I was sitting alone in my client’s office, observing some of the bric-a-brac she had collected during her career.  On one wall was a photograph of her and a former president.  The credenza above her desk contained white binders of what appeared to be various user manuals, each one filed chronologically from left to right.  One binder was labeled, The Purpose Of A Call Center—The Big Room With All The Phones In It.  To the right of it was one labeled, What To Do In The Event Of A Soviet Attack.

The photograph made me wonder how many people had their picture taken with a U.S. president.  Let’s say the president takes one hundred pictures a day. That amounts to around a hundred and fifty thousand photographs during a four-year term.

And here is what I think is noteworthy about having your picture taken with the president.  I am willing to bet that ninety-nine percent of the people who have their picture taken with the president display that picture prominently in their home or office.  They do so because they want to remember the experience, and because they want others to know of their experience.

Having your picture taken with the president is a big deal.  You remember everything about that experience; the date, what you were wearing, even what you ate for breakfast that day.

Now for the irony.  If you were to visit the Oval Office, or the president’s living quarters on the second floor of the White House, you would learn that he does not have the photo of the two of you displayed in a prominent position.  In fact, he does not have it displayed anywhere. Nor does he have any of the other one hundred and fifty thousand photos on display.  Pressed, he will not remember the date he was photographed with you, what he was wearing, or what he ate for breakfast that day. He would not even remember you if he sat next to you on the plane.

Here is the distinction.  He is the only president you met, so it is easy for you to remember the experience.  You however are merely one of a hundred and fifty thousand people he met, and chances are there was nothing special or memorable for him of your interaction.

And here is how the point relates to the business of healthcare.  The people who answer the phone at your health system’s call center—the big room with all of the phones in it—probably speak to a hundred different people each day, five hundred a week.  Twenty-six thousand people a year.  After a while, one call sounds like the next to the people answering the phones.  The calls all blur together.  The call center agent will not recall the date she spoke with one of your patients, or what she was wearing that day, or what she had for breakfast.  It is sort of like the president remembering the person in any single photograph.

Now, what if we reverse the roles and look at the call from the perspective of the caller—the patient or the consumer on the phone.  That caller, every caller, will remember every detail of that call.  They will remember how long they were placed on hold, how many times their call was transferred, and how many times they had to call your health system.  They will remember the date of their call, what they were wearing that day, and what they had for breakfast.

And if they had to call more than once, their ability to recall their experience will be reinforced.

People do not want to call your health system any more than they want to call Verizon.  They call because they have to.  They call because they have no real alternative to calling.  One in four callers, no matter how good their experience during the call, will think about changing providers just because they had to call.

The bad news is that nobody in your health system knows what kind of experience any single caller had.  They do not know because they do not ask.  More people, patients and consumers, interact with your health system by phone every day, than in any other way.  Most probably wish they did not need to call.  Most hope they will not have to call again.  And many won’t call again.

And if you are keeping score, that is a bad thing for you.