Improving Customer Satisfaction: The Pleasure And Pain Of Behavioural Science

Author: Christian Bamber
Posted: Monday 17th October, 2011. 13:12:15

Service industries are the obvious setting for applying some of the ideas emerging from behavioural science. Scientists have studied some of the many millions of interactions occurring between organisations and their customers and clients every year and have observed the influence of considerations such as the sequence of painful and pleasurable experiences comprising each interaction.

However, the application of behavioural science to the service setting is generally patchy at best. With this in mind, Professor Richard Chase from the University of Southern California’s Marshall School of Business conducted research on how people form opinions about their experiences to then go away and design the actual service.

Several principles emerged from the study that Chase urged managers to consider when designing any form of customer service interaction; get bad experiences over early so that customers can focus on the more positive subsequent aspects of the interaction; break up pleasure and pain so that the pleasant parts of the interaction have chance to stick in the mind; finish strong as the final elements of the interaction will remain in the customers’ memory; give the customers choice so they feel more in control; and let them stick to their habits, at least for a while, rather than force them to endure unexpected change.

So, the question is whether we can use these principles when considering client interactions in the healthcare/veterinary context. To help answer this, let us refer to a McKinsey study (DeVine & Gilson, 2010) that examined the application of these principles to the management of patients by a North American health insurer.

The senior executives of the insurance company wanted to help patients manage their treatment programmes for chronic illnesses such as diabetes or congestive heart failure. These types of conditions have always been challenging for clinicians, insurers and patients alike to manage due to their protracted nature and outcomes dependent on the patients’ ability and willingness to make significant lifestyle changes.

An experimental health-management programme was designed whereby patients received regular, scheduled calls from a team of nurses over a period of several months. The goal of these calls was to provide additional support to the patients by helping them understand the treatment options available to them, and by reinforcing the lifestyle changes recommended to them by the clinicians. For the insurers, better compliance means better outcomes which reduces the overall cost of the treatment.

Previously, the clinical treatment programme designed by the clinicians would dictate the content of the calls, with a fixed formula of objectives given to the nurses for each call.

However, in order to begin applying behavioural science, the nurses were split into two groups, a pilot group and a control group. The pilot group applied Chase’s principles of behavioural science:

1. Get the bad experiences over with early

In the case of the insurers, these were often situations such as the forthcoming lapse of certain insurance cover or tricky questions concerning a patient’s alcohol consumption or eating habits. Moving these to the front of the conversation allowed more positive points to be covered in the latter part.

In the veterinary context we could imagine a conversation between a vet or nurse and a client explaining that the good news is their pet is going to make a full recovery but that the bad news is it’s going to cost Ł1,000. The best way of tackling this, according to Chase’s principle, would be to say that there is a treatment option available that is quite expensive and will require several visits to the clinic, but the great news is Dave the cat is likely to make a full recovery and lead a perfectly normal life.

2. Break up pleasure and pain

By tackling the most challenging elements of the insurer’s call in the first phase, the nurse could focus on the positive aspects during the rest of it. The study showed that patients responded very positively to coaching by the nurse and so efforts were made to always ensure that nurses were well trained in coaching skills and topics.

In veterinary practice, we could aim to get the worst news over with right from the start and then focus on dealing with the issues raised. Therefore, for example, nurses should be trained in dealing with the most common questions arising from the bad news such as “how am I going to pay for the treatment” or “ will the insurance company pay out for this” or “what aftercare is my pet going to need?”

Being able to give the client answers and focus on the positive outcomes (hopefully) arising is far preferable than simply stating, “I don’t know, you’ll have to ask the vet/practice manager.”

3. Finish Strongly

Instead of the previously scripted endings the insurers made to patients highlighting all the benefits of their healthcare package, nurses were trained to deliver a final call to the patient at the end of the health-management programme celebrating their progress, goals achieved and all the positive steps taken to achieve those goals.

“Finishing strongly” in the veterinary context could take many forms. Perhaps the interaction is a follow-up appointment with the vet following a pet starting treatment for cardiac disease where the vet could highlight what a difference could be seen in the pet’s progress. Perhaps a client is feeling a little despondent about her pet only losing 0.5kg this month on its weight programme but the nurse could point out that he has actually lost 6kg over the past 3 months. Whatever the message, end on a high note.

4. Give customers choice

The insurance company made efforts to give their patients a choice, treatment options to follow, facilities to visit, clinicians to see, and the timing of follow-up calls. Choice gives the customer an element of control even if we limit the options or strongly emphasise certain choices.

All of the above would apply to veterinary practice. It is far more preferable and well received by a client if we give them a choice of treatment options for their pet so they don’t feel backed into a corner, even if we highlight certain preferred courses of action. Similarly, there would be nothing worse than to be forced to see a particularly disliked vet!

5. Let customers stick to their habits, at least for a while

In many cases, the health-management programme indicated a change to the patient’s lifestyle. Rather than adopting the draconian approach of “you must stop eating X or else…”, nurses introduced the idea over a series of calls or tried to offset the severity of a required change by altering the perception of how drastic it would really be.

I used to work with a nurse who would place a particularly overweight pet on the scales and after tut-tutting would demand that it needed to lose 8kg as soon as possible otherwise the consequences would be severe! Although factually correct, it would be far better to suggest a series of weight loss goals over the next six months whilst highlighting all the benefits of a healthy lifestyle that would be achieved by meeting each goal.


When the overall results of the insurance company study were examined, not surprisingly the test group significantly outperformed the control group in terms of patient satisfaction. Perhaps more importantly, the test group patients were more likely to state that the calls had motivated them to make positive lifestyle changes.

In addition, costs to the company of adopting the behavioural science principles were negligible and the nurses reported a greater degree of job satisfaction themselves.

At the beginning of the article we said that for the insurers better compliance means better outcomes which reduces the overall cost of the treatment. In the case of veterinary clients, the benefits of better compliance would also be passed on to their own pockets.

In conclusion, there is no reason why we couldn’t adopt and adapt these five principles within the veterinary practice environment; they’re relatively easy to do with a little training and their benefits would be almost immediate. More importantly, in an industry where customer satisfaction is often the only key differentiator between you and your competitor, can you afford not to give behavioural science some consideration?


References

DEVINE, J. and GILSON, K. 2010. Using behavioural science to improve the customer experience. McKinsey Quarterly, Feb.

CHASE, R. B. and DASU, S. 2001. Want to perfect your company’s service? Use behavioural science. Harvard Business Review, 70(6), pp.78-84.

Christian Bamber is Principal Consultant and Director of Approach Strategy, a consulting firm specialising in strategy services to service industries and not-for-profit organisations. For more information, please contact Approach Strategy at christian@approachstrategy.co.uk. Tel: 01225 722 654 or visit their website www.approachstrategy.co.uk

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