“Patient-Centric” Health Care? (Just Smiling Doesn’t Cut It)

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Have you visited your doctor lately? Seen a specialist? And how many nurses and administrators did you see? You probably saw lots more smiles that you’re accustomed to. After all, the word is out. “Time to be nice with patients.” There’s probably been a run on that teeth whitening toothpaste crap as a result.

But has anything substantive changed? Let me relate an incident I experienced this week, and I’ll let you be the judge. I was running out of a prescription drug last week. So on Thursday I ordered a refill over the Internet, only to receive the dreaded message—”This prescription requires physician approval.” What’s so “dreaded” about that? Read on.



I went into the pharmacy Saturday, hoping it was there. It wasn’t. No reply from the physician. So the pharmacy “loaned” me several pills, and I returned on Tuesday. It wasn’t there. No reply from the physician, despite a second fax. So the pharmacy loaned me several more pills. As I was driving by on Wednesday, I stopped again. Surely it would be there. But it wasn’t.

Now I’m really ticked. So I called my doctor’s office – a clinic, actually, with among the sloppiest administrative processes I’ve ever witnessed. When I couldn’t get anyone in a position of responsibility, I set off a grenade under one of the dysfunctional admins and sent her scurrying to my doctor to get the prescription approved, before I called again. And I finally got the meds about two hours later. End of story? Hardly.

Before I’d hung up from the clinic, I’d asked for the clinic manager. She, of course, was in a meeting, so I left her a voice mail with enough steam for an entire Starbucks day worth of Cappuccinos. And when, I picked up my late prescription, I also had a “talk” with the pharmacy about following up by phone instead of faxing. Shrugged shoulders was all I got. Then I asked them when they sent the first fax. “Oh, it went out right away.” Liars.

The clinic manager did call me back after investigating, and she was quite contrite. But she did tell me that the first fax the clinic received was after business hours on Friday, not on Thursday when I placed my order. And then she went on to say that they’ve discovered a shortcoming in their fancy-dan new medical management system. They can’t forward prescriptions digitally for physician approval. The docs have to fish out faxes from an in-box, which my doc forgot to do on Tuesday after he was off on Monday.

Now lets look at this from a process perspective. How many process defects can you count? I count seven. And will any of them be addressed anytime soon? Hell no. Hey, smile and apologize and it’s all better, right? Yeah right. The medical industry will be practicing patient-centric medicine when fax machines are thrown out the window, and we e-mail docs directly instead. When pharmacies get reamed out by clinics for sitting on refill requests, because someone at the clinic cares. When medical management systems are designed to take care of patients first, not clinics. And when all parties involved in a mess like this feel compelled to do something more than smile and apologize, if that.



I won’t likely be around when that day comes.

4 COMMENTS

  1. Dick

    I am one of the lucky few who rarely needs to go see a doctor. But I can certainly imagine the irritation it must have caused you. Lucky the pharmacy was able to find a work-around by giving you a few pills.

    Sounds like your medical system needs a bit of lean CRM. Take a look at the many healthcare companies starting to employ customer-driven lean thinking as they reengineer their business processes. Much better than just reengineering processes for their own sakes.

    Graham Hill

  2. It’s unfortunate that the “workaround” (getting Dick a few pills) masked the true process problems that, as Dick said, probably won’t get fixed.

    Making excuses, smiling, and apologizing doesn’t fix anything either.

    We have a LONG way to go in health care.

  3. 1. Clearly the process is flawed, and should be addressed by the lcinic
    2. You shouldn’t have waited so long before taking action , only to then explode in frustration after vain attempts without communicating with the clinic(Thursday, Saturday, Tuesday, Wednesday…).
    3. Of course a workaround is good – it typically addresses the current immediate need. (And no, Alt/ctl/delete or reinstall the software is – usually – not a workaround. And of course a fundamental solution is required)

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