Take a Tip from Domino’s – The Health Care Blog


If you’re already thinking ahead to next Sunday’s Super Bowl, you might be thinking about Domino’s, because, as everyone knows, pizza and football go together like mom and apple pie.  I’m thinking about Domino’s too, but not because I’m planning my order.  It’s about their new program to reward customers who do more of their own work.  

Ahem, healthcare: pay attention.

Last week Domino’s announced that customers who picked up their own orders, rather than using delivery, would earn a $3 tip.  Art D’Elia, Domino’s executive president and chief marketing officer, explained: 

It takes skill to get pizza from a Domino’s store to your door. As a reward, Domino’s is giving a $3 tip to online carryout customers who take the time and energy out of their day to act as their own delivery drivers. After all, we think they deserve it. 

The program – Domino’s Carryout Tips – isn’t quite as rewarding as it might sound.  The $3 is actually a credit on your next order, and that credit has to be used by the following week.  There’s a $5 minimum to qualify, and orders have to be online.  The program was announced in time for the expected Super Bowl surge and is scheduled to end May 22.  

But still.  I don’t like waiting for deliveries, I do like pizza, and if I ordered a lot of Domino’s (which I don’t), the $3 tip would be decent discount, even if I had to order even more Domino’s to actually get it.

Domino’s once was famous for it’s “30 minutes or it’s free” delivery guarantee, until it lost a $78 million lawsuit in the early 1990’s, as the court agreed the promise resulted in reckless driving (and even, it was claimed, multiple fatalities).  Still, during the 1980’s that promise catapulted the chain to be the biggest pizza chain in the U.S., a position it still holds (it now is also the largest in the world). 

Although the tip initiative was portrayed as a customer reward program – Mr. D’Elia is, after all, the chief marketing officer – most analysts believe it is more about labor shortages.  Domino’s, like many companies and especially those in the food service industry, is struggling to attract/retain enough workers, including those delivery drivers.  So if customers want to be their own delivery driver – Domino’s ad literally shows that – hey, that’s worth a $3 credit, right?  

In 3Q 2021, Domino’s suffered its first decline in same-store sales in over a decade; initially, the pandemic had been very good for pizza sales, but the combination of fewer workers, higher supply prices, and ongoing competition took its toll.  At the time, Chief Executive Richard E. Allison, Jr. noted: “The carryout business will continue to be a focus of ours, given the significantly lower amount of labor involved in those transactions, We’re going to continue pushing there.”

Thus, Carryout Tips.


Healthcare has its own share of pandemic woes, most of which exacerbated existing problems.  Healthcare workers are burnt out, and many are simply leaving – about one in five, according to some estimates. Patient data continues to be siloed despite huge gains in electronic health records; not only do different EHR vendors not communicate well, but different health systems using the same vendor also have problems.  Patients not only often don’t have good health habits but a surprising number don’t follow their doctor’s orders, including medication adherence.  Health inequities abound.

Somebody needs some $3 tips.  Well, actually, given health care prices, there better be a lot of zeros after the number, and I’m not talking decimal points.  We’re doing way too much of the work, for free.  For example:

  • Have you ever filled out a form in a healthcare office that you’d already filled out previously, either there or in another office?  You get a tip!
  • Have you ever had to carry some of your health care records (either on paper or on a CD) from one healthcare office to another?  You get a tip!
  • Have you ever had to take time off work to sit in a healthcare office or facility, waiting long past your scheduled appointment?  You get a tip!
  • Have you ever had to fight with a healthcare organization about incorrect bills, or with an insurance company over incorrect payments?  You get a tip!
  • Have you ever been a caregiver for someone with acute or ongoing health care issues?  You get a tip!

You get the idea, and you probably have your own suggestions.  We’ve all had encounters with the healthcare system that felt way too hard, during which we felt we were doing more of the work than we should have had to.  Frictionless, it is not.  

The healthcare industry would say, well, nice idea, but there’s no money for that.  We could do that, it might say, but, of course, we’d have to charge more in order to pay for all those tips.  I would say, balderdash.  There’s plenty of money; it’s just going to the wrong places.


I’m not naïve.  Domino’s is not offering its tips because it truly wants to reward its customers.  It’s doing it mainly because delivery drivers are scarce and too expensive.  If it can persuade more customers to be their own delivery drivers by offering a $3 credit, better for Domino’s, and if the $3 engenders some extra customer loyalty, better still for Domino’s.  

Similarly, healthcare workers are expensive and becoming increasingly scarce.  There weren’t enough of them before the pandemic, and there certainly aren’t not enough of them now.  Given the way they’re leaving the industry, there aren’t going to be enough of them once the pandemic becomes endemic and things reach a “new normal.” 

Healthcare better find ways to incent patients to take on more of the work.  Appeals to “more self-service” or even to “managing your own health” aren’t going to be enough.  Healthcare organizations need to be thinking about financial incentives.  Call it a tip, call it a credit, call it a customer loyalty reward, but they should find some way to acknowledge, and reward, patients for the various ways they provide unpaid work in our healthcare system.

A healthcare “thirty minutes or its free” promise wouldn’t be a bad start either.

Maybe healthcare organizations could at least order pizzas for patients…although they’d probably expect them to pick them up.   

Kim is a former emarketing exec at a major Blues plan, editor of the late & lamented Tincture.io, and now regular THCB contributor.

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