Sunday, January 8, 2012

The dark side of customer satisfaction

Four stories:  

  • On a recent television show in Canada on customer service, the most common complaint was that all too frequently Canadians could not find customer service staff, and when they did, all too often the staff were ill informed.  The comment was made that many large companies find that hiring and training customer service staff did not result in increased sales.  In a related story, retail outlets are losing business to on-line services.
  • I did an inspection for a laboratory recently where I was given the names of two clients that account for a huge amount of the work done by the laboratory.  One gave an OK review of the laboratory and the other trashed them.  When I asked if the complaints had gone to the laboratory the response was something to the effect of they know how I feel.
  • I booked a large chain hotel in the United States a little over 2 month ago for a meeting next week.  I thought everything was in place, but I was wrong.  I went to the ‘net and checked out reviews on travelocity, tripadvisor, and and found that others had had similar dissatisfaction.  I decided to cut my losses and cancelled my reservation and stay elsewhere.
  • In an informal survey of 20 accredited medical laboratories around the world, I identified only 5 that maintained a formal log of received/resolved complaints, and all the logs that did exist, were incomplete (they only recorded complaints submitted in writing).  Only one laboratory maintained and monitored received/resolved complaints as a regular metric.

A few questions came to mind.  Why do some very large retailers and apparently some laboratories and profession groups see so little return on investing in customer service?  I can understand part of it. 

In the public sector laboratory and indeed throughout all the civil service the work process is near always the same; work comes in and work goes out.  Workflow in most laboratories is not obviously associated with complaints.  Institutional budgets are set based on factors all independent of satisfaction.   As budgets become constrained, it is easier to focus on the issues that sit front of mind, which continues to mean stamping out fires and trying to keep up with technological and human resources change.

Even if laboratory management want to reward good service, it is very difficult, indeed often impossible.  While there is much discussion around reward programs such as pay-for-performance, most programs have either been blocked or have failed because they are seen as too subjective, or too easily manipulated.  Pay-for-performance in the teaching profession is viewed as striking right to the heart of unionism and the concepts of collective bargaining.

The observation that some (many?) medical laboratories do not maintain an active and complete complaints received/resolution log is troublesome especially since addressing complaints is identified as an accreditation issue in the United States (College of American Pathologists) and by ISO15189:2007.  An argument might be made that just because there is not a metric that monitors complaints doesn’t mean that complaints aren’t taken seriously.  But how would anyone, including an accreditation assessor know?

The unfortunate reality is that with larger institutions and organizations the only driver that pushes for more attention to customer satisfaction is certification and in some laboratories, accreditation.  And that is too bad.  The reality is that is unhappy customers have all sorts of ways of sharing their experiences these days that didn’t exist before.  Until about 10 years ago, complain options were fairly limited.  One could write a letter or make a phone call, but short of making a formal complaint to formal state or college authorities, or spending money on civil suit action, that was about all that could be done.  Both of these are processes that most of folks find either unduly bureaucratic and time consuming or expensive. 

Today people can complain far more broadly with less problems.  There is email, and Twitter, and Facebook, and blogs and public review sites.  In healthcare you can register both positives and negatives about pathologists and clinics and laboratories in a variety of sites (,,  Word can spread in a very public way in a heartbeat. 

By the way, as mentioned before, the increasingly present option that patients have for direct-to-patient reporting will inevitably mean more unhappy people, more complaints and more public awareness. The general public I suspect will be less tolerant of wrong identifications, late reports, misleading results, false positives, and false negatives.  Poor customer service is no longer remains a private issue.  It can become very public and very ugly.

Welcome to the dark side of unhappy folks with access to social media.


  1. It is unfortunate that often change doesn't occur until the accreditation/certification machine drives fear into the hearts of these labs. I like the idea of social media being able to overcome this inertia by making information more available. Although, unless there is a formalized social media forum to register complaints, I feel that institutions (such as a lab) that run on pre-established budgets and don't behave as profit based organizations will continue to disregard complaints brought about by twitter, facebook, blogs etc. We should perhaps advocate for a formalized but readily accessible complaint process that addresses institutions funded by the government.


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