Proud to Be Polite


For many of us, socially unacceptable behaviors began developing as a child. How many times did we complain to our parents about how rude our siblings or friends were? “Why do I have to apologize, she started it?” “He gets away with everything.” I can still hear my parents asking, “Who did this or that?” “You knew you were not allowed to do that, WHY did you do it? Nowadays my wife and I have been asking similar questions to our 12 year boy and girl twins and 9 year old daughter. As a new and naive father, I was determined to develop and implement a revolutionary strategy with flawless execution and accountability. I believed I had created the “holy grail” and our children would display the perfect demeanor. I followed the KISS method and developed the ideal mantra “You have to be polite and wellmannered at all times.” It’s too early tell whether our never-ending chant will positively impact their behaviors. But all kidding aside, it is parental responsibility to teach your children to understand right from wrong. Unfortunately, somewhere during the transition to adulthood, many people begin to lose their affectionate civil behaviors and do not improve their emotional intelligence. They are unable to understand and fully develop their self-awareness, self-control, empathy, relationship development skills and ability to lead and inspire others.

Workplace rudeness is widespread and on the rise. The costs of these inappropriate behaviors diminish customer loyalty resulting in lower financial margins. An article from the Harvard Business Review (HBR), The Price of Incivility, details a study which collected data from 14,000 people from the United States and Canada. It concluded two pain points. Incivility is expensive and few organizations recognize or take action to curtail it. Many of the managers admitted incivility was wrong, but didn’t realize the tangible costs. The study also polled 800 managers and employees in 17 industries. Among the workers who’ve been on the receiving end of incivility:

  • 48% intentionally decreased their work effort

  • 47% intentionally decreased the time spent at work

  • 38% intentionally decreased the quality of their work

  • 80% lost work time worrying about the incident

  • 63% lost work time avoiding the offender

  • 66% said that their performance declined

  • 78% said that their commitment to the organization declined

  • 12% said that they left their job because of the uncivil treatment

  • 25% admitted to taking their frustration out on customers The costs of incivility not only negatively impacts the company, but also the individual’s professional development.

A recent anesthesia event made national headlines and established the cost of incivility for healthcare providers. Last month a jury decided in favor of a Virginia patient that underwent a colonoscopy with anesthesia in 2013. The patient accidentally placed his phone on record mode and heard the voices from the GI Suite. The rude and offensive comments by the Anesthesiologist were not only humiliating and degrading, but the physician also mentioned documenting a false diagnosis in EMR. The jury awarded the patient $500,000 and the Anesthesiologist is no longer employed.

Why do so many people display obnoxious behavior at work to their customers and teammates? The following points help explain why civility leading to customer service is hard to find (Weinzweig):

  • Unfamiliar behaviors with employees and employers – In the opening paragraph I shared my “Holy Grail” for raising our children. Hopefully that sticks with them. But, for many organizations and individuals, they have not been taught how to properly act within the work environment. This leads to poor customer service, especially within organizations that maintain sub-optimal corporate directional strategies, proper training, ongoing/focused evaluations and positive feedback.

  • It’s not respected – Providing excellent service is thought as a skill for the traditional service jobs involving teenagers on their way to a more meaningful career. Although many organizations and individuals say they want to supply great service, few actually deliver it.

  • It requires more work in the moment – It requires much more effort in the short-term and the reward is not immediate.

  • It’s not fair – Unfortunately, not all customers are also polite and well-mannered. Despite a person’s best intention to deliver world-class service, customers may be unpleasant, uncaring and commanding. People who skillfully deliver great service look past those challenges and remain focused and controlled to follow the company’s customer service guidelines.

  • There’s plenty of good talk, but also bad walk – Staff will emulate their leader’s behaviors. If a team leader does not deliver exemplary and compassionate customer service, nor will the team.

  • Reward systems don’t reinforce – The healthcare reform has implemented Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) or financial rewards for hospitals and providers delivering above average customer service. I predict this model will extend into the CMS physicians fee schedule. Many physician practices have current compensation models with money at risk for customer service and behavioral outcomes. As you reflect on this, keep in mind the story of the Anesthesiologist from Virginia.

  • It’s not defined – This is probably the biggest reason. Companies want to deliver it, but few define what customer service is.

Delivering excellent customer service is one of three major goals for Premier Anesthesia’s team at Mount Carmel in Columbus, Ohio. The team constantly reviews the benefits of maintaining a collegial and professional environment. The following 5 elements are critical when implementing a successful and sustainable customer service system that exceeds your customer’s expectations (Weinzweig).

  • Define it – You can’t teach something you don’t know. Organizations should have a simple and clear vision, beyond a theory, of what their customer service looks like.

  • Teach it – When companies do not offer effective training, the customer service is nothing more than another idea discussed, but not executed. Training should include classes, materials and role playing.

  • Live it – This is the most fundamental element. Companies that define, teach and dedicate tremendous energy will execute and deliver the service.

  • Measure It – Customer service metrics are becoming ubiquitous in healthcare. They are an excellent tool to compare the results of your customer’s data to that of the employee’s perspective. Minimizing that gap will lead to alignment of the customers’ expectations and the service deliverables. Initially begin by identifying a few meaningful metrics and just start measuring. In our practice, our outpatients are surveyed daily and the surgeons are surveyed annually. Our team has discussed additional metrics that will be focused on the voice of the customer and improving processes for all of our customers, not only patients and surgeons.

  • Reward it – Formal and informal celebrations should be awarded to those who go the extra mile. When leaders recognize their staff, it reinforces the need for a preeminent customer service system and culture.

Incivility within an organization has been described to reduce employee satisfaction and decrease the profits of an organization. The HBR article, The Price of Incivility, presented data that stated most managers are unaware of the slow erosion of their company’s operations. Businesses that report increasing employee turnover rates tend to hire less qualified employees with lower emotional intelligence. Their productivity begins to decline and customer loyalty slowly fades. This negative feedback loop continues until leadership decides to make a philosophical change and transforms its operations to regain its competitive advantage.

Within the specialty of Anesthesia, we now can quantify the price of incivility. A precedent has been established by the jurisprudence system. If found guilty, a provider may be expected to pay $500,000 and be terminated.

I have been providing anesthesia services for 21 years and am fully aware of the many cultures within a hospital, and more specifically, the operating room. Developing a culture of civility within the Anesthesia Department and operating room first starts with me, the Medical Director. Personally, I am proud to be polite and well-mannered and honored to work with Premier Anesthesia’s team at Mount Carmel West. Our members work very hard at recruiting and retaining the right people for our service vision. They represent the best of a world-class culture system.

References: Harvard Business Review, The Price of Incivility, Lack of Respect Hurts Morale – And The Bottom Line, Christine Porath and Christine Pearson, January-February 2013, http://www.washingtonpost.com/local/anesthesiologist-trashes-sedated-patient-jury-orders-her-to-pay- 500000/2015/06/23/cae05c00-18f3-11e5-ab92-c75ae6ab94b5_story.html, Washington Post

Zingerman’s guide to giving great customer service, Ari Weinzweig

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