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D E B A T E Open Access
Am I seeing things through the eyes of
patients? An exercise in bolstering patient
attentiveness and empathy
James K. Elrod
1
and John L. Fortenberry Jr.
1,2*
Abstract
Background: Modern marketing thought heavily emphasizes the need for healthcare providers to possess a
customer orientation, placing patients at the focal point of attention within health and medical establishments.
This has motivated significant investments in tools and techniques that foster outstanding service, attention, and
support. Such investments in isolation, however, offer no guarantees that a true customer orientation will emerge.
Proper implementation also is required—and that falls on the shoulders of health and medical personnel.
Discussion: The most innovative and expensive of customer-oriented tools and techniques mean very little unless
they are placed in the hands of capable individuals possessing the ability and desire to serve patients well. But the
rigors of industry life complicate matters, resulting occasionally in lost focus, compromising the patient experience. One
of the simplest and most effective methods for encouraging patient attentiveness rests with a reflective exercise that
encourages staff members to see themselves and their actions from the perspective of patients. Asking the operative
question, “Am I seeing things through the eyes of patients?”serves as an effective reminder of priorities, building
empathy and motivating personnel to continually deliver their very best.
Conclusions: Viewing one’s actions from the perspective of patients can be very revealing, opening eyes wide and
permitting opportunities for any necessary improvements, making for a simple but powerful learning experience. The
“Am I seeing things through the eyes of patients?”reflective exercise helps well-intentioned staff members avoid
tendencies which can lull them into states of complacency, ensuring that they remain focused on those in their care.
Keywords: Customer service, Patient relations, Marketing, Hospitals, Healthcare
Background
Modern marketing thought heavily emphasizes the need
for healthcare providers to possess a customer orienta-
tion, placing patients at the focal point of attention
within health and medical establishments [1–3]. Institu-
tional decisions regarding all facets of service and sup-
port are made with patients at the forefront of thought,
with intensive efforts being directed toward meeting and
exceeding their wants and needs, all while treating
them with empathy and respect [4–6]. It represents the
exemplification of customer service, attention, and sup-
port [3]. In the discipline of marketing, this particular
philosophy is known as the marketing concept [3,7,8].
As relevant today as ever, it emerged in the 1960s in
tandem with the disciplinary subcomponent of con-
sumer behavior which directed concerted attention to-
ward understanding customers and their patronage
habits and practices. Subsequent research confirmed
the value of customer-focused attention and support,
unseating prior philosophies which tended to focus pre-
dominantly on institutional capabilities and proficien-
cies, typically at the expense of served audiences and
their defined wants and needs [3,9,10].
The importance of healthcare organizations being
highly attentive to patients continues in present day, evi-
denced by extensive institutional investments in assets
aimed at meeting and exceeding the desires of target au-
diences, including innovative technologies, attractive and
* Correspondence: john.fortenberry@lsus.edu
1
Willis-Knighton Health System, 2600 Greenwood Road, Shreveport, LA
71103, USA
2
LSU Shreveport, 1 University Place, Shreveport, LA 71115, USA
© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Elrod and Fortenberry BMC Health Services Research 2018, 18(Suppl 3):929
https://doi.org/10.1186/s12913-018-3681-x
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
inviting service environments, wide-ranging service ar-
rays, and similar resources [1,9,11,12]. Further evi-
dence of the value of embracing a customer orientation
is found in the wide array of techniques supporting asso-
ciated advancements, illustrated by robust initiatives in
the areas of patient satisfaction (i.e., efforts directed to-
ward meeting and exceeding the wants and needs of care
recipients), customer relationship management (i.e., ef-
forts directed toward the delivery of personalized atten-
tion, service, and support to patients for purposes of
building loyalty), customer experience management
(i.e., efforts directed toward crafting all-encompassing
experiences that engage patients), and related pursuits
[3,9,10]. Such institutional efforts are supported and
advanced by a burgeoning body of knowledge, with
publications in both scholarly (e.g., [13–16]) and trade
(e.g., [17–20]) realms directing significant attention to-
ward understanding patients, permitting healthcare
providers to more proficiently deliver compelling ser-
vice experiences.
