Social media seems to be the modern equivalent of the stocks. The main objective of the stocks was public humiliation. Nowadays, any member of the public can use social media to highlight grievances they might have against companies, organisations, and institutions and post them for all to see and comment on.
Our current political masters are very keen to persuade clinicians to consider patients as customers rather than passive recipients of care. If this is the case then customers need “great” customer service. Until fairly recently, the process of registering a complaint against a utility or other large private sector company had become a health hazard in terms of potential for a rise in systolic blood pressure. Despite companies employing people in their customer service departments it proved almost impossible to speak to one directly. The technology used for customer service was especially frustrating with the perpetual need to choose “option 2 followed by the pound sign,” and the ubiquitous but bland and unhelpful email response that “we value your custom,” and “thank you for bringing this to our attention,” without any hint of apology or a possibility of change. In later years this has been followed by the outsourcing of customer care to call centers in other countries, which are manned by incredibly polite and patient individuals adept at reading pre-prepared answers to FAQ’s. On a positive side these types of approach to customer care remained more-or-less hidden from public view.
This has all changed with the exponential growth in social media. In a recent article in the Harvard Business Review, Michael Schrage highlighted the new form of public humiliation available through social media sites such as twitter. A tweeted complaint moves much faster to the top of the customer service totem poll leaving any carefully penned (and polite) letter gathering dust. Schrage argues that this encourages bad behaviour; he (or she) who speaks loudest, especially in public on a social media site, gains the most – so called “power complainers.” The problem for those in receipt of a tweeted complaint is the potential for the response to develop a viral life of its own with the actual cause of the complaint being of secondary consequence.
The UK healthcare system actually seems rather good at handling complaints. The NHS complaints procedure is a statutorily based system and all NHS organisations are required to operate the procedure. In 2010-2011 almost 150,000 complaints were received. The NHS constitution states that everyone should have any complaint dealt with efficiently with a “proper” investigation and that the outcomes from the complaint should be provided. If this is not to the complainants liking then further investigation can take place at the level of the Health Service Ombudsman or even the Judiciary. Each NHS hospital is also obliged to make details of the number of complaints available and this is an indirect measure of a hospital’s performance. Somehow it is difficult to imagine BT or British Gas adopting a similar approach!
The great unknown will be what happens when patients-customers start to use social media to complain? How many NHS hospital “patient advice and liaison services” are able to pick up an adverse tweet or a grumbling Facebook comment? The Guardian newspaper reckons there are around 134 NHS organisations on Twitter–which means that there are very many who still do not have a social media presence. These are vulnerable to complaints going viral before they realise this! Perhaps another reason for the NHS to “get social?”
David Kerr wears many hats, sometimes at the same time – Diabetologist, editor of Diabetes Digest, researcher, and founder of VoyageMD.com, a free service for travellers with diabetes. He has received consultancy fees and honoraria for participating in advisory boards for Medtronic, Roche, Lifescan, and Abbott Diabetes Care. He also holds a small amount of stock in CellNovo (a new insulin pump company) and Axon Telehealth.