Healthcare Quarterly

Healthcare Quarterly 12(2) April 2009 : 10-10.doi:10.12927/hcq.2009.20670

Opinions: A Westjet Health Care System?

Steven Lewis

I fly a lot - too much actually; I am chagrined by my carbon footprint. Most of my flights are on Air Canada (AC), indisputably an international class, full-service airline. You can go pretty much anywhere in the world on AC or its Star Alliance partners. You can pick your fare, frills, seat, and class. I've been an Elite AC member for about 15 years, so I get to wait for my flights in swanky lounges with free food, booze, newspapers, magazines, and business centres. I get free flights from the Aeroplan miles I accumulate and an annual stack of upgrade certificates. I get a special number to call if I need to change a reservation or seek help. Cool, eh?
But I fly Westjet (WJ) whenever I can, and would happily abandon AC altogether if WJ decided to go after the Saskatoon-to-wherever (especially Toronto) business traveler markets. Why? What would lead me to turn my back on the airline that gives me all this stuff, and what accounts for the almost giddy affection for the one that doesn't? Here's my hypothesis: it's because Canada's airlines are akin to the health system we have (AC) and the health system we need (WJ). Here's how.

What do I need? Business class to Kuala Lumpur? Single malt scotch in the lounge? Special meal? AC can do it. WJ? No can do. AC is pretty good at tertiary air care; WJ is the primary care airline. Most travel needs are primary: a reasonably priced ticket, leave on time, decent legroom, a modern aircraft. My own travel life is, well, pedestrian: Calgary, Vancouver, Toronto, Ottawa, Winnipeg (quit smirking - I like Winnipeg). WJ gives me a Boeing 737 with good overhead luggage capacity and a quiet ride - every time, all the time. AC gives me cramped Bombardiers that force passengers to compete for comically little carry-on baggage room. Advantage: WJ for the basic journeys; AC for the continental transplant operation.

What happens when there's a problem? Planes break down and weather mocks schedules. The test of an airline is not when things are ticky-boo; it's when misery descends. AC appears to believe that keeping the passengers in the dark about why the flight is delayed is reassuring, and that parcelling out the delays in two hour increments is comforting. "The 2 o'clock flight that was to leave at 4 is now departing at 6. We can't tell you which gate." WJ makes it a point to tell you what's happening. Call AC with a problem and you almost feel the blame-the-passenger vibes as the agent leafs through the policy manual to confirm your non-entitlements. WJ seems to want to help. AC has done some nice things for me, but WJ has performed truly heroic feasts of creative problem-solving and in one case was generous beyond the call of duty. Advantage: WJ on both comportment and delivery.

Surprise, it's a service industry. Aviation is incredibly safe. Planes of equal size are pretty much interchangeable. The highway up there is the same for everyone and an airport is an airport. WJ offers no business class, no hot meals, no fancy lounges, no air miles of its own. It pursues advantage by other means: the attitude of its people and their capacity to solve problems. Their entire ethos is built around the customer. I used to think the "AC attitude" was the inevitable result of an aging workforce fatigued by the wear and tear of a zillion flights and alienated by repeated labour strife and restructuring. Likewise I was sure that the happy-faced, fun-loving, energetic WJ honeymoon would end.

Well, WJ is a decade old and still no sign of passive aggression; not all their employees are fresh-faced kids. AC actually tries, but there is too much ennui and complexity . Their own agents can't figure out their absurd aeroplan mileage redemption rules and its website produces some legendarily idiotic itineraries. Small wonder they can't reliably produce quality service in the crunch. Pleasantness and can-do are hard-wired into WJ's DNA: I once bought a ticket from a WJ baggage service agent. WJ gives you more while giving you less. It has chosen the right quality indicators. Advantage: WJ.

Simple, reliable, effective, pleasant: whether from an airline or from health care, that's what we need most of the time. And where simple won't cut it, more than ever we need reliable, effective, and pleasant. AC is besotted with complexity and covets the overseas, long-haul market segment. You can tell it doesn't really care about most domestic routes outside the big cities. Though they try their best, it's clear the employees have no great love for the corporation they work for.

AC is to air travel what our acute care-obsessed, high-tech-envy health care system is to health. It's great that we can find the cystic fibrosis gene and separate Siamese twins but not so good that chronic disease management is a national catastrophe. The vast majority of people don't need glitzy miracles; we need sound, evidence-based, timely, respectful, and well-communicated primary health care from a team dedicated to getting it right.

In the end it's about culture, that maddeningly elusive notion that signals what an organization or system is about. The truly successful put the customers first and pay attention to the workforce and the workplace. They get the fundamentals right and understand where their bread is buttered. WJ has mastered primary air care; it makes money where AC bleeds red ink. Health care, take a lesson.

About the Author(s)

Steven Lewis is a Saskatoon-based health policy consultant and part-time academic.


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