By JIM NICHOLS

Occasionally, a question is asked whose answer is difficult. This is because there seem to be multiple facets that are conflicting. The consideration features a series of, “Yes, but . . . “statements. Sometimes we try to deal with it by asking related questions.

If one enters Walmart or Starbucks, one clearly is a customer. However, if one is a university student, are you a customer? If you are a patient in a hospital, are you a customer? If those two comparisons seem odd to you, they are certainly not odd to those who work in higher education or medical settings. In both of those places, such language is common as are the expectations from leadership. While I understand the good motives, it does make me somewhat uneasy.

Many words have been written regarding these questions and I have found wrestling with them fascinating; perhaps with a few more words here, you will too.

The days of paternalistic medicine are gone. People may be sick, but many of them are also educated in terms of health. They are not looking for a healthcare provider or facility who will treat them like a child. Patients expect information. They may be willing to submit to a situation with someone who plays the part of a technician or someone with whom they have a contract, but they really desire a partnership in their healthcare. Furthermore, they will have little patience with complex scheduling and billing processes, long waits, and crowded waiting rooms. Those sound like customer service items, do they not?

On the other hand, what exactly is the “product” of the healthcare encounter? What is being sold? In this transaction, what is occurring? There is not clear equality between the “buyer” and the “seller.” Would we agree with a “patient is always right” approach? Patients are paying for a service, but they cannot reasonably demand a positive outcome. Sometimes the illness continues (even to death) despite being treated well. 

We cannot overlook the large amount of money involved in healthcare. Third party payers (such as insurance companies and Medicare) are concerned a great deal about efficiency and accuracy from those providing care.

When a university student walks into a classroom or lab, someone is paying money for that. What is the student receiving? Whether it is the student’s earnings, parent support, scholarships, taxpayer funds, or a combination, a transaction is occurring. Without a real “product,” we note that, as with a medical transaction, the purchase is for service. The student (and payers) has a legitimate expectation that the service provided will include time with an experienced and knowledgeable instructor who will aid in the student’s development academically, emotionally, personally, and spiritually.

My unease with this customer approach considers the expectations of the customer. If the customer is expecting a defined product, that is problematic for both educational and medical settings. This is not the purchase of a Starbucks mocha. The student or patient is purchasing a service and does have the right to expect certain qualities of that service. They should expect effective communication skills from nurses, physicians, and professors, and responsiveness from the hospital and university staff. The buyer can legitimately expect service that listens, empathizes, apologizes if necessary, and resolves confusion and misunderstanding. However, striving to supply quality customer service does not simply imply the recipient is a customer. Supplying helpful medical or educational services goes much more deeply than dealing with a customer.

Quality customer service is dealing with people as you would like to be dealt with. It almost sounds biblical, right?

I fret that our contentious world of election denying, gerrymandering, and distrusting has poisoned many relationships that should be taken at face value as positive. Even though physicians and patients are not equal nor are professors and students, all are humans. How about we assume that the service provided is done with compassion, accuracy, and skill as best as possible? As we treat others kindly, it increases the chances that it will be returned. Good customer service is simply following the Golden Rule.

Jim Nichols is a retired Abilene Christian University biology professor and current hospice chaplain