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Power Hour Optometry
The ROI of Experience: How to Build Loyalty Through Memorable Patient Interactions
01:02:19
In this episode of Power Hour, renowned author and customer experience strategist, Dr. Joseph Michelli, joins Eugene Shatsman to explore how practices can craft emotional, memorable, and loyalty-driven experiences that set them apart. With a track...
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- [00:00]
Dr. Joseph Micelli
Foreign.
- [00:07]
Eugene Shotsman
Welcome to the Power Hour, Optometry's biggest and longest running show. I'm your host, Eugene Shotsman and today's episode is by request. See the last time we did an episode on patient experience, so many of you reached out to me and said I want to hear more on this topic, I want to find more insights, more guests, whatever you can do, Eugene, to get us more content. So I brought on Dr. Joseph Micelli. This is a gentleman who has written multiple book on experience and customer experience. And he is a New York Times selling best author of the Starbucks Experience, the new gold standard, driven to delight when fish fly. He's consulted with brands like Mercedes Benz, Zappos, Ritz Carlton, Starbucks, and of course the Pike Place fish market. And he did all kinds of things to help them elevate their culture, improve their service and improve their impact. And today we're going to bring a lot of that insight directly into your practice. So I'm going to give you some examples of what we talk about. For example, we talk about the idea that every business starts with a feeling and how getting your entire team aligned, the emotional outcome that you want your patients to walk away with, might be the single biggest competitive advantage that we may be not even looking at today. We also talk about cultural rituals like I was fascinated to learn about the 10 minute daily lineup that Ritz Carlton does and how they bake service excellence into the DNA of every single team member like coachability. We talk about WOW stories, we talk about hiring for values and even how like some companies repossess a car with empathy. Joseph also introduces me to the concept of the way that we serve or the way we serve statements and how defining these types of statements across your patient journey can actually make every interaction, every handoff, every conversation, every touch point more consistent and more memorable for patients. We then talk about how you can take a look at your practices, defining moments across your entire patient journey and and then with the smallest tweaks possible, you can create stories that your patients actually will want to share. I think you're really going to enjoy this episode. I think if you're tired of good enough culture and want your team to truly just desire to deliver a better experience, this is definitely an episode you're probably going to want to play at 1x before we jump in. Quick reminder, make sure that you're subscribed on YouTube, Spotify and Apple podcasts or wherever you get your shows. And if you have questions, want to suggest an episode, or just want to connect, head to Eugene Shotsman.com or visit the Power Hour website. And now let's go to the show. Welcome to the Power Hour. With me is Joseph Melli. I am just so excited to have you on the show. You are a powerhouse of knowledge. And I mean, the number of books you've written and the. And the A brands that you've worked with are just such an impressive opportunity for our listeners to learn from you. Joseph, welcome to the show.
- [03:00]
Dr. Joseph Micelli
I'll grant you that I've been blessed with great companies to work for. I'm not sure if I'm a powerhouse of knowledge. I guess we'll determine if that's true or not here in the next minutes. Thanks, Eugene. Pleasure to be here.
- [03:09]
Eugene Shotsman
It's exciting to have you jump in and maybe like even just start from a place of helping the audience get to know you a little bit so they understand the context with and they can really understand where we're coming from. When we start talking about practical things we can do in your practice, help people understand your background, your experience, and really how all this started for you.
- [03:36]
Dr. Joseph Micelli
Well, my mom and dad used to say, you're not put on this earth to be served. You're put on this earth to serve people. So I think that was kind of the substrate by which everything else landed right. I went to University of Southern California, got a PhD in clinical and organizational psychology. Came out, did the clinical psychology practice, had my own private practice. So I ran my own independent business in the healthcare space. And in addition to that, I worked for a hospital system as an organizational development specialist. And it was in the context of that experience that I really got into what it meant to deliver great patient experiences at scale. Prior to that, I'd done consulting in graduate school for companies like the Pike Place Fish Market. Long story short, I kind of took the blend of the experiences in health care with things that I had learned before and started applying it in. The success of the Pike Place Fish Market then led me into lots of other places over.
- [04:30]
Eugene Shotsman
Well, and maybe zoom in a little bit, Joseph, on this whole Pike Place Fish Market because I think it's such a cool origin story that I know a little bit about, but just like, give people the real feel of what, what it was like to be there and consult them and why and how they built their success was a lot.
- [04:47]
Dr. Joseph Micelli
Different than the way it looks today. If you were to go to Seattle, there's like energy and vibrance and it's a wonderful thing. When I first got called in in graduate school, the owner of the market, Johnny Yokoyama, was floundering, quite literally and figuratively. They were fourth in the market out of four fish markets within the geographic area. It's a 1400 square foot retail space, so it's tiny, but they were getting their heads just kicked in. And largely because he had the same fish as everybody else and he had a worse experience. They were very underwhelming when he came up to the fish market, and over time, he tried to remedy that by getting a supply chain advantage. So he started buying fish wholesale from the fishing boats in Elliot Bay and giving them to himself first and giving the lesser fish to other people in terms of the. The supply chain. But that didn't work for him. He didn't have any retail knowledge, he didn't have any wholesale knowledge. So he was in deep trouble and underwater, literally in terms of his financial position. So it was under those circumstances that he reached out for help. And since he had no money, the graduate student got it, not a professor, and quite literally just went up there and we started to look at what can we do to make this a more enjoyable place for people to come and buy fish? Because fish, dead fish sitting on a. On a, you know, ice show is not something that most people get all that excited about. So if you're selling a fish morgue, you got to put some life to it. And we literally looked at how we could do that. And in the simplest terms, we thought about what do we want everyone to feel when they interact with the fishmongers. That was our starting place. And I think it's a good business tip, no matter what you're doing, certainly optometry. What do you want? Every single person who steps into your building or who has contact with you on your website or who calls you on the phone, what do you want them to feel as a result of that interaction? Interaction, you know, we know what we want them to have happen. Right? We can do a checklist operationally of all the things that we want to make sure we got the right information, the right billing information. We perform the exam this way. But what do we want them to feel as a result of their time with us? And that's what we focused on at the Pipe Place Market. We got that dialed in to. We wanted them to feel as if they were world famous. And once we treated everyone who came near us like they were world famous, like they were celebrities, that it was really amazing how much people told other people about their celebrity experience. At the Pike Place Fish Market, where they caught a fish or they threw a fish and the Next thing we knew, it really had become a viral sensation. Not through social media.
