COMMENTARY Critical Service Encounter Models and Dentistry By Melissa G. Hartman S ervice consists of both an outcome and a process, the former being what the customer receives as a result of the service experience, and the latter being the systems in which the ser- vice is delivered. Satisfaction or dissatis- faction with the process has been shown to have a definite influence on satisfac- tion or dissatisfaction with the service outcome. Perhaps the most comprehensive model on the critical service encounter was developed by Mary J. Bitner, Bernard H. Booms, Mary S. Tetreault, and, later, Lois A. Mohr. In classifying the pivotal incidents that result in either a satisfactory or dissatisfactory service encounter, they devised four categories, at least three of which turn on human contact between an employee and the customer: • Employee response to service delivery system failures. • Employee responses to customer needs and requests. • Unprompted and unsolicited employee actions. • Problem customer behavior. Melissa G. Hartman is a Quality Management Con- sultant based in Wichita, Kan., and a DBA student at the University of Sarasofa in Florida. 38 SPRING 1998 llluslrHlmnOBLiimitTimmras/ThelnuM ENCOUNTER MODELS R esearch involving customer groups as diverse as airline travelers and dental patients has provided a useful framework for assessing service encounter satisfaction and dissatisfaction. The common thread in such research is the importance of human contact in ser- vice encounters. Service delivery failures can have favorable outcomes if handled properly by employees. The ability to meet perceived special requests also can result in greater satisfaction. Simply giving the customer information may sometimes be sufficient to mitigate dissatisfactory experiences. These biases would result in different views of sources of service dissatisfaction. For example, airline service delays can provoke feelings of anger and uncertainty. with the intensity of those feelings increas- ing with the length of the wait. Passengers left waiting because of unexplained delays are much more likely to experience feel- ings of uncertainty than if they are told about tbe reasons for the delay. Feelings of anger over delays are more profoundly experienced when people believe the airline has control over the delay (baggage handling problems, missed departure windows, etc.). In terms of dental service, an ongoing relationship with the same dentist has been shown to contribute significantly to overall dental satisfaction, even when high bills and long waiting times occur. Both continuity of care and personality influence patient satisfaction with dental care. Likewise, hospital patients' degree of satisfaction has been attributed to the level of personal interaction experienced by the patients. TRANSAQION DIFFERENCES T he studies that yielded these models were based on customers and employees in the hotel, restaurant, and airline industries. Transactions in those service industries are relatively routine.
Transcript
C O M M E N T A R Y
Critical Service Encounter Modelsand Dentistry
By Melissa G. Hartman
Service consists of both an outcomeand a process, the former beingwhat the customer receives as a
result of the service experience, and thelatter being the systems in which the ser-vice is delivered. Satisfaction or dissatis-faction with the process has been shownto have a definite influence on satisfac-tion or dissatisfaction with the serviceoutcome.
Perhaps the most comprehensivemodel on the critical service encounterwas developed by Mary J. Bitner,Bernard H. Booms, Mary S. Tetreault,and, later, Lois A. Mohr. In classifyingthe pivotal incidents that result in either asatisfactory or dissatisfactory serviceencounter, they devised four categories,at least three of which turn on humancontact between an employee and thecustomer:
• Employee response to service deliverysystem failures.
• Employee responses to customer needsand requests.
• Unprompted and unsolicited employeeactions.
• Problem customer behavior.
Melissa G. Hartman is a Quality Management Con-sultant based in Wichita, Kan., and a DBA student atthe University of Sarasofa in Florida.
3 8 SPRING 1 9 9 8
llluslrHlmnOBLiimitTimmras/ThelnuM
ENCOUNTER MODELS
R esearch involving customer groupsas diverse as airline travelers and
dental patients has provided a usefulframework for assessing serviceencounter satisfaction and dissatisfaction.The common thread in such research isthe importance of human contact in ser-vice encounters.
Service delivery failures can havefavorable outcomes if handled properly byemployees. The ability to meet perceived
special requests also can result in greatersatisfaction. Simply giving the customerinformation may sometimes be sufficientto mitigate dissatisfactory experiences.These biases would result in differentviews of sources of service dissatisfaction.
For example, airline service delays canprovoke feelings of anger and uncertainty.with the intensity of those feelings increas-ing with the length of the wait. Passengersleft waiting because of unexplained delaysare much more likely to experience feel-ings of uncertainty than if they are toldabout tbe reasons for the delay.
Feelings of anger over delays are moreprofoundly experienced when peoplebelieve the airline has control over thedelay (baggage handling problems,missed departure windows, etc.).
In terms of dental service, an ongoingrelationship with the same dentist hasbeen shown to contribute significantly tooverall dental satisfaction, even whenhigh bills and long waiting times occur.Both continuity of care and personalityinfluence patient satisfaction with dentalcare. Likewise, hospital patients' degreeof satisfaction has been attributed to thelevel of personal interaction experiencedby the patients.
TRANSAQION DIFFERENCES
The studies that yielded these modelswere based on customers and
employees in the hotel, restaurant, andairline industries. Transactions in thoseservice industries are relatively routine.
but can the same models be applied tobusinesses in which the transaction is less
s 0 hman smice,also Me{s fm adms,
keis^onifesiamntskmseikmiomrisaniniegralponiofiksemedelim^pwcess.routine, such as health care in general anddentistry in particular?
Dentistry can be described as highlycustomized, di.screte transactions providedas part of an ongoing relationship betweenthe customer and the service provider. As ahuman service, dentistry also differs fromairlines, hotels, and restaurants because thecustomer is an integral paii of the servicedelivery process. Dentistry also differsfrom other health care areas such as radiol-ogy and family-practice medicine becauseof the large percentage of private fundsspent on care and the high level of manualskill required of dental care providers. Thissuggests two research questions:
• Can critical service incidents reported inthe dental industry be classified in theexisting framework?
• Are uew categories necessary to catego-
rize fully all critical service incidentsreported in dentistry?
Three categories of contact employeesshould be considered in dentistry: den-tists, clinical employees (hygienists anddental assistants), and adminisu-ative staff.The contact each of these groups has withcustomers should be studied to assess theeffectiveness of the existing models. Forexample, do dental employees report thesame types of critical service incidents ashotel, airline, and restaurant employeesdo? Do dentists report the same types ofcritical service incidents as hygienists do?Do dentists report the same types of criti-cal service incidents as dental assistantsdo? And so on.
A second worthwhile study would usedental patients to replicate earlier studiesinvolving hotel, restaurant, and airlineemployees. Additional questions can beadded to the earlier questionnaire todetermine the primary method of pay-ment for each respondent. Two additional
ful/itcomkavaMetfain-ini and i:elationsl\ipm(kefmtool for tk competitive denta]W
research questions are proposed for thissecond study: Do dental patients reportthe same types of critical service inci-dents as hotel, airline, and restaurant cus-tomers do. and are the descriptions ofcritical service incidents influenced bythe method of payment for dental care?
Although these research proposalsfocus on a single industry, they wouldprovide insight into the service encounterclassification scheme in dentistry andsimilar industries as well. If the model isdetermined to be appropriate and mean-ingful, it could be a valuable training andrelationship marketing tool for the com-petitive dental industry.
These studies would add to the empiri-cal offerings in management research inthe $45 billion dental industry and, per-haps, open doorways for future patientsatisfaction research and strategy devel-opment. •
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