return for treatment after their first session, and of those who do return, 37 to 45% attend only two sessions;
· Up to one-third of inpatients leave treatment against medical advice (AMA);1 and
· Healthcare reform is going to create major shifts in “how we do business.”
Customer service refers to a series of activities designed to enhance the level of customer care, resulting in the customer’s perception that the service has met his or her expectations. Everyone provides customer service. The question is whether the received service was perceived as good or something short of that. One way to assess our approach to customer service is to examine the language used to determine how we regard the people we treat.
If we regard them as “clients,” they need us. If we regard them as“consumers,” we have something they need or want. If, however, we regard them as “customers,” we need them. Often, when describing a program or practitioner, we say (and providers always do) that the program/practitioner provides “quality treatment.” How do we know that? Are there treatment outcome studies done by a credible third party such as a university that can document that? Can we even agree on what constitutes quality, or agree on outcomes?
When it comes to complex purchases such as treatment, consumers and referents use proxy indicators of quality and this is the perception of good customer service. Said another way, customer service determines the perception of quality. If asked who the customers are, most treatment professionals would answer clients and their families, and obviously they are the most visible of our customers. Others, often not thought of as customers, are our staff, board of directors, referents, payers, regulators, donors for 501(c)3 organizations, members of the community, and anyone else who interacts with us.
There are many reasons why good customer service is important. For clients, it means that fewer will drop out of treatment, and there is a clear relationship between length of treatment and positive outcome. Also, when there is good customer service, patients will be more focused on recovery than on griping about whatever problems they identify with the provider. Good customer service translates into a heightened perception of high-quality treatment, a more positive image and more referrals.
Customers do not care about the reasons for poor customer service. It is estimated that a satisfied customer (patient, patient’s family, referent) will tell two to three people about their experience while a dissatisfied customer will tell eight to ten people and sometimes up to 20.2 Good customer service also has significant financial ramifications.
In addition to generating increased referrals, it can reduce premature discharges or treatment dropouts, which are very costly to a program. For example, if a 50-bed inpatient program or a 30-slot outpatient program has 50% of its clients leave halfway through treatment but is able to replace them with other patients (no net change in census), the costs to the program still will grow exponentially, since costs for patients are front-end loaded with the most labor-intensive and expensive activities at the beginning of the process (history and physical, psychosocial assessment, etc.).
The points at which good customer service is deliverable occur at the beginning of the inquiry process (by phone or face-to-face), during treatment(assessment, treatment planning, treatment, point of discharge), after treatment (post-discharge and during aftercare and/or follow-up), and at all points in between. Most of the guidance in the remainder of this article applies equally to inpatient and outpatient treatment programs, and to mental health organizations as well as addiction treatment providers.
The importance of the telephone
Your telephone is your service’s “window to the world.” Have a real person answer the phone. Callers do not want to talk to a recorded voice. If necessary, use call forwarding or an answering service. During normal business hours, determine how many times the phone will ring before it is answered. Set the system up so that if that number is exceeded, someone else will pick up at his/her desk.
Answer the phone in ways that let the caller know that you are really glad he/she called. Maximize the first encounter, assuming that you might never hear from the caller again. Make certain that everyone who calls for help gets it, even if you cannot provide it yourself. Don’t grill the caller. (This author called an agency to speak with the executive and was asked so many questions that he ended up surprised he wasn’t asked for his Social Security number.) Make the phone system easy to navigate. Return all calls promptly.
Phone answer exercise
This is a worthwhile, no-cost means to assess the level of customer service at the point of initial contact. Have someone whose voice will not be recognized call and play the role of a prospective client or family member looking for help. Look for problems such as the phone answerer “marketing” the service before listening to the caller’s concerns and needs.