- [07:22]
Eugene Shotsman
Talk a little bit more about that. So what did you guys, when you say you want people to feel as if they're world famous, tangibly, what did you do? Operation.
- [07:34]
Dr. Joseph Micelli
So first and foremost we communicated a three part strategy that says we are going to, we're going to be it, we're going to coach it and we're going to be willing to be coached about it. So the first and foremost thing we said was that we want to create a world famous experience where everyone feels who comes up here as if they're world famous. So if you were to come up to this push stand right now, Eugene, I as an employee would be trying to make treat you as if you were a cause celeb. Name your favorite celebrity and we're going to try to treat you like that. We're going to give you that focus and that attention that famous people get that the ordinary folk like me don't normally get in interaction and whatever that means, we're going to focus our attention. If you say, boy, I'd really love to catch one of those fish, we'd say yes, and we'll do that. And we have one fish that we throw all day long, to be quite honest with you. And if we drop it, we give it to charity. So it's a, it's, it's fish and loaves, if you will, into the community. But so literally we teach our people that our job is to be world famous. Pike place fish is a very eastern concept that they use. Not just do it, but to be it be in the fullness of celebrating your, your celebrity and whatever that means. We just need to be present with it. And so we do that. And then if I, if I were trying to do that with you and a coworker saw that I wasn't, they might come up to me and say, can I coach you now? You know, I'm just wondering if you might have thought to do this with Eugene or that with Eugene. And lo and behold, it really created a culture of coachability and a primary driving focus. And we didn't tell them how. We didn't say, okay, this is what be, you know, what it means to help Eugene feel like he's world famous. I think most of us know in a real clear sense of when it is we're treating somebody like they're a celebrity and when we're treating them like their trash. And so we're just trying to help people get in touch with that capacity we have to elevate an experience for someone or take them into a lower level. And we just stay very vigilant to each other, coach it, celebrate it. And it was really transformational. I mean, they went from bankruptcy quite literally to being the number one seller of fish in the area, with the other three fish companies cumulatively not selling as many fish as Johnny's fish stand did. And then Johnny went on to sell his fish stand to his team, even though he could have made more money when he exited the business. So I think it's a very. It's just a wonderful, heartwarming story of a small business that has attracted national and international attention. Because as a result of that, some guy came down to the fish market who was wanting to do a. He was there to do a video series for a poet on Whidbey island. And he had such an amazing experience. Somebody treated him so much like he was a celebrity that he said, I want to do a video about you guys. And that video was part of the Ken Blanchard family of videos. It was a number one training video at the time. And then it spawned the first fish book, which then spawned five sequel books, because if you sell a million at anything in America, you got to have a sequel. And Johnny and I wrote the authentic story Windfish Fly about how that fish market literally transformed from nothing to world famous in its own right.
- [10:42]
Eugene Shotsman
And one of the key parts of it is that you guys, I mean, before this, like, the whole fish throwing thing, like, it talked to me like, I know nothing about this, but, like, the whole fish throwing thing is. Is not something that happened before, right? Like, this is something you guys invented to basically make people feel more special.
- [10:59]
Dr. Joseph Micelli
Yeah, I think it was because somebody said, I would like to throw a fish, and you go, wow, that's really strange. Like, in a normal world you would say that. But if it's a celebrity, if it's, you know, some, you know, if Elton John were there and said he wants to throw a fish, people would let him throw the fish, right? And so we did. We said yes to the experience, and that became really powerful. And people celebrated it with a. Almost Greek chorus echo. And we then started Greek chorus echoing. Right. Like, these things were all a byproduct of organically being present with the person in front of you and saying yes to an experience, which then created a lot of virality because people were using their cameras to take pictures of their family members catch and throw fish and the energy of the fishmongers. And yeah, it made it a destination in Seattle. So we had no super. No super. We had no great plan. We just trusted that if we knew what we wanted people to feel and we tried to execute against it, good things would come. And that's very different. Say the Ritz Carlton. They're not throwing fish at a Ritz Carlton. Right. I mean, it's about nurturance, because the emotion we want people to feel is very different than what the Pike Place Fish Market wants people to feel.
- [12:13]
Eugene Shotsman
Yeah. And I think the. I mean, as you're. As you're talking about this, it's immediately clear to me that it's okay to go into this without a plan with the only key part of the plan or with the only key part being just understanding what it is that you want people to feel and then getting everybody united around that.
- [12:33]
Dr. Joseph Micelli
Yeah. And once you have that, sometimes it's not even just a people thing. It can be your process design, like your overall experience design. The aesthetic elements should be related to what you want people to feel. If it's a joyful, energetic thing, your building should have joy and energy. If it's soft and warm and nurturing, it's going to be kind of more cozy in its feel. I had a dentist office I consulted for where they were. Their one focus was, we want to have people feel really at home and very nurtured here to kind of take away any of the sterile anxiety of dentistry. And so they had just purchased an old home in Colorado Springs, and we just redesigned the entire physical space so people literally came in through the kitchen. And we didn't remodel the kitchen. We kept the kitchen. And we baked cookies in the kitchen. And people came through there before they sat in the waiting room and they went to the. You know, to the dental procedure area. And my point isn't, you know, it's all about people. It's about the way you want people to feel when they come in. And then all elements, the aesthetic, the human, the processes, they should all really be trying to drive that emotional state. Because why people come back is not what happens in the frontal lobes. It's what happens in the limbic system. Right. So if we can create an emotional, resonant experience, it is positively memorable for people. If it's just satisfying in the frontal lobes, you know, you're a coupon away from competitor. Taking your patient from. Yeah.
- [14:03]
Eugene Shotsman
And I want to dig into this a little bit because I think I'm curious and pick Ritz Carlton, pick Starbucks. But talk a little bit about how they did this and what their transformations were like and what tools they used to try to make sure that everybody was unified around making people feel a certain way.
