Will health care look to Zappos for inspiration — or to Comcast?


The Zappos Ideal

Mention "customer service" - or better, "customer experience" - to entrepreneurs the world over, and you are likely to hear one example cited above all others: Zappos, and the culture CEO Tony Hsieh has very deliberately created there.

While ostensibly a consumer apparel store, "It's very clear," Anthony Tjan writes in the HBR Blog, "that in Tony's mind that Zappos is in the customer service business, and it just happened to start with shoes."  Hsieh has even written a best-selling book entitled "Delivering Happiness," and there's a whole history, and legend, about the lengths to which Zappos will go to please customers.

And then there's Comcast.

While stories about underperforming cable providers seem more appropriately relegated to the "Dog Bites Man" bin, I was struck - and admittedly even a bit captivated - by the contrast between a recent Comcast experience and the Zappos gold standard.

The Comcast Experience

My latest Comcast experience started a few weeks ago, when my internet and phone service started to go on the fritz; after the usual interventions (unplugging, rebooting) failed, I called Comcast, and after fighting my way through a series of automated voice prompts, excruciating hold music, and requests for account verification information, I eventually reached an agent who tried to troubleshoot for a bit, and then suggested I exchange my modem to solve the problem.

So, I trooped off to the local Comcast center, waited in a long line, received my replacement, reinitialized my system - but no dice; nothing had changed.  So I called Comcast again, navigated through the same series of annoying prompts, and ultimately reached an agent who eventually managed to set up a service call for the following weekend, and gave me a 2 hour window, 8-10am.

Our family planned our day around the Comcast visit, because we really wanted to get this fixed.  8am arrived, and the wait started.  Around 8:15am, I checked my phone (which hadn't rung), and it turned out Comcast had left a voice message.

Although the reason we had requested a technician visit was precisely because we had lost consistent phone service, I was nevertheless concerned that their failure to reach me would result in a visit cancellation.

At 8:30am, I called Comcast, and sure enough, received an automated notification that my service call had been cancelled because they couldn't reach me; however, when I subsequently spoke with an agent (after once again fighting through the voice prompt menu), I was told not to worry, the visit was still scheduled.

9am, 9:30am, 9:45am: no Comcast (though plenty of irritated tweets, for all the good that did me).  At 10am, I called Comcast again, navigated the voice prompts, spoke to an agent, then requested a supervisor.  No luck-the supervisor was said to be on another call, did I mind waiting?  Sure, I said.  Ten minutes later, the agent returns - the supervisor is still on the other call, I'm told, but will be glad to call me back at the most convenient number, which I provided.

Meanwhile, I'd been on Twitter all morning, and after striking out with "@Comcast" and the utterly Orwellian "@ComcastCares," I managed to connect with "@ComcastPete," who's job seems to be to run interference for Comcast on social media, and try to solve problems from irritated customers like me.

Ultimately, @ComcastPete was unhelpful, the supervisor never called back, and my guess is that I'm going to have to go through the whole carnival again another day.  I'm dreading it.

My Comcast experience hardly seems unique.  Comcast earns miserable ratings on Yelp, and seems to be routinely written up for their poor customer service - see this LifeHacker article, this Consumerist article, and this depressing but riveting Quora discussion.  Or simply track "@ComcastCares" if you're a bit twisted, and enjoy experiencing the pain of others.

Lessons For Healthcare?

You might think such consistently poor customer service might be hurting Comcast's business.  You'd be wrong.  According to the NYT earlier this week,

"Judging by the second-quarter earnings reported by two major media companies on Wednesday, the good times are still rolling in the television business.

Comcast reported that its earnings rose to $1.7 billion from $1.35 billion, or to 65 cents a share from 50 cents a share, in the period a year earlier. The results surpassed analysts' already sunny earnings projections of 63 cents a share."

And to twist the knife: "Comcast's strong quarter was spurred by its broadband Internet business..."

The only way I can make sense of this is to assume that the success of organizations like Comcast must reflect the near-monopolistic powers they enjoy - or perhaps more accurately, are permitted to enjoy.

Of course, cable isn't the only business where rapid growth and capture of share is leading to a dangerous dominance in the marketplace, as this presentation from CMU's Martin Gaynor eloquently attests.

This is the real question that should keep us up at night: will massive hospital systems like Partners and the Mayo become next Zappos - or the next Comcast?


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About the Author


  • Dr. Shaywitz trained in internal medicine and endocrinology at MGH, and conducted his post-doctoral research in the Melton lab at Harvard. He gained experience in early clinical drug development in the Department of Experimental Medicine at Merck, then joined the Boston Consulting Group’s Healthcare and Corporate Development practices, where he focused on strategy and organizational design. He is currently Director of Strategic and Commercial Planning at Theravance, a publicly-held drug development company in South San Francisco. He recently wrote Tech Tonics: Can Passionate Entreprenuers Heal Healthcare With Technology? 

  • Email: davidshaywitz.aei@gmail.com

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