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My last post on building patient confidence through emotional attachment, referenced the book, Human Sigma, by John Fleming and Jim Asplund. When patients are confident in our services they feel a sense of security and are willing to expand their relationship with us as their providers, potentially resulting in patients who become our emotional advocates and our most effective marketing force.

To progress relationship buildingwith our patients, the next level of Fleming and Asplund’s hierarchy is integrity, or fairness. When providing good service there are 3 types of fairness we must work to address. The first is distributive fairness – is there an equitable exchange of resources? For example, patients come to our clinics expecting to receive care in exchange for payment from themselves or a third party payer. There is an expectation of integrity in the exchange of resources between our practices and our patients.

The next type of fairness our patients expect is procedural fairness. There is an understanding that there is a consistent set of steps that will be followed by our clinic and by our patients when receiving care.  A patient schedules an appointment, and we reserve our time to provide them expertise and skills during said appointment time. We then collect co-payment, and the patient receives care.

Finally, our patients expect interactive fairness – they expect that we will be polite and courteous. They expect to have our undivided attention and that if something goes wrong we will show genuine concern and effort to make it right.

These three concepts of fairness can guide our actions when addressing patient complaints and influencing how we develop policies and procedures for managing our practices. When a patient complains of bills received, consider- distributive fairness (have the correct resources been accessed in exchange for the care received?), procedural fairness (were the correct processes followed for submitting the claim?), and interactional fairness (have the patient’s interactions with your practice been polite, courteous and sincere?).

By looking at patient interactions through these lenses, the chances of creating a patient advocate become much greater.


Bridget Morehouse PT, MBA is a consultant with Steffes and Associates, a rehabilitation consulting firm based in Wisconsin.