Are you tired of tipping the “obligatory” 20%?  I believe everyone (companies and people) should get paid what they deserve.  I often tip 50% but sometimes I tip $1.  It is performance based.

Continuing on with international and summer travel along with the parallels of healthcare, last week we explored Overseas Observations: US Healthcare vs Abroad.

I think about the level of quality and results in a system that is financially and individually driven.  When traveling abroad, I look at the tipping culture or lack thereof.  I don’t believe customer service or delivery suffers. If you walk into a restaurant or bar abroad, you are still going to get your meal/drink, but you might not get it as fast.  I was struck by a bar that had 3 bar tenders in Amsterdam that showed there was no rush to get the drinks to the customers because it seemed like they were not hustling for tips.  Typically if I go to a similar bar in NYC, the bartenders are rushing around to make more money faster and get more tips. 

Now comes the bigger question for me which is how does the quality/outcome suffer without a tip?  Other than speed, we still get the outcome which is our food/drink is delivered.  The final factor, of course is the cost.  The cost is less because the tip isn’t added.

At Advize, we have often asked ‘Does Higher Spending Drive Better Outcomes

It gets us back to the same ole’ project management triangle: Time, Cost, Scope. Here rather than scope, lets replace it with quality. As it pertains to healthcare, what is important to us as the consumer and why?


Restaurant – if no tipping, is service slower when waitstaff is paid?

Healthcare – if we do not pay extra for concierge services or run the costs that we do in the US, will we die waiting for treatment as we have heard the horror stories for socialized medicine.  We have all heard this horror story but is it true?


Restaurant – is our meal any different if we don’t tip? No because the meal is the meal.

Healthcare – “Higher healthcare spending can be beneficial if it results in better health outcomes. However, despite higher healthcare spending, America’s health outcomes are not any better than those in other developed countries. The United States actually performs worse in some common health metrics like life expectancy, infant mortality, and unmanaged diabetes.”


Restaurant – tipping more typically leads to better service if you go back to the same restaurant.

Healthcare – if we pay more do we get better results? Not really, see quality above.

Before packing your bag to go international this summer, check out some tips on tipping.

Jeanmarie Loria
CEO at Advize