Customer Obsession in Healthcare: Primary Care Redefined

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Customer Obsession in Healthcare: Primary Care Redefined | Dr Raj Behal (Amazon One Medical)

From Metrics to Meaning: Redefining Quality in Primary Care

Jono Hoogerbrug

Apr 09, 2025

Transcript

"I think of quality as what is the patient's ‘job to be done’. What are they trying to get out of this encounter or from their help? What are they trying to achieve? Making quality about that."

— Dr Raj Behal.

Listen now on Apple, Spotify, YouTube or wherever you get your podcasts.

Dr. Raj Behal is a medical doctor and Chief Quality Officer at Amazon One Medical. With a background in internal medicine, medical informatics, and public health, Dr. Behal has spent his career translating evidence into better care. Before joining One Medical, he worked with academic medical centers to improve quality metrics and patient outcomes. Today, he's focused on redefining quality in primary care through a blend of in-person visits, 24/7 virtual care, and digital health solutions.

What you'll learn:

The #1 mistake in healthcare quality—focusing on metrics rather than the patient's "job to be done"
Why quality in healthcare requires solving the "three-body problem" of patients, providers, and payers simultaneously
The power of simple, targeted follow-up questions like "Are you better?" to measure what truly matters
How AI and large language models could transform healthcare by passively extracting quality signals from unstructured data
The vital importance of the "reservoir"—addressing pre-disease conditions before they become chronic illnesses
An ambitious vision for knocking heart disease from its decades-long position as America's #1 killer
How healthcare quality should encompass multiple dimensions: safety, timeliness, effectiveness, efficiency, equity, and patient-centeredness

Key Takeaways

Quality is multidimensional: The Institute of Medicine defines healthcare quality through six domains—safe, timely, effective, efficient, equitable, and patient-centered—but these shouldn't be viewed as separate boxes to check.
Standard metrics aren't enough: HEDIS measures like cancer screening rates and diabetes control are important but capture only "a sliver of what people actually want from their health and healthcare providers."
Respect drives efficiency: One Medical starts appointments exactly on time not because of efficiency targets but out of genuine respect for patients' time—a cultural shift that transforms the care experience.
The coaching approach works: When hospitals received mortality data without guidance, nothing changed. When Dr. Behal worked directly with clinical teams to interpret the data and develop solutions, mortality rates dropped 20-25% in less than a year.
Technology should augment, not replace: The future isn't about AI diagnosing patients but about automating routine tasks—"about 80% of routine testing screenings can be ordered by a machine," freeing clinicians for higher-value work.