When I was single my mind worked like the minds of most guys.  For example, housework.  Ironing.  I did not own an iron.  My reasoning, that was why God made dry cleaners.  If I ever lost a button on a shirt my head wanted to explode.  My only salvation, as I did not own a needle and thread, was if I had brought home the little sewing kit some upmarket hotels provided along with the coconut-guava soap, I might spend an hour or two during a ballgame trying to sew on the button.

When I married, an iron came with my wife; kind of like the prize that comes in the box of Cracker Jacks.  While I have no problem with a division of responsibilities, I think it makes sense to be efficient when the opportunity presents itself.  As an example, take dusting.  What I discovered is that if your spouse is five feet tall it would be a waste of time for me to dust anything higher than five feet tall.  As a result our coffee table is a tad over five feet tall.  It looks silly but it serves a purpose.

This morning I ironed my shirt.  Scratch one item from my bucket list.

During college, I spent several summers volunteering for a group called Young Life at camps throughout the US.  Silver Cliff was one of their camps in the mountains of Colorado.  Each week we’d take in a few hundred high school kids from throughout the US, and give them the opportunity to do things and challenge themselves in new ways; everything from riding horses to rappelling.

The prior summer I was the head wrangler at one camp—I had never ridden a horse prior to being made head wrangler.  This summer is was the person running the rappelling program.  Needless to say, I had never done rappelled before either.

We received a day’s worth of instruction before we were turned loose on the kids.  One of the first things we had to learn was that the ropes and harness, if properly secured to the carabineers and figure eight, would actually keep you from falling to your death.  My first test was jumping from a platform way up in a tree while on belay.  After a few moments of white-knuckle panic, I stepped over the edge and was belayed safely to the ground.

From there, we scouted a place for the rappel, and found two suitable cliffs, each with about a hundred foot vertical drop.  Watching my first rappel must have reminded others of what it would have been like watching a chimp learn how to use a fork.  After several tentative descents, I was able to make it safely to the bottom in a single jump.

Each day we’d run a few dozen kids through the course, ninety-nine percent of whom had never rappelled, or ever wanted to rappel.  To convince them that it was safe and that they could complete it, I would instruct them in the technique as I hung backwards over the chalk face of the limestone cliff.

Each day we’d have one or two kids who wanted nothing to do with my little course.  Occasionally, while on belay, one of them would freeze half way down the cliff, and I’d have to belay down and rescue them.

Once or twice I’d have an attractive female counselor on belay.  She knew I was the only thing keeping her from being a Rorschach stain on the rocks below.  Scared, and looking for a boost of confidence, “She’d ask, how long have you been doing this?” I’d look at my watch and ask her how many days ago was Sunday.  I viewed it as an opportunity to have a little fun with her.  I also hoped I might even have the chance to go on a heroic rescue.

How long have you been doing this?  That’s seems like a fair question to ask of anyone in a hospital setting.  It’s more easily answered when you are in someone’s office and are facing multiple framed and matted attestations of their skills.  Seen any good patient experience certificates on the walls of the people entrusted with the execution of the patient experience strategy?  Me either.  I have a cardiologist and he has all sorts of paper hanging from his wall.  Helps to convince me he knows his stuff.  Now, if I were to pretend to be a cardiologist—I’ve been thinking of going to night school—I’d expect people would expect to see my bona fides.

Shouldn’t the same logic apply to investing scarce resources to improve patient experience?  Imagine this discussion outside of the hospital cafeteria.

“What do you do?”

“I’m in charge of patient experience.”

“Why?”

“The feds say we’ve got to have it.”

“Oh.  How’s that working?”

“Nobody really knows.”

“How long have you been doing this?”

“How many days ago was Sunday?”

“What’s it cost?”

“Somewhere between this much,” he stretches out his arms, “And this much,” stretching them further.

“Do the doctors want this?”

“Some do, some don’t.”

“How will you know when you’re done if you got it right?”

“Beats me.”

There is a big difference between improving patient experience and improving patient experience scores.