The Importance of Earnest Service

Archive for the ‘Doctors’ Category

Service of “You Choose”

Thursday, March 9th, 2023

A friend was a talented interior designer. She would come to our home with a stack of fabric samples all of which were great choices. “Big deal,” you think. When it came to home décor, my husband and I had very different likes: He leaned to the formal and elaborate. I prefer the opposite. Yet she’d surmount that hurdle with ease and arrive with perfect color and pattern pitches for the pieces that needed upholstering. And we’d happily choose the finalists and the winner.

But you don’t expect that approach at a doctor’s office. Seems it’s a popular tactic these days. A few years ago my doctor, knowing I was going to visit a surgeon next, said, “I hope to goodness he doesn’t give you choices.” Sounded strange to me: I either needed a procedure or I didn’t.

Here are two examples in which the patient was asked to decide. In one, it involved which operation of several needed should take place first. The surgeon told the patient to choose. In the other, the same words were uttered about two powerful drugs. Neither patient is a physician. Without the background, how in the Sam Hill can a patient make the most judicious choice?

Had we made a bad selection of fabric the only damage would have been to our wallet. But a patient choosing door number one when it should have been door number three could be seriously up the creek.

There are exceptions. My dentist has warned me that a conservative approach and tricky fix for a dental crisis might not work and I’ve chosen to give it a whirl. Dr. Alan Jaslove is a spectacularly talented dentist and if anyone can carry out a challenging procedure, he can. I’m braced to tolerate the more costly alternative if he can’t pull off the difficult, less expensive one—he makes clear the risks.

And obviously there are countless examples of patients who refuse to take medicine the side effects of which are worse than the disease or who stop physical therapy or decline to follow suggested diets. But sometimes we need guidance from an expert.

I’m guessing that passing the buck to the patient approach is influenced by insurance companies in a litigious society. Can’t you hear it: Doctor to the judge: “Well Jeanne opted to do thus and such. I gave her the choice. I had nothing to do with her decision.”

Has a doctor—or anyone else, such as a builder–given you a choice you weren’t prepared or educated to make? Are the medicine and operation examples I described one-offs? Why do you think some doctors leave crucial decisions up to the patient without recommendation?

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Service of Knowing When You’re Not Considered or Wanted

Thursday, February 10th, 2022

What will seniors do if they aren’t computer literate, don’t own or know how to use a smartphone other than to speak on it or a tablet other than to read a book and have nobody to help them? The third reminder confirming an eye doctor appointment asked me to sign in to a website to fill out a bunch of Covid information. And if I couldn’t?

I will only order food from businesses that take my request over the phone or have easy-to-navigate websites and I usually pick it up. I avoid Grubhub, Uber eats, Doordash and the other delivery services and I use restaurants that have their own delivery crew on the rare instance that I require it. The additional cost appears to be prohibitive although you’d never know it by all the bicyclists whizzing around the city toting packages big and small.

Here’s one example. There’s no flat charge for a Grubhub delivery. In addition to the recommended $5 tip to the delivery person, Brett Helling explained on ridester.com “Grubhub’s pricing is based on delivery and service fees, which make up 70% of the meal price.” He wrote:

“Grubhub’s delivery fee is the fee charged by the restaurants to deliver food to the customers’ locations.
“The service fee is the amount Grubhub charges the restaurants for facilitating the order.”

In addition to the expense, and confusing pricing, arranging for delivery is done online. Older citizens on fixed incomes who may depend on such service will feel the impact most or do without.

Some restaurants are making a drastic change–the ones that Victoria Petersen wrote about in her New York Times article “Restaurants to Customers: Don’t Call Us, We Won’t Call You.” She reported: “Channeling all communication through emails, direct messages on social media and reservations apps might frustrate diners and deter those who are technology averse, but restaurants are finding that communicating this way frees up time for front-of-house employees, is more efficient for restaurant administrators and gives flexibility to restaurants operating with a small team or through Covid-related staffing shortages.”

Nice for the business, but what about customers? At the same time I read about the difficulties that restaurants are still having because of the Pandemic. I’m not sure that this is the best time for them to eliminate a form of communication that some depend on–that is, unless they don’t want taking up space, and ruining the hip vibe, older folks who would probably prefer the traditional way to reserve a table.

