A New Challenge for Studer Group and all the Hospital Smile Consultants

Finally, the Studer Group and all the high priced consultants that are trying to fool patients and their families into believing that healthcare institutions are “patient-centered” when they may not be have a real mission to fullfill.  Get thee to France where, it now turns out, the French tourism board is trying to convince Parisians and other assorted Frenchmen and women to be kind to tourists.  In an article in today’s New York Times entitled “A Quest to Make Gruff Service in France More Gracious,” Liz Alderman catalogues the legendary rudeness of the French and how it’s turning off tourists.  Apparently efforts to make France more tourist friendly have failed since they were launched after World War Two. 


So that’s where healthcare consultants come in.  Their specialty is trying to manipulate people into thinking institutions that don’t seem to care much for them or about them (except for the money they bring in that is) actually do by encouraging staff to smile constantly and ask their customers (i.e. patients)how  they are doing on an hourly basis.  Health care consultants impose scripts on nurses docs and other staff, a la “can I do anything for you, I have time?”

There would be nothing wrong with this if people actually had the time to deal with even basic patient needs.  Problem is, today’s  productivity standards make it impossible for them to take that time. You know all about it, the ten minute visit in which the physician has to take a history, make a diagnosis, create treatment plan, prescribe and explain what’s going on to the, not to mention computer charting — yes, just in a few minutes.  Or the six to 10 patient loads nurses shoulder in most states.   Consultants have been peddling these scripts and smiling protocols for years now.  With new reimbursement models that base some of their payment on patient satisfaction, hospitals and other health facilities are upping the smiling ante in order to rig patient satisfaction scores.  Sadly, patient safety– the real key to patient satisfaction as well a reducing  healthcare costs — is at risk of being overshadowed by efforts to implement superficial measures developed by the hospitality industry like hotels and restaurants.

So my solution is to send all the high priced healthcare consultants over to France where the real hospitality challenge seems to lie.  Imagine the Studer Group coaching  Parisian waiters in all the ubiquitous cafes that line French boulevards.  These are the ones who, when a tourist arrives and asks if he can sit down, retort haughtily, as Times reporter Lisa Alderman writes, “Look around! You see empty tables, don’t you?”

These waiters are the ones that really need help.  First they  need to be taught how to smile (something they learned not to do in wait school). This may take considerable time, but that’s cool for people who bill from $250 to $750 an hour.  As consultants now do in America hospitals, mirrors need to be strategically placed behind the bar or in the kitchen so that waiters can practice smiling into them before they race out to take an order or deliver a demi or cafe creme.  As tourists are passing cafes, waiters can intercept them and ask if they have any questions about their beautiful city.  Or they can learn how to do rounds every fifteen minutes or so, checking on the classic tourist vital signs.  If a customer has gone to the bathroom or walked outside for a smoke,  the newly transformed Garcon can offer a dazzling smile accompanied by a heartfelt “welcome back,” as the tourist sits down again.  And of course, any time a customer looks even slightly discontented or in need of help, the waiter must obsequiously dash over, putting one hand reassuringly on their shoulder and another on their wrist to check their pulse.

After they have conquered the French cafe, they can move on to the Parisian boutique where staff routinely ignore their customers — particularly the  American tourist — and act as if assisting someone who wants to buy a stunningly expensive silk foulard or embossed handbag was totally beneath them.  Again, practice mirrors cunningly concealed behind the cash register or in the back storeroom and smile school are de rigeur.

The French targets are endless — hoteliers, department store salespeople, taxi drivers, ticket takers, innkeepers.  The French economy is in desperate straits and the Studers and their ilk could actually do some real good.  And here in the US, our hospitals would have a lot of more money to focus on what really matters — patient and worker safety, something that fake smiles will never produce.


