While working in Rio we received a briefing from former members of MI-6 and the Secret Service about how to work and play in South America.  If you were going to be kidnapped, Colombia, they told us, was the best, because the kidnappers treated it as a business and they would do their best to keep you alive.  So for Christmas, I took my family to Colombia.

The woman next to me on the flight to Medellin was watching the movie Proof of Life.  The movie was about a woman living in Colombia whose husband is kidnapped.  Ironic?  I hoped so.  It reminded me of the scene in the movie Airplane when the people on the plane were watching a movie about a plane crash while their plane was about to crash.

I knew little of Colombia other than from a combination of impressions formed from watching the movies Clear and Present Danger and Proof of Life.  The US perception of Colombia was that there were guerrillas hiding behind every banana plant.  Readying myself for a run through the mountains I knew I would have to rely heavily on the fact that I owned a Navy SEAL t-shirt, and that I had seen a television series on SEAL training on the Discovery channel.

I carried with me a bottle of dehydrated water as I made my way up the mountain.  My escape plan, if push came to shove, was to build a hang glider using my shoe laces and by weaving together leaves from one of the tropical plants.

The run proved to be uneventful.  Colombia was amazing, exceeding my expectations.

Nowadays nothing exceeds ones expectations.  A handful of firms meet your expectations, but what firms do not know is that we have lowered our expectations so much that meeting them is still unsatisfactory.

If someone at any organization asked me what my expectations of doing business with them were I would reply that I expect to be disappointed. I feel that way about trying to business with my hospital.

If this is your first time reading my blog, I have been called the Stephen Hawking of Patient Experience,

I have been a heart patient for eleven years.  During that period I have spent a total of four days in the hospital, way less than one percent of the time.  For the other four thousand days I have been having experiences with the hospital; scheduling appointments and labs, checking-in, ordering refills of my prescriptions.

The thing is, none of the ten thousand employees knows about my experiences, or knows if they were good or bad.  The reason nobody knows is because nobody has asked.  And the reason nobody has asked is because the hospital is not required to be aware of my experience, and more importantly, it is not penalized if my experiences are poor.

Patient experience reminds me of the commercial about Las Vegas—What happens outside of the hospital stays outside of the hospital.  Hear no evil, see no evil, speak no evil.

In other words, don’t make waves.  If you were a mariner you would be familiar with the word doldrums.  The doldrums are a period of inactivity; no wind, no waves; the same thing day-in and day-out—Groundhog Day.

It is week 17 in the NFL.  I was listening to a few interviews on ESPN of players whose teams are still in contention for the playoffs.  Every person interviewed said that they were going to treat this last game as though it was a playoff game.  Really?  They play sixteen games.  Now that there is nothing beyond tomorrow they are going to treat their last game as a playoff game.

What if they had approached game one or game six as a playoff game?  Would they still have to treat game sixteen as one?  Had they won any single game that they lost maybe the outcome would have been different.  In September players say they are playing to compete in January when everything is on the line.  Perhaps they should notice that if they do not play like everything is on the line in September they will not have to worry about January.

We do that in healthcare. We treat patient experience that way.  We wait to learn the results of the next round of surveys, then we make a plan, then we try to implement the plan.  Civil wars were won and lost in less time.  It is like reading yesterday’s paper to learn yesterday’s news.

It’s time we make a few waves—if you do not nobody else will.