Nothing is insignificant
By Bob Levoy

Peeling paint, worn carpets, and poorly maintained restrooms send strong signals to discerning patients: Either management doesn't notice or doesn't care.

In the bigger picture, disrepair leads some patients to believe that perhaps other aspects of the practice are also neglected. The reasoning involved? People tend to judge the unknown by the known.

I've seen this line of reasoning used by patients many times over the years, so I was pleased to discover Michael Levine's new book, Broken Windows, Broken Business: How the Smallest Remedies Reap the Biggest Rewards (Warner Business Books, 2006).

The "broken windows" to which he refers, can be taken literally or as a metaphor for a host of "little things" invariably noticed by patients, but frequently overlooked by practice owners.

Perhaps the most visible and potentially damaging type of "broken window" is an employee who's not in tune with the culture of your practice, especially one who has direct contact with patients.

"In business, perception is critical," Levine says. "The way a customer (or potential customer) perceives your business is a crucial element in your success or failure. Make one mistake, have one rude employee let the customer walk away with a negative experience one time, and you are inviting disaster."

Levine goes on to say that what's needed to fix broken windows is an intense interest in all aspects of your business and a singular focus on the smallest detail. This implies a commitment that goes far beyond what most businesspeople believe to be adequate, what some might even consider as excessive.

And that fervor must be communicated to every single employee. It's not enough for you to be obsessed — everyone who works in the practice must be equally single-minded.

This commitment means never letting a patient see a bathroom that isn't spotlessly clean. It means never allowing someone to stay "on hold" with a voicemail system for more than a minute before contact with a real person. It means not keeping an employee who isn't going to say "please" and "thank you" to every patient, no matter what the circumstances.

Levine's premise is that constant attention to such matters not only demonstrates the competence of an organization, it also shows that management cares about the people it serves.

"Having a policy of being considerate and polite to customers," says Levine, "is essential, but it's not enough. Those employees who go out of their way to help customers with a problem, who notice the 'regulars' and remember their preferences, but are just as accommodating and helpful to newcomers, are the ones who are going above and beyond. But it should be made clear that you expect all your employees to go above and beyond, that this is a company policy, not an individual initiative. Set standards and ask employees for suggestions on how to exceed them."

In most cases, there is very little or no cost in doing things the right way. "How much does it cost for each employee to smile," asks Levine. "How much does it cost for an employee to take a sense of responsibility for each problem he or she is presented? If an employee can't smile, even for minimum wage, you have the wrong employee, period."

Become obsessed with your hiring practices, Levine adds. Know ahead of time what kind of person you need, and then take steps to hire someone with the proper knowledge for the job and the proper attitude to go with it. Nothing is more important.

"An employee who can't do the job properly", says Levine, "should be fired. Not warned, not shifted to another position, not admonished. Fired. Fast. Before another customer is spoiled."

Hard-learned lesson: "Nothing is insignificant," says Levine. "There is no such thing in business. If it's wrong, and it can be right, it must be made right."

Bob Levoy is author of the just-released 222 Secrets of Hiring, Managing and Retaining Great Employees in Healthcare Practice, published by Jones and Bartlett Publishers (www.healthadmin.jbpub.com). He can be reached by e-mail at b.levoy@att.net.