Now Reading: Articles challenging “Do happy employees = happy customers?”

I used to spend a lot of time struggling with this question, and I see many people still struggling with it, especially in Health Information Technology. I see a focus in a lot of places on making sure physicians are happy in order to be successful. The struggle is normal, this is a controversial idea. This article from HBR says that it’s the E=MC2 of customer loyalty.  

I’m not sure I agree, though.

I last did some deep-dive business study research on this a few years ago and came to the conclusion that patient happiness and doctor happiness are probably co-mingled. My work experience in several places has always worried me that excessive focus on the happiness of one population (doctors, nurses, allied health, anyone) puts patient happiness at risk, so why not just focus on their satisfaction as the key to everyone else’s?

In the article Employee Happiness Isn’t Enough to Satisfy Customers , the authors state:

The idea that employee satisfaction simply rubs off and benefits the company is wishful thinking.

And then go on to state that there’s no evidence that satisfied employees equal satisfied customers.

In the feature article, What Only the CEO Can Do, A.G. Lafley, chairman and chief executive officer of Proctor & Gamble notes throughout his interest in customer satisfaction first, in crafting the role of the CEO (much of it based on Peter Drucker’s philosophy)

Drucker also wrote that the purpose of a business is to create a customer. P&G’s purpose is to touch and improve more consumers’ lives with more P&G brands and products every day. Of all our stakeholders, both outside and inside, the primary one is the consumer.


As for employee stakeholders, we believe that P&G people are the company’s most valuable assets. Without them we would have no P&G brands, no P&G innovation, and no P&G partnerships. However, putting employees ahead of external stakeholders, especially consumers, would result in a more internal—and, arguably, more short-term—focus. P&G people are inspired by the company’s purpose and motivated by how they can personally touch and improve consumers’ lives.

In the article, Lafley talks about how the CEO shapes values and standards, and how in his role, he shifted the values more toward placing the customer’s needs first, as he felt that values prior to his tenure had evolved to place employees’ needs ahead of consumers. It’s an interesting read throughout to discover how the metrics of P&G are based on customer loyalty and penetration of P&G satisfaction into consumers’ homes.

I like articles like this because they connect the philosophies of some of our best health care organizations, like Mayo Clinic, where it is said,”The best interest of the patient is the only interest to be considered.”

I connect all of this to working with physicians through the understanding that physicians are passionate about helping patients succeed and often put this success ahead of their own emotional success, because they will do whatever it takes, however inefficiently or indirectly they must do it in the systems they work in.

If I/we can allow them to fulfill their passion, to support patients where they live, work, and play, in being successful, as efficiently and directly as possible, their emotional success will ensue, or as it said the Employee Happiness article,

…engage employees by giving them both reasons and ways to please customers; then acknowledge and reward appropriate behavior.

So I know this is a controversial idea, and my research may not be as deep as anyone reading this post – I welcome your comments.



This is great, and, all to often, if the company is not in touch with the market, the customer is way ahead of the service provider, who is relying on out-dated systems to support the customer. It's not enough to say to employees: "please the customer, that's why you are here." the company has to also update systems continously to support their service providers, so they, in turn, can please the customer.

All to often our work is in service of maintaining the company's outdated structure. In Healht IT, nowhere is this more true than our continued hommage to the 1970s medical record: the paper record of SOAP, orders and results collection doesn't begin to aggregate information at the level of the whole person, much less incline the physician to tailor recommendations in that view. We are stuck in episodes of care (the encounter), silos of delivery (specialties): the automation of same (the EMR) has confronted us with the conundrum.

If we truly wish to serve the customer, our structures of delivery and support have to allign accordingly. As today's mass production/project focused companies are giving way to smaller, more nimble companys, so our health care delivery, as it enters the information age, will look different: tailoring access to care to people in the midst of their lives, rather than in the midst of the health care system (hospital,specialties, etc)

That will be people and software in service of Health care 3.0: not a place, but an activity. Not a source but a choice for care, not an industry, but a way of life for all.

Ted Eytan, MD