How Intuitive Health Used NPS to Grow During a Global Pandemic

This is not a point of sale type transaction. Right. So nobody's, they're not walking through the facility handing us their credit card and we can measure receipts and impact on a daily basis and all those other things. It's a very convoluted process. So when patients leave, it's hard to really understand what was the impact of the visit unless we ask. And I'm not talking reviews, I'm talking feedback. What can we do to improve?

Hello, everyone, and welcome back to another episode of the Account Experience podcast. And today we're excited to welcome David Apple to the show. David is the Chief Marketing Officer of Intuitive Health.

And in this episode, David walks us.

Through how he leverages his NPS and experience program to not only grow his company faster, but pivot during the pandemic. And it's an inspiring story detailing all.

Of the great things that will happen.

When you use customer feedback to constantly improve your business.

This episode is a can't miss, so let's dive on in.

My name is Ian and I'm here.

As always with my co host, Kerry, twice.

Say hello, Kerry.

Hello, everybody.

And today we have a really special guest. Full disclosure, David is one of our customers, but we are proud to introduce David Apple.

He is the Chief Marketing Officer of Intuitive Health.

How are you doing today, David?

I'm very well.

So we're really psyched you decided to join us on the podcast. I think you have an amazing story to tell with everything that you've gone through over the last year. We're really excited to dive into this thing.

Great. Yeah. Looking forward to discussing it.

So let's just kick it off. Give us a little background about yourself.

And your current role at Intuitive Health.

Yeah. I'm Chief Marketing Officer of Intuitive Health. Been with the group for five years.

The company is really unique.

You know, Intuitive Health, we operate and build a dual model urgent care and ER under one roof, single entrance. It's pretty unique from the standpoint of each market that we build in and operate in. There's typically an urgent care standalone or there's typically an emergency room standalone. We've combined both to really help the patient eliminate that choice of where to go to get care in that time of need. We know that's a pivotal time, whether.

It'S a family member or it's yourself deciding on where to go. And so we've really taken that out of the equation. We started in 2008 in North Texas. At the time a tiny little town of Frisco, Texas, which is now a full blown city Frisco, Texas. So we've been part of that growth. And that was in 2008, really, when these facilities started to emerge. And I call them retail because of their size and their placement. So they're typically in high traffic trade areas, strip malls, you know, around where consumers are already doing their normal trade on a daily basis. And now you have the opportunity for healthcare, you know, services. And so that's really where the retail aspect you know, comes in. No appointment, walk in whenever you, whenever you need it, 24 hours, you know, 24 hours a day. And right around that timeframe, especially in Texas, this market really started to explode. So not only health systems, but individual investors, they started to invest in these facilities, branch out, grow market share, and in North Texas is really the battleground, if you will, for this retail healthcare size. So our model was really unique. We pioneered this dual model in 2008 as really a way to counter against the overutilization of the emergency room. The founding physician said, hey, we're treating all these patients in the emergency room, giving them great care. Many of them don't need to be here. We know this in the first couple seconds that many of them don't need to be here. But unfortunately, the way that the billing system works and the health system works, they're going to be charged an emergency room rate. So the thought process around these facilities was, hey, can we triage a patient that comes in, determine their level of care, treat them appropriately, and then bill them appropriately? And as you could imagine in those days, that was a kind of a pioneering type mindset to go at it that way. A lot of difficulty, a lot of explaining to do, the insurance companies, a lot of explaining to do to the customer and patient. But as you can imagine, it really blossomed and grew into a couple facilities in Texas. Then through some acquisition, we grow to six facilities in Texas. And then now through a lot of interest around the country, we formed Intuitive Health to take this Texas brand and mindset across the country with health systems. So now we joint venture with major health systems around the country. We have 12 operational facilities right now. We have another 10 under development, and we're in projection to have almost 40 through 2022 and 2023 open and operational around the country. So it's been a really strong growth trajectory and it's been a really exciting team to be a part of.

Well, every time I hear David talk about it, I just get so excited about it, and I'm going to tell you why, and I don't want to downplay what you do, because I think it's amazing. But I love the contrast or how.

You call it retail.

You know, I have a lot of roots in retail, and a lot of what you're doing is leveraging on that a little bit. So when you were talking about that, a couple of questions popped in my head. And the first one I really wanted to know is competition.

