Even if 50 is the new 40, it still marks the decade of life when things start to fall apart.  I am well into my 50’s and am blessed with good health, but all around me I see friends dealing with serious stuff.

Big decisions must be made about cancer treatments, arthritis, early dementia, heart disease and Parkinson’s.  These are heavy health burdens that don’t include the sagging eyelids, basal cell skin growths, near-sightedness, hormone replacements, elevated cholesterol and love handles that are less worrisome, but still important to those contemplating the scalpel and a $5,000 deductible.

It is interesting the degree to which these big decisions are influenced by really small ones made when my friends were in their 20’s.  Back then they needed a flu shot, a physical or a prescription for birth control.  So they asked a friend, or ran their fingers through a phone book and picked a doctor.

For many, there is an excellent chance the doctor chosen years ago for something minor continues to influence the biggest decisions of their lives.  What specialist do I choose?  What hospital?  Should I have that procedure now, or wait?  Should I take this expensive medication . . . for the rest of my life?

All around I see health systems spending millions to make sure patients have the best possible experience when they walk through the sliding doors.  And that is certainly important.

Few health systems, however, put equal emphasis on the small transactions that introduce a new patient to the health system and, for many, establish a pattern of consumer behavior that will influence the organization for generations.

What happens at the primary care office, in the emergency department, at the urgent care center, in the waiting room, at scheduling, when the copayment is collected, when the follow-up is scheduled, when the test result is reported (or not)—all these little experiences determine if a new patient will ever hang around long enough to become an old one.

The primary influencers over these interactions are often hourly employees, overworked office managers and salaried physicians who don’t own the practice, and who care more about making the kid’s soccer game than talking to patients.

Great health systems are built on the compound interest of millions of little consumer decisions.  Great health care marketers never forget this truth.

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