PE: Internal Service

Internal Service

How does service drive differentiation?

  • Significant service differentiation only occurs when an individual organization ruptures a widely held industry stereotype
  • Both positive and negative stereotypes of an organization or industry often influence the expectations of customers.

Stereotypes = pre-conceived notions a customer may have when they do business with you

The key to exceeding expectations is to deliver positive surprises relative to the stereotypes of your industry.  Consistent delivery of exceptional service will help rupture stereotypes and drive clear service differentiation.

Here is an example using Disney:

  • Positive stereotypes:  fun, clean, safe, themed, friendly staff
  • Negative stereotypes: long lines for attractions, crowded, tough to navigate, expensive

Before Walt Disney most theme parks were perceived as dirty, unsafe, tacky, and temporary.  Parents and kids were disengaged from the experience. Walt Disney totally redefined the amusement park experience creating theme parks that are clean, safe, landscaped, and welcoming – all with an impeccable attention to detail.  All theme park goers were not called simply customers but cherished guests.

Here’s another example using the local hospitals in your area. Most of them are probably known for long waits with unpleasant doctors who don’t make eye contact and rush through exams. If your lucky there may be another hospital within driving distance that has a reputation for a nicer ambiance in their waiting room (music, refreshments, cleanliness), less wait time, and friendly doctors and staff that are thorough and make sure all of your questions are answered.

We are all in the service industry and depending on how you run your cash-based practice we are also in the industries of healthcare, physical therapy, wellness, and/or sport performance. For the purpose of this next example, let’s say we are in the physical therapy industry.

What are the good and bad stereotypes in healthcare?

  • Positive Stereotypes: Helping people,
  • Negative Stereotypes: Long waiting times, health insurance, too expensive, & poor customer service

Here is where it gets interesting.

What are the commonly held good and bad stereotypes for the physical therapy industry?

  • Positive Stereotypes: Nice people, exercise personal trainers, post op rehab
  • Negative Stereotypes:
    • Glorified personal trainers or massage therapists
    • Need a physician script in order to be seen
    • I’ll just get put on machines
    • Double and triple booked with others
    • Did not help me with my pain
    • Seen by assistants and technicians
    • Cookie-cutter factory approach

Yes, we have a damaged brand with a lot of catching up to do, but this is where your business can thrive and have a massive advantage over your competitors!  Stereotypes will eventually change over time, so eventually the rest of your industry will catch on and try to match your level of service.  I believe in a cash based practice we can still overcome any negative stereotypes that standard healthcare and standard PT clinics possess.

So how are you going to overcome these physical therapy stereotypes and set yourself apart from the competition in your area?

Stereotypes eventually recalibrate or reset, creating a new standard of care. In order to be successful organizations must continually adapt to the new stereotypes in order to stand apart.

How can you create a remarkable service design and recalibrate your business quality standards?

Focus on these 3 factors when designing your service:

  1. Your Purpose
  2. Understanding the Customer
  3. The Business Economics


Establishing a common purpose is essential, because it’s the foundation on which all other service decisions are made. Purpose drives everything your organization does, leading you down the path to higher performance and exceptional service delivery.


  • Disney’s Purpose- We create happiness by providing the finest in entertainment for people of all ages, from all around the world!
  • Pursuit Physical Therapy – To serve the people of Orlando and to help the community receive the best, high-quality patient care available.  To Serve  To Help  To Care

Employees need a reason to come to work and a common purpose provides meaning to the work.  The work, and the meaning associated to that work must be internalized in order for an organization to truly thrive.

Understanding the customer

You cannot have exceptional customer service without knowing and profoundly understanding your customer.  Most organizations limit themselves to doing the obvious things that they know their customers care about, such as how long they wait in line, or how many rings will occur before someone answers the phone.  Organizations need to move beyond the obvious service criteria.

What do your customers need and want? (You can even get feedback directly from your customers if needed!)

Needs – not human needs but situational needs.  Consider what your customer needs from you?


  • Customers at Disney need a great vacation and a getaway.
  • Customers at a life insurance agency need an insurance policy.
  • Customers at a grocery store need food.
  • Customers at a bank need an account, loan, or withdraw.

Patients at Pursuit Physical Therapy need:

  • resolution to their pain problem
  • a proven treatment approach to get results
  • to get pain free again
  • cost effective treatment

Wants – while needs meet a pre-determined service or product need, wants can be defined in terms of desired outcome or what the customer hopes to gain from the experience


  • A guest at Disney may need a vacation but they want magical memories that last a lifetime.
  • At a life insurance agency the customer wants peace of mind.
  • At a grocery store people want a wide selection, fair pricing, and shopping convenience.
  • At the bank, people want security and a return on their investment.

