Variability in health care services: the role of service employee flexibility

Researchers in services marketing in general, and health services in particular, are increasingly recognising the need for strategies to manage customer variability in the service encounter. The focus of theory and practice to date has been on managing or reducing variability through means such as customer education and tightly controlled service protocols. Growing recognition of the value of co-creation in health care raises the prospect of providers embracing rather than reducing the variability in the service encounter. In this study we investigate how flexibility on the part of service employees can help manage customer variability, and whether this employee flexibility results in favourable outcomes for the patient and the organisation. First, a qualitative study was undertaken to determine the extent of patient variability experienced and how this variability is perceived and managed. Second, a quantitative study, informed by the qualitative phase, was undertaken to test the impact of employee flexibility in a health care service encounter on performance outcomes, namely patient perceived value and patient satisfaction. The results provide support for the conceptual framework, with employee flexibility having a positive relationship with patient satisfaction, partially mediated through the creation of patient perceived value. Managerial and theoretical implications of our findings are discussed.