These marketing decisions have most impact on older citizens. Have you noticed systems and setups that convenience vendors and service providers and ignore or discount some of their patients and customers?

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Service of Automation Hiccups

Monday, November 22nd, 2021

I’ve written 74 posts in the “technology” category the most recent about the hurdles to sign up for the first Covid-19 vaccines; a restaurant where the only way to order was through a smartphone app that was faulty and platform upgrades that benefit the vendor and make life more complicated for the user.

Here are some examples that illustrate that those who designed the programs didn’t consider the vendors or customers.

Seeing Straight

I received an email asking me to make an eye doctor appointment. I’d already done that before leaving my last one but figured the office may have had a computer hiccup that erased all appointments so I called. There were 17 people ahead of me–an unusually high number. [I use telephone waits to water plants]. Turns out my appointment is scheduled and that the lovely assistant who kept her sense of humor said she’d received countless similar calls. The email had been sent automatically, she explained. My suggestion: revise the automated notification so people with appointments don’t get such reminders. Then office staff can focus on their work and patients don’t waste their time.

Image by OpenClipart-Vectors from Pixabay

Here’s to Your Health

Prescription renewals usually take a minute by phone using a simple system: the customer types or says the Rx number. This time after I’d punched in the numbers the computer voice turned me over to the pharmacy department. Another wait. The pharmacy clerk who took my name and that of the prescription mouthwash was out of breath on answering and said to come in for it in the afternoon. The automated system used to do the same. Why bother drugstore staff? I have a lot of plants to water but not that many.

Do You Hear Me Now?

I’m early on this journey to unravel malfunctions galore and may write a post about the twists and turns once there’s resolution. But for this post I will simply note that to change my Verizon account from my husband’s first name to mine has caused tangles of many layers. Just one: the company is now billing me for both the cancelled account and mine. Hoping for resolution to this and the rest very soon. I think I’m in capable hands.

Have you found that some automated systems have fallen short or wasted your time? Which ones worked like a charm? What do you do while waiting on hold to speak with someone?

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Service of Change

Thursday, August 19th, 2021

I passed a deli with signs on the door: “To Dine-in Proof of Covid-19 Vaccination Required.” It surprised me because the place didn’t look like a restaurant but there must be a few tables and chairs inside. This requirement is a change for New Yorkers who won’t fully feel the brunt until the winds of fall make outdoor dining less appealing. I signed up for an Excelsior Pass so that proof of my vaccines are accessible by clicking on an icon, with me when my phone is. In addition to my driver’s license, I’m set to enter any place proof is required.

I get attached to people. A few months ago my hair stylist of years retired. I’m still adjusting though we’re in touch as friends. I envy women who are comfortable going to a range of hair salons. Not me.

My investment advisor also just retired. Wow! Will the roof fall in? No spring chicken, she was entitled years ago. But still: Couldn’t she hang on a little longer for me? A person’s doctor, accountant or lawyer can have the same impact when they leave the scene. Two years ago my eye doctor moved his practice out of NYC. Calamity! I miss him.

A friend suggested that Virgos don’t handle change well which is why, she explained, I find these changes disturbing. I’d be curious to know if others–born under other astrological signs–feel as I do over a change of doctor, hair stylist, stock broker, lawyer, accountant or other key person. Do you?

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Service of Heroes II

Thursday, March 19th, 2020

Photo: mnn.com

There are many heroes these days who face the dangers of coronavirus while many of us have the luxury of being able to work remotely. Cashiers at grocery and other stores, apartment and office building staff, construction workers, firemen, policemen, doctors and nurses, radio and TV production staff and reporters to name just some.

Regardless of pay they are on the front lines in contact with potential germs.

Photo: chicagodoorman.com

From the start we’ve been told most at risk for this virus are older people and yet, as Julia Marsh reported in the New York Post, “In just a single day, one thousand retired and private practice doctors and nurses answered City Hall’s cry for help, volunteering to join the Big Apple’s medical reserve and help treat their fellow New Yorkers stricken with coronavirus.” The underline is mine.

The owner/founder of the Union Square Hospitality Group, Danny Meyer, has laid off 80 percent of the staff in his 19 restaurants–2.000 people. He’s not the only one. What else can he do?

