To the point of my post yesterday (The doctor who wouldn't listen), good communication between doctor and patient isn't just a courtesy... it's often the difference between life and death.

From the Boston Globe recently, A deadly information gap:

The usual experience of a sick older person today is similar to that of an American traveling in a foreign country with no passport, no ability to speak or read the language, and no tour guide, all while deathly ill, often hungry and thirsty, exhausted, confused, and frightened. During my mother's illness, my sister (a lawyer) and I were her "health care navigators,'' and together we managed the treacherous voyage.

In the hospital, after her heart attack, my mother's diabetes doctors weren't allowed to prescribe her medications or diet because she was on a cardiology unit. Despite good intentions, the hospital almost killed her by giving her 32 ounces of apple juice one day, causing her blood sugar to rise to a dangerous level. To compensate, they had to give her a lot of extra insulin, which caused her blood sugar to drop precipitously. At one point they had to resuscitate her because her blood sugar went so low. This happened because the diabetes doctors had almost no real-time way to communicate with the cardiology doctors. They needed a navigator -- a knowledgeable intermediary -- to make sense of the overall picture and connect the doctors to each other.

(Thanks to John A. for the pointer.)

A couple of years ago I had a quick question for my primary care physician. So when I made a flu shot appointment over the phone with his receptionist, I mentioned my question. She hesitated, as though this was a large and unusual request - pass a question along to the doctor? - and asked that I just bring it up in person during the appointment.

When I arrived for the appointment, I was unable to get the question to my doctor. (My flu shot was administered by someone I'd never seen before - I assume she was a doctor, as she never introduced herself.) I asked her - and then another doctor - if they could pass it along, or hand him a note, anything - no. Everyone involved was polite, but it was clear that this was an annoyance: a patient with a special request.

Here's the ironic part. As I explained to each person along the way, I was trying to invite my doctor to attend, as my guest, an event a few blocks away from his office. It was my Gel Health conference - all about creating good patient experiences.

A few weeks later, I recounted my experience on-stage at Gel Health. (Jump ahead to 3:05, where the story starts.)

The topic of patient experience was picked up by last week's New York Times article Concierge Medical Care With a Smaller Price Tag, which describes the work of One Medical Group, a network of primary-care offices that actually provide a good patient experience. I'm quoted in the article as a patient of One Medical - having joined, in fact, after my bad experience with the previous doctor. (The founder of One Medical, Dr. Tom Lee, is speaking at my upcoming Gel 2011 conference.)

I left the old doctor because he wouldn't listen to me - literally. I joined One Medical because they'll take my call, they'll answer my email, and they'll start the appointment on time. There are other benefits, too, but my point is that sometimes customers' expectations are so low that just delivering the basics can create an extraordinary experience. Banks, airlines, credit card companies, insurance companies, and many, many others - take note.

Companies often spew about "customer relationship management" or "disruptive customer-led innovation" or any number of other impressive-sounding processes. But as often as not, what the customer wants is as simple as sitting down and listening for a minute.

They may just invite you to do something great.

A quick quiz in "masters of experience design." When you hear the name Steve Jobs, what products come to mind? iPad, iPhone, iPod, iMac, some others, perhaps.

OK, now the same question of product associations - with the name... ready?... Shigeru Miyamoto. Go for it.

Plenty of people will know the answer right off. But lots of people have no idea who Miyamoto is - even though they know his products quite well.

If you've heard of an Italian plumber named Mario, his twin brother Luigi, and their many adventures in videogame worlds, you know Miyamoto's work. Zelda and Link, Star Fox, and others were also his creations. Even the Nintendo Wii owes its design, in part, to Miyamoto. The man knows how to create successful games.

So - Jobs and Miyamoto, masters in the field of good experience. In the past month or so, two major publications have run profiles on them: the New York Times on Steve Jobs, and the New Yorker on Miyamoto. They're worth reading.

Apart from both being accomplished creators of great digital experiences, there's one striking commonality between the two profiles. I'll run the quotes, and you (as quiz question #3!) try to spot the similarity.

From the Times:

Mr. Jobs, colleagues say, is uncompromising. Prototypes and early working products ... are shown not to focus groups or other outsiders, but to Mr. Jobs and a few members of his team.