Showing 19 comments
  • Teresa

    I found parts of a recent “patient satisfaction” survey sent to me pretty ridiculous. For example, they actually asked me, the patient, how I rated the skills of the procedure’s technician. Why are these surveyors asking Patients to rate a technician’s skills, when most Patients have never been taught how it’s done? I left the likert scale blank and wrote to the side “how would I know?” I suppose no one will see it except the technician who enters the data…

  • Faith

    Well, Suzanne….Don’t really understand the purpose of instituting Studer at a hospital and paying enormous fees when the PR and Admin could easily assemble the same questionnaires and ask directors and physicians what they need to make their jobs better and more effective. Wow, so these coaches come in and tell us how to run a hospital? Give me a break…most of them can’t find jobs after leaving a hospital so they run work for Studer. Just a PR campaign and creates more work for nurses and physicians that don’t have time nor the energy!!! They should lower your fees and find out more about the hospitals they’re visiting instead of walking in like a cheerleader! Why should the coach receive an extra bonus for hospital ratings going up?? Did they do the work??? NO! The visit was a dreaded one if you ask me, I can run “rings” around a coach. The rounding only brought more problems to the staff meetings and created more work on top of what was already expected. Meeting with the directors each month to get a score report is just a witch hunt…Did you do your work?? What’s the real problem and who is accountable??? Just my 2 cents…

    • Suzanne

      Couldn’t agree more.

  • mindmuse

    Suzanne, Not sure where you got your impression of Studer Group, but your experience could not be more different from mine. I found the focus on creating a more engaged staff and seeing the evidence of how that drives higher quality outcomes to resonate with why I became a nurse leader in the first place. Learning to shift from a focus on counting the tasks my staff had to do (endless audits!) to delivering care that was wrapped with caring, empathy and an honest desire to help patients heal gave more meaning to our days. I’m sad you have not had the experience many of my staff had had- one actually said “I had lost touch with my core. This work has helped me reconnect to my real purpose for being on the planet”. That’s powerful stuff. How do you put a price on saving a career? And, by the way, in our hospital, when we reduced our staff turnover by over 5%, we more than paid for the Studer coaches. Wish you could feel the benefits we have felt!

    • Suzanne

      I have actually heard almost nothing but bad things about staff nurses experiences with this group. I am glad you have shared this perspective. I am skeptical still but welcome all views. Perhaps healthcare consultants — I have been accused at times of being one — have some important things to offer but the charges of groups like this are exorbitant and often the fixes not long-term. But thank you for posting, I really am delighted to hear about your experiences.

    • Jackson

      Someone has drank the Kool Aid

  • Dieter Otto windelschmidt

    great! funny!….I was born, raise close to Cologne , so Paris in 70ies, 90ies and the difference ..hahaha exactly!!!!……
    migrated to Los Angeles 2004… had to start all over … did RN in West Berlin in 80ies in Benjamin Franklin University Hospital….registered in 2004 in US….after 18 years mostly builder and short RN periods….in Gernany…
    reading First Do Less Harm….
    work at Saint Vincent Medical Center Los Angeles since 2006….
    2010 to 2012 studerized , active with introducing the sepsis screening…
    they “graduated” us…and yes there where head hunters from them looking into us….
    but I did not catch the bait…
    Daughters of Charities last attempt to manage up the five california hospital did not work out…
    selling now…
    we have all the problems you can think of … very good ratings… but internally our telemetry director is only
    starting new graduates…. or very young RN…
    all the older ones suffer from discrimination , bullying ….cherry picking of union activist and antagonists
    agony of fear is on the floor…. everything is punitive …. for us older ones …
    the young RN have great overturn come and leave…
    retirement waves are going on ….

    since 2010 we have sepsis screening , clapsi , cauti, electronic charting (ARCIS,last year), hand washing campaign , infection prevention / isolation campaign…now Medication scanning… introduced and quality is in full swing… write ups staggering….too much…. I can take it …. but others not…good RN go on their knees…
    our telemetry floor is denied break resource RNs, most of other floor have…. the director prevents it ….
    more then 50% of the RN are very scared and intimidated….
    yeah one of these directors(or cannon boat captains )….just now retaliates massively on my for suggesting her to introduce Just Culture algorithm… ha ha ha …. got me there….next slap …. ha ha ha ….
    she is working us with performance improvement demands and evaluations , non studerized insiders do not understand was is going on….(low-medium-reluctant-high performer ..must move on or out -system )
    in cologne region we grow up with very satirical humor to laugh about our pain and shame… but this does not help any more and confronts me only with the value line guy …ha ha ha ,laughing for low performers , medium performers dangerous….
    the book is a blessing for me… I find tons of arguments for all upcoming grievances …..
    what I need is some really good tips of links, articles books research about the studer system and impact of it …
    if you could be so kind and send me some tips to my email…
    danke schön …
    amazing editing ( my wife is Dr. for literature) , we are amazed….
    thank you for this book…..
    best for you and yours Otto

