The Promise of Time: The Ultimate Customer Value Proposition | What’s Your Edge?

Today’s conversation explores how a lean process improvement initiative, originally launched to address patient complaints about long wait times, evolved into something much more: a deeply embedded customer-centric culture grounded in customer value and customer-centricy, and a move away from random acts of efficiency toward a systematic, measurable approach to customer experience. Stephanie Collins, CEO of Austin Retina, a practice that has been serving patients since 1979, joins us today as our guest for What’s Your Edge. Stephanie has been with the organization for 25 years, rising through the ranks to lead the practice through significant growth. The practice has grown from a single provider to 19 physicians and nearly 300 employees. And recently, it became a part of Cencora, a global leader in pharmaceutical and medical supply distribution. Stephanie, I’m looking forward to learning how Austin Retina reframed time as a critical dimension of value, how you operationalized customer-centricity, and how you measure the impact of customer value on growth, loyalty, and performance.

Stephanie, welcome to the show.

The Inflection Point: From “Just A Number” to Valuable Customer

Stephanie, let’s start with the moment that really catalyzed change. In 2015, Austin Retina initiated a lean process. One of the primary triggers was patient feedback that they felt the practice didn’t value their time—that they were being treated like a number. I imagine most everyone listening has experienced this feeling. In fact, nationally, studies suggest that patients spend roughly 11–18 minutes just waiting to be seen in a doctor’s office, and when you add travel and disruption to the workday, researchers estimate about $89 billion a year in lost time due to medical visits. Now, when we wind back the clock, patients were often in the office for three hours, and these patients often see their physicians every 4–6 weeks. That is a significant time commitment. We can easily see why the initial goal of the lean initiative was straightforward: shorten wait time. Congratulations on achieving your goal and reducing the wait time from three hours to about 90 minutes. Take us back to that period. What were you hearing from patients that made you realize “we have to do something different”? Was there a specific story or piece of feedback that made the leadership team say, “We cannot continue this way”?

When I think back to that time, what really struck me wasn’t just that patients were waiting a long time — it was how that wait made them feel. We began hearing consistent feedback that patients felt like they were being processed rather than cared for. One moment that stuck with me came from a long-time patient who very kindly said, “I know you’re all working hard, but it feels like my time doesn’t matter.”

For a patient who is already managing a chronic condition, that comment was eye-opening. Many of our patients visit us every four to six weeks, and for many years. When they’re spending three hours in our office each time, it adds up to a tremendous burden.

That was the moment when our leadership team realized this wasn’t just about efficiency — it was about respect, empathy, and dignity. We couldn’t continue operating in a way that unintentionally signaled that our time mattered more than theirs. That realization is what pushed us to take bold action and pursue a lean initiative.

I personally believe time is our most precious asset. How did you and your team come to frame the problem—not just as an operational issue, but as a patient or customer value issue?

As we started digging into the long visit times, we realized the real question wasn’t just “How do we make the process faster?” — it was “Are we delivering what patients truly value?” That shift in thinking was important. We wanted to reduce waste, costs, and redundancies in the process, but never at the expense of the quality of their care or the relationship they have with their physician.

Framing the problem through the lens of patient value helped us focus on improving flow and eliminating waste while still protecting the elements of care that matter most. It allowed us to design improvements that were more meaningful, more patient-centered, and ultimately more sustainable.

I love the fact you stepped into your customers shoes. In our work, we define customer value as the balance between what customers receive and what they must give up, such as time, effort, money, and risk, to obtain that value. For many customers, time is one of the most precious currencies. From your perspective, when did you begin to see time not just as a scheduling issue, but as a core component of the value proposition Austin Retina offers its patients?

The turning point for me was recognizing that time is deeply emotional. It’s tied to autonomy, to a sense of control, to quality of life. In retina care, many of our patients already feel like they’ve lost control — their vision, their health, their schedule revolves around injections and follow-ups.

So, when we began mapping the patient journey, we realized that if we could give time back to them, we were restoring some of that control. That’s when it became clear that time wasn’t a scheduling matter; it was a core part of our value proposition.

Lean as the Catalyst for Better Customer-Centricity

You started with a lean initiative to reduce wait times, but over time, that effort evolved into something deeper—a cultural shift toward patient or what we call customer-centricity. At what point did you recognize, “This is no longer just a process improvement project; this is reshaping our culture”?

For us, the moment we realized this had grown beyond a process-improvement initiative and had truly become a cultural transformation was when patients started commenting on their own. We began hearing things like, “I don’t know what you’re doing differently, but keep it up!”

Those spontaneous comments were incredibly validating. They showed us that patients weren’t just experiencing a shorter visit — they were feeling a real improvement in how they were cared for.

What was just as meaningful, though, was what happened internally. As patients started noticing the changes, our staff re-engaged in a way we hadn’t seen in a long time. They began bringing forward new ideas, suggesting areas where we could streamline or improve the experience for everyone. You could feel the excitement building — this sense that we were accomplishing something important together.

That combination of patient appreciation and staff enthusiasm is when we knew we weren’t simply adjusting workflows. We were reshaping our culture around valuing time, reducing frustration, and creating a better experience across the board.

What an excellent point about how the process helped reshape the culture. We often talk about the need to operationalize customer-centricity; that is, to move from slogans about being customer-focused to embedding customer value into processes, metrics, and decision-making. What were some of the concrete operational changes that signaled to your patients, “We heard you, and we’re changing how we work to respect your time”? And how did you make those changes stick so they became “the way we do things here” rather than a one-time initiative?

Some of the most meaningful changes were:

• Standardized rooming and diagnostic workflowsto eliminate unnecessary steps.
• Reviewing patient flow dashboards and metricsso staff could anticipate bottlenecks and improve processes to keep them from happening.
• Cross-training team members, which gave us more flexibility to keep patients moving smoothly.
• Redesigning the appointment templateso it accurately reflected the true time needed for different visit types.
• Physician huddles every morningto align on the day’s flow.

What made these changes stick was that we embedded them into daily management. They weren’t “projects”; they became expectations. And as soon as patients started noticing shorter visits and smoother experiences, the team became even more committed.

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The Importance of Expectations: Defining and Measuring Customer Value

I think that’s a powerful point about making changes expectations. We often emphasize that customer-centric growth depends on being able to define, measure, and monitor customer value. We’ve written about customer value metrics that facilitate customer-centric growth and about the importance of identifying the variables that matter most to your customers, like time, access, outcomes, relationship, and so on: What measures and metrics are you using to track whether you ...