- [14:20]
Dr. Joseph Micelli
Perfect. So let's talk about Ritz Carlton. Now, Ritz Carlton has two episodes in history. It's the old Cesar Ritz episode and then there's the modern day Ritz Carlton hotel company. And Cesar Ritz was an old world hotelier who said the customer is always right. I mean, he's the guy who's quoted saying that. But the hotel chain that we know today was founded by a guy by the name of Horst Schultze. And Horst is a mentor of mine and I love the man immensely. But Horst, when he was going to hotel school in in Germany years and years ago at age 13, left his village to go to a high end hotel. It means the artisan trade, right? He literally went to a hotel and started from the bottom, lived there at the hotel, went to hotel school to get an educational background along with his his training in the artistry of being a hotelier. And literally when he was asked for English assignment or a writing assignment about, you know, what, who did he aspire to be? He talked about this mater d and he titled the paper we are ladies and gentlemen serving ladies and gentlemen. And the premise of this was that he saw this service professional be the person that all these elegant ladies and gentlemen in the dining hall wanted to come to their table. And he realized this maitre d had come from abject poverty, much like he had, but had refined the art of service and could speak multiple language and had spot polished shoes. And so ultimately he wrote this paper about we elevate our social status by serving. Well, that was kind of like the premise. So over the course of time, when he now is in a position, having come from the Hyatt to start this new hotel chain, leveraging the Ritz Carlton brand, Cesar Ritz's brand, he focused on how do we communicate that to everyone? We need to elevate our service standards. And in the process of doing so, we become elevated in the interaction. So he literally crafted it. It's the motto of the Ritz Carlton hotel company. That along with a variety of other core gold standards of what they wanted people to have, he created and put it on a what's called a credo card. And I'm holding one up for you right now. The credo card is literally a part of the uniform of every lady or gentleman. That's what we refer to the the team at the Ritz Carlton. It is a part of their uniform. I was in the Naples Ritz Carlton yesterday and I asked for their credo card and they have to give it to you. So if you visit a Ritz Carlton and you ask for the credo card, they will have to give it to you so you'll have the actual tool that they use. This credo card is used every day. It's referred to, it's part of the uniform. So as soon as I asked for it and they gave it to me, that lady or gentleman had to go to HR and get another one because their uniform was incomplete upon handing it to me. The point is, this card is the. This the hymnal that is sung every single day at a Ritz Carlton. And they're going to focus on one of the elements on one of the panels. It might very well be a service standard of the. Of the 12 service standards that are there, it might be the credo which I referenced or the motto, we are ladies and gentlemen, serving ladies and gentlemen. Every single day they're going to talk about some element that's on this card. And the point of that is that there is what service looks like. If you live those service values. If you aspire to be a lady or gentleman serving ladies and gentlemen, if you try to create the emotional outcome that is reflected in the credo. I can go for that if you want, but yeah, please, trying to create that emotion, then this. You're talking about it every single day. So the credo, I won't go into the full. It's just it says Ritz Carlson Place, where genuine care and comfort of our guests is our highest mission. I'll skip a paragraph, but it goes to basically say the Ritz Carlton experience enlivens the senses. So we're in a business of emotionally activating your senses. That means we better have a great Ritz Carlton smell. There's a certain scent that they are corporatized. And we should also have visually beautiful things that stimulate and insight your senses. It should instill well being. So this should really say, you're okay, you're safe here, you're at peace and at rest. And the final thing is we should fulfill even the unexpressed wishes and needs of our guests. So we should be looking at not just fulfillment in a transactional sense, but we should be looking at how do I anticipate needs to make you go, wow, how did they know that I wanted that? I didn't even know that I wanted that or way to think about my needs when I wasn't even saying it. So that's the magic of A wow experience. So suffice it to say, this is a practical tool. And they talk about it every day at lineup 10 minutes every day is going over something on this, including WOW stories that are a reflection of having executed against these services.
- [19:21]
Eugene Shotsman
And when you talk about what they go over, I actually, I think that's such an interesting point, is that this seems to be the most important thing in their business, right? Are they also in that same meeting, are they going over metrics? Are they going over whatever and how much time are they spending? And again, you know, if everybody's got this thing and it's mostly memorized or probably 100% memorized, what could they possibly be saying, Joseph, that. That. That's different yesterday than it is today.
- [19:49]
Dr. Joseph Micelli
So they have a just, I'm giving you behind the curtain look at this, right? So they have this, this commitment to excellence sheet that's sent to every hotel. It has wow stories that have been captured by corporate, that have been fed up to corporate, so that everybody's getting the same wow story once a week. Plus you have your local wow stories that every general manager has to be able to provide every week. So they're constantly trolling for these wow stories. So they start these meetings with that. They have inspirational quotes in there as well. So that's all part of the context, the day. But they'll ask, you know, I don't care how many times you said, what is, you know, Service value number 12, which relates to creating an environment of uncompromising cleanliness? Yes, we do. Who, those who have experienced it, haven't internalized. Right. But what does that mean to you? What does that mean to you, Eugene? To live that service value of, you know, creating an environment of uncompromising cleanliness and safety. And then I'm going to say, well, when I see something on the ground and I'm walking by, it means picking it up. Right? Like that's what it means to me. So every day we're kind of looking at ways to bring this, some piece of this alive. And it's constantly reinforcing it. You know, what gets valued gets done. Now to your question of our KPIs in there. Yeah. They'll insert that data in the middle of the meeting. It's not like they can't do that. But this is not a business meeting. You know, we may be able to say, you know, we had this many guests in today, we have many of this many guests coming in tomorrow. Here are a couple of our VIPs that we really need to pay Extra attention to all that's there. But the bulk of this meeting isn't about operations, it's about culture.
- [21:26]
Eugene Shotsman
So they drill this culture. And I imagine you're encouraged to bring your own wow stories. Whether you're a bellboy or a manager, you're encouraged to bring your own wow stories to this meeting. Is that how that works?