  • mr

    This is so true, our facility (one of the largest in NJ) contracted the Studor group and we have been trained as if we were stepford wives, scripted responses to patients, making calls to patients to ask about their “experience” instead of being able to take care of our patients! I have been a nurse since 1978, and we have gone so far away from the bedside nursing of caring to all of this truly artificial reteric its disgusting. here is the a fact also Quint Studor is NOT a nurse but an entrepeneur who is making alot of money hard wiring people to say and do certain things to make sure the HCAPS ratings improve. so that’s the bottomline not patient care but the “illusion” of patient care

  • Jeffrey Flynn

    Can you say opportunistic parasites? What they did in my hospital was ridiculous. They had the CEO and COO literally wearing crowns in one of the meetings, Has that happened anywhere else? They did absolutely nothing for my shop. Didn’t even interact with anyone except senior management as far as I know . The chairman of my department refused to drink the Kool Aid and quit going to the meetings.

    Keep up the good work and keep speaking the truth.

    BTW I really think mindmuse is a studer employee paid to monitor websites.

  • Jack

    This philosophy sold to our senior managers, has been used to discredit and get rid of some of our most senior staff. It is now O.K. to stab your colleagues in the back, as your anonymity is protected. I actually do not think that the primary reason for this management style is designed to improve patient satisfaction and improve care. In my organization, it is being used to persecute staff, especially those who question safe staffing levels for patient acuity, it is being used to hound and bully these staff, who after all need their jobs. The medical staff are not being touched, it is nurse managers, bullying nurses in the name of Studer. the benefits have been minimal, if anything at all. We work in a system that does not rely on patient satisfaction scores for funding, but naturally as professional nurses, we do our best to give the patients the best experience in hospital as possible. Studer has decimated our nursing team and has been used to bully certain individuals very badly. While senior staff got a nice little trip to a Studer conference in Chicago. Just how much does this system cost a hospital, do you know?

  • Tiffany Yowell

    Hi, I am curious if you still feel the same way after 5 years. I am a MBA student and I am reviewing the Studer group for my communication class. Surprisingly this is one of the only articles I could find that reported a negative review on Studer. I am sure there are more out there but I would like an updated opinion if possible

    • Suzanne

      Studer just tells hospitals how to rig scores. Attacks workers, RNS etc, you should look at what unions think about all this.

      • Genna

        If you go to any hospital implementing the AIDET + promise, the only people raving about it is management (because they have to). Ask any nurse and they would love to give you their opinion of the Studer group…

    • Genna

      If you go to any hospital implementing the AIDET + promise, the only people raving about it is management (because they have to). Ask any nurse and they would love to give you their opinion of the Studer group…

  • mary

    I am just reading this article and agree with the other RN’s that the Studer initiatives in healthcare have created a hostile environment where I work. The whole AIDET nonsense depersonalizes the communication between nurse and patient and I am sure seems disingenuous to patient’s and families. Health care institutions need to put money where it counts: staffing, safety issues which will help achieve better outcomes than focusing on survey scores.

  • mary

    Please support nurses and their mission to better quality care and placing revenue back to patient care and staffing.

  • Shirly rossman

    This program is a JOKE !!.. I have been a nurse for 22 years.. The patients know this is all scripted verbage and phony..

  • Mary

    I just came across this article today. I have been a nurse for over 35 years and basically when my health care institution bought into the Studor initiatives everything as far
    as staff morale went downhill. I left my RN job that I had with this company for over 15 years because I felt bullied and when I brought safety and patient care concerns to my manager I was deemed as the enemy. So much time and money is spent on Leadership conferences and consultants and yet patient outcomes did not improve. I bet the institution now wishes they had some of that money wasted on financially and ethically inept purposes.

  • Beverly Bohano

    Studer is just a group of “self help” individuals who spew packaged responses to long standing problems.
    Individuals who are admitted to hospitals will never have a “disney” experience. Unique as it may sound there are no “patients” in an amusement park or a resort. The word in “patient” in its very essence describes a person not feeling well……… there is no comparison to a family vacation and a family illness….. STUDER IS A SCAM>>>>>

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