Yeah.

Is there competition? I mean, you're probably the only guy doing this. Right? You got all the business in the world just walking right into you guys, right?

Yeah, that would be fantastic.

I wouldn't need to be here, that's for sure. No, absolutely. You know, competitions in North Texas without boring anybody in your audience with the legislative landscape of Texas. But it allows these freestanding retail facilities to not be associated with the hospital. That's just the basic way to kind of explain it. So privately, you can invest and build these on your own.

Now, you still have to have an.

ER license and those kinds of things, but you don't have to be an affiliated or an outpatient department of a hospital. So we saw massive growth. So you can imagine physicians could get together and build these things. A lot of different avenues. Real estate companies could get together and build these things. So we typically measure our micro DMAs in Texas by drive time. So 15 minute drive time. So we have six facilities in North Texas within a six minute. Excuse me, 15 minute drive time to all six of those facilities. We have over 460 competitors. So it's an exceptionally competitive market in North Texas. Now, outside of Texas and these other states, it's growing. But because of that legislative hurdle in the other 49 states, for the most part, it's not as fast growing. However, the consumer has adapted to a urgent care retail type model, but nothing like what goes on in Texas.

That's crazy. That's a. That's a wild stat. 15 minute drive. Wow.

Yeah. Yeah. It has been an exceptional growth here in North Texas. No, no plan on stopping. Things change all the time. But it's. So you can imagine our attention to detail, our attention to service, which we can talk a little bit more about, but all these finite components and you layer on the fact that, you know this group of professionals and physicians and nurses and all those people that it takes to run a healthcare facility. We have always had the mantra of doing it right. So it's always. It's got to be ethically 100% sound. Right? So we're never going to bilk a patient and try to take an urgent care patient, put them in the Er, and get more charges. We have a very systematic process. And many times when you're in a high competitive market, you wonder, hey, can we just cheat a little bit? Can we go this way, go that way? Everyone else seems to be doing it that way, and it's an absolute no. And if you met the rest of the team, you would get that same answer, and that's what's kept us around. So in that same competitive landscape that we talked about with 400 plus competitors, just in our little micro DMAs, we have seen name changes, ownership come and go. You know, it has just been a pulsing market, you know, in North Texas. And here we are, the same group from 2008, many of the same nurses, same physicians, a lot of the same administrators still on staff, still a part of the team, you know, getting new opportunities. And we've never, we've never wavered from that, you know, you know, that mantra of staying ethically sound.

That is, that's amazing because again, I'm gonna go back to that retail thing one more time, because I think you talked about service, and I think this is the perfect bridge for us to kind of talk about what you are doing with that and why it's so important. Because I hear competition, consistency, and you're not selling T shirts and jeans. Legitimate business, but much higher standards in so many ways.

But make that bridge for us, make that connection. Let's lead us a little bit into this. Why is experience such an important part of what it is you've been doing?

