Under My Skin

Say it with a smile



“Have a nice time!”

I looked around, trying to tell where the piping, childish voice was coming from. I’d just swiped the barcode of my pass to the local lake I swim in every summer. There it was – the voice of one of the high school kids who works at the lake. She wore a wan smile.

I’ve been swimming at this lake for 35 years. No kid ever said a word to me before. “Have a good swim!” said a young man standing at the desk where, “All Children Under 12 Must Check In!”

Goodness me, I thought. The management consultants have made it to the lake.

You know who I mean. The ones who see to it that front-desk personnel always flash a bright smile and recite the corporate script. At the hardware store, the fast-food chain, the airline counter. Even the people in the auto dealer’s service department smile and murmur sweet nothings. They used to glare and growl, and make you feel like an idiot. “Whatsamattter, Bud? Dontcha know anything about cars?” Now it’s all politeness and smiles and “How may we help you, kind sir?”

And of course there’s the pharmacy. When I fill my prescription, the tech flashes a bright grin of welcome. Either that, or she has tetanus.

“Welcome to DrugTown!” she says. “May I have your name?”

I tell her. She retrieves the prescription. “Verify your address?” I do.

“Do you have a DrugTown Rewards Card?” she asks. I enter in my cellphone number, swipe my card, turn to leave.

“Be sound!” she says, still grinning. The DrugTown motto is: “Where Safe Meets Sound!”

It is easy to mock this sort of thing as formulaic and false. Insincere or not, smiling makes a difference. Some say you can actually get happier by making yourself smile. Whether that’s true or not, watching other people smile and make eye contact makes you feel good. Seeing them scowl and look away does the reverse.

This is true in doctors’ offices too. I learned this recently by being a patient.

I approached the front desk at my first visit. The lone receptionist was looking at some papers. I tried to get her attention. “Hello,” I said, “My name is ... ”

Still looking down, she shoved a clipboard across the counter. “Sign in,” she said. “And fill this out.” She handed me a sheaf of forms. “Leave it here when you’re done.” She was still looking away.

I sat in one of the waiting room chairs to work on the forms. I felt bad. As I watched the clerk ignore a succession of other patients, I asked myself why I felt so bad. First of all, it wasn’t personal; she was churlish to everyone. Second, what did this have to do with my visit? I was there to see the doctor, not his receptionist. Weren’t his skill and expertise what mattered?

True enough, but I still felt lousy. At later visits I took on the personal challenge of trying to force the clerk to make eye contact. I failed. In truth, her behavior colored my impression of the medical experience – mixed anyway – more than the medical outcome.

Sometimes I force myself to look at my own online reviews. The bad ones often focus on the alleged rudeness of my staff. It can be hard to tell from cranky patients whether their complaints are justified. But sometimes they are.

Management consultants know this. They teach employers that the customer experience has to do with more than the quality of the good or service provided. Even if the quarter-pounder is delicious, it may not taste that way if the burger-flipper is having a bad day and doesn’t know how to hide it.

So my office manager now trains our front-desk staff to be insistently cheery. This can be hard when patients are stacked three-deep, each with a form to scan, a credit card to swipe, a follow-up to book. But smile we have them do.

We don’t, however, have them recite a script when smiling. (“Make the scene! Wear sunscreen!”) We’re not up to that chapter in the customer-service handbook.

Who do you think we are? The town lake?

Dr. Rockoff practices dermatology in Brookline, Mass., and is a longtime contributor to Dermatology News. He serves on the clinical faculty at Tufts University, Boston, and has taught senior medical students and other trainees for 30 years. Write to him at dermnews@frontlinemedcom.com.

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