consumers evaluation of pharmacy service

CONSUMER’S EVALUATION OF SERVICE

Surprising facts about what consumers want from pharmacists

David Holdford, RPh, MS, PhDProfessor, School of PharmacyVirginia Commonwealth University

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Slides to Accompany Chapter 10 in “Marketing for Pharmacists”

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Learning ObjectivesDefine the key terms including: satisfaction, dissatisfaction, service quality, value, expectations, technical quality, and functional quality

Discuss why pharmacists should care about patient perceptions of service

List the 10 dimensions of service quality that patients use to evaluate pharmaceutical services

Describe the two dimensions of service quality most important in determining overall perceptions of service

Compare and contrast affective loyalty and behavioral loyalty

Explain why dissatisfaction is more important than satisfaction in determining patient perceptions of service

Suggest things pharmacists can do to understand and influence patient perception of services

HOW DO PATIENTS ASSESS THEIR SERVICE EXPERIENCES?

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CustomerSatisfaction

Situational Factors

CustomerLoyalty

Individual CharacteristicsPrice

Product Quality

ServiceQuality

Antecedents and Consequences of Customer Satisfaction

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CustomerSatisfaction

Situational Factors

CustomerLoyalty

Individual CharacteristicsPrice

Product Quality

ServiceQuality

WHAT IS SATISFACTION?

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Satisfaction results when a customer concludes that a transaction meets or exceeds expectations

Dissatisfaction results when it fails to meet expectations

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Comparing Service Performance with Expectations

Comparison of Performance with

ExpectationsMeets

Expectations

Does Not MeetExpectations

ExceedsExpectations

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Comparing Service Performance with Expectations

Comparison of Performance with

ExpectationsMeets

Expectations

Does Not MeetExpectations

ExceedsExpectations

There are 3 basic outcomes associated with evaluations of service performances

1.

2.

3.

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Consequences of Service1. Bad service = dissatisfaction = lost customers

2. OK service = not dissatisfied or mild satisfaction = customers continue to do business with you until something better comes along

3. Great service = delight = loyalty

EXPECTATIONS

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Zone of Tolerance

Level ofService

Given byPharmacy

EXPECTATIONS OF SERVICE EXIST

ON A CONTINUUM

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Zone of Tolerance

Level ofService

Given byPharmacy

Service Most Desiredby Customer

Service DeemedMinimally Acceptable

Zone of Tolerance Service HereIs Deemed MerelyAdequate

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Zone of Tolerance

Level ofService

Given byPharmacy

Service Most Desiredby Customer

Service DeemedMinimally Acceptable

Zone of Tolerance

THIS IS WHERE CUSTOMERS ARE MOST SATISFIED, EVEN DELIGHTED, WITH THE

SERVICE

PERCEIVED VALUE

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PERCEIVED VALUEWhat you get for what you give

Perceived utility of product and services

Perceptions of what has been paid

SERVICE QUALITY

Service quality describes customer perceptions of the quality of services over time

Not price, product, or other non-service related issues

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CustomerSatisfaction

Situational Factors

CustomerLoyalty

Individual CharacteristicsPrice

Product Quality

ServiceQuality

CONSUMERS ARE UNABLE TO ASSESS SOME ELEMENTS OF SERVICES

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FOR EXAMPLE, HOW DO YOU KNOW YOUR MECHANIC DID A GOOD JOB ON YOUR CAR?

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HOW DO PATIENTS KNOW THEIR PHARMACIST DID A GOOD JOB ON THEIR MEDICATION REVIEW?

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Consumer’s Ability to Assess Aspects of Services

Services Provided

Attributes that can be evaluated

Attributes that can be evaluated prior to

receiving the service

Attributes that can be evaluated only after experiencing them

Attributes that can never be evaluated

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ImplicationsConsumers have trouble evaluating many

aspects of pharmacist servicesMany professional attributes can never be validly assessed

Therefore, consumers rely on those things they can easily assess E.g., fast, friendly, appearance, time spent, price

HOWEVER,PHARMACISTS CAN HELP PATIENTS ASSESS PROFESSIONAL ATTRIBUTES OF CARE…

BY DESCRIBING WHAT THEY ARE DOING

“CAN I SCHEDULE YOU FOR MEDICATION CHECK-UP? I WILL

REVIEW YOUR MEDICATIONS WITH YOU TO SEE IF ANY CHANGES ARE

NEEDED.

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FUNCTIONAL QUALITY VERSUS TECHNICAL QUALITY IN SERVICES

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A PATIENT’S ASSESSMENT OF THE PERFORMANCE OF A

PHARMACIST IS A FUNCTION OF TWO THINGS

OverallEvaluation ofService

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DID THEY GET ACHIEVE A THERAPEUTIC BENEFIT

BASED UPON WHAT THE PHARMACIST DID?

TechnicalQuality (TQ)- the end result of the care

OverallEvaluation ofService

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TechnicalQuality (TQ)- the end result of the care

FunctionalQuality (FQ)- how care was delivered

OverallEvaluation ofService

HOW WAS THE CARE DELIVERED? WAS IT FAST?

FRIENDLY? PLEASANT?

Which is more important on average in patient perceptions of services, FQ or TQ?