And from the New Yorker:

In fixing games, [Miyamoto] relies on his taste and intuition. And then he asks family and friends to play them. Nintendo doesn't use focus groups.

Did you spot it? No focus groups. Maybe a few close insiders get a peek at a new product, but otherwise it springs forth from Jobs or Miyamoto (and the employees who build it for them). Customers, with their lack of design skills and market savvy, are kept safely away from the design process and only begin their role when the product hits the virtual store shelves.

Or maybe not.

Lots of attention these days gets paid to the question of innovation. Where do ideas come from, how to find good ideas, how to build an organization or a culture that constantly innovates and disrupts. One tempting archetype, often advanced by the media, is the "lone genius" - a Jobs or Miyamoto, so far advanced in their visionary powers that they can sit inside the corporate tower and generate insanely great ideas, emerging only to show a few colleagues the prototype before sending it off to mass production.

Now, I'll be the first to acknowledge the genius of Steve Jobs and Shigeru Miyamoto. And I don't fault them for avoiding focus groups - I don't do focus groups, either (though I do advocate a different research method called listening labs).

However, I just can't buy into the myth that great ideas like Jobs's and Miyamoto's emerge from a single person's vision. There's always another party involved in the process, and that's the end user. (The customer, the player, the reader, etc.) Great ideas, great products, great experiences come from creating something that is especially useful, meaningful, or fun for another person. Masters of experience design always have an orientation toward benefiting "the other."

Interestingly enough, both profiles above manage to include some data on this point. For quiz question #4, spot the similarity. (Emphasis mine.)

employees at Apple stores provide the company with a powerful window into user habits and needs, even if it is not conventional market research. "Steve visits the Apple store in Palo Alto frequently," said a former consultant to Apple. The design decisions made by Mr. Jobs, Mr. McKenna said, are informed by his grasp of users' desires, technology trends and popular culture.

In the New Yorker piece, noted game designer Will Wright (of the Sim City series) says this about Miyamoto:

he approaches things from the players' point of view, which is part of his magic.

Miyamoto himself describes an unusual tactic for getting his designers to think about users other than themselves:

sometimes I ask the younger game creators to try playing the games they are making by switching their left and right hands. In that way, they can understand how inexperienced the first-timer is.

Understand the customer's desires. Think about the player's point of view. Jobs and Miyamoto, not surprisingly, both have the habit - the discipline, the worldview - of creating things with someone else in mind.

Do you see? The "lone genius" is an attractive myth but not much more. And whether Apple or Nintendo runs focus groups is really beside the point. I can bend your ear about research methods (contact my company if we can help), but the real point is how these disruptive ideas, these great products really get created: they're born through a desire to benefit someone else. If you want to become the next Steve Jobs, get to know your customers.

This Newsweek post, from awhile back, describes the design decisions in improving the traveler experience on Virgin America airlines.

Designer Adam Wells describes just one improvement - lighting:

Typical airlines are so badly lit. There's a greenish hue that comes from fluorescent lighting. That gives a distressed, nauseous skin tone. It doesn't do anything to help your frame of mind to see everyone looking sickly around you. People have an emotional and physiological response to lighting. So we decided to shift the color of our cabin lights during the course of flight. They're associated with time of day outside, or ambient light outside. If you're flying by day and heading into dusk, it will reflect the light level outside. It's less jarring.

Virgin America has been my favorite domestic airline for a couple of years now.

See also: Disney improves the experience of waiting in line

Wait in a line at Disney World? There's a back office dedicated to making the experience better, according to this NYT article:

If Pirates of the Caribbean, the ride that sends people on a spirited voyage through the Spanish Main, suddenly blinks from green to yellow, the center might respond by alerting managers to launch more boats.

Another option involves dispatching Captain Jack Sparrow or Goofy or one of their pals to the queue to entertain people as they wait. "It's about being nimble and quickly noticing that, 'Hey, let's make sure there is some relief out there for those people,' " said Phil Holmes, vice president of the Magic Kingdom, the flagship Disney World park.

Lesson: Good logistics create good aesthetics. And details matter.

P.S. In New York City, it's waiting "on line." In the UK, you're "in a queue." Any other regional phrases?