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Whose experience is it anyway? Toward a constructive engagement of tensions in patient-centered health care

Timothy J. Vogus (Vanderbilt University, Nashville, Tennessee, USA)
Andrew Gallan (Florida Atlantic University, Boca Raton, Florida, USA)
Cheryl Rathert (Saint Louis University, St. Louis, Missouri, USA)
Dahlia El-Manstrly (The University of Edinburgh Business School, Edinburgh, UK)
Alexis Strong (Cornell SC Johnson College of Business, Ithaca, New York, USA)

Journal of Service Management

ISSN: 1757-5818

Article publication date: 27 August 2020

Issue publication date: 12 November 2020




Healthcare delivery faces increasing pressure to move from a provider-centered approach to become more consumer-driven and patient-centered. However, many of the actions taken by clinicians, patients and organizations fail to achieve that aim. This paper aims to take a paradox-based perspective to explore five specific tensions that emerge from this shift and provides implications for patient experience research and practice.


This paper uses a conceptual approach that synthesizes literature in health services and administration, organizational behavior, services marketing and management and service operations to illuminate five patient experience tensions and explore mitigation strategies.


The paper makes three key contributions. First, it identifies five tensions that result from the shift to more patient-centered care: patient focus vs employee focus, provider incentives vs provider motivations, care customization vs standardization, patient workload vs organizational workload and service recovery vs organizational risk. Second, it highlights multiple theories that provide insight into the existence of the tensions and how they may be navigated. Third, specific organizational practices that engage the tensions and associated examples of leading organizations are identified. Relevant measures for research and practice are also suggested.


The authors develop a novel analysis of five persistent tensions facing healthcare organizations as a result of a shift to a more consumer-driven, patient-centered approach to care. The authors detail each tension, discuss an existing theory from organizational behavior or services marketing that helps make sense of the tension, suggest potential solutions for managing or resolving the tension and provide representative case illustrations and useful measures.



The authors have no sources of funding or other support to report nor do any of the authors have any potential conflicts of interest.


Vogus, T.J., Gallan, A., Rathert, C., El-Manstrly, D. and Strong, A. (2020), "Whose experience is it anyway? Toward a constructive engagement of tensions in patient-centered health care", Journal of Service Management, Vol. 31 No. 5, pp. 979-1013.



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Copyright © 2020, Emerald Publishing Limited

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