The Perception of Quality

As a president of a software development company, I am both a vendor and a consumer of customer service.  After 30 years of working with my customers and obtaining supporting services for our tools and systems, I have learned the value of quality service and the damage that is caused when this aspect of our business is taken lightly.

Despite your opinion of the Supreme Court decision in the Citizen’s United case a few years ago, it seems to me to be a fact that corporations, and all forms of social organizations, develop a personality similar to individuals.  From this perspective, corporations really are like people.

Like individuals, corporations can be generous and caring, willing to sacrifice short term gains for long term results.  They can be driven, focused, and talented.  They can also be cold, vindictive and focused on the next measurable performance period at the expense of everything else.  Like people, the superficial organizations that talk about quality and teamwork without actually backing it up with action are much more common than those that actually exhibit these qualities.




Like individuals, every business wants to be liked.  They want to have many friends and to be admired by their peers.  Like many people, they seem to be confused when this doesn’t pan out like they think it should.  Their self-analysis usually misses the point.  We all wear suits and ties, why do people consider us to be unprofessional?  We have a mission statement, why do people feel that we have no direction?  We have a team meeting three times a week, why would people think we are disorganized?  Like people, when the perception of others toward them is negative, they usually look for a way to assess the blame rather than correct the perception.  Often blaming competitors, their business environment, or looking for scapegoats within their own organization.  This attitude only serves to accelerate this negative perception and drives out any individuals in the organization with the qualities that they actually need.

Like in my personal life, I seek out organizations that I can depend on.  Businesses that I can trust, that exhibit a sense of honor and commitment to what is important to them.  I like working with businesses that enjoy what they do and look forward to each day of work.  Most importantly, I want us to be one of these businesses.  I want MEDTranDirect to be admired and respected.  I want our customers and vendors to feel that they can depend on this organization to act professionally, even at the expense of short term gain.  Like in my personal life, I often have to deal with organizations I don’t like.  It is impossible to avoid them, however, I have learned to set limits and sometimes I have discontinued business with a customer that is too difficult to deal with or is continually disrespectful to my staff.

With individuals, I believe that it is the quality of our character that ultimately determines how we are perceived in our social interactions.  In business, I believe it is through customer service and the perception of quality that we build similar bonds with our customers and vendors.  I believe that if we can develop this perception of quality, it will make our lives easier, less stressful, and make our workplace a more enjoyable place to be.  In the long run, it will contribute to our financial success as well.

Although I have to always be on guard for self-delusional analysis, I believe that this perception of quality is the greatest strength of our organization.  This can be measured statistically by our ability to retain customers and employees, through surveys, and by the frequency and quantity of support issues and emails.  It can be assessed subjectively by talking with customers, reviewing the content of support issues and communications, and assessing the morale of your organization and how your customers perceive you.

I am not an expert businessman, my background and education is as a programmer. On the other hand, I have 30 years of experience in customer support and I have learned a few lessons along the way.

The readers of this blog are mostly healthcare providers, but I know there are some vendors as well.  In either case, the perception of quality matters.  Here are a few tips on how any business that depends on customer interaction can improve the perception of quality when it comes to how they are perceived by others.  They may seem obvious, but they are often absent from the organizations I deal with.

  • Treat others like you would want to be treated.  People will remember kindness and extra effort just as they do rude behavior and the often robotic demeanor of larger institutions.  This is particularly prevalent in healthcare where people are often organized like cattle, moved from one holding pen to another until services are rendered.
  • ALWAYS be on time.  Another big healthcare problem and a personal pet peeve for me.  In my opinion, when you are late for any type of scheduled interaction, you are making a statement to the other party that your time is more valuable than theirs.  This has a negative impact on the perception of quality that is difficult to overcome.  If it happens, do what you can to apologize and make up for the incident.  Make sure it is clear that you understand that this behavior is rude and will not be repeated.
  • Respond to all communication quickly.  This is a corollary to the previous issue.  It shows that you value and respect the time of your customer or prospect and it sets a standard and expectation for future communication, whether it is positive or negative.