DIMENSIONS OF SERVICE QUALITY

SERVICE QUALITY IS A MULTI-DIMENSIONAL CONSTRUCT

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10 GENERIC DIMENSIONS HAVE BEEN IDENTIFIED

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CustomerSatisfaction

Situational Factors

CustomerLoyalty

Individual CharacteristicsPrice

Product Quality

ServiceQuality

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Dimensions of Service Quality

Reliability -- performing service correct the 1st time

Responsiveness -- willingness and ability to provide prompt service

Competence -- Knowledge and skill of customer-contact personnel

Communication -- explaining service in a way that can be understood

Credibility -- trustworthiness of personnel

Security -- Confidentiality of transactions

Understanding/knowing the customer -- making effort to ascertain a customer’s specific needs

Access -- Ease of contacting the service firm

Courtesy -- Friendliness of personnel

Tangibles -- appearance of facilities and personnel

ANY DIMENSION CAN DETERMINE A CONSUMER’S JUDGMENT OF SERVICE, BUT SOME ARE MORE IMPORTANT THAN OTHERS

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Dimensions of Service Quality

1. Reliability -- performing service correct the 1st time

2. Responsiveness -- willingness and ability to provide prompt service

Competence -- Knowledge and skill of customer-contact personnel

Communication -- explaining service in a way that can be understood

Credibility -- trustworthiness of personnel

Security -- Confidentiality of transactions

Understanding/knowing the customer -- making effort to ascertain a customer’s specific needs

Access -- Ease of contacting the service firm

Courtesy -- Friendliness of personnel

Tangibles -- appearance of facilities and personnel

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Summarizing the Findings about Service Quality

Patients focus on those things they can assess (search & experience qualities).

They use the process (FQ) of service as a surrogate of the outcome (TQ).

Reliability and responsiveness are most important to patients although any dimension can affect patronage and continuing loyalty.

RELATIONSHIP BETWEEN LOYALTY AND SATISFACTION

Satisfied patients are more loyal….

But not always

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CustomerSatisfaction

Situational Factors

CustomerLoyalty

Individual CharacteristicsPrice

Product Quality

ServiceQuality

Satisfaction/Loyalty Relationship

Loyalty

Satisfaction

Hi

Low

Apostles

1 2 3 4 5Very

dissatisfiedVery

Satisfied

Satisfaction/Loyalty Relationship

Loyalty

Satisfaction

Hi

Low

Zone ofIndifference

1 2 3 4 5Very

dissatisfiedVery

Satisfied

Satisfaction/Loyalty Relationship

Loyalty

Satisfaction

Hi

Low

Zone of Defection

1 2 3 4 5Very

dissatisfiedVery

Satisfied

Subversives

IDEALLY, YOU WANT YOUR SERVICE TO GENERATE MORE APOSTLES AND FEWER SUBVERSIVES

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Satisfaction StrategiesAvoid Causing Subversives

Avoid serious interpersonal or technical errors

Keep promises, Be responsive, Show respect

Demonstrate you care

Preserve and Create Apostles

Give patients exceptional service experiences

Make them feel that they got something of real value

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Assessing Patient Perceptions

Observation

Employee feedback

Patient complaints

Patient interviews

Patient surveys

Critical incident surveys

Focus groups

Mystery (secret) shoppers

Sales figures

Social media chatter

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Observation - Observing patient interactions with pharmacists and technicians can identify service problems. Observation can identify unproductive practices, length of time spent in various activities, and customer responses.

Employee feedback - Employees know many of the problems within service systems and can suggest solutions. They can also assess the quality of internal marketing initiatives. Employee feedback should be solicited with any service venture.

Patient complaints - Patient complaints can help identify which aspects of service are most irritating. Complaints may indicate just the tip of the iceberg and reveal a serious service problem. Service recovery strategies should be developed to deal with complaints. Complaints on social media sites like Yelp can help identify areas needing improvement.

Patient interviews - Patients can be interviewed formally or casually about their assessments of pharmacist services. Most good pharmacists ask patients how they are doing and how they can improve.

Patient surveys - Surveys can solicit patient feedback about service while experiences are still fresh in the patient’s mind. The shorter and more accessible the survey, the better.

Critical incident surveys - Critical incident surveys are designed to identify particularly good and bad services. Patients are asked to describe the details of service incidents that stand out in their minds (e.g., “Describe a particularly good or bad experience you had with a pharmacist”).

Focus groups - Focus groups are gatherings of patients who are invited to discuss issues of importance. They can be used to solicit quick, informal insight into service problems.

Mystery Shoppers - Mystery, or secret, shoppers are often used to supplement patient feedback. They provide analysis of specific service features that patient feedback may overlook. A mystery shopper who visits a pharmacy typically has a checklist for assessing aspects of service such as whether the pharmacist greeted the patient, offered to counsel about the medications, was friendly and helpful, checked the patient profile, and completed other required tasks. Most patients are not able to assess the service experience as critically or in as much detail as trained and observant mystery shoppers can.

Sales figures - Sales figures are the ultimate measure of patient satisfaction. Patient perceptions of service should be linked to total sales, repeat sales, and other sales figures to identify which measures are most predictive of sales.

- Peter F. Drucker

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THE MOST IMPORTANT THING IN COMMUNICATION IS TO HEAR WHAT ISN'T BEING SAID

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SummaryPatient perceptions are important as proxies for patient behavior (I.e., association with patient loyalty, word-of-mouth, and profitability).

Pharmacists should attempt to

make their services reliable and responsive.

minimize negative service experiences.

monitor patient perceptions of service.

SEE MARKETING FOR

PHARMACISTS FOR

MORE DETAILS

D HOLDFORD