- [21:41]
Dr. Joseph Micelli
Yeah, and I may very well. And it's frequently assigned to different people. So maybe you're the leader, but I am the bell middle. And you're going to ask me to lead the meeting tomorrow, which really anxiety provoking, right. For somebody to do it with the. I've been in meetings where, you know, frontline staff were there, as was the president of the Ritz Carlton Hotel company. And it wasn't the president that was leading the meeting. The other thing that's interesting about how cultic this gets, and I think culture and cult are a fine line. I mean there's like a fine line of drilling something to that point, but you almost have to shoot for that level of reinforcement to have a strong culture. I've been to, I've been to events where ladies and gentlemen from all over the country are there not in their hotel, not in their own hotel community. And they still do lineup because it's so much part of like having coffee for breakfast. You know, they can't, they can't start their day with colleagues from multiple different hotels without assembling to do lineup.
- [22:39]
Eugene Shotsman
And how long is this meeting at every.
- [22:43]
Dr. Joseph Micelli
Yeah, it averages 10 to 20 minutes a day. And it's part of what they consider their daily training. And when they calculate how much training does every team member get that 20 minutes a day or 10 minutes a day is calculated in the overall amount of training received by each employee.
- [22:58]
Eugene Shotsman
Interesting. So I mean, we're getting to the point of, okay, so we know how to make, how we want to make people feel. I'm just summarizing some of the concepts you're talking about and then really creating some level of consistency with the way that every member of your team gets to view the steps essentially and review and analyze the steps that are going to get you to make people feeling that way as well.
- [23:26]
Dr. Joseph Micelli
And I think the big thing right now, if I were listening, would be, okay, why in the world would you spend this much time droning on and on about your service behaviors and talking about ladies and gentlemen, serving ladies and gentlemen, or instilling well being. I mean, this is ridiculous. I gotta run a practice, right? And I think, think that's a totally fair Consideration. Right. Because that's a lot of staff time to just be potentially navel gazing. Right. But here's, here's where I would at least make a business case for first. Ritz Carlton has continued to grow and excel. Between the Ritz Carlton and the Four Seasons, you really do have the luxury brand tier. Now there are ultra luxury hotels. These two are not the most elegant hotel you could ever go to. But in that luxury space they have continued command one and two. They continue to drive net promoter scores that are in the 90 plus range. Net promoter scores are predictive of repeat business. They're not predictive of referrals. So, you know, the net promoter score basically is how likely are you to recommend, you know, my practice to your family and friends? And if you get a 9 or 10, they're considered a promoter. If you get under 6, they're considered a detractor in the sevens and eights or passes, they're on the fence. And so if you have a lot of promoters, not many detractors, very few on the fence, you have a super high net promoter. You can literally have 100 net promoter score. It's not a percentage. So you'd have a net promoter score of 100 or you can have a minus 100 if everybody hates you. And no, you have no passes and no nines or tens. So when you're talking about 90% of people giving you a 9 or 10 and very few people passive or detracting, that's a pretty remarkable thing. It doesn't necessarily mean they're going to literally go out and recommend you. It does mean they're highly likely to return.
- [25:21]
Eugene Shotsman
Yeah, totally agree. Now, interestingly, you know, and I try to think about this, the big, I think oftentimes in practice, whether we have five people working in a practice or 50, I think consistency amongst employees is something that you get that's difficult to accomplish. You have people who have been here for 10 years and they're kind of the local champion of, you know, specific things. They're the subject matter expert in certain things. And then you have people who've been here for five days and you know, you've got, and they're just trying to soak up and learn. You mentioned. And it stuck with me, this whole concept of cult versus culture and culture as a, as a point of, as a point of success in order to make this happen. Give me a little bit more insight onto how larger companies make this happen and how they develop a consistent culture.
- [26:17]
Dr. Joseph Micelli
Well, first I'm talking hopefully about pro social Cult and not all the key elements of cult like, cult like you can't leave. But, but I do think the reinforcing qualities that make somebody cultic and in a culture are very similar. And what, what I mean by that is, is a constant repeating of our mission, our vision, our values and the behaviors that support the values and the behaviors that ultimately cascade up to the mission. I think unless you're saying that and also helping people see line of sight as to do they really want to be party to this mission? You know, is this mission that something excites them and is it aligned with their own personal mission, their own sense of what they want to have accomplished in their lifetime? Looking back on their career, the more you're able to help people see that, the better off. So to your point, how do they do it? Right. So I think you have to give time and space to it. You can't just put it on a wall and assume that people get it. I think it's the kind of thing that companies like Zappos, who I've worked with for a long time, start way before you ever get there. So if I were going to hire on at Zappos, the first thing they would do is ask me to send a video along with my, my CV or my resume. And that video is being evaluated before they look at my resume to see if it's a likely culture fit it. So what is the culture of Zappos? Well, among their many values is they're a little weird, right? Like that is a full on value. So if you're not a little weird in your video, we're going to move you off. If you are so buttoned up and straight laced and intense in the way you present on your video, we're like, thank you so much. You'll be better off somewhere else. Not with Zappos. You're not going to like it here and you're going to kind of be a drag on what we're trying to create by way of our culture. So it starts there. Assuming we evaluate you as a little weird, now we're going to look for in our interview process whether you meet other values. So if you were to fly into Las Vegas and we brought you over to downtown for the headquarters, the person who drives that shuttle bus while you're being taken to the interview is going to be making some determinations. Are you humble because that's a value or are you all about yourself in that shuttle bus? You might hit the interview and you're like super humble looking because you've read the values. But when you're not thinking you're being observed for the purpose of employment, that shuttle bus driver is giving input on whether or not you're a culture fit or not, right? So we're constantly looking for ways to preload this with. And then we're going to talk to you about your values. We're going to, as soon as you're in the interview, we're going to ask you about how do you manifest these values in your real life. Give me an example of where you compromised a value related to this really difficult behavioral interviewing questions. And then once you get on the job, we're going to spend four or six weeks on values, all part of your training. And then we're also going to ask you to do a collective team event with your new hires that help elevate some of one of these values at Zappos. And then, oh, one last thing. If at the end of the value inculcation we say to you, tell you what I will give you, and this varies based on market conditions, but I'll give you $3,000 to not, not start working here if you don't think there's a value fit, take the money, bridge yourself to your next employment. We would rather invest that money now in helping you go there than have you contaminate our culture. So here's your chance. Take the money and run or own these values. You've been forewarned, right? Now that's pretty crazy, right? And occasionally someone will. The only consequence, we say, is that you'll never be able to hire back into Zappos, but we won't give any prejudice to you in your future. You know, references, you can use this as a reference for your self awareness, but other than that, here's your money. And go. You know, not many people do, but here's the point. When you've done that, you've pretty much signaled culture matters a heck of a lot to us. You better be aligned.