For those healthcare organizations that have made
prudent investments in proper tools (e.g., infrastruc-
ture, technologies) and techniques (e.g., programs, pol-
icies, procedures), achieving a customer orientation
becomes a distinct possibility. Such investments in iso-
lation, however, offer no guarantees that a patient-
focused organization will emerge. Proper implementa-
tion also is required—and that falls on the shoulders of
health and medical personnel. To help ensure that staff
members consistently demonstrate patient attentiveness
and empathy in their work efforts, Willis-Knighton
Health System suggests a simple exercise, one which
encourages them to see themselves and their actions
from the eyes of patients.
Discussion
The most innovative and expensive of customer-oriented
tools and techniques mean very little unless they are
placed in the hands of capable individuals possessing
the ability and desire to serve patients well. Hiring
right is essential but the realities of industry life com-
plicate matters even when workforces teem with cap-
able and devoted personnel. In modern healthcare
establishments, demands are significant, obligations
are ever-increasing, staffing shortages are common,
and shifts can be very lengthy and tiring, making
even the most dedicated staff members weary. Fur-
ther, it is not terribly uncommon to see at least some
health and medical personnel pursue technical mas-
tery with such voracity that it supplants rather than
complements attentiveness to patients. Workplace fa-
miliarity also can be detrimental as, in some cases, it
can blind staff members to institutional oversights and
inadequacies (e.g., worn waiting room furniture, poor
directional signage, excessive wait times) which are read-
ily apparent to patients and other guests of healthcare
establishments but remain unseen and unaddressed by
those in positions to effect remedies [9,21–23].
Despite good intentions, the challenges and imperfec-
tions of work life sometimes can result in inattentiveness
to patients; a loss of focus that lulls employees away
from mindsets of selfless service, compromising the
quality of patient experiences. No one is exempt from
the risks of complacency developing in their work habits.
It can happen to anyone—physicians, nurses, adminis-
trators, technicians, and so on—necessitating that each
and every staff member, regardless of capacity, be aware
of this potential and remain on guard. While it is incum-
bent on individuals themselves to avoid attitudes and be-
haviors that diminish their sensitivities to patients,
healthcare institutions must assist them in this process
at every possible opportunity. Typical mechanisms used
to foster patient attentiveness in workforces include em-
ployee onboarding and orientation programs, staff devel-
opment initiatives, and related constructive opportunities
[24–26]. These pursuits are designed to educate and en-
lighten staff members regarding institutional missions,
their respective roles and associated importance, and the
imperative of being attentive to and respectful of patients
as they go about conducting their assigned duties and
responsibilities.
But static initiatives, while holding immense value,
have limitations, especially regarding their ability to
thwart complacency that can creep into the work lives of
otherwise well-intentioned personnel. What actually is
needed is an ongoing dialogue between and among staff
members which emphasizes customer-oriented conduct,
and just as importantly, issues appropriate guidance to
help personnel remain focused on this goal. One particu-
larly effective method for encouraging patient attentive-
ness and a resulting customer orientation also happens to
be among the simplest; a reflective exercise that encour-
ages staff members to see themselves and their actions
from the perspective of patients.
It might sound unusual to focus attention on some-
thing so seemingly rudimentary, however, seeing things
from the perspective of others is not a natural process;
individuals are programmed to view the world from
their own eyes. But in order for personnel to be their
best and deliver the most satisfying patient experiences,
these self-serving instincts must be abandoned, shifting
perspectives from oneself to those one serves. This ne-
cessitates that staff members be reminded to view them-
selves and their actions with outside eyes, ensuring the
proliferation of selfless rather than selfish mindsets. To
the conscientious employee, the question, “Am I seeing
things through the eyes of patients?”serves as an effect-
ive reminder of priorities. It challenges staff members to
Elrod and Fortenberry BMC Health Services Research 2018, 18(Suppl 3):929 Page 42 of 48
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
critically evaluate their own actions from the viewpoint
of patients, building empathy and motivating them to
continually deliver their very best [27].