These employees and millions like them with nowhere else to work will need the help and support of heroes to keep them afloat at a time when millions of others have seen their savings evaporate. In future such small businesses may be forced to set aside money for such crises. The public will pay more but what other choice?

Here’s to all the heroes and bless them. Can you identify some in your life? Will you thank these heroes for going to work in spite of the danger?

Photo: verywellhealth.com

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Service of Facing the Music: It Doesn’t Get Better if You Wait, Yahoo and Target

Monday, October 3rd, 2016

When something goes wrong you’re better off taking action quickly—that goes for people and companies: Most have to fight putting off facing the music.

Urged by my husband to move quickly I averted a disaster last week by immediately acting on a dental emergency that seemed overwhelming when it happened. My instinct was to hide and hope. My great dentist, Alan Jaslove [Photo, right]—I’ve written about him before—saved my tooth and a whole lot of stuff that depended on it, squeezing me in and staying late to do so. Had I waited, as he was scheduled to be out of the office for four days which I didn’t know, I might have damaged the tooth beyond repair causing a domino effect of horrendous proportions.

I know this yet avoidance is in my DNA.

It must also be in Yahoo’s. It took two years for the company to report and/or discover a humongous customer hack. It doesn’t reflect well in either case: That it knew and didn’t tell or that it didn’t know.

“The Yahoo theft represents the most accounts ever stolen from a single email provider,” I read on usnews.com from a syndicated AP story, “The Yahoo Email Hack is Bad,” by tech writer Michael Liedtke.

According to Liedtke, “Yahoo didn’t explain what took so long to uncover a heist that it blamed on a ‘state-sponsored actor’ — parlance for a hacker working on behalf of a foreign government. The Sunnyvale, California, company declined to explain how it reached its conclusions about the attack for security reasons, but said it is working with the FBI and other law enforcement. Yahoo began investigating a possible breach in July, around the time the tech site Motherboard reported that a hacker who uses the name ‘Peace’ was trying to sell account information belonging to 200 million Yahoo users.
Jeff John Roberts on Fortune.com, in a fact sheet format, answered the question “Why did Yahoo take so long to warn everyone?” as follows: “Good question. It’s currently unclear when Yahoo learned about the attack…….All Yahoo has said so far is that a ‘recent investigation… has confirmed the breach.’”

The breach happened in 2014 well before the public knew that Verizon was planning to buy Yahoo. Did executives at the digital services company really think a hack involving so many customers could be forever hidden from the purchaser and that a sophisticated company like Verizon wouldn’t protect itself from such a bad surprise had the sale gone through before this news leaked? And what about 500 million hacked customers who turn to Yahoo for email, finance or fantasy sports—according to Roberts–who must take steps to change passwords and, in some cases, answers to security questions.

Two years seems to be the magic number for Target too. From August 2014 to July of this year it sold—for as much as $75–what it thought was 100 percent Egyptian cotton sheets and pillow cases according to Bloomberg news, the company bought the products from Welspun India that turned out to be lesser quality cotton. Target has offered refunds to its customers. But I wonder why it took so long for buyers to discover this. Eons ago, at a party, a friend in the retail business remarked on the quality and thread count of the shirt my husband was wearing without touching it. He was right: It was a pricey shirt in soft, fine Egyptian cotton.

Do you drag your feet when you really shouldn’t?
It can’t help people sleep well at night to realize that it takes years to discover a giant email hack. Should it take two years to learn something’s amiss?
As for Target, did no buyer open a single package over 23 months to check the contents and did he/she even know what Egyptian cotton was supposed to feel like?
Do you pay for premium products and sometimes wonder if you are getting your money’s worth?

Photo: cbsnews.com

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Service of Gentle Care at the Hospital

Monday, April 18th, 2016

If you need medical attention, it’s a blessing when you’re treated kindly. It might even make you feel–if not get–better.

Big Apple

I was taking in the scene at a bustling waiting room at New York Hospital (NewYork-Presbyterian Hospital/Weill Cornell Medical Center) last week. Periodically technicians or doctors stood at the door and called a name. An elderly woman got up to eventually follow a doctor down the hall and close behind was a man.

But first the doctor greeted and shook hands with both and invited the man to join them. “Oh I’m just the escort,” said the man after acknowledging that it had been two years since he last saw the doctor. I couldn’t tell if he was trying to be funny with his escort service remark when he added, “I’m her neighbor,” which didn’t clarify much. The neighbor turned to the patient and asked if she wanted him to come with her. She said “yes,” and off they went.

