Healthcare foodservice today is rife with stories of both the success and failure of efforts to change retail programs, customer behaviors and hospital food perceptions. Consider some of these:

A food service director at a major Southern medical center says, “if we don’t have fried hush-puppies, fried okra and fried chicken on our comfort food bar every day, I don’t have a job!”

A former food service director and now hospital administrator frequently observes that his cafeteria customers always complained that the French fries portions were too small!  

A Northeastern food service director tried offering  a “meatless Monday” program—that lasted one week!

Another offers that only 1% of her cafeteria menu comes from the deep fat fryer but that percentage alone generates 15% of the cafeteria's total revenue.

And yet one more says 40% of his total cafeteria revenue (and most of its net revenue) comes from beverage sales—mostly bottled and fountain drinks.

There are just as many anecdotes illustrating successes:
An east coast director who developed a menu/program that included turkey burgers, turkey meat loaf (both less costly than beef), lots of flavor modifications, sauces made with wine, fresh tomatoes and other flavor enhancers, and new low fat soups. Everything but the whole grain pasta was embraced by customers.  “You've got to be flexible and creative,” he says.
Another FSD who reports,  “Sure, we saw a drop in sales for two to three months when we started our healthy food initiative. But then sales came back and have climbed every year since!”
Still another says 57% of her cafeteria menu is comprised of healthy foods. "If a customer wants to eat healthfully, he can."  The café runs plenty of healthy specials and offers healthy combo-meals—pleasing the administration and, in turn, reporting sales of such options to keep the Board of Trustees informed of positive efforts and results.  Perception is reality.

A mid-western director who initiated a quiet, go slow approach that over the course of two years converted a conventional retail program to a largely healthy-choice orientation:

New, open front refrigerated merchandizers were installed to improve the visibility of and access to healthy choice items. 

One healthy entrée and one traditional entrée are featured at each meal, with all vegetables prepared in a healthy manner,

90% of starch items are healthy, three of four daily soup selections are healthy, only low fat mayonnaise is used, the number of salad bar ingredients increased, only 2% and skim milk are offered, only healthy snack items are displayed. 

No discounts are offered for healthy items, the reaction has not been negative and sales and net revenue have not been negatively affected.