By Dane Pflueger, Assistant Professor, Operations Management, CBS
Customers are beseeched endlessly to respond to surveys about the performance of their healthcare providers, education, airport security, and much else besides. These surveys are often dismissed as mere annoyances by customers, but for professionals and organizations, whose performance and future is increasingly linked to the survey results, the survey is becoming an ever more pressing preoccupation and concern. The result of this, it is argued in this short essay, is to transform the relationship between customers and providers into one that resembles the freak show—an encounter or performance that magnifies difference in the name of the viewer.1 Such a relationship short-changes customers and producers alike, circumscribing the possibilities for the customer to speak and also her potential to be heard.
Surveys have been seen as ambiguous social phenomena over the years. For authors such as Habermas (1970) and Bourdieu (1990), the survey and the opinion survey in particular was thought not just shoddily composeb, but politically stifling. For other authors, particularly in the medical sociology field, the survey has been seen and advanced as a source of salvation—a means of freeing people from professional domination and allowing them to speak up about themselves (Cartwright, 1964).
These radically opposing views, in the case of contemporary customer surveys, are both simultaneously true. Customer surveys, on the one hand, have been institutionalized as a voice for the customer in many settings once hospitable to professional assumptions about what the customer really needs. Surveys of students at universities, for instance, have been incorporated into systems of accounting and reporting in a way that the student’s view previously was not. Here at CBS, it is stated that:
CBS continuously monitors the quality of its study programmes and teaching. As part of ensuring the quality, students’ experiences of the teaching and study programmes are continuously and systematically surveyed. In particular, CBS attaches great importance to the students’ assessments in the overall evaluation of quality, which also includes the assessments of graduates, employers, and external examiners
And indeed these evaluations, which take place through surveys, constitute much of what is seen to be ‘teaching quality’, and dominate discussions of the theme.
As such, the customer survey might rightfully be seen as a kind of salvation for the student. It transported the voice of the student inside of the offices of university professionals and administrators, and it has transformed the student along the way. No longer just passive and grateful recipients of information, students now give information, ‘feedback’, and assessments. With the help of the survey, they can say that, for example, the teacher “succeeded in explaining and giving an overview of the content of the course” and that “there was a distinct coherence between the course’s academic format and pedagogical approach”.
On the other hand, however, customer surveys have fabricated the voice of the customer in a way that few students would find empowering. Surveys increasingly focus on and ask about not the customer or student herself but about the providers and things that they did or did not do. Surveys ask about “experiences” rather than about “satisfactions”, “perceptions”, “feelings” and “views”.
This is a product largely of methodology and the ambitions of accountability and managerial control of which the survey and customer participation are a part. Designing an ‘accurate’ customer survey for the purposes of accountability and control entails removing as much of the customer as possible (her expectations, perceptions, thoughts and fears) in order to isolate information about what the provider did or did not do. Indeed, to hold providers accountable, surveys need to show that they relate to the providers rather than the idiosyncrasies of the consumers.
The effect of such customer surveys is to enable the customer to speak while simultaneously limiting the possibilities for what she can say. Surveys, indicatively, centre on some tangible encounter between the customer and the provider, and what precisely is done there. The CBS survey for instance, asks about “explaining and giving an overview of the content of the course”, “competence in English”, and other such things. Information of this type is useful for improvement: it highlights specific points and locations at which performance can be improved. However, it comes at the cost of knowledge about the student herself. Her view emerges from the requirements of accountability and control, rather than from the student herself.
This movement is significant and consequential at the societal level. How and to what extent customers are enabled to speak to institutions indicates the possibilities for social progress in the face of a “risk society” (Beck, 2009). By constituting the survey as the mechanism linking the customer to the professional institution, the ambitions of participation and empowerment are delayed or decayed into the dynamics of the “evaluation” and “audit” “societies” (Dahler-Larsen, 2011: Power, 1994).
At a practical level, the survey establishes arrangements that look something like freak shows. Encouraged to attend to ‘the customer’s view’, organizations and professionals seek to improve their performance by attending ever more specifically to the encounters that the surveys specify. Here organizations and professionals perform: they manipulate and transform themselves and their bodies in order to guide the customer toward the perceptions that they seek to inspire.
This indeed is the case in the classroom. As a teacher at CBS, I do all that I can to provide high quality teaching. But to focus singularly on the survey returns increasingly means to focus on the encounters that the survey asks about, and to perform there in the student-customer’s name. The survey, for instance, asks about ‘success in explaining and giving an overview of the contents of the course’, and to be successful in providing this overview means orchestrating this success: not just giving the information or communicating it in course outlines and slides, but proving it by acting it out. Indeed, perhaps the most successful way to improve the student’s experience with this would be, as if a gimmick, to turn it into a song and have students sing it aloud.
An anecdote from healthcare shows this process taken to its most logical and absurd ends. Discussions of performance and quality in healthcare have become dominated by the patient experience survey as it has come to be linked with reimbursement rates, regulations, systems of public reporting, and performance evaluation (Pflueger, 2015). And constituted as such, healthcare professionals and the newly named “Chief Experience Officers” have focused their attention ever more specifically on transforming the patient encounter. To do this one London hospital has recently spend half a million pounds to train its doctors, nurses, and paramedics in physical theatre. As the article titled “The doctor will dance for you now” explains, such interventions are about getting doctors to perform for patients (Winship, 2014). However, as this paper shows, these patients are not the flesh and blood ones that enter the hospitals, but the ones who speak about the encounter that the survey has made central to care.
Beck, U. (2009) World at Risk. Cambridge: Polity.
Bourdieu, P. (1990) “Public opinion polls: a science without a scientist”, in In Other Words. Cambridge: Polity.
Cartwright, A (1964) Human Relations and Hospital Care. London: Routeledge and Kegan Paul.
Dahler-Larsen, P. (2011) The Evaluation Society. Stanford: Stanford University Press.
Habermas, J. (1970) “The Scientization of Politics and Public Opinion” in Toward a Rational Society, pp. 62-80. Boston: Beacon Press.
Pflueger, D. (2015) “Accounting for quality: On the relationship between accounting and quality improvement in healthcare” in BMC Health Service Research. 15(1).
Power, M. (1994) The Audit Society. Pp. 299-316 in: Anthony Hopwood / Peter Miller (eds.), Accounting as Social and Institutional Practice. Cambridge: Cambridge University Press.
Winship, L. (2014) “The doctor will dance for you now” in The Guardian. Culture/stage/dance. Accessed online 1 Jan 2015. http://www.theguardian.com/stage/2014/nov/02/dance-shows-curers-how-to-heal
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