It is time we pull back the curtain and tell the truth about patient access and scheduling. The points of truth are:

• Almost all access happens by phone
• Most health systems do not have a “call center”. What they have is a room with a lot of phones and a lot of people whose job is to schedule appointments
• Less than thirty percent of inbound calls are about scheduling
• More than seventy percent of calls are transferred into a black hole where call resolution cannot be measured
• Of the scheduling calls, only about 59% are completed on the first call

Just so we are on the same page when it comes to measuring how bad is bad, the cable television industry only transfers around 11% of its calls. Scheduling a healthcare appointment takes about 60% longer than it takes to schedule a cable appointment. If scheduling a healthcare visit at your health system is more disappointing and less productive than scheduling an appointment with Comcast, if you have to up your game considerably just to be able to state “we are just as good as the cable company”, then alarm bells ought to be going off in somebody’s office.

After all, people do not need cable, but they do need healthcare. On average, an astonishing 30% of callers who do not have their needs met will not call back. They will not call back, but many of them will head straight to the ED. That’s an expensive cost to pay for not being able to manage a phone call.

Twelve percent of people who have to call more than once will change their provider—now there’s an easy way to understand one component of leakage. At an average lifetime value of a patient of between $180,000 to $250,000, a health system should calculate the loss of these assets in the millions of dollars. Again, that is an expensive cost for not being able to manage a phone call.

In most industries, the measure that has the greatest impact on customer satisfaction is first call resolution; were the caller’s needs met the first time they called? There is actually a one-to-one correlation—increase first call resolution by two points and customer satisfaction increases by two points. And did I mention that a part of the Affordable Care Act has to do with patient satisfaction?

So, if that news isn’t bad enough, permit me to raise the angst bar even higher.

People used to say things like I have to go to the doctor. That phrase is falling out of favor because people no longer have to go to the doctor. They can go somewhere else when they are not feeling well. Last year, my family went to the CVS Minute Clinic thirteen times. We went to the doctor three times, and we only did that because the nurse at the Minute Clinic recommended we see the doctor.

How many times did I have to call the Minute Clinic to schedule an appointment? How many times did I have to pull out my credit card, or call to get someone to explain the bill? How many times did I have to make an extra trip to get my prescription filled?

None. It is like hitting the Easy Button.

None of your patients wants to work hard to give you their business. None of them want to work hard to have their needs met. So why not design patient access and patient experience so people do not have to work hard?

CVS, and all of the other healthcare retailers, did one thing that your health system did not do, and it shows. They designed the access experience. Instead of saying how do we make scheduling an appointment easier and faster—a six-sigma approach—they eliminated scheduling.

And please note, from a patient’s perspective every health system has its own version of the Minute Clinic. It’s called ED.