I do my best writing from ideas I get while running.  For those who are thinking, ‘it must have been a while since you’ve run’ I saw that one coming.  I’ve run since I was fourteen, minus the last twelve months.  I started again Monday; even my teeth hurt.

By the way, it may be time to fire Ferguson.

I was listening to Imus this morning as he was interviewing a famous music promoter, Jerry Weintraub.  The promoter relayed a story about one of his clients, John Denver.  Mr. Denver was constantly complaining about a number of things on one of his European tours, and he demanded the promoter come speak with him.  Here’s a replay of the conversation.

“Yes. Well, he was in Europe, and he was on tour. And everything was wrong. He hated everything. He hated the venues. He hated – the airplanes were no good. The sound systems were no good. Everything was no good. And he said to me, you know, I’m going to fire you; everything is wrong here. I said, yeah, I know, I know.”

I sat down with him; I said, John, everything is going to be fine. He said, why? Why? I said, because I fired Ferguson. He said, why did you fire Ferguson? Why? What is firing him – going to do? I said, he’s been responsible for all the things that you’re troubled by: the hotels, the sound system, the venues, yada, yada, yada. And he said, Is it going to be OK now? I said, Yes, I’m putting other people in. Great.

And that evening, Denver and I went out to have something to eat. At dinner, I said to him, John, you know, I feel really terrible about firing Ferguson. He asked, why? I said, because it’s not like you and it’s not like me. Besides, it is almost Christmas, and Ferguson has a family.  And John Denver said to me, I agree with you; it’s not like us. What can we do to help the guy? It’s really not like me. I’ve got to help him. I said, I’ll put him in another area in the company. He’ll be fine. We’ll take good care of him. He said, that’s great, I feel so much better.

Of course, there never was a Ferguson.” Where does Ferguson work in your hospital?

It might be an interesting exercise to discover just how much patient experience data your organization has purchased since when it began purchasing data.  I bet there is a lot of it.  It might even be a more interesting exercise to discover what improvements in patient experience, if any, can be tied directly to the aforementioned purchases.

Have you ever wondered where your hospital keeps all of that data?  I envision all of the purchased data being locked away and stored in hundreds of shoe boxes, healthcare’s version of Al Gore’s lockbox.  If that is the case, maybe the data can be streamed and sold to Al Jazeera—the more liberal readers are throwing tomatoes at their screens.

Hospitals have reams of data, and there are plenty of firms trying to sell them even more; customer experience data, business analytics, EHR reports.  What does a hospital do with all of that data?  Does it have more data than it can put to good use?  Of course it does.

Here is a little something for all of the folks in the hospital’s business development and sales and marketing, a little something that all of that purchased data does not tell anyone.  The average spend for an inpatient procedure for one hospital across the sixty procedures they listed was around fifty thousand dollars. 

It is estimated that a person is admitted to the hospital once every seventeen years and goes to the ER once every three years.

The average cost for an ER visit is around twelve hundred dollars.  So, net net, the value of an average patient, when viewed as a potential asset of the hospital that needs to be managed is around $225,000 over their lifetime.  For a family of five that comes to one and a quarter million dollars—roughly the equivalent of treating a sprained ankle in Beverly Hills, or treating Michael Douglas for “throat cancer”.

So here is the question nobody seems to have answered and few are trying to answer.  Why not spend the hospital’s scarce resources trying to keep that patient as your patient for as long as they both shall live?  (Please pardon the wedding metaphor.)  Even car dealers have figured this out, they want you to buy all of your future cars from them.

If a hospital starts losing a laptop a day, they will soon figure out how to stop losing laptops.  Twenty-five hundred dollars versus two hundred and fifty thousand dollars.  A hundred-fold difference.

Imagine with me that you just underwent one of the above mentioned sixty procedures.  Statistics show that in the next seventeen years you will undergo another one and have six trips to the ER.  As will every member of your family and your extended family and your friends—tuck away these two words for later; retention and referrals.

The hospital wheels you to the front door; you clutch your bouquet of roses and wave at the people who helped you.  The hospital does not know, will not know, and has no way of knowing whether your wave meant until next time, or goodbye.  The scenario resembles a first date in high school where one person says, “I’ll call you” and the other person has no idea whether they will ever hear from that person again.

Two hundred and fifty thousand dollars may have just waved goodbye.  Plus the two hundred thousand from every member of your family, plus your extended family, plus everyone you did not refer.  That amounts to a lot of plusing. 

What if every hospital, your hospital, took its business development and marketing strategy and divided it by its inverse?  The current strategy, the one for which the hospital pays hundreds of thousands of dollars a years for a Chief Marketing Officer has nothing to do with retaining you as a patient.  (Let me share an unspoken secret, a secret everyone knows—existing patient experience management strategies exist for one reason, scoring high on the HCAHPS surveys.) 

Press Ganey, Studer, the Disney Institute, et al.  Your hospital’s 1980’s growth strategy; an NPR radio public interest spot about the hospital’s ability to treat beriberi, the billboard showing the hospital’s beriberi specialists, and a shotgun telemarketing campaign trying to find people inflicted with beriberi.  Don’t know what to do, buy more data, and hire a coach.

What is the return on investment of this approach?  A million people hear the ad, ten thousand people a day see the billboard, and the hospital pays thirty dollars a call to solicit beriberi patients.  How many drive-byes result in a new patient, how many telemarketing calls? 

Whether one call in a hundred or one call in a thousand results in a new patient, it does not matter, it is not a good business decision.  Three thousand plus dollars, or thirty thousand plus dollars to get someone to walk through your door.  Are your margins so good that your hospital’s current approach is cost-effective? 

Even if you acquire this patient, will the person return?  Who knows?  Who should know?  Your hospital should know. It should be focusing its resources on knowing and ensuring two things; retention and referrals.