In software development there are three basic types of communication with customers, phone, email and personal interaction.  The mix is different in every organization.  For MEDTranDirect it is about 70% email, and 25% phone and less than 5% personal interaction.  Personal interaction with customers is very infrequent due to our web-based products and support.  Here are a few tips we have learned to make these types of communication better.

Email communication tips

  • Provide a clear signature in your emails that includes your name, title and a direct phone number for voice communications.  If you have a web site, provide this as well.
  • Always use “reply all”.  Whenever you receive a message that includes multiple people, make sure you reply to all of them.  Otherwise, some of the people excluded will perceive that you have not responded to the original issue.  My personal rule is that the original sender of the message should determine the audience and that you (and others) should continue to address this audience until the issue defined in the original message is closed.  This means that you should not introduce new users to the list, unless it is being forwarded to others in your own organization.
  • Reply within one hour.  Email is the most efficient and suitable form of communication for any business.  There are privacy issues with emails in the patient care arena, but outside of this environment, they are far superior to phone calls.  For this reason, your organization should encourage email communication.  Here are some of the reasons why email should be the preferred form of communication:
    • Email is time shifted communication.  In a phone call, both parties must be available and present at the same time.  If not, you exchange voice mails (phone tag) until communication is possible.  Although this is not anyone’s fault, it can create a perception of inefficiency and delay work being done.  Emails and text messaging is time shifted, meaning that communication can take place when the last person receiving the message is available.  The net result is faster problem resolution.  This is a larger issue as you add more people to the mix.  We are all busy people and communication is going to happen faster through time shifted communications.
    • Email is self-documenting.  It is its own objective record of what was said.  Phone calls and personal interaction require additional documentation if these communications include information that must be retained.  This documentation will always be influenced by the perception and memory of the documenting participant.
    • Emails are subject to our “filter”.  By this I mean that before we send an email, we all have the chance to review what we have to say and word it properly.  Phone conversations always include the possibility of including information we may regret or may have wish we had rephrased, inaccurate information and invalid assumptions.
  • If you agree with the premise that email is preferable to phone communications in your business, you need to create an environment where the people you interact with prefer them as well, at least when they communicate with you.  This can be done by replying quickly and doing your best to resolve the subject in as few emails as possible.
  • The 24 hour rule.  This was a hard lesson to learn on my part and is more of a personal rule than a general one.  If you are an emotional person, one who might have a tendency to get angry easily, never reply to an email until the emotion has passed.  Try this experiment.  When this happens to you, write your email and save it as a draft.  Wait until the next day, about the same time, and review the email.  In my case, 9 times out of 10 I will be glad that I did not send the initial email.  In some cases, anger is an appropriate response, but that decision should be made when you are not angry.
  • Use alias accounts.  One of the reasons why people avoid emails is that you often don’t know when to expect a response or you never get one.  When your organization replies to emails quickly, your customers will have a better idea of what to expect.  One of the problems with emails is that customer service associated with your organization is affected when individuals don’t respond quickly.  On reason could be that they are not available.  When staff is sick, on vacation, gone from the organization or just busy, important emails addressed to them can go undetected by the organization causing a negative support experience.  The best way to handle this is to promote the use of alias email accounts to your customers.  These are like or  These accounts can have multiple individuals associated with them.  This allows your management to determine a protocol for responses so that if any individuals are unavailable, their absence in accommodated in your internal procedures.  If your replies include these groups, everyone in the group is aware that the subject has been dealt with.  If not, your protocol can make sure that none of these messages go unanswered in a given time frame.  This also allows management to review these communications without involving themselves in them.  In my opinion, the frequency and professionalism of these communications improves when your staff knows they are being monitored by management.

Phone communication is an essential component of customer service and the perception of quality.  There is a lot of information out there about phone communication and improving efficiency, but this seems to be a major weakness in many organizations, especially larger ones.  There has been a trend over the last several years to improve the bottom line of an organization by reducing support costs through automated systems and outsourcing support.  In my opinion, if your objective is to improve the perception of quality for your organization, this is the opposite of what you need to do.

