Some of you may be old enough to remember when cars had hubcaps. Shiny metal things that made your wheels look nicer.  Shaped like a Frisbee; round, convex, and designed to fly. Today, cars do not have hubcaps. I think that is because when your car hit something the hubcaps tended to leave the wheel at a speed of Mach 2 and impact whatever they hit with the force of a cleaver.

If you were riding in your car, you did not know if your hubcaps were on the car, or if they took flight when you hit the last pothole.  You didn’t know because you could not see them from your position.

Last week the woman next to me complimented me on my cufflinks.  I had to turn my shirt sleeve around to see which ones I was wearing.  Cufflinks are a lot like hubcaps in that way—you cannot see them unless you make an effort.

Patient access is a lot like hubcaps and cufflinks.  From where most hospital executives sit they cannot see patient access or patient trying to access their hospital.  To see whether access works, to assess its effectiveness one must go and observe it.  Observe what happens when a patient calls the hospital to accomplish a task. Observe what happens when a patient tries to accomplish something online.

From what I have observed, if hospital executives actually looked at access they would either find it to be broken or at least in need of a makeover.

If you haven’t made over access since people started conducting their business on smart phones and tablets your access is not what it needs to be. And if I cannot access you, it does not matter to me how noisy your hospital is or how communicative your clinicians are. I will keep calling hospitals until I find one that thinks my call is important to them.