So, tell me what you want, what you really, really want’. I thought of these immortal words sung by the Spice Girls in 1996, when I eventually realised that quality doesn’t always impress a medical assistance company searching for an air ambulance. ‘No matter how good your service, it’s all about price’, my colleagues told me.
All things being more or less equal, why does air ambulance company X get the contract over company Y?
Has anything changed?
Many years later and having given this much thought, I can see that the cost estimate (inappropriately and euphemistically called a ‘quote’) for the provision of an appropriately staffed and equipped air ambulance is important, but it’s not the only factor that the decision makers (DMs) rely on. With experience, a little insight, some retrospection and a few tips from the ‘other side’, it has become clearer to me that medical assistance influencers and DMs balance their judgements on a percolated mixture of experience, bias, speed of response and availability. But is that all that’s important? All things being more or less equal, why does air ambulance company X get the contract over company Y?
I’d like to think that the days of kickbacks and dodgy deals are behind us, and that all air ambulance companies are operating from a level playing field. This may not be true everywhere but, hey, I’m a believer that karma wins out and the bad guys eventually leave the party. So, what’s left? What do the medical assistance companies really really want?
Three key issues
In essence, much of the answer comes back to honesty, probity, transparency (HPT), i.e. knowing what you ask for is really what you get. The medical assistance industry knows that a quote is actually a best guesstimate. They expect that sometimes, the invoice will be more expensive because of the variety of unpredictables that plague those of us that operate expensive aeroplanes in unscheduled work. That’s part of the game. What’s not part of the game is adding hidden costs that come as a surprise to the commissioners. Where did that come from? Why weren’t we told in advance so the costs could have been reserved or pre-authorised?
Fraud is too strong a word, but dodgy practice could be a fair description. The art of working just within the bounds of legality has been perfected by some operators who have stolen the cream from the cake. ‘Nothing illegal in that’ some might say, but when borderline practice pushes normal ethical business aside, then the law should be reviewed, and normal service resumed.
sometimes, the invoice will be more expensive because of the variety of unpredictables that plague those of us that operate expensive aeroplanes in unscheduled work
Stick to the rules
So, you want the contract? Then, rule number one is be transparent about your pricing, and don’t add any unsavoury little extras. The HPT trio is also distorted and mangled if you agree to accept a mission and you end up sub-contracting or using providers who, let’s say, aren’t in the ‘best in the world’ club. Not keeping the commissioner (i.e. any paymaster, not just the medical assistance companies) fully informed is tantamount to deceit and will erode trust faster than the time it took Scary Spice to get dressed for a performance. Trust is hard won and easily lost. Once lost, it can be impossible to recover. Although your company may continue to be asked to quote, you’ll be wondering why you’re never invited to the party.
Rule number two: if you can’t do the job, then don’t accept the mission.
Rule three: if you need to subcontract or use untested providers, be honest and fess-up to the commissioners. They may be happy to proceed, but they won’t be happy if they find out themselves that you are infringing an agreement or simply working unethically.
Time is money! A wise old saying that has a bad vibe to it. You’ve been asked for a quote or maybe just for availability. That means your company is in with a chance. But the medical assistance company wants to know the answer now! Take a moment to stand in their shoes. This case has been languishing for days, waiting for a good medical report, disputes over validity of the claim, verification of cover, tracing the patient’s ups and downs, getting clearances, waiting for translations, pushing the patient’s general practitioner for a pre-existing medical history, and now, all the ducks are in a row and the patient needs to travel in either a health-related window of opportunity or a finance-related effort to put a cap on the fast escalating costs from the hospital overseas.
Rule four: if you want the job, turn around that quote in 15 to 20 minutes and make sure that you have availability of aircraft, aircrew and medical team for the timeframe requested.
Rule number five: don’t renege on that agreement later when you discover you don’t have one of those vital components. Remember that part about ‘trust’? You may be surprised, or even shocked to hear it, but the DM working for your medical assistance company client will have personal likes and dislikes. They may be based on nothing more than a hunch, but are more likely a combination of knowing who’s aircraft are reliable (will the alternative companies let us down?), and which companies say they can do everything, accept the job, but have a high eleventh hour withdrawal rate, plus a new excuse every time it happens.
Rule number six: manage your relationship with the client, be fully HPT, apologise profusely for all the inconvenience – you know it makes good ‘customer service’ sense. Examine the situation with a little more depth. Does your client need something extra than the normal service? Can you take over some of their case handling, maybe manage the medical logistics, document translations, booking of support service and so on? Even if your client hasn’t asked, it may be tempting for them, especially during the high season when they are overloaded with cases. This could be an income generator, as well as a carrot to gaining more of the share of their workload.
Other options may include sharing intelligence about facilities and services around the world, offering a medical advisory servicing or medical solutions centre, and even offer a sort of one-stop-shop so the client can be more hands-off. This takes a great deal of trust, mutual respect and good will.
So, rule number seven: investigate the possibility of adding extra services to complement the air ambulance provision.
Find out what your client really really wants.