Yeah, you think about that label, retail. And you know, a lot of times we're doing, when we're training and we're training these great nurses and physicians and stuff, and we say it's retail not only because of location, but it's also retail from the standpoint of expectations, right? So if you build this facility in the shadows of a major anchor store like Target, Trader Joe's or something along those lines, the expectations of that consumer in that environment is very high. You got to set expectations high, right? So we are in. As soon as we make that, you know, build that facility in that area, we are automatically in that same high expectation realm. We expect patients to and consumers to open up that door, walk in, get the smile, get the high level of service as they would as any other door in that complex, right? And we start off with that. They have to understand that, that retail is a mindset and there's a service level. So when we started to really try to understand, hey, we know we're doing it specifically By a process and by training and how are we doing? And that's when we really started to measure impact and feedback. And we looked at NPS as that methodology because we said, hey, if we're retail and we're making this promise not only to the patient, but also to the hundreds and hundreds of employees that we've told that we have to hold them to a higher level expectations, then we should start measuring and benchmarking ourselves against other retailers, because that would really be the only true measure. So we started looking at NPS as not a vanity score, not any of that stuff. It's something that we can get that feedback in a regular basis, understand where we need to improve and improve daily and hold ourselves accountable for that level of service. Our organization is a servant leadership organization. There is no top down at all. Customer is our most important part, part of our matrix. Everybody looks up to the customer. So we really hold that feedback very close to heart and we measure it daily. So our process, without giving too much away, is obviously, we use your platform. We've been partners with you guys for quite some time and it's been a great relationship, but mainly because, well, not only the service level and the platform is fantastic, but, but also because this is not a point of sale type transaction, right? So nobody's, they're not walking through the facility handing us their credit card. And we can measure receipts and impact on a daily basis and all those other things. It's a very convoluted process. So when patients leave, it's hard to really understand what was the impact of the visit unless we ask. And I'm not talking reviews, I'm talking feedback. What can we do to improve it is so incredibly important. So we survey every single patient that comes through all 12 of our operational facilities right now, and we plan on doing it for all the remainder. We survey every single patient on a daily basis and we get that feedback. We get a nice trajectory of feedback. 20 to 24% of all patients that visit us provide us feedback. There is absolutely no mention of the survey. We don't do any type of, what I call, you know, I'm from New Jersey, so this is my term, the survey, racketeering or anything like that. You know, there's no, there's no promises being made. We actually, we forbid it. We don't allow any verbiage against it or anything like that because we want that unsolicited feedback to hit that patient. They had, they've had time to digest the experience, understand, understand a little bit more about it. We're not hitting them in the facility, we're not hitting them as they walk out, you know, we're hitting them within, you know, 18 to 24 hours after they can digest the experience. And then we ask for honest feedback and it's okay for it to be bad, you know, and it's okay if you didn't like the air conditioning temperature, it's okay if the seat was uncomfortable. These are things that we put into that continuous improvement culture and training and say we can fix on a daily basis. And if things are escalated and need more attention, obviously there's a process, process to that. But everyone is bought in. So it's not just the feedback is not just coming to me or the CEO or leadership. It goes right to the clinical leaders, the nurse leaders, the physician leaders, the main facility leader, the front office leader. They get this, they get that escalation in real time. And we have a very specific clock driven process to get back to every single one of them. And we, and we take pride in hitting a 100% score every single month across every facility, meaning every single detractor and passive feedback has been addressed 100% of the time at the end of every month. It's something that we hold or within a box of 30 day windows, but it's always, it is something that we hold true and dear. And guess what happens? Customer service improves. I mean, it's 100% going to work if you actually work on customer service and working on improving so there is no ridiculous feedback.

Well, you know what I love most and it was all amazing. Again, I get excited every time you talk about this, but I know when I go to one of these facilities, typist, even my own doctor, nobody cares if it's too cold in the waiting room or the chair is uncomfortable. And what you have done is said, look, we know you're here. You don't probably want to be here. No one wants to do this. And what you're more worried about is the diagnosis, the care and all that. But you've gone a step further and go. But we're going to make you feel comfortable when you do it. We're going to hear you out and what can we do to make this a great experience? I'm always floored when I hear you talk from these perspectives and what you do.

So I want to jump into because something got me really excited. You said feedback, not reviews. I just want to remind everybody we're talking to David Apple, chief marketing officer at Intuitive Health and I'm an aspiring CMO myself, I love marketing and I think If I asked 9 out of or 10 CMOs what they would prefer and I'm pretty sure 9 out of 10 would say reviews. And the fact that you want feedback and you're more concerned about improving your business and relying on the word of mouth I think is just, it's a breath of fresh air from a marketing standpoint. But I think it's also just 100% the right way to do it because that will spread so much quicker than fake reviews. Everybody knows that the review game is propped up by, you know, honestly, you can't really trust them anymore. It's at that level.