This reflective exercise, of course, applies to every-
one working in healthcare institutions, as they all in-
fluence patients in one way or another. Physicians,
nurses, and other caregivers have obvious interactions
with patients making reflecting on their actions from
the perspective of care recipients quite easy. How
might the caregivers themselves feel on the receiving
end of their own actions? Contemplating their con-
duct from the patient’s viewpoint can shed significant
light on their behaviors, guiding improvements when
shortcomings are noted. Many employees, however,
do not have such prominent interactions with pa-
tients, yet their conduct influences and impacts care
recipients just the same, as associated service failures
illustrate.
A dietary aide, for example, who haphazardly pre-
pares a patient’s meal has a direct hand in the dimin-
ished patient experience even without formal patient
contact. A maintenance technician who does not re-
spond in a timely fashion to repair a leaky faucet in a
patient’s room certainly is not seeing things through
the eyes of the care recipient. An administrator who
fails to act on suggested improvements noted in a re-
cent patient satisfaction survey also is not viewing
matters from the perspective of those served. Serious
infractions, of course, are resolved through disciplin-
ary processes. This reflective exercise reaches out to
those staff members who actually do care and are
committed to service; it endeavors to help them en-
sure that their focus on patients is not lost in the
rush of work life and all of the challenges that it
imposes.
As for timing and placement, an introductory event
can be helpful in initiating such pursuits, but vitally, an
ongoing dialogue over time is required for the effort to
have any lasting impact. Consider this to be an enduring
conversation between and among staff members. Since
viewing things from the perspective of others goes
against natural tendencies, repetition is essential. There-
fore, it is advised that these exercises be delivered as best
practice reminders across multiple events over time
within healthcare institutions. Treated in such a way, ex-
ercises can be inserted unobtrusively in virtually any
context (e.g., orientation sessions, department meetings,
celebratory events, etc.), requiring only a few minutes of
time for delivery. Brevity facilitates routine conveyance
and helps to ensure continuation, fostering all-important
repetition.
Content presentation options abound, subject to the
tastes and preferences of given healthcare institutions,
but a suggested approach entails the following.
Provide a succinct overview profiling the
institution’s mission, the importance of operating in
a customer-oriented manner, and the critical roles
played by staff members in addressing the wants and
needs of patients capably and respectfully.
Compliment staff members on their dedication and
commitment to the institution and to patient care
and encourage them to continually deliver their very
best.
Acknowledge the complexities of work life and
advise staff members to take a proactive stance
against the onset of complacency which can enter
subtly if one is not vigilant.
Challenge staff members as they go about their work
duties to view themselves and their actions from the
perspective of patients; encourage them to think
deeply to assume the role of the patient and evaluate
how they would feel on the receiving end of their
own efforts; and urge them to take corrective
actions, as warranted, to ensure patient satisfaction.
Conclude the session by encouraging staff members
to continually ask themselves the question, “Am I
seeing things through the eyes of patients?”as they
go about completing their work assignments,
reminding them to always view their actions from
the perspective of those they serve.
For added value, products (e.g., pens, posters, mag-
nets) featuring the “Am I seeing things through the eyes
of patients?”inquiry can be circulated to staff members,
helping to reinforce prior learning experiences. Sticky
notes printed with the associated language are particu-
larly effective, as they can be placed on computer moni-
tors, bulletin boards, and other areas providing handy
reminders as one completes their work. With dedicated
conveyance efforts, top-of-mind awareness will result,
guiding the perspectives of staff members even in the
absence of direct prompts, becoming part of the cultural
fabric of the institution and increasing the potential for
consistent patient attention and concern. Ultimately, the
ongoing dialogue supplied by the “Am I seeing things
through the eyes of patients?”reflective exercise assists
staff members in developing and maintaining a mindset
of compassion, something quite fitting for those serving
in health and medical organizations. In its highest state,
true customer ambassadorship on the part of staff mem-
bers emerges, benefiting personnel, institutions, and
most importantly, patients.
