Secondary but significant: secondary customers’ existence, vulnerability and needs in care services

Abstract

Purpose The purpose of this paper is to increase understanding of the status, vulnerability and needs of the health-care and nursing service customers’ (hereafter, care service customers’) loved ones. Design/methodology/approach The position and vulnerabilities of secondary customers of care services are studied and examples provided by reviewing empirical research reported in the care service literature. A conceptual discussion is developed on the “customer” concept in an extended sense, beyond the focal customers. The “primary customer” and “secondary customer” concepts are employed to supplement the extant discussion on customer units and ecosystems. Findings Secondary customers are exposed to secondary vulnerability and their well-being is affected by the services provided primarily to their loved ones. The most recurring needs of secondary customers concern psychosocial support, communication and information and cultural sensitivity. Practical implications New perspectives on understanding the “customer” concept in an extended sense. This assists in supporting the customers’ dynamic activities and processes within the customer ecosystems. To address care service customers’ loved ones’ vulnerabilities and needs and to support their well-being, they should also be recognised as customers – “secondary customers” – with patients being the “primary customers”. Social implications The results are especially relevant when considering services’ influences on vulnerable customers’ ecosystems and on individuals within them. It is important to recognise that beyond a vulnerable customer, several secondary customers may be exposed to secondary vulnerability, needing support. Originality/value The paper is apparently the first to connect the constructs “primary” and “secondary customer” and customer vulnerability to the customer ecosystem discussion. Also, essential future research questions are provided.

Balancing service inclusion for primary and secondary customers experiencing vulnerabilities

“…First, the primary and secondary customers' needs are interrelated (or unrelated) in four ways: they are separate, congruent, intertwined or discrepant (Figure 3). Embodying the interrelatedness of needs in a customer entity, the study contributes to the service literature by supporting the adoption of an extended consumer/ customer view (Fletcher-Brown et al, 2020;Leino, 2017) and a relational perspective (Kelleher et al, 2020), and provides an understanding of customer needs, including latent ones. The family member viewpoint (Alonso et al, 2017;Verbeek, 2017) and Figure 3 Relationship between primary and secondary customer's self-and other-related needs, influenced by experienced vulnerabilities patient/resident viewpoint (Griffiths and Harmon, 2011;Hare et al, 2013) have been studied separately, but a gap in using the relational perspective has existed.…”

“…These actors can range from service providers to consumer advocates, service gatekeepers and risk analysts, encompassing unofficial and official actors related to the consumer; thus, all TSMs are not in close relations with the consumer. Leino (2017) focuses on those actors who can be regarded as close others of the vulnerable customers and calls them secondary customers. She underscores their role as service recipients alongside the primary customers: ‘secondary customers should be seen as an integral part of the service process […] created to serve both the primary and secondary customers, yet recognising and addressing their differing needs in the service design.’ (Leino, 2017, p. 766)…”

“…Johns and Davey (2019) introduce the concept of the transformative service mediator (TSM) to explain how multiple actors (from service providers to consumer advocates, such as family members) can mediate services and value outcomes for consumers experiencing vulnerabilities. Besides mediating services for the primary customer, secondary customers are also influenced by the service provided to their close other (Leino, 2017). Furthermore, individuals that experience secondary vulnerability may seek relief from systems and services originally designed for the primary customers facing vulnerabilities (Pavia and Mason, 2014).…”

Communicating with Companions. The Impact of Companion Empowerment and Companion Literacy on the Well-being of Elderly Patients

“…The increasing complexity of health ecosystems signifies that, when defining health communication strategy for 2020 and beyond, both patients and their local networks should be taken into account (Leino, 2017). This paper is based on previous findings in the field of patient empowerment and patient health literacy and explores the effect of health literacy and health empowerment of companions of chronically-ill elderly patients on the well-being of the accompanied patients.…”

“…Moreover, as friends, family and significant others can help to transmit knowledge to patients in daily life (Gordon et al, 2013), the effect of companion health literacy and companion health empowerment on patient health literacy and patient health empowerment should be studied. Furthermore, as the needs and vulnerability of the companions are frequently ignored (Leino, 2017), the effect of health communication strategies on the companions' well-being, and not only on that of the patients, merits further attention. This research could also be extended to consider the negative effect of companion involvement in terms of ethical concerns related to patient autonomy or patient privacy.…”