- [30:27]
Eugene Shotsman
Well, and when I, when I think about values and you know, again, I'm trying to translate this from, into the vantage point of a typical practice, you know, like I, a lot of people think about values as we'll call them, like isms, like corporate isms, right? You've got honesty, integrity, service quality. Like I don't know that these are anything other than just rules of doing business in general, right? Like you never want to go to do business with a company that's like, we're both dishonest and we have horrible quality and we definitely don't prioritize service. So like, these are a lot of what people call values tend to be, you know, just rules of being an employer or rules of being in business and providing a service to someone who, who, who's paying you money. Talk a little bit about developing values that matter. When you're thinking about, you know, culture being so dependent on values.
- [31:26]
Dr. Joseph Micelli
Oh, I love this question and I wish more people thought like you do about this because I am sick of the integrity as a value. I mean, Enron had integrity as a value, right? Where did that get him? It was a nice sounding word. Everybody wants to be whole, right? Integrity comes from the word integer. To be whole, as in a whole number, whole in action and word. Oh, great, good stuff. But it's not differentiating. It doesn't speak at all about what it takes to be successful in our practice. That's what it takes to be successful in life. But in our practice it might be something different. So let's go back to Zappos for just a moment because the way values were created was Tony Hsieh then the CEO of Zappos, God rest his soul, he said, what does it take to be successful here? What are our high performers doing? What did they value? What did they, how do they behave? And he sent out an email to his high performers and said, tell me what you think it takes to be successful here. And that's where things like being a little weird came in. I mean, being a little weird is seldom a value you're going to see in most practices, but it should be. If that's the irreverent culture you have, it should be what it makes you special and different. We are zigging when others zag. That's our thing. We don't want to be known for conformitism, right? We want to be a little offbeat or humility. Humility is not a value. You see a ton. You know, it's not something we say we value. And yet Zappos is a very humble. And if you looked at Tony Hsieh, he was the first person to greet you walking into the building, though he was a billionaire from his initial purchase, you know, when Amazon purchased them. So I think you just have to kind of dig a little deeper to what values differentiate you. What is a high performance, what drives high performance in your business? And let's value that. So yeah, I'm so with you. And I think once you dial that in better then you're able to screen people against it. If it doesn't help you Know whether somebody should be or shouldn't be with you, then it's not a worthwhile value for your business.
- [33:40]
Eugene Shotsman
Yeah. The exercise we went through in our organization, and I've recommended this to a couple people, is that it's very similar to what you just said, Joseph, is that you take your top performance performers and you know, you kind of, in your mind you say, who are the people I want to clone in this company? Like if I could just have more people like that, how? And then you start writing down on little sticky notes of like, what are the, what makes those people who they are. Right. And sometimes it's just like this relentless in our, in our business it's like, well, this relentless curiosity. Like that person is like a fast learner and they're always curious and they're always asking questions. And I, we're like, okay, well that, like we're gonna to maybe say it in four different ways about four different people. But that is one of the core things that makes us who we are if we're to be successful. And so, you know, one of the things we start thinking about is well, how do we, how do we interview for curiosity? Because it's kind of, you know, and the obvious one is, okay, well if they don't ask any questions at the end of the interview then, or if their questions are pointed at like, so what are the benefits? Like that's not necessarily curiosity, self serving.
- [34:47]
Dr. Joseph Micelli
Curiosity, very self serving of curiosity.
- [34:51]
Eugene Shotsman
But there's lots of different ways you can build in for something like that. So, you know, I love this discussion of culture. I also, I want to go back to the thing you started with, which is the making people feel a certain way. Let's identify, let's think about. And we're going to start translating this down to the eye care space. But I still want to hear a few more stories, you know, from out in the field as you've worked with these super impressive organizations, like how do they figure out how they want people to feel? And then like just start trying to figure out how, what they're going to do to make them feel that way.
- [35:26]
Dr. Joseph Micelli
Right. So I call it a way we serve statement. I have that actually trademarked though I don't really use it all you want, I don't care. But it is a phrase that I think is really important. It's the way we serve. And so what is it? And if you think sometimes one of the greatest places to start, if you've done your values work well or you really have a clear mission, and then you said, okay, if we achieve our mission, then what would people feel like if we executed what we said we're all about, how would people feel if we did that? So there is a certain natural derivative set of feelings. And at a Ritz Carlton, if they execute their mission of, you know, creating the well being of the guest as the highest concern, you know, people are going to feel fairly nurtured under that circumstance. If you're at Nike, that, you know, that if they execute their mission of dominance, people are going to feel like they've created a victory or they've accomplished or they've, you know, they've, they've, they've had success. And there'd be a certain pride that would come with executing. So we want people to feel proud. Right? So a lot of it starts with trying to understand what is our mission and what's the likely derivative and that the feeling state is the inverse of living our values. Like we may value curiosity, you know, relentless curiosity, but if we did, then how would people feel? You know, they would feel understood, potentially. They would feel, it could be that they would feel, you know, as an innovator, some kind of sense of creative. They'd feel like they have had this positive creative experience. And again, some of this is, are we talking about the employer? Are we talking about the guest? Right in these things? So the employee might be in, you know, creative to what end emotionally for the guests, like what, what's that creative creativity going to do to leave a human being transformed? And that's how the work gets done. So, and it's not easy. It's not like you can just go, okay, well if it's, you know, widget A, then the feeling state should be, you know, outcome Z. It doesn't work that way. You really have to kind of put some time into it. And what do you want to be known for as a leader? If you're the creator of a practice at the end of your career and people look at you, how did they want? How do you want to be thought of? Not just in your practical clinical skills and the outcomes you've generated for people clinically, but the way you cared for them. What words would you most like to hear? Your practice executed in the day to day care of your community. And I think that's where you can reverse engineer some of these things and then define it. And then, okay, if this is what we're trying to generate day in and day out, where are people processing technologies positioned to do that? And one last thing I would say about that is that you can't do it. Every single touch point, every single time, you know, particularly long term patient relationships, you're looking at targeting certain moments that behavioral economists have shown us matter more than others to the way people perceive us. So it's defining what we want, looking at the patient journey, determining what moments in that journey are the most salient to patients, the most memorable. What have been, you know, called defining moments, moments that are, that stay in our memory. And then once we have those defining moments, what people process or technology are we going to deploy and in some cases, what are we going to take away from the experience? Because it's just cluttering it up and making it impossible for people to have a clean emotional experience. It's just too busy, too much happen.
