Insomniacs and those with small children have likely stumbled across a Ron Popeil infomercial on late night television. Popeil, for those with reasonable sleep habits, is the master salesman of kitchen gadgets such as the Showtime rotisserie, the Ronco food dehydrator and the Ronco pasta maker.
In an excellent profile of Popeil published in the New Yorker about a decade ago, the author Malcolm Gladwell makes an interesting point. Ronco’s massive (and somewhat surprising) success, Gladwell argues, comes from a highly disciplined approach to business. Popeil develops his own products using prototypes tested in his own home kitchen. He continuously refines the machine, streamlining its use and making its inner workings transparent through glass doors. He uses simple controls and large knobs and makes the machine work via a series of simple steps.
Popeil then goes on TV and coaches his potential customers on how to use the gadget, narrating the simple steps, repetitively, as if a mantra… Gladwell writes:
All the time, the camera is on his hands, which are in constant motion, manipulating the Showtime apparatus gracefully, with his calming voice leading viewers through every step: “All I’m going to do here is slide it through like this. It goes in very easily. I’ll match it up over here. What I’d like to do is take some herbs and spices here. All I’ll do is slide it back. Raise up my glass door here. I’ll turn it to a little over an hour. . . . Just set it and forget it.” (Gladwell)
Gladwell’s point is that Popeil has figured out that consumers respond to two things: intuitive machines followed by simple coaching on how to use the machines to get consistently good results. By designing and then selling his own appliances, Poleil sells the “rotisserie experience” in a way that resonates with buyers. This is in contrast to the VCR which, Gladwell notes, was so poorly designed that it became the object of many quips regarding the unusability of technology. Originally designed to record TV shows for later watching, the VCR was so obtuse that most consumers gave up trying to set the time and the timer and used the machine only to play movies. Many machines, my own included, had black electrical tape over the flashing 12:00. Gladwell writes:
If Ron had been the one to introduce the VCR…he would not simply have sold it in an infomercial. He would also have changed the VCR itself, so that it made sense in an infomercial. The clock, for example, wouldn’t be digital. (The haplessly blinking unset clock has, of course, become a symbol of frustration.) The tape wouldn’t be inserted behind a hidden door–it would be out in plain view, just like the chicken in the rotisserie, so that if it was recording you could see the spools turn. The controls wouldn’t be discreet buttons; they would be large, and they would make a reassuring click as they were pushed up and down, and each step of the taping process would be identified with a big, obvious numeral so that you could set it and forget it. (Gladwell)
My mother recently died in her late 70’s from cancer. She received her oncology care from a great team of physicians at a large academic healthcare system. Nobody in the family had any quibbles with her medical care– we knew that each caregiver was thoughtful and compassionate and that the medicine and treatments she was receiving were state-of-the-art.
But, as we took my mother to her appointments and negotiated the maze of specialty pharmacies, hospice programs and infusion centers, it stuck me that the system was the healthcare version of a VCR: confusing, illogical, and uncoordinated to the point that we were always looking for workarounds to make things happen. Communications lacked consistency or form, with my mother’s oncologist’s secretary occasionally emailing us screenshots from her computer with upcoming appointments because there seemed to be no more robust way of sharing this information. There was no dialog between the cancer team and the palliative care folks. And, figuring out how to access home care was a consumer mystery that my sister and I deciphered through independent online research.
The system, in other words, was so Byzantine that we were partly convinced that there was actually no system. And, aside from the fact that the system of care delivery was ad-hoc, the second problem was that we had absolutely no idea how to navigate the thing. A VCR without instructions, if you will.
As I reflect on the healthcare delivery system of the future, I like to keep Ron Popeil in mind. Popeil, who is the master of responding to needs consumers never knew they had, could teach those of us in healthcare management a few things about patient-centric care. Here are a few things I suspect he’d say:
- The system needs to be logical and intuitive with big buttons and predictable results. I can think of multiple ways that we can improve things in our own clinics: painted lines on the floor leading from one place to another, better signage, far more robust systems of communication between members of the team, and so on.
- There needs to be be transparency so that progress in healthcare is clear and immediately apparent to even the layperson. I don’t need to understand cooking science but I should be reassured that the chicken is browning like Popeil said it would. Popeil offers big glass doors on his machines: we should offer online portals, access to online schedules, results and graphs showing patient progress.
- Simply producing and selling the product isn’t enough: Patients and their families need to receive understandable communications about how to use the system, what to expect and when. This message needs to be consistent, unvarying and repeated with everyone on one playbook. In healthcare we are experts in developing complex systems while expecting patients to somehow divine their way through. The system and the message need to go hand-in-hand.
- Ongoing improvement is critical. Popeil, I note, seems to be on the fifth or sixth version of his rotisserie, with each model an improvement on his last. He now even offers a digital timer version of his machine…
I don’t want to overplay the similarities between a chicken rotisserie and a complex healthcare system. But, much to think about and learn from the king of the consumer mind. Here’s Ron Popeil in action: