You are making dinner for a few friends. The plan is for spaghetti, but you forgot to buy the sauce and now you’re out of time. But hey, it’s still free noodles. And you went to all the work to plan it, so they should be grateful, right?

You manage a hotel that is offering new free, fast WiFi, but the system isn’t working as planned. After much work on your part, it’s fine on the first floor, but the other 15 floors get only spotty signal. Before this, there was no WiFi at all, so it’s better than nothing. It’s free anyway, so people shouldn’t be upset, right? 

Many if not most people reading this will agree that they would not be happy with sauce-less noodles or weak – albeit free – WiFi. But why not? Isn’t something better than nothing?

People don’t compare your product or offering with their baseline, they compare it to their expectations, which are set by both implicit and explicit promises. When you invite people over for dinner, they expect that you are going to try your best to try to provide them a nice meal. You can try to set their expectations, but they already have in their minds an acceptable range of what such an invitation means, and boiled noodles are likely to fall below their threshold. “Free WiFi” means that guests will be able to use their phones to access the internet without paying their personal data fees. Anything less than that is a failed promise. 

From your perspective, you’ve put in a lot of work to provide even part of a solution, and people should be grateful for that effort. Unfortunately, you don’t get to decide how people feel about what you give. The value is determined by the recipient.

Let’s also look at the nature of that value. Value can be incremental: some is better than none and the more, the better. Other times it’s closer to binary: anything less than a complete version is nearly worthless.

Boiling water and purchasing the uncooked noodles may be 20% of the work, but serving that for dinner is not 20% as good a plate of finished spaghetti – it’s 0% as good. The value consideration is fairly binary. On the other hand, if you meant to give a $100 gift certificate as a gift but realize you can only afford $50, that’s probably at least half as good (the thought counts for something, after all). If you promise your kids a dog and then get them 50% of a dog…well, you understand the point by now.

We don’t always think about it in this way in healthcare, partly because we we tend to focus more on the needs of the providers than the customers. But we offer products just like other businesses, consisting of both healthcare business offerings as well as one-on-one interactions with providers. Sometimes our customers are internal; as a radiologist, my customer is not only the patient but also the recipient of my interpretation. We should be asking ourselves if our offerings will be perceived as adding incremental or binary value.

If a healthcare system establishes a way for patients to email their doctors, but they have to use an awkward new app instead of regular email, will patients see that as a good start, or frustratingly complex?

If a patient comes into the ED with abdominal pain, wanting to know the cause and the ED physician can’t find the source, but is able to exclude any emergent issues, is that worthless, or is there incremental value? How does the patient see it? 

Although the ultimate judge of value is the recipient, it is possible to nudge the perspective. “We let you down, we can’t find the source of the abdominal pain,” creates a different value proposition than “Good news! We know that your pain is not caused by anything serious”. You may be able to shift an otherwise binary situation into an incremental one.

Try to ask yourself a few questions when offering something new:

• Does this product/offering/service offer incremental or binary value, from the perspective of the recipient?

• If it offers incremental value, what is your process to increase the value over time, and make sure that each step also adds additional value?

• If it’s binary, is there a way to turn it into incremental value? If it’s truly binary and it’s incomplete, then should you offer it at all? 

Maybe spaghetti is binary and you should put aside your bland noodles and order take-out. Or maybe with a some extra butter, pepper, herbs, and cheese, you can make an 80% solution provide at least 80% of the value.

Consider it from the perspective of those you wish to serve and don’t assume that the degree of effort on your part will create proportional value to them.