And I get that question a lot, you know, and we of course we pay attention to online reviews and our online reputation and we have the processes in place, but the more systematic as it relates to our, you know, our searchability are in some of the digital metrics related. But, and we, and we, and we address and we have a service recovery process for, you know, negative reviews and things along, and things along those lines and, but it's a different mindset. You know, we always say that, you know, somebody that had a poor experience becomes an instant broadcaster, right? They cannot wait to tell the millions of people they do not know how mistreated, you know, they were. And that gives them the avenue. It's not feedback, you know, it's, it's, it's, it's, it's, it's a soapbox, right? Feedback is different, you know, feedback is intimate. It's a one on one conversation. The surveys come from our founding partner. The same guy that used his credit card to start this business and was broke 100 times because he believed in it. Is asking you, how do I improve still 11 years later, how do I continue to improve? So you get a really honest, specific kind of improvement methodology. And the online reviews, again, they play a role. But if we're handling feedback and we have a close attention to customer service, our reviews are, our reviews are just fine. We don't do any manipulation, we don't do any gateways, cherry picking, nothing along those lines. So if we get a one, we get a one and we deal with it. But for the most part, we generally get the fours and fives and we organically become the most recommended facilities in each market through that process. But we're handling it at the core, right? We're not trying to delete bad reviews and manipulate the review process to create this vanity score that helps my search score. We're just doing it at the core. And whatever happens on the other end of that happens. And trust me, I'm not a friend. I get inundated on a regular basis with the online review companies. They want to do something and they want to change our 4.1 to a 4.5 and they're going to guarantee 500 five star. I don't want any part of it. Now I'm trying to guarantee 500 five star reviews by making sure that we're constantly improving our customer service process because that'll just organically, you know, organically happen. So that's how I feel about it.

I think you're spot on. Really. It's the right way to do it. And like you said, your growth and your organic growth speaks for itself.

Right.

I mean, that's really where it's at, is you take that feedback, incorporate it into your business, good things will happen, people will talk. Like you said, it's just so well done. And I really. The other thing that caught me, Carrie, and I'm sure you'll jump in on this, is the close, the loop, time and goals and how you're feeding that feedback in real time to multiple different stakeholders in the organization. Frontline, middle management, all the way up to the top. I mean, that's something I know, Kerry, you believe in very strongly as a previous champion at a company. Um, let's talk about that a little bit. So what has that had as far as an impact on like your culture? I mean, that's that feedback getting right to your front line has to be an amazing feeling when that 10 comes in. I mean, all of that stuff, it's gotta be.

Yeah, there's. Yeah, it's fantastic. You know, in an organization, I think anybody who's working mps properly, you know, can probably fall into the trap of forgetting that they're getting so many good, much good feedback when, you know, you want to handle the negative. Right. And, you know, we're an organization that fortunately, you know, sees 89 to 90% of all feedback in the promoter bin and you know, 4 or 5% in the tractor and 4 or 5% in the, in the, in the passive. And so we can get really, you know, we fall in that trap too. We get, you know, wrapped up in the escalation, you know, component and handling those and trying to get, you know, our goal with every detractor is to get into passive, with every passive, get him back to promoter and just follow that chain and what we do there. Just to give you a little bit of idea of kind of the Workflow process is we hold leadership very near and dear, so we expect leaders to be accountable. So we have a physician leader and we have a radiology leader and front office leader, and they get all the escalation and then they allocate it or discuss with the person involved, get a little bit more insight into each of those escalation cases. And then they reach. And the leader reaches out to that patient and addresses and kind of works through it. I don't have an exact number, but I know it's very high. 60 to 70% of the time when a patient picks up the phone and it's us and they're like, holy moly, you read those? You know, and right away whatever the problem was is gone because it's just an appreciation. And we're expected to make first contact with an escalated patient within 48 hours and close the case within 72 hours. And we do, like I said, we pride ourselves on getting those to 100% closed every 30 day period and making sure nothing lingers on. So there's a really specific accountability structure in that. And then on the promoters, you know, that's probably because I'm part of the, I'm really kind of responsible for the whole funnel, the patient funnel. So not only keeping that new patient funnel full, but then also retention. And so one of the things that our team works on very closely is talking to those promoters, right, and making sure that we know how appreciated they are. Because a promoter doesn't necessarily broadcast, right? So you had this amazing experience. You come home and you say, you know, to your colleague or your next of kin and you say, yeah, it's fantastic there. And then maybe when a neighbor asks for a recommendation, you recommend, you know, you know, adversely if you had a terrible experience, you can't, you get online and you, and you broadcast it to, you know, so it's really important to concentrate on those promoters just as much as you concentrate on the escalation cases and, you know, the tractors and passes. So we have a process for both, but we make sure, in addition to not only reaching out to those promoters, but we are constantly inundating our clinical staff with these promoters and the feedback. And we do a lot of internal rewards and gratification because, man, nothing, I mean, especially during a pandemic when these guys, some of these, our staff haven't seen their families in weeks at a time and months at a time because they need to be constantly quarantined. I mean, to know that. And we're seeing 50, 60% more patients than we've ever seen. You know, they need to know that how strong their work is and that attention to detail is really not going unnoticed, for sure. And one other part of that question you just mentioned is it's not for everybody. I mean, you can picture healthcare, right? It has got a very traditional methodology, right? I mean, and we have some of the finest physicians, you know, in the country, er, physicians that work for us, that come to work for us, and they just say, I don't like this type of visibility, you know, and. Because some of them, you know, and they're great doctors and some of them say, you know, they can't handle, you know, their first week on the job as a 40 NPS, right? And for us, it's not. It's not about the score, it's about the improvement. I mean, we have so many great case studies of, I mean, physicians that have been in the field for 20 and 30 years and renowned and researchers. And I mean, you can't. And then here they are working in this little retail facility, seeing, you know, lower acuity patients. You know, these are people that have, you know, ripped open people's chests and got hearts beating again. And, you know, like, you know, they've seen it all. And then they're, you know, then they're in this environment and they're dealing with, you know, families and stuff like that. And they're going, I can't believe these people are telling, you know, are scoring me bad because I don't smile enough or I don't, you know, and it's. And for the most part, you know, we, you know, we encourage them to use the feedback effectively. I mean, this is a, you know, you can work on your bedside manner. And this is. Now you really know how you're being, you know, perceived and spend more time with the patient. You're allowed to spend more time with the patient and go through it, you know, thoroughly because, you know, you live in these people's neighborhoods, right? These are. You're part of the community. There's a lot more exposure now. And so it's a fine line because some really gravitate to it, like, hey, this is the greatest thing ever. I've never really been held this accountable for the service level. And some say I just, I'm not comfortable with that. And, you know, and they can't do it. So it really is not. It's definitely not for. It's definitely not for everybody, that's for sure.

