Milllion Dollar Smile

Posted by Birju Pandya on Apr 5, 2014
18689 reads  
From Shawn Achor's Beyond Happiness book (originally heard in this video):

Ritz-Carlton has franchised a method called the 10/5 Way. It involves just a few behavioral rules that all staff are trained to follow. If a guest walks by a Ritz employee within ten feet, the employee should make eye contact and smile. If that guest walks by within five feet, the employee should say, "Hello." It sounds simplistic but these small changes can have a huge impact.

Ochsner Health System decided to adopt the 10/5 Way. They formally trained more than 11 thousand physicians, nurses, managers, and administrators to smile anytime they were within ten feet and say hello anytime they were within five feet of another person -- patient or fellow employee.

As a researcher, though, my job is to skeptical, so I naturally had a lot of questions about how this would work. Would people find the smiling to be inauthentic and forced? Would all this time spent saying hello to everyone distract doctors and nurses from all the other important things they were supposed to be doing? Would negative employees find a loophole and simply walk eleven feet away from everyone in the hospital?

At first, many of the doctors and staff were equally skeptical. Some would say, "Aren't these just cosmetic changes? Smiling couldn't possibly affect the underlying performance of a hospital" or "I don't have time to waste on this silly HR initiative. I'm busy saving lives here." There were some stubborn individuals that were too hard to reach at first. But for the next six months, every time one of those resistant, negative doctors walked down the hallway, something was different. People were saying hello or smiling at them. Not just employees, but patients as well. You've probably noticed how when someone says hello or smiles at you, your automatic reaction is to say hello or smile back. Well that's exactly what the doctors started doing. Eventually, they started adopting the 10/5 Way -- even if they weren't fully aware they were doing it.

In short, the behavior became contagious. It completely transformed the shared reality in the hospital. Not only did this improve patient's satisfaction with care; it improved outcomes for the hospital. Moreover, patient satisfaction with care is one of the greatest predictors of profit for a hospital; and indeed, within one year, the hospital had a 5% increase on Press Ganey's "Likelihood to Recommend" score, a 2.1% increase in unique patient visits, and significant improvement in the medical practice provider scores. Ochsner Health System reported $1.8 billion in revenue in 2011. So if they experienced even a 0.1 percent increase in revenue, positive inception saved millions of dollars to help care for more sick people! That gives a whole new meaning to the phrase "million-dollar smile."

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Comments (4)

  • Bill Miller wrote ...

    That certainly fits with my experience. (I think I shared this already in a different context, so sorry if it’s a repeat, but …) For exercise, I used to walk the loop trail on the Stanford campus, around the radio dish. It’s about 3 miles and takes about an hour to walk. I used to note/grumble about how rarely the oncoming pedestrians would make eye contact - as if they were too self-absorbed or maybe just defensive. I noted that on the entire walk, an average of two people or groups would make eye contact as they passed.

    Being sort of self-absorbed myself, I resolved to try an experiment: as I went about my day, in all public contexts, I would try to make eye-contact and smile at four strangers per day. (I kept a log of it to be sure.) That was fun in itself but more mysteriously, over time it seemed to affect others as well. On the Dish Hill walk for example, I was now exchanging eye-contact and smiles with 10-11 people per circuit rather than 2. I’m pretty sure I wasn’t doing anything to call additional attention to myself. It really seemed there was some metaphysical connection that got amplified.

    Anway, try it yourself - it can’t hurt!

  • Sukanya Patwardhan wrote ...

    Cant agree more ! Mos of the times people look for someone else to take a step and approach them

  • Doctora Vazquez wrote ...

    Awesome:-) There should always be time for kindness...great article. Thank you for sharing.

  • Audrey wrote ...

    The most powerful story I’ve ever read was contained in an article about the history of the Golden Gate Bridge and of the many suicides that have occurred from jumping off of the bridge. In that horrific number was the story of a young man whom the author focused upon to give the article a human (rather than factual) focus. The young man left a note in his apartment that said his plan was to walk to the bridge and jump and that if his note was found it meant no one stopped to look at him, say hello, smile, or make contact with him in any caring way. The story changed my life. It made me realize how important something that May seem insignificant to us can be a lifeline to a person in need and that we must assume that everyone is in need of connection, at the very least and maybe more on any given day. Since reading about that young man, whenever I pass others, in the street or on a building, the content of his note always comes into my mind as a reminder that we never know how many hearts and minds we can touch, by being aware of the strength of our power to heal hearts and minds, if we’re present, kind, and loving and whenever we offer to help, however we might be able....even if it’s only to hold someone’s hand until better help than we’re capable of arrives or to go for better help than we are able to give.