- [38:57]
Eugene Shotsman
Yeah. You know, those moments, and I heard you say it before when you were talking about wow stories in the Ritz Carlton. And I know that the concept of surprise and delight is a big one from your Starbucks book. My question is really kind of like, you define wow for me and how do I find areas in my business where I can, where I can insert wow consistently? And I'll, I'll actually premise this a little bit with this concept of, you know, I've heard the four season stories, I've even told some of the four season stories from stage when I talk about customer experience because I'm so fascinated by it. But, you know, telling the story of the guy finding, you know, the bellboy who found the briefcase and then, you know, had, and then personally flew the briefcase across the country so that the Washington delegate who had accidentally left that briefcase in the, you know, in the trunk of a car or something or in the, on the cart, didn't have to walk into a presentation without his notes. Like, that's a wow for sure. But that's not like a scalable wow when you're thinking about, you know, an eye care professional building their business. So tell me more about this concept of wow and surprise and delight and how would you define it and how do you replicate it?
- [40:20]
Dr. Joseph Micelli
Yeah, so let's. I love that you make such a distinction between these heroic wows that are not scalable. They are fabulous. Like, I threw myself under a bus for my client. Well, you only get to do that once. You best try to last a little while in the service industry. So wow for me is kind of a relatable, shareable phenomena. And it, it, it's, it typically has a couple of elements. It should be emotional. You know, a wow is a reaction that says, whoa. It's more than just a thought. And it's normally comes as a result of exceeding expectations. Now, expectations are interesting because there are two levels of expectations. There's kind of a. What we've been conditioned to expect in an industry and what we think should happen, like a moral expectation. So I'll give you an example in that when I fly in an airplane, I think there are certain things that should have happened in the way they treated me. But I've come to realize I'm not going to get that treatment. So I've dumbed down my moral sense of expectations to the kind of the lower equation. So there's these what ought to be and what is expectations. So if you exceed the what is. What I've come to believe is the industry standard, then you normally wish. It doesn't take much to get over most of those bars. If you think about what is the, the most common run of the mill thing that most people have come to expect in our industry. And I just tweak it a little bit, a little twist I got, you know, it's good. And then it normally needs to not be a super complex thing. If you do these grand staging things, it's hard for people even to describe it, to share with somebody else. So you want it to be exceeding expectations, emotional and easily retold. Right. I want to be able to tell you about my experience quickly or tweet it quickly. That's a wow. If I can tell somebody about it pretty succinctly, show an image of it and we all go, ew. Who would have known somebody would have done that? Now you've executed. So that's the goal. And, you know, Len Berry, professor at Texas A and M, has really identified what it takes to get there. He has this raider phenomenon. No, it's, it's worth looking at his standards of service excellence, but it's about being a little more responsive than most people are. You know, having this ability to have an acumen about something a little bit more knowledgeable than most people are. Right. And there's all these little. The tangibles are a little bit sweeter or cleaner or there's just a little something about the texture or aesthetics of the thing make it. The reliability is a little greater than I've come to expect. Right. The empathy seems to be deeper than what I've come to expect. So there are these dimensions that you can really look at and say, I can wow somebody by just being more, slightly more responsive, a little bit more knowledgeable.
- [43:25]
Eugene Shotsman
So anyway, yeah, that's Great. When we come back from the break, I'm going to talk to you a little bit about how we take some of these big concepts and translate them down to our day to day operations in the eye care world. Stay tuned, everybody. We'll be right back.
- [43:40]
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- [44:34]
Eugene Shotsman
All right, we're back with Joseph Michelli and I am just, I'm enjoying this conversation so much and I feel like we probably could have this conversation for hours and hours and I want to bring it home for the audience who's listening and saying, wow, there are these really cool concepts. Right? We're talking about building a great culture in our organization. We're talking about wowing our patients. We're talking about creating consistent experience and thinking about how it is that we want our patients to feel. Fantastic stuff, but like, let's try to get tactical. Like, what do I do tomorrow? What do I do differently tomorrow? If I own an eye care practice and I want to start doing better at patient experience?
- [45:17]
Dr. Joseph Micelli
Yeah. If I have a leadership team, I'm going to get them together. I'm going to say, what do we want every patient to feel every single time? I'm going to ask them individually to give me the answer to that. Before we define it, I'm going to ask, I'm going to walk around my, my building and ask, what, what are you trying to create by way of an emotion for every patient or person you interact with? Colleague, what are you trying to Do And I'm just going to get a certain, I'm going to get a sense of how much true north there is there. Do we have 50 different norths going on in the building? All well intentioned, but no really defining true north. And that's going to set me into a position. Do we need to define this for our people? Because they're all trying hard but they just don't, don't. They're all doing, trying to create different emotional experiences as outcomes. Once I have that data, then I'm going to get together, we're going to try to align. We're going to claim something based on our mission vision and then at that point we're going to start talking about it. We're just going to talk about it. We're going to give examples of it as leaders. We're going to catch people doing things right that execute that. We're going to link it back to the, the delivery of the way we serve statement. Probably about three or four months in, I might do a quick little survey and just say what is our way we serve statement?
- [46:24]
Eugene Shotsman
And wait, wait, so hold on. The way serve statement in your. Because you're, you're already in one in under a minute. You already created a, a paradigm that we need to really dig into. So the way we serve statement, how long, how big? And you know, is it just like I want a patient to feel really cared for or is it like, you.