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I hope when people listen to this, they go back and listen two or three times. There was so much there and I mean, man, did you answer the question, how does this impact the culture and the impact it has on the company? And I mean you could just, just the way you tell that story, it's the right people continue to stay and grow and fit. Feed it. Yeah, definitely answer. But I can't let one word, you threw one word out and all that. So I'm going to be the bad guy here and I'm going to bring it up. You mentioned the word pandemic.

So, okay, so, all right, Davey, talk a mean game. I hear you. But 2020 was hard on everyone, right? So let me ask the question everyone's thinking, right? So how did your program and what you were trying to accomplish, what did that look like in 2020?

Yeah, so it was an exciting year, let's put it that way. Maybe I'm an optimistic. It was an exciting year for sure. You know, we learned a lot about ourselves. You know, the organization, like I said, is our leadership structure is servant leadership. We have really well known military leaders that are part of our leadership team. Great education levels, you know, so we, we, it's, it's a very broad spectrum. So the, you know, the mantra from, I mean it was basically that Friday in March, you know, when Tom Hanks got, and his wife got Covid to the, to the NBA game being canceled to Monday, we're in a pandemic, right? So it happened quickly, swiftly, you know, in our, like I said, kind of cool under pressure leadership team. You know, the mantra, right? From day one, the first five seconds of our kind of meeting call, what we're going to do was we're going to pivot, not panic, right? There's absolutely nothing we can do. This is a health pandemic. We are healthcare providers. We are going to buck up and we are going to do our part in serving our community any way we can. And if you can imagine, I mean, it's behind the scenes in healthcare. It was crazy, right, because there wasn't necessarily patients, but there was shortages in supplies. There was a lot of unknowns, there was slow moving government oversight on testing. There was a lot of components going on. But we're not going to close the doors. We're not going to do anything. We're not going to do anything drastic. Our two focuses were obviously continue patient care and to keep our employees safe. That was top priority because obviously early on in Covid, nobody was really totally sure of the impact. The science was lacking. You know, when you get it, do you automatically die? I mean, you know, here, you know, can you imagine being a nurse and all this and there's really no clear cut answer and you're terrified of being within six feet of somebody or Somebody sneezing on you, you could die. We've all seen the movies, right? Like, here we are, we're thinking that this is the beginning of the. And, you know, we can laugh about it now, but, you know, that that was the, you know, that was the tone. So it was really, you know, kind of a pivot. Don't, you know, panic, take care of those employees first. So, I mean, I'm talking about construction companies donating N95 masks, you know, I mean, getting them from all over the place. And, you know, and it's, you know, the great thing about our organization is obviously we're very heavily involved in the community outreach and first responders. So a lot of that favors got repaid to us, and we were always able to have enough legitimate supplies to keep our staff safe. So once we kind of got to that point, it was time to start. Now, focusing on the patient again. April and May, we saw very low numbers of patients worldwide. I mean, everybody was closed. You know, primary care physicians were closed, surgeries were canceled. So those were very low months. But it allowed us to really concentrate on our process and what we saw. Even though we were only seeing a few patients, the feedback in that time period was amazing. And we never wavered from that one bit. I mean, we loaded up that patient data every single day as if it was any other day. And we poured over the responses. What did people want? To feel safe because you're still going to cut your finger open, you're still going to get sick, you still might be diabetic. There's all these things that weren't going to go away because there was a pandemic. We shifted very quickly to start to meet the needs of this feedback. So, for example, it was. Healthcare facilities seem to be the unsafe place. You didn't want to go to the hospital because Covid was lurking on every wall. If you walked into a hospital, you were going to get Covid, and understandably so, right? The media was blowing