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Writer's pictureNicolas Gondard

When "Thank you Sir/Madam" is Ruining Your Business.


By: Nicolas Gondard


Degeneration, or in more blunt terms, deterioration, is the change from a higher to a lower form. This is the kind of term used by the medical industry to gently notify you that you are ageing and that your body is now in a different state compared to when you were in your 20s.

I looked at the medical professional in front of me and did not know whether to cry or show him that I still had some strength in my ageing body, or both.


Let’s put the above into context.


I’m in the age bracket called the new 30s and I’ve never felt so good. I’m taking my fitness and nutrition pretty seriously and even went into a fitness level 3 personal trainer accredited program to solidify the knowledge I acquired during all my years of training and coaching friends and fitness enthusiasts.


Fitness is part of my daily routine, as for many of you, and I make sure to challenge myself enough to keep in shape and to prepare for happy days when I enter the new 40s, 50s and above.


In an athlete’s life, professional or not, the road is paved with progress, frustration, dead ends and injuries. It is part of the deal and almost inevitable, especially if you go out of your comfort zone.

Injured athletes may or may not come back to their best fitness level post-injury and, a lot of that, is based on their military discipline while being on their recovery phase. A similar level of discipline should be invested while training or while recovering from an injury. Failure to do so usually leads to a longer recovery period or worse, to an aggravated state.


Well, I managed so far to go through the storm and avoid major traumas up until end of November 2020.


2020 not being challenging enough, I though it would be a good time for something more serious and finally experience surgery with full anesthesia!


So here I am with a distal bicep tendon fully ruptured from the bone. Before I know it, I’m in the prep room ready to go for a 1-hour surgery.


On waking up, my fingers are moving and after 1 night under observation at the hospital, I’m driving my car back home. Good!


2 weeks post op have passed, and it is now time to schedule physiotherapy sessions to support and speed up the healing process. The hospital where my surgery was performed does provide such a service through their rehabilitation center. In due time, I receive a call from this department informing me that they have received approval from my medical insurance for 10 physiotherapy sessions and that they would like to book the first session.


I inform the very polite caller that I did not wish to proceed with my physio treatment at their premises and that I would book with another facility. Her answer was, “all right Sir then thank you very much.”


It got me thinking.


10 x 500 = AED 5,000 (USD 1,300) – That is the approximate value of those 10 sessions. This amount was guaranteed to be paid by my medical insurance so there are no collection problems for the hospital to be expected. Just provide the service, bill the insurance company and receive the money at the bank. What a beautiful business model right?


Now AED 5,000 is most likely not a very significant sum when put into perspective against a huge hospital chain’s yearly turnover. It might become more relevant if you attach it to the rehabilitation department’s monthly target, then the branch’s monthly target and perhaps daily target.


While we can debate forever whether this budget deserves to be fought for, and I strongly believe it does, why don’t we focus our attention on the operator’s response?


The response “all right Sir then thank you very much” is for me a total, brutal, unconditional, deep team member de-engagement from the value she can bring to her job and to his/her organization.

Meaning, (and let me impersonate the operator for the next section), should I book those 10 sessions for you or not, does not change anything for me, on all levels.


- The first one, which is the most obvious, is that I have nothing to gain on the financial side. I’m not being incentivized to book appointments and fill-up the schedules of my fellow colleagues at the rehabilitation center.


-Secondly, I don’t see that, if my fellow colleagues’ schedules at the rehabilitation center become empty, then painful discussions will happen at some point where staff might be requested to go part-time or to simply leave. And as a booking agent, my role might even be threatened as the hospital will not need X number of operators anymore.


- Next, I’m disconnected from my job and there is no passion attached to it. I have the ability to have a patient treated from A to Z in my organization, but I don’t see this as an added value nor a personal reward.


Let me revert back to Nicolas now. Ultimately the operator’s response breaks the whole value chain and loses me to another medical provider, without a fight. To date, I have not been contacted about the reasons why I decided not to perform my pre-approved physiotherapy sessions by this entity, and I know I will not be.


Now, who’s fault is it? Time to pinpoint fingers.


The operator? I believe partially, even though proper background information would be required to issue an accurate statement. I understand that not all team members are built-in with an entrepreneurship mindset, but a minimum engagement should be there, at least to sustain an intellectual interest on a daily basis.

The management and/or the company? Definitely. How on earth, in this current business climate, actually in any business climate, can a business walk away from a pre-approved-for -payment-work?


-Should you train your teams to handle such situations? The answer is YES.

-Should you put in place incentives, financial or otherwise? The answer is YES.

-Should you create the right culture so team members understand that their actions have an impact on their fellow colleagues, even if they work in different departments? The answer is YES and YES.


Should you multiply my example by 100 patients, the amount climbs up to AED 500,000 (USD 136,000). Now I have your attention.

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