Whenever someone reaches out to you as a customer, it is an opportunity to improve this perception of quality.  It is a chance to reinforce the idea that they are working with professionals that understand their own products and services and have a genuine interest in helping your through your issue.  When your customer hangs up the phone, they should have completed a positive experience that will encourage them to contact you again in the future, when they need to, and to recommend you to their associates.

To make a phone call a positive experience, there are two basic objectives.  The first is to get the customer to a person that can assist them as quickly as possible.  The second is to have this person deal with the issue professionally and from a position of knowledge and experience appropriate to the situation.

The first issue deals with call routing.  This can be done through an operator or through an automated phone system.  Everyone has a personal preference of one type of system or the other.  I did a survey a few years ago and asked the question of our customers, if you called MEDTranDirect, would you prefer to get a person who directed your call to the appropriate party or would you prefer an automated system that routed your call to the extension or department as soon as the number was entered?  The response was almost exactly even between the two choices.  For this reason, we provide two phone numbers, one that is answered personally, and another automated number that accepts extensions.

Automated phone systems can route calls quickly, but have the potential to create a very negative customer service experience.  I believe everyone has experienced this.  Many times I have spent fifteen minutes, or more, being processed by these systems before getting an individual that can help me.  When we are finally connected, I am already angry and the quality of the remainder of my experience will not create a positive experience, regardless of the situation.  I believe that the nature of these systems convey the personality of the organization.  It is difficult for me to believe that any company that has me enter in four different consecutive options, then wait on hold for 10 minutes, actually wants to help me.  More likely, they are hoping I will hang up and reduce their workload/expense.

If you really care about your customer experience, make sure that your automated phone systems support that position.  Here are a few tips:

      • Always accept the option “0” as a method of transferring the call to a live individual.  As I mentioned, many, if not most people, would prefer to explain the issue to an operator and be manually routed, even if it means waiting on hold.  I have never heard anyone say, “wow, that automated system really helped me solve my problem”.
      • Always immediately accept the entry of an extension, or as quickly as possible in a call.  Your regular customers are very important and they should not be forced to sit through an automated explanation of their options on every call.
      • Never have two nested levels of questions (options) in your system.  If you take an option, and are presented with another numeric option, the first thing that pops into someone’s head is “how many of these am I going to get?”  Another related issue is when an automated system asks you to enter in information on your keypad, like account numbers, and then a subsequent individual asks you for the same information verbally.  What was the point of putting this in the system the first time?
      • Always make sure you can reestablish the communication.  If you are disconnected, a transfer fails, or some other problem occurs, if the business is important to you, you should reestablish the connection, not wait for them to call back.  This is a simple way to turn a negative incident into a positive one.
      • Return voice mails quickly.  If an automated call, ends in leaving a voice mail, the experience is negative.  Make sure that your customer knows that this is the exception, not the rule, a quick response does this.
      • When a customer gets your company representative on the phone, if at all possible, make this person the person that solves their problem.  This is not always possible.   Sometimes someone will call support about a problem with their bill, but if calls need to be transferred, it should only happen one time.
      • If the issue can be solved better by email or some other technical means, present this option to the customer, but make sure they understand that calling is still always an option.  The objective is to make the process comfortable and positive for the customer, not to reduce your support expenses.
      • Test your system.  Create and test support issues through your phone system, did it work as you expected?  Try to put yourself in the position of the customer and attempt to contact yourself.  Was this a positive experience?  Was it as fast as possible?

I understand that customer service is expensive, but so is the negative perception of your organization by people who are trying to give you their money.  I see many organizations that measure their success by how many new customers they get over the existing ones they lost.   It is difficult to measure this lost business by the cause, let alone compare its cost to the financial benefit of cheaper communication and outsourced support.

Obviously, many organizations feel that the savings is worth it.  My personal opinion is that these organizations fail to understand the total value of the perception of quality or they are in denial about this perception and their own relationship with their customers.  Like individuals, many organizations are more concerned about the instant gratification of cost savings in support, which they can see easily in their financials, rather than the more subjective benefits of the perception of quality, which is difficult to measure both financially and objectively.  The perception of quality is like pornography, it is difficult to define, but we all know it when we see it.


By Kalon Mitchell, President – MEDTranDirect