- [46:44]
Dr. Joseph Micelli
Know, they're, some are really elegant, they're in metaphors. So the Ritz Carlton, if I translate what they have on the card to what we really talk about, we want to create the home of a loving parent. That's the Ritz Carlton at the start. At Starbucks we want to create the third place, the place between work and home. We want to create that place where people want to come when it's too formal to go to work and too informal. That's that emotional place of familiar but not ostentatious, so affordable luxury kind of place. You know, at the fish market we want to treat people like they're world famous. Right? It's very, in its level of description, we want to deliver wowful service at, at Zappos. So you got to find out what that means. Like what does it emotionally resonate to be. We want to deliver delight at Ritz, at the Mercedes Benz, whatever that looks like. Then once you've defined it, that's when you start to ask just do I have free recognition of it if I just ask my team in one survey question, what Is our way we serve statement. I'm not going to give them a choice of three different options. I just want to see how many people freely rec wallet without queuing. About three months in and now we're getting it communicated. People are starting to do it. I'm going to spend a lot of time. Well, how do you make that come to life? Give me some examples of if you're trying to drive that and it's this kind of a patient under this kind of a need state in this phase of their journey, how do you try to bring that to life if you're doing a billing call. I just did a meeting for a company that does auto refunds, auto financing. And so how do you execute your way we serve statement? When you have to repossess a car, how do you leave people feeling with the sense of dignity that they want them to have even when the person is not able to pay their loan on their car?
- [48:36]
Eugene Shotsman
Yeah, that's. So you apply it to all the different cases. Yeah, I heard you say earlier, take your like really define your patient journey every step of the way and then identify what processes or steps you can take at different parts of the patient journey to deliver the wows.
- [48:56]
Dr. Joseph Micelli
Yeah, I start with the phases of the journey. What would you, you know, where is the discrete transitions of the phases, where they've gone from prospect to patient or you know, whatever it might be, they've been in the reception and now they're going into the treatment area. These phases, what are the triggers and what can we do in that? First off, let's look at all those touch points. Let's evaluate how positive or negative are those touch points. Let's remove some of the pain if we can. Let's celebrate the positives. These are all elements in behavioral economics research. And then let's also make sure those transitions go smoothly because people, when I'm feeling like, oh, I'm really being loved in the, you know, the welcome, but now I'm going into the next phase, are they still going to love me as I go into that? And now that I've seen the the dock and I've had a really good experience, what's my experience going to be as I'm exiting the building and will the people treat me as well, you know, on the exit? And so it's really important, I think, to focus on arrivals, departures, transitions, peaks, valleys along the experience and make sure that you're executing on the most high value moments against that emotional outcome. Along with all the behavioral, you know, the operational Checklist stuff.
- [50:04]
Eugene Shotsman
Okay, so coach me. I'm going to give you the big picture and then I'm going to kind of zoom in a little bit. But the patient experience in a typical eye care practice is the patient sets an appointment. Somehow whether they call and we'll just use call right now, they make a phone call. During that phone call, one way or another, they maneuver to setting an appointment. Likely there's a confirmation call before they actually walk in the door or there's some sort of confirmation text or something. Then they walk in the door, they interact with the staff in some capacity. Maybe they fill out some paperwork or maybe they fill out some paperwork at home. And then at some point after they've been in the office for some period of time, somebody takes them back and does what we'll call pre testing, some number of tests that are different by practice, but some number of tests that are going to happen. Some of those tests they have to pay money for cash, right? So I'm now being told that by the way, this isn't included in your eye exam. It's $39 extra to go to get this photo of your eye. And then they, after the, after the, it's usually a tech person who picks up at the position is called the tech. They pick them up at the front desk, they cart them through the, or they, they navigate them through the pre testing area and the pre testing that, the pre testing experience. And then they, they drop them off at the exam room where the, you know, where, where the, the doctor is going to later walk in and use the phoropter and say one or two, which one's better? One or two, and talk about some of the results from the, from the imaging and from the pre testing. And so then I sit there. If I'm a patient, I sit there, I wait for the doctor. The doctor walks in, there's a conversation, there's an experience with the doctor. Those tend to, you know, those tend to vary. But usually there's some combination of reviewing results, talking about lifestyle, talking about things that, that the patient's trying to accomplish, and then some recommendations from the doctor. And then assuming again that I'm going through a well visit where a patient is determined to, you know, that they have a prescription, they need to buy glasses. Then there is some sort of transition between the doctor and a staff member in the optical department and that optical department, and then that person in the optical department helps the patient shop for glasses. And then there's probably a checkout process and then I leave and Then I get notified that my glasses are in. And then I come back and I. And I pick up my glasses and hopefully I've set an appointment for the next year or the practice will contact me again a year later to get me in for the next exam. So I just gave you like the patient journey. In a minute and a half, coach me as to what I should really. Which rocks should I be looking under? Joseph, with your lens of masterful experience in this particular area, which rock should I lift up and check under first? And to see if my. To see if I'm really delivering on what I should be trying to deliver on?
- [53:04]
Dr. Joseph Micelli
I would start with just the first moment in every one of those interactions. Like whenever there's a transition, change that first moment. Owning that moment with whatever your emotion is. Maybe it's fun. Like it's a fun moment, or maybe it's nurturance, or maybe it's a. You know, you have made the right decision because we're uber competent. Like, we are the most expert of it all. So it has a gravitas quality to every interaction. So every one of those should. Bam. You got to the website. It should look like this is gravitas or this should look fun, or this should look like we're super here to nurture you. We're gonna. We're gonna take care of you in a gentle, warm, nurturing way. It should be on your website. It should be the way the voice responds to you when you call. It should be when you walk in the door, the. The way you're received. It should be when that person is gonna grab you and take you back, back. That should be it. When you're handed off to the next person, the next person, whoever it is in this chain should be thinking about it when you're doing the exam. That should be the arrival moment. As soon as you walk in the room, you should be trying to execute it. Everybody in the organization is saying, bam. This is fun. Bam. This is so we. We are gentle and kindly and here in a soft kind of way for you or boy, you are smart. You chose us. Let me show you. You Bam. Every time. And I think if you look at most practices, you have lots of that. But there are people who are letting that experience down. They're just doing their job transactionally. They're just putting you there. It's been done. It's the. How many patients today? I mean, it takes incredible effort to reset for the next patient walking in and deliver that experience that the last patient got. And it's Even harder if the last patient was a pain in the rear. Right. Like now suddenly I have to overcome the negative juju from that human being and recycle myself and say it's not their fault. This person deserves their interaction today to be top flight on brand delivering against the emotional outcome we want to give them.