Conclusions
Viewing one’s actions from the perspective of patients
can be very revealing, opening eyes wide and permitting
opportunities for any necessary improvements, making
for a simple but powerful learning experience. The “Am
Elrod and Fortenberry BMC Health Services Research 2018, 18(Suppl 3):929 Page 43 of 48
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
I seeing things through the eyes of patients?”reflective
exercise helps well-intentioned staff members avoid ten-
dencies which can lull them into states of complacency,
ensuring that they remain focused on those in their care.
Combined with institutional investments in related tools
and techniques, a dedicated workforce committed to
meeting and exceeding the wants and needs of patients
affords opportunities for healthcare establishments to
achieve a customer orientation, resulting in satisfied pa-
tients, loyalty, and the potential for word-of-mouth re-
ferrals which can generate additional patient volume,
fostering growth and prosperity. A simple reflective ex-
ercise can go a long way toward keeping staff members
on point, attentive and empathetic in service to others.
Acknowledgments
A special note of thanks is extended to Brad Perry, Eydie Comeaux, Becky
Billingsley, Laura Allen, and the greater Willis-Knighton Health System family
for their helpful assistance throughout the development and publication of
this article.
Funding
Article processing charges were funded by Willis-Knighton Health System.
Availability of data and materials
Not applicable.
About this supplement
This article has been published as part of BMC Health Services Research
Volume 18 Supplement 3, 2018: Engaging patients, enhancing patient
experiences: insights, innovations, and applications. The full contents of the
supplement are available online at https://bmchealthservres.biomedcentral.com/
articles/supplements/volume-18-supplement-3.
Authors’contributions
The authors jointly developed the submitted manuscript, with each performing
critical roles from early conceptualization through to the production of the full
manuscript. The manuscript resulted from a collaborative effort. Both authors
read and approved the final manuscript.
Authors’information
JKE is President and Chief Executive Officer of Shreveport, Louisiana-based
Willis-Knighton Health System, the region’s largest provider of healthcare
services. With over 53 years of service at the helm of the institution, JKE is
America’s longest-tenured hospital administrator. A fellow in the American
College of Healthcare Executives and honoree as a Louisiana Legend by
Friends of Louisiana Public Broadcasting, he holds a bachelor’s degree in
business administration from Baylor University, a master’s degree in hospital
administration from Washington University School of Medicine, and an
honorary doctorate of science and humane letters from Northwestern State
University of Louisiana. He is the author of Breadcrumbs to Cheesecake,a
book which chronicles the history of Willis-Knighton Health System.
JLF Jr. is Chair of the James K. Elrod Department of Health Administration,
James K. Elrod Professor of Health Administration, and Professor of Marketing
in the School of Business at LSU Shreveport where he teaches a variety of
courses in both health administration and marketing. He holds a BBA in
marketing from the University of Mississippi; an MBA from Mississippi College; a
PhD in public administration and public policy, with concentrations in health
administration, human resource management, and organization theory, from
Auburn University; and a PhD in business administration, with a major in
marketing, from the University of Manchester in the United Kingdom. He is the
author of six books, including Health Care Marketing: Tools and Techniques,3rd
Edition, published by Jones and Bartlett Learning. JLF Jr. also serves as Vice
President of Marketing Strategy and Planning at Willis-Knighton Health System.
Ethics approval and consent to participate
Not applicable.
Consent for publication
Not applicable.
Competing interests
JKE and JLF Jr. are both employed with Willis-Knighton Health System.
Publisher’sNote
Springer Nature remains neutral with regard to jurisdictional claims in published
maps and institutional affiliations.
Published: 14 December 2018
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