The patient’s comfort was the objective. The greeting wasted little time; nobody was rushed, resulting in the best, most relaxing outcome. Anyone in the waiting room who observed this moment was charmed.

Bean Town

Faulkner Hospital

After an accident where she broke two fingers, a friend needed an operation and was elated at the care she received. This was at Brigham and Woman’s Faulkner Hospital in Boston, known by the locals as Faulkner Hospital. For starters, still shocked by the fall and in pain, she appreciated that the doctor’s office called her to set up the appointment and gave her the next available date at the location nearest her home. Philip E. Blazar, M.D., her doctor, was forthright, offering to show her as much as she wanted to see/learn about the breaks and was undaunted by peripheral health issues that posed potential hurdles.

She knew precisely what to expect because the pre-op team, from surgeon and nurses to fellows, anesthesiologist and assistants, explained every step and reassured her.

Residents came to her room one at a time, introduced themselves, explained their function and confirmed that she understood what they said. The person charged with making her cast did it quickly, with concern for her mobility, and the outcome was pristine. She left after the operation with all follow-up appointments set with the surgeon and a variety of occupational therapists.

Hospital staff was polite, detail-oriented and kind. Even the cleaning crew seemed happy. On every visit, if my friend or her husband passed anyone related to the hospital in a hallway, they’d ask if they might direct them to their destination. The receptionist seemed to keep track of patients to send husbands, wives or friends, coming separately, to the right floor.

Do you agree that how you’re treated is almost as important as the skill of the people who treat you? Have you observed or experienced similar recent examples to share?

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Service of Potential Typos: New York State’s Electronic Prescription Drug Law

Thursday, April 7th, 2016

The new law in New York State that makes it mandatory for physicians to order drugs electronically immediately made me think of a few things.

I worked in an office where if one person chronically left open a window midwinter potentially causing frozen pipes and other calamities or did some other thing management frowned upon, everyone got a memo—not just the offender. The alleged major reason for ordering prescriptions online is to cut down on doctor shopping for pain killers like Vicodin or Percocet. So why make doctors go through the rigmarole for all prescriptions?
An ace editor reporting on product introductions in a trade magazine mistyped one digit in a client’s toll free number, [prior to websites]. Readers calling the number got an earful of porn. We laughed, she was embarrassed, errors happen when you juggle work and are rushed. I predict that when a doctor types a bunch of digits while listening to a patient’s complaints and questions he/she either won’t hear important information or is set up to make mistakes in the order.

Say you’re the receptionist tasked with the pill ordering chore. As you take messages, make appointments, greet patients and mishear the name of the drug the boss yelled in from another room, do you think you’ll get right all the codes for meds and pharmacies? What the patient gets may be a surprise.

I feel that the more personal information we are forced to put in easily hackable places the worse for all. In a recent comment about a previous post “hb” wrote: “Given that the internet is now totally insecure as to confidentiality… if you catch syphilis cavorting with a prostitute, not just your wife/husband and children/parents, but also all your friends and neighbors are going to know about it within weeks. Maybe the young just don’t care, but I do!” My thoughts precisely.

I heard Jon LaPook, MD, chief medical correspondent for CBS News with Holly Phillips, MD, [Photos, Left], on the “Morning Rounds” segment of CBS This Morning Saturday on April 2. Dr. Phillips admitted it’s faster for her to call in a prescription and doesn’t think the electronic logon and pharmacy search is time-effective but she seemed resigned as all NY docs must be. If they don’t comply, they are subject to fines, loss of license—even jail time.

Dr. LaPook said he loved the system. A patient contacted him while he was on a flight and he was able to submit a prescription from the plane. However, the only additional benefit he could point to, in addition to controlling access to painkillers, was that there will be no mistakes made by bad handwriting where the pharmacist “reads quinine when the doctor meant Quinidine.” He admitted that the checking part of the process—to confirm that the patient isn’t getting painkillers elsewhere–is clunky but predicted that the system will eventually be great.

A young friend, who can fix any computer and is more tech-savvy than most, told me that the only winners in this new arrangement are the people who sold the programs to physicians and pharmacies. Do you agree?