- [55:11]
Eugene Shotsman
So how do you, and obviously the enemy of that, of being able to do that is exactly what you said is kind of like this mediocrity and just sort of, I guess convergence to the mean. When you think about, okay, like I'm doing okay, I'm delivering an experience, but you know, that experience, like I'm not mean to the patients, but you know, it's my 14th patient today and I got it that I got to take through the pre testing lane. How do you keep, are there any tricks or suggestions that you have to keep that person motivated throughout the day?
- [55:47]
Dr. Joseph Micelli
Yeah, if it were you that was the 14th patient in some other setting, that would be okay. I mean it's really okay then to go to mediocre the mean because you're just mediocre and you're the mean then, right? You're the recipient of the mediocrity in the mean and that's perfectly okay for your mom, it's cool, it's perfect, no biggie, it's fine, it's acceptable. Fine. Fine is the death knell to a long term successful business. And I think as a leader, we have to lead there. If we run these organizations, we've got to gear up, up for that 14th patient in a way that says to everybody else who sees us interacting with it, it's not okay to give less to 14 than it was to number one. And I just, I really think mediocrity has been accepted as service experience delivery in our country so long that people come in our door thinking that's all we're going to expect of them and they don't feel all that great at the end of the day. They feel burnout and tired and numbing themselves. I think when you really give yourself to people, you get so much back. Oh yes, there are days when it's terrible, but for the most part I feel like I've spent myself in a purposeful connection to other human beings to make their lives better. Not just through my skills in, you know, in, in eye science and eye medicine. No, it's in the pure commitment to the well being of another human being. And through that I can really sleep well at night and I get excited about the prospect of who I Get to serve the next day, including Eugene today.
- [57:14]
Eugene Shotsman
Yeah, I, I love that. And I think that the question becomes, how do you hold people accountable to that? Right? Like if I am the office manager listening to this podcast, or if I'm the doctor listening to this podcast, and I'm saying, yeah, but I mean, that sounds great. And you know, we'll do our 10 minute meetings every day to, you know, to go over the certain to kind of drill some of our core tenants and our core values and our core in our way, we serve message. But, you know, how do I, like, do I stop the person in the flow and say like, hey, that was pretty mediocre or what do I do?
- [57:50]
Dr. Joseph Micelli
People, you definitely coach people. You know, can I coach you now? Can I pull you aside, help tell me how you're doing? How do you think that went? Here's some of the things I would encourage, right? Like, I think it's. It's not a voice of you've screwed up, right? It's like, I believe you can do more and. Or I was really excited about what I just saw you do. That goes a long, long way. You know, in most of our culture, we give more negatives than we get positives. Like, it's, you know, even a happy marriage, it's something like 20 negatives to every one positive. So you want to have a happier marriage if you're doing 40 negatives to one positive? Just do one more positive and you'll get your ratio right. It's just adding a little bit more of celebrating people when they get it right, does a whole bunch. So it's not always coaching people on the boy. You seem kind of apathetic today. No, I really heard a lilt in your voice. I heard you really communicating with that person in a way. They matter. I'm excited about that. You keep that going. I imagine you're going to do that in the next patient and then that's awesome, right? I think there's a, there's a shift in the way we approach this because I want my people to be great, like, I really do, and I don't want to sit around telling them how they're not. But if they chronically aren't able to get this, then I chose wrong. And it's my responsibility to help them move on to something they're better suited for. So I can put somebody in that seat who can love on the, on our patients so that they feel like they've got a special experience they're not going to get had. They made the Error of going to that other person just down the street a piece.
- [59:16]
Eugene Shotsman
Yeah, I might not pay them $2,000 to leave if I ended up choosing wrong right away. But I think your point about making sure that you get a core values fit up front as opposed to struggling with an unfit person for a long time and having them negatively erode your culture and I think you said contaminate your culture. I think that's a really important thing for us to consider as we wrap up because I really feel we'd probably keep this conversation going for another three hours. But I am just, I, I'm so impressed with your wealth of knowledge and I want to make sure our listeners have an opportunity to absorb this. Any parting thoughts or, you know, you kind of gave us the play by play of what, what do I do tomorrow? But really, as people think about experience as a competitive edge in their practice. Any other parting thoughts? Joseph, that before we wrap for the day?
- [60:11]
Dr. Joseph Micelli
Yeah, I was blessed to have an eye doctor from early on. I had glasses in second grade and I, I always looked forward to going to see my eye doctor like it was a thing. And we lived in a small town in Kansas City and we went up to Colorado Springs for the appointments. It was like an event. And the staff from the beginning to the end made me feel like they really loved on me. And I mean that in the sense that they cared about me, they were excited to see me that, you know, this was. And it was just, I always saw better, like my life was better because of them. And they treated me in a way that I look forward to going. So. So I think this is incredibly noble profession to help people experience the world through this incredibly important sense. And I've also since then had some pretty terrible experiences. So my childhood warmth of the experience has been just almost like a manufactured next get in, get out. I was never anything but a couple of eyes.
- [61:14]
Eugene Shotsman
Interesting. And I think it's so important to think about what, what is it that you're making your patients feel? That's the real question of the day. Joseph Michelli, thank you so much for joining me on the Power Hour. You are truly a wealth of knowledge. So grateful for all the wisdom you shared with our audience today.
- [61:29]
Dr. Joseph Micelli
Thank you.
- [61:30]
Eugene Shotsman
Eugene, thanks for listening to today's Power Hour episode. The Power Hour is actually owned by the Power Practice. Power Practice is a premier consulting group who helps practices achieve freedom of time, confidently solve practice issues and grow their practices. They do this by having coaches and OD consultants, people who have actually done it, been there and they're ready to help. You want to learn more? Go to powerpractice.com there's a bunch of free tools there. You can also get a whole bunch of information and decide whether it's right for your practice. Again, if you're looking for more time, you're looking to solve complex practice issues or grow the power Practice might be right for you. Go to powerpractice.com to find out more.
- [62:09]
Dr. Joseph Micelli
Sa.