“Killing in the Name Of” was a song released by rap/metal rock band Rage Against the Machine in 1992. Written about revolution against institutional racism and police brutality, it fast became the soundtrack to many teens angry, hormonal, anti-establishment years. This was helped by its distinctive guitar riffs and no doubt by the famous end-of-song chant “f**k you, I won’t do what you told me” (an ideal anthem for every teen!). In fact, before or as you continue reading, you might want to re-visit the energy of your youth below? (we can all do with a bit of rock in our otherwise average day!)


I heard the song play on the radio recently having just come from a hospital visit, and I was curiously drawn to the parallels between the band name and my experience within the sterile walls of the institution I’d just left. The medical world, like many other business organisations today, seem not to understand consumer centricity, or in fact not even care that they don’t. It is a machine, a big one, dominated by systems, procedures, processes, consultants and bureaucracy where they have a nasty habit of treating the patient as an input as opposed to the consumer. And from this machine there is a learning for us all.

The Wrong End of the Telescope?

Back in the 17th century, Galileo worked out that the sun was at the centre of our solar system, and that we on Earth revolved around it. The Catholic church didn’t like this idea at all. They preferred the current status quo, that we on earth were the centre of everything, and all other heavenly bodies revolved around us. And so, they accused him of being a heretic, put him to trial, and placed him under house arrest for the rest of his life. Unfortunately for Galileo this was before Snapchat, so essentially they just locked his idea up with him.

But I feel just as the Catholic church was fascinated about looking down the wrong end of this telescope, both metaphorical and actual, many businesses today seem to be doing the same. Instead of placing the consumer or shopper at the centre, they seem intent on placing their processes, systems, ways of working or themselves at the centre. And in today’s new consumer-led world, this is paramount to a heresy of a different kind.

Old Ways Won’t Open New Doors

Today as consumers we are used to being at the centre. Our digital re-design has meant that we expect the ‘system’ to know us. Those little cookies remember you, curate your content, predict what you might want to buy next, deliver to you. Payment and ordering systems have become more frictionless, more of our needs met with just one click. As consumers, we expect to be at the centre. We expect things to revolve around us, and our needs. It has simply become the norm in many of our life interactions.

Recently I was booking a family vacation. I had a number of holiday operator websites open on my browser and was flicking between them trying to work out the best mix of locations, flights, hotels and routes in terms of timing and value. What was interesting was that every time I started a new search, some sites ‘remembered me’ and auto-completed my travel dates and room preferences, while others started with a blank screen every time. Within minutes I found myself just using the one that ‘remembered me’ for my searches. It was just easier. And I felt a little less impressed with the others. The booking engine for one company had placed me at the centre, the others hadn’t.


You are Now Just a Number

So back to healthcare and hospitals. Their issue starts in the very beginning of the customer journey when they allocate you your patient number and attach it to your wrist via that little plastic bracelet thing. From that moment, I think you disappear as an actual person/consumer and just become a patient record. The system opens up and swallows you. Back to our friends in Rage Against the Machine and another lyric from that song “… now you do what they told you, now you’re under control”. The machine has you.

There is a reason prisons allocate and refer to their inmates by number. When you are just a number you are no one, an individual treated as just an input, a personality-less part in a large machine. It breaks the spirit, which might have seemed a good idea in the prison system, but less so as a patient I would think. From that point the patient stops being at the centre and the machine takes over.

With some isolated exceptions, any interaction I have ever had in a hospital has been system led. The patient is moved from station to station, diagnosed, treated and comes out the end of the process much like having travelled along an assembly line. I have never received a customer satisfaction feedback form from a medical consultant. I have never been asked what I would like to happen next. I have never been made to feel that I am the one in control, in fact quite the opposite. The medical system seems to have been built to keep the patient in the dark as much as possible, and often it treats the patient as the sand inside the oyster shell – something that needs to be ‘dealt with’ as opposed to the person paying for the service. Where HCAHPS surveys are used in the US, they simply seem to track satisfaction as opposed to actually do anything about it. The tail ends up wagging the dog.

Challenging the Experience

And then sometimes you see a glimmer of hope. Like when you see MRI and CT scanner rooms in children’s hospitals like the ones below.


Optimising the Healthcare Customer Experience (CX) is now seen as possibly the most important element of most business delivery today. Understand the customer journey, identify any friction or pain points, strive for seamless, delight the customer, surpass their expectations. I am unsure that most medical practioners or businesses take CX seriously, if they think about it at all.

Instead, they have become governed by their system, by their ways of working, their schedules and diagnostic tests, their bureaucratic machines. The consumer is never at the centre, their system is. It is difficult to deliver on CX when you think the Earth is at the centre of your universe.

You are Not the Pope

So, for any business, regardless of the industry, this new reality has to be faced. There is no point in pretending anymore that you are the Pope (unless you like large pointy hats?), intent on believing that your business and ways of working should be at the centre. Your customer and their CX is at the centre, and you build out from there. Otherwise you are simply not relevant.

So, the next time you are in hospital and the medical professional treats you like just another record, another patient to be processed, try singing the last line of that Rage Against the Machine song and see what happens … “f**k you I won’t do what you told me”. (WARNING: I take no responsibility for needles stuck in places where they shouldn’t have been in response!)

Part II of this blog commentary (using the healthcare industry as the focus) will look at peer-to-peer and Patient Power and what we can all learn from the P2P economy

Of course, I should end by acknowledging that most of the medical professionals are often just trying to do their best in a system that is broken and often under-resourced, so don’t necessarily blame them!


Ken Hughes is one of the worlds leading Shopper and Consumer Behaviouralists, blending his vast expertise in consumer psychology, social & digital anthropology, behavioural economics and neuromarketing to answer the question to which he has dedicated most of his career: Why do shoppers buy and how can we make them buy more? Click here to read more

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Ken Hughes, known as The King of Customer Experience on the International Conference Circuit, studies emerging consumer behaviour and helps businesses and brands establish deeper and more relevant connections with their customers.

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