At Pursuit Physical Therapy,

  • they want to live life pain free again.
  • they want to return to __________ (favorite activity).
  • They want to enjoy family time.
  • They want to compete in __________ (event).
  • They want to live an active and healthy life.
  • They want to get pain free for the cheapest amount in the fewest visits

Clearly identify want your patients need and want!

Highlight Emotions!– We have discussed the importance of connecting with your customers on an emotional level, not just a rational level, in order to drive differentiation from your competitors.  You must recognize and be sensitive to the different emotional levels of your customers.  You must see the people not just the issues.  A customer’s emotions become heightened when a service failure has occurred.

Create VIP Patients!  VIP = very individual person – when customers feel like an individual, they are more likely to perceive their experience as unique and special only to them.

Each customer has his or her own individual needs and wants.  So, use the above guidelines to help your employees assess the needs, wants, stereotypes, and emotions of the person in front of them at any given moment, and personalize their interaction accordingly to help understand the customer.

Business and Economic Assets

Customer service cost must be viewed in light of an unshakeable belief in service as an economic asset, even when the returns on these costs are not immediately measurable.

Organizations should try to take in account the overall value of a service investment, not just the immediate expense.  You may not be able to measure the return on those costs immediately but over time your organization will recognize the value of the initial service investment.

How are you going to design your service?

This is different from designing your business like we discussed in my Business 101 course. Looking at your organization through the eyes of your patients in an effective way to start developing standards for your organization.

What would be a list of words or phrases you think your customer would use to describe an ideal service experience with your organization?   What words would you use to describe your patient experience?  Do they match your patient’s words?

Better yet, lets not guess, send an email survey to your past patients asking them these questions to help ensure you and your patients are on the same page!

Here is the list of words and phrases I would use to describe the patient experience at my practice:

High Quality

Educational or informative


Thorough and detailed


Solving Root Cause

Friendly, trustworthy, and caring

Wow factor



Cost effective

Cheaper than standard healthcare

Efficient and convenient


Worth the cost

Once you have your list keep 4-6 words that hold the most meaning for you.  Next consider how you would define each of these standards from a behavioral and emotional standpoint, and then write some notes about your behavioral definition of each standard.

Here are mine, prioritized in order:

  1. Informative – every patient will be educated and well informed about their diagnosis, prognosis, risk factors, root causes, how much it will cost, and expected timeline for recovery. Every patient will be given an opportunity to ask questions and fully understand their pain and injury.
  2. Trustworthy – My patients are not viewed through a patient versus clinician lens. We will work along side of them on their journey to heal. Every Pursuit patient will be considered a friend after treatment ends; a personal and meaningful relationship will be fostered and attained.
  3. Appreciation – Every patient will be treated as a person not as a diagnosis or dollar sign. Only high quality One-on-One patient care will be received, which means they will never be booked with another patient, and each session is an hour. Every patient will experience a personalized treatment approach, tailored to each individual to optimize his or her level of care.
  4. Convenience – There will no waiting periods to be seen and evaluations are usually booked within a week. No long waiting periods at scheduled appointments either, because we do not run late. If your appointment is at 3pm, it starts at 3pm. No more wasted hours in a waiting room, only to have additional waiting time in the treatment room. Every patient will have direct communication with the Concierge Specialist and treating Physical Therapist for quick and easy communication.

It’s important to prioritize your quality standards, and then clearly communicate them to everyone in your organization. This can easily be done at a staff meeting, or you can create a fun way to do it by engaging your staff in coming up with your quality standards as a team. Regardless of how you choose to accomplish this, it’s imperative that you and your staff are on the same page.

So, how do we make sure you and your staff are delivering exceptional service?  This next concept is called the Service Intersection.

Your quality standards are now in place and you are ready to take action.  There is a natural tendency to believe that service delivery emanates from people alone, but in fact, exceptional service derives from the intersection of Process, Place, and People.

Process – A series of related structured activities or tasks put in place to enable the delivery of seamless and issue free customer experience.  The process must support the common purpose.  You cannot have good processes if all operations, policies, and systems do not support the common goal.  This goes back to your organizational chart, chain of command, policies, and procedures we outlined in the Business 101 course.

Place – Where your customers meet you.

People – The employees in your organization.


The key to integrating the competitive interests of different parts of the organization is making sure they operate in support of the common purpose.  It’s actually easier than it sounds.  When I first expanded my business and started hiring staff, I was not organized, which created a lack of direction, role clarity, and chaos ensued.

