Remember renting movies at Blockbuster?
It used to be a field trip, right? Go out to dinner on a Friday or a Saturday night, then go to Blockbuster and roam the aisles for videos (VHS, to boot!) and rent one or two of them at a time. It was an era that seemed like it would never end. Who could have imagined life in the '80s, '90s, and early 2000's without the video store?
Enter Netflix.
At first, people received DVDs in the mail in a little red envelope, not via the streaming platform we all know today, but the convenience was striking. Today, many people don't even realize just what a metamorphosis Netflix has gone through, but in its earliest days, it simply turned the Blockbuster business model on its head: it delivered videos directly to the consumer and didn't charge any late fees — versus Blockbuster forcing the consumer to come to them, and charging (lucrative) late fees if videos weren't returned on time.
In just a few years, Blockbuster went from business darling to business bankruptcy. So what happened?
Numerous accounts of why Blockbuster failed have been written, and we don't need to rehash them here. But there are specific lessons we can learn from Blockbuster's failures — especially when it comes to making sure healthcare doesn't meet the same fate.
It's all about friction.
Roger Dooley wrote a book about the concept of "friction," which describes how people will abandon a conversion because of the "unnecessary expenditure of time, effort or money in performing a task." How many times have you abandoned an online shopping cart or hung up on a support call because it's just too hard to get through or too hard to convert?
Blockbuster's business model created multiple layers of friction for the consumer – friction that consumers didn't even know existed until new market entrant Netflix turned the model on its head.
Blockbuster forced the consumer to come to the store to rent a movie
The consumer had to physically browse for a movie and if the movie was completely rented, there were really no other options.
The consumer had a set timeframe to rent the movie and if delivered late, had to pay a late fee.
When Netflix came along, it became apparent that going to Blockbuster was suddenly inconvenient (friction). Physically browsing (instead of searching online) for a movie was suddenly inconvenient (friction). Paying a late fee if you kept a video for longer than you had rented it was suddenly inconvenient (friction).
And we don't just see this with Blockbuster and Netflix:
Hailing a taxi (e.g., taxi company forcing you to find a taxi) versus Uber (your ride comes to you).
Going to the movies to watch a blockbuster hit versus sitting in the comfort of your own home and watching the movie on Amazon Prime, Netflix, Hulu, Apple+ and more.
Shopping in person and schlepping your purchases home (going to the store for a product) versus shopping on Amazon, comparing products, price and reviews and having your purchase delivered to your front door (product comes to you)
New market entrants like Uber, Spotify, Amazon and more have all sought to reduce friction in their respective industries. It has worked phenomenally — which shows us a thing or two about what consumers want and have adapted to.
How is this at all relevant to healthcare?
Roger Dooley writes about four types of friction:
Decision Friction
Consumer Experience Friction
Technical Friction
Internal Friction
Healthcare experiences the most friction with #2: Consumer Experience. It's really hard to find a provider on Google unless the healthcare organization is actively managing this strategy — and don't even mention finding a provider or an answer to a healthcare question on a health system website.
If a patient wants to call for an appointment, they have to go through 100 different hoops to book, or stay on hold for almost an hour. If they can't easily book an appointment online, they're more likely to abandon.