it up and everybody was really uncertain. So we immediately pivoted, and I'm talking with under 24 hours to a dual care model. So if you had Covid symptoms, we treated you outside in a safe, secure way, you know, in your car, near your car. We had all of our parking lots completely mapped and coned and arrows. And I'm saying this is within 24 hours, right? And then we had an inside process where you were screened at the door. And then if you. Even if you came in with a, you know, a broken hand, you know, we had to take your temperature. And we had to get some of those, you know, components. So if you had any symptoms, even though you didn't know you had symptoms, you sat over here, you know, and then you went, you went this way. So even though we were seeing these low numbers, we had these processes worked out and it was so great that we did ahead of time because as we know, what happened moving forward is we went from, you know, April, May being non existent to June, July and August, you know, you know, seeing thousands of patients a day all scared, all worried, you know, as they should be, you know, they need care, you know, they have symptoms. Now in COVID testing started to come back, you know, kind of get to become mainstay and come into the market. And that allowed us, because we had these systems in place and it's all based on feedback. We didn't make any of it up. These were all patients asking us to do these things. We put these processes in place and we rocked and rolled with it. And it really carried us all the way through the end of the year. We still have a lot of the stuff in place, but it worked, it kept everybody safe. I mean, we did not have a healthcare related Covid case with any of our employees until close to Christmas through that entire realm. And we were really proud of that. That meant we were going above and beyond what we needed to do to keep those. And that was first priority, right? Really go above and beyond what we needed them to do. And we continued to measure that feedback on a regular basis and change some things up. We were pivoting every single day, every single week. I mean, we literally met on a call every single day, seven days a week for five months, measuring the feedback, putting action plans into place every single day. Sometimes that call was five minutes long, sometimes that call was six hours long. I mean, we just, you know, we were just in a constant, you know, pivot mode. And then you come down at the end of the year and all of a sudden when everyone comes up for air, you know, we saw more patients than we've ever seen, you know, as an organization, you know, and that, and I call that a 10 month year too, because of those two slow years. We saw more patients than we've ever seen. Our NPS never dipped, you know, if not grew, which we're always proud of our teams. Because even when we see big flu outbreaks and stuff like that, when the facilities get really busy, it seems to be the time that everybody shines. It seems to be the time that everybody really kind of grasped hold of the concepts and wowing patients and making sure that they have the best experience ever. And so our NPS never wavered. There were some dips and dives, and there were some tough periods and stuff like that, but it really continued to grow. And then I've been saying since the beginning, I think that really a true measurement of an organization is when you have times like this, you know, it's, who are you on the other side? Right. You know, and we were lucky to see more new patients than we've ever seen. And now it's our job to really make sure that, you know, when they're now, when they come back, you know, outside of COVID that they get the same experience. Right. And those expectations are met again, you know, and so it was a really great. It was from a business standpoint, we met all of our needs. I feel like we're a better company on the other side, 100%. I mean, you know, and to kind of answer your question, everything has changed, you know, everything. I mean, it is a new world. And we know that in this retail healthcare space, you know, patients are going to be resetting their expectations now, right? They're going to be looking for new care providers. It's kind of a reset, you know, especially with primary care physicians, a lot of them going out of business or kind of transitioning or selling, you know, there's going to be a whole reset. So we are hoping that we are poised because we responded, we listened, we responded and we. And we reacted, you know, positively that, you know, we're going to, you know, gain that patient base, you know. You know, you know, through the. For the years to come, which. Which is the goal.

