The Three Aspects of Quality

The one question I always get while talking to people about First Opinion is, "How is the quality?" On the surface, quality seems like such an easy thing to measure since most people (myself included) usually only view quality in terms of results: I have a problem, I seek a solution, that solution solved my problem, so it was a quality solution.

But in actuality, a quality experience can be much more nuanced and can change depending on the circumstances of the person and their expectations with regards to not only results, but also speed and empathy. I think this anecdote from The Innovator’s Prescription demonstrates quite nicely how fluid the definition of a quality experience can be:

We'll illustrate how the definition of quality health care can change by recounting the experience of a friend, whom we'll call Helen, whose youngest daughter woke up on a recent winter morning with an earache. Having seen the symptoms dozens of times before, Helen called their pediatrician. "Katie has an ear ache," she said. "I bought an otoscope a few years ago because this happens so often with our children—and Katie's eardrum is bright pink. Is there any way you could just call in a prescription for ampicillin to our pharmacy?"

"No, I can't do that," the pediatrician replied. "I really need to see her."
"Can I bring her in this morning?" Helen asked. "She's in a lot of pain, and I have a busy day at work."

"Unfortunately I'm booked all day—but if you bring her in at about two o'clock, I'll see if I can work her in," was the reply.

Helen arrived with Katie at the pediatrician's office at 2:00 P.M., and waited for two hours before the doctor had time to see her. Then in 30 seconds, with one look in her ear, the doctor diagnosed, "She has an ear infection."

"That's what I told you this morning!" Helen grumbled in frustration. "We need to get home because the older kids are home from school. Can you please give us the prescription?"

The pediatrician then wrote out the prescription. After a 10-minute drive to the pharmacy and another 20-minute wait, Helen and Katie drove home with the medicine they needed. The process, which is played out tens of thousands of times every day in America, cost Helen four valuable hours.

Was that a quality experience? Helen got her desired result, but the lack of speed and empathy resulted in an overall poor quality experience. In fact, I think there are even times when speed and empathy might actually be more important than just results alone, especially in situations where the desired result might not be completely obvious.

I want you to close your eyes and imagine being awakened abruptly, in the middle of the night, by the crying screams of your three year old daughter. You rush into her room to find your daughter, and her bed, covered in throw-up. You jerk off the covers and strip off her soaked clothes. As your wife works to calm her down, you start to clean up the mess. Then, ten minutes later, your daughter throws up again.

Your wife pulls out her phone and sends a message to her doctor (using First Opinion of course) to see if her doctor has any thoughts on what could be wrong. Within 15 minutes, your wife and her doctor are messaging back and forth--in the middle of the night. In this situation, there was no real result to be had with that conversation with her doctor, but this was a quality experience nonetheless, not because the problem was solved, but because the response was quick. The experience wouldn’t have been nearly as high quality if that conversation had happened just one hour later.

Now I want you to close your eyes again and imagine you’re a new parent, you’ve only had your baby home from the hospital for a few days, and she’s having trouble sleeping, you’ve tried everything you could think of to help her sleep, you’re tired, and you’re baby still isn’t sleeping. Your wife convinces you to take her and the baby to the Pediatrician, so she can talk to him.

At the office, the doctor pokes and prods your daughter with his finger for a bit, takes some measurements, and tells you she’s healthy and asks if you have any questions. After you run through your list of what you’re doing to get her to sleep, he sits down for a minute and talks about how frustrating it is when babies aren’t sleeping, and how he’s been through it himself with his kids. He assures you it’s normal and that he thinks you’re doing a great job and that he’s sure she’ll start sleeping soon.

Once again, there was no direct result to be had from that doctor visit, but this was still a quality experience because the doctor was there for you, to tell you he thought you were doing a good job, to empathize with you.

I, of course, don’t need to imagine the above scenarios because they both happened to my wife, our daughter, and me. And so I know they were both positive experiences and high quality interactions with our doctors. These are the exact type of experiences I hope you have with your First Opinion doctor, so, if we ever meet in person, I can ask you, “How is the quality?” and you can share a similar story to me.