Here are 2 ways to organize your processes so this doesn’t happen to you:

  1. Clarify your company’s purpose and ensure senior leadership continually reinforces it to everyone in the organization. This means that you, the CEO, need to give your staff specific job descriptions, roles, and responsibilities that all support the common purpose.
  2. Balance the use of metrics to support the larger argument of doing the right thing to drive the desired behavior. Every job position has to have a statistic to measure their outcomes.  The staff needs to be able to see how their stats affect the numbers in order to attain the company goal.


Now lets discuss Place – the location where your customers or patients meet with you.  Place is a very significant yet often underestimated contributor to the customer experience.  The importance of managing the effect of place on the customer experience can be summed up in two words = everything speaks.

To increase patient satisfaction, you must understand 2 critical statements that every organization that is seeking to revolutionize their customer satisfaction must grasp:

  • Customer satisfaction is based on our customers’ perceptions and expectations, not our self centered view of what the customer may want. What does your patient walking in the door expect during their first visit? What do they perceive during the evaluation? What do they expect from standard care compared to yours?
  • The level of customer satisfaction will change as customers expectations change. As a patient goes through your business approach and their expectations increase, do disappointments arise or do you continue to raise the bar and exceed expectations on an ongoing basis?

Aspect 1:  Everything sends either a positive or negative signal. Look at what touch point signals you are sending when a patient walks into your place of business for the first time?  Choose one of the touchpoints currently from your patient experience and determine what signals this touchpoint could send or is sending to your patients.  Is it positive or is it negative?

Aspect 2: Careful management of place can be instrumental in separating patients from features of your business to which they should not be exposed too (open trash cans, messy floors, a disorganized office, dirty kitchen area or bathroom).

Aspect 3: Place can be used to strategically drive customer behavior, which improves the customer experience. What is their waiting room experience like in your facility? Does it offer comfortable seating with aesthetically pleasing things to look at, read, and listen to? Do you offer any refreshments like water, coffee, tea, or mints?  At Pursuit, our patients walk by our “Wall Of Testimonials” on their way to the evaluation and treatment rooms.  This is something we are very proud of, and we think it helps reassure new patients that they are in the right place because of all the success and healing that other people before them have experienced with us.

Aspect 4:  It is much easier for employees to deliver great services in a place that naturally encourages them.  It is difficult for people to rise above their setting if it is not supportive. For example, I make evaluations 90 minutes long in order to give the PTs ample time to conduct the evaluation, educate the patient, and finish their documentation. I also create motivation for my employees to receive bonuses if certain agreed upon numbers are hit. It’s a win-win for everyone.


Your organization needs great people to complete the service intersection.  You will not be able to deliver your exceptional experience without people who have a genuine desire and heart for customer service.  Employee service actions need to be experienced as genuine by the consumer; not just something they have to do for everyone.

Let’s fast forward and say you have now hired the right people who have a passion for exceptional service, and you have provided them with training that is infused with your service-oriented culture.  Your people are ready to deliver exceptional service provided you offer them the right tools.

In order to be successful your employees and patients must understand:

  • the common purpose
  • the quality standards and their order of importance
  • what quality service is and how you differentiate from your competition

The intersection of Process, Place, and People = Zone of Exceptional Service

Without a seamless process, your business will deteriorate and your people will improvise, which ultimately alters the standard.  Without paying extreme attention to the details of your setting, your processes will suffer, and your people and customers will sense something is off.  Without commitment from the people you have selected to hire, you cannot deliver great service.

Your company must have a firm understanding of each of these delivery systems in order to execute your quality standards and consistently deliver exceptional service.

You can use this patient experience course and touch point integration to help with this.  Observe your patient experience through the lens of process, place, and people in multiple touch points throughout your business.  You can integrate and change the purpose, place, and people using your outline of every touch point throughout each phase of your patient experience.  Do you need to change the person who is delivering it?  Do you need to re-focus the purpose?  Can you adjust the place to make it better for the patient?  You can continually fine-tune and tweak every touch point to make it truly exceptional and continually exceed your patients’ expectations.  We will focus on these concepts in each phase of this Patient Experience Course.


  1.  Identify the positive and negative stereotypes in physical therapy and how you can overcome and differientiate your business from your competition and common stereotype norms
  2. Clearly define your company purpose
  3. Clearly define what your patients NEED and WANT
  4. Define 4-6 quality standards that patients would describe your your services and experience
  5. Define your Zone of Exceptional Service.  Processes, Place, and People for the patient experience
    1.   Finalize all processes for each touch point in each phase of the patient experience
    2.   Finalize what the patient experiences and goes through when they arrive at your place
    3. Make sure all policies are reviewed and trained with the employee responsible
  6.  You can start putting everything together into Patient Experience Policy Manaul


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