So, yeah, I would say the one thing that didn't change was your approach. And, you know, we scream this, we yell this, we try to get people to act on the feedback. If your customer is telling you something, listen and do something. And because you had that model in place going into this, you didn't use it as a distraction or anything else. It was your strength. It was your guide through it the whole way through. You rallied around that feedback. You made business decisions on that that helped you grow. Look at you now.

Right?

And, yeah, I'm in awe. I'm Ian.

Oh, thank you.

I know you've got, like. I know Ian's got a whole list.

But, yeah, I mean, the thing that.

Jumps out at me in that description is the daily meetings that you had a whole team baked around it, and every day seems like that's like the first thing you guys did was look at the feedback. I mean, if a quarter of the companies that we encounter in this world did that, I mean, can you imagine what that would look like? I mean, that's such a commitment to the customer to dedicate hours out of your day, every single day to look at the feedback and just address any issues or you have to be true.

With the fact of, you know, what, how do you grow, right? I mean, we don't do anything we don't have. And we pivoted. We had telemedicine live. We did. I mean, we integrated more tools quicker than I can even, you know, imagine. We made, you know, 140, you know, digital updates to our websites and to our, you know, we built telemedicine platforms. We did. I mean, we did, we did everything that we were supposed to be doing. We were, you know, based on the feedback. But the reality of it is, is that we don't do anything without the patient, you know, and we don't. And telemedicine maybe because, you know, retail health has become kind of a strong point and access is pretty easy, that telemedicine didn't really take off as projected across the. There's some that are doing pretty well, but it didn't really replace on site care as much as it was kind of anticipated. And I completely understand why everybody would think I'm even bullish on it, that you could replace a lot of this low acuity care with telemedicine, but it never really took off. And so the reality of it is that we don't do anything without that patient walking through the door. So we, we have to continue to give them the confidence to walk through that door. And that was really the mainstay of that, you know, kind of daily huddle of, you know, you know, is getting them in. Because there was a time period there too where, you know, death rates were going up because people not Covid related but people weren't getting care for pre existing conditions and stuff because they were so nervous to go in. And that to me is scarier than the pandemic was, is that people were ignoring symptoms and care opportunities and sacrificing their lives. That was never supposed to be the, you know, so we wanted to, it was a constant reassurance that we're doing everything we can to keep you safe. But do not ignore care. You know, that was a huge part of it.

So how do you see this evolving.

In the next kind of few years? And I know that's a difficult question knowing the current state of everything, but specifically your experience program, how do you see this moving forward? So clearly you have amazing system in place. You have buy in, you have close the loop in action, cases management, all of that great stuff you have going on. What's the next thing for you guys?

Yeah, we're definitely going to continue it the way we're doing it. It's a mainstay in our training. You know, MPS is a, is a core component. So we do all this training. You know, it's the best way to measure the impact of the training and the progress of everybody individually. So that will, that will never change. I think, you know, you know, part of the things that we, part of the challenges, I think any company that's using NPS is that there's always this rush to change it to this like vanity score. And we're fighting hard to never do that. Right. There's plenty of vanity scores out there and we're fighting really hard to keep our NPS and our methodology away from converting it to an out of five score. All these things that are going on now that we just think are just so detrimental to why you're even doing it anyway. So we're just gonna, we're just gonna. And I say that, a couple reasons because obviously we're approached on a regular basis as a customer service organization and people say, oh, well, you should be converting your NPS to a 0 out of 5. And then it looks like a Google rating. And then everybody thinks, you know, and, and then I don't, I don't have time to educate on the difference. But, you know, it's, it's not, that's not an apples to apples comparison by any means. And that's not how we, you know, how we use it. And it is a struggle. And it comes up a lot as we expand across the country. There is other, in healthcare, there is other survey methods, right? And I just call them survey methods because I don't think they're even scoring methods. They're just survey methods. But they're not. The impact is not measured the same way. So there is, we do get, we are getting, we have to pitch this every time, you know, this process. And not even just a platform, I mean, the platform. I mean, you guys are baked into our processes. So that's aside, it's the NPS process, right? It's the feedback process. It's exposing physicians and nurses to feedback. And why wouldn't you just use XYZ Survey over here? We've been using it for years. In those kind of components. So I see a continued kind of, for lack of better term, a battle. But we are never going to waver from, you know, the 100% feedback continuous improvement methodology, you know, without a doubt. And I hope it just kind of, it gets, you know, becomes mainstay and it just kind of becomes part of our, you know, vernacular. We don't have to, you don't have to fight off those, you know, the vanity demons, you know, to try to turn that into a public score because, you know, NPS is hard to explain to the public, but it's not really for the public. The public is experiencing NPS through the customer service. Right. You know, we're super proud of our Texas based facilities being in the 80s, you know, and NPS. But that's a B, right? That's a B and a great point out of 100, you know, and so it's hard to explain, you know, how, you know, 70 and above is world class. Right. If you benchmark it, it's, you know, world class. So we've done some translating of top 1% of global retailers. So we know we're in a upper echelon of retailers who use mps. We try to use the wordsmithing and everything to try to explain NPS, but 90% of it is for our internal process and the rest will work itself out if we're hammering it down. It has become just one other point on that. It has become easier to explain NPS for sure. Over the last five years. We used have to give a whole deck education on what it is. Now at least most of the people that we are dealing with in the health systems and other partners have some understanding of what it is, whether they're using it or not, but they have a general understanding of, of the, of the science behind it and the methodology.

Yeah, I think that's amazing. It's inspiring. David, thank you so much for sharing your story with us. It's, it's really, it's been a crazy year. But I really do want to kind of commend you guys for like you said, pivot, not panic. I've been to a couple of those in my local town. So it's, it's, it's felt across the country, right, that it's, you guys needed to step up as an industry and I think you certainly did across the board. So it was just amazing to see as a country. And I think any Europeans listening this probably isn't quite as clear because they have central medicine. But yeah, it really was up to Communities like you said, like individual communities, individual healthcare providers for those communities to step up and provide a safer environment for everybody.

If we asked patients over the last 15 years to start making their own decisions in healthcare in the United States. Right. Everybody did. It wasn't just, it was the insurance companies, it was the health systems. Start choosing is no longer a horizontal referral channel. Not everything starts with your PCP anymore. And we asked consumers and patients to do that. The last thing we could have done in this situation was abandoned that. Right. So they're still making their own decisions. We had, everybody had a step up. I think a lot of the urgent cares did a fantastic job around the country. A lot of the, you know, the health systems, everyone did, you know, did a really good job sharing equipment and everything else. But you had a, you can never let go of the fact that, you know, patients are doing exactly what we asked them to do. You can't ignore them now in this situation because this is when you have to, this is really when you had a step up. So I 100% agree with you and I think it's been an exciting and world changing year, for sure.

Absolutely. And step up you guys did again. David Apple, Chief marketing Officer at Intuitive Health. Amazing, amazing story. I can't wait to get this out to you guys. It's just so good. Kerry, any last thoughts before we part?

Yeah, I mean, the only thing I.

Would leave with people is you might hear the title or think Intuitive Health and think it doesn't relate to business. But everything David is talking about is what we've been living and breathing and trying to get any company. Listen, we used to joke around that experience isn't life or death. For David, it is, right?

Let's be honest, it really is.

But because they were so forced to have to have this culture and this program in place, what they're doing is spectacular because the results are there and so many different types of businesses can learn from that. We're more similar than we are different when it comes to service and experience. So again, David, thank you so much.

For sharing that with us.

Yes, I appreciate you both. Thank you very much, guys.

You guys are listening to the Account Experience podcast. We'll talk soon.