We only need about a hundred more reads for this little missive to hit 100,000 reads. Nobody is more amazed by that statistic than I, but I am also very appreciative of the fact that you continue to play along, and I have learned a lot from your thoughtful feedback.

And I have decided that the hundred-thousandth person to read a post will win my neighbor’s new BMW—he is not among the readership, so that will serve him right.

Over the last few years several of you have been kind enough to read and comment on the draft of my second novel. As an undergraduate I majored in math, in part because I wanted to get through university without writing a term paper. My strategy worked, save one. Political science.

A philosophy professor mentioned that if you ever did not know how to reply to an essay question on an exam, the best approach was to rewrite the question in a manner that turns the question into one you could answer. I took his advice. Apparently my Poly Sci professor had also taken philosophy. He wrote on the top of my Blue Book, “Great answer. But we both know that was not the question I asked.”

Fifteen years ago I was taking a flight to Rio to meet with my client. The book I had purchased at the airport wasn’t worth the money; it wasn’t even worth it in Canadian dollars. I started thinking about what it might take to write a novel, wondering what authors had done that I had not done. They wrote. I tossed the paperback aside and I began to write about a former boss of mine. A gentleman for whom I had very few fond memories.

Twenty pages later he was dead. I read what I had written, and concluded I was even less fond of him than what I had written, so I did away with him in a more egregious manner. It was a very cathartic experience. Six weeks later I had written almost four hundred pages.

The second most entertaining part of writing is that some character that I would invent during the day would wake me in the middle of the night and tell me what he was going to do next. The best part about writing is that I had finally found an outlet for the voices.

A month after that I had an agent. The agent said I wrote like a mathematician, and she suggested I might want to use a few adjectives. She would see me again in a month.

Upon reading the revised draft, chocked-full of adjectives, she asked, “Paul, have you ever spoken to a woman?”

Her question left me confused and concerned. She saw my look and knew I had no idea as to why she had asked. She explained saying, “Women do not talk the way you have them speaking in your book.”

“Have you even spoken to a woman?”

I thought of that question today and I thought we could tie that question into the topic of customer/patient experience.

“Have you ever spoken to a customer?” To a customer outside of the hospital. It is easy to speak to a customer or patient inside the hospital. Part of the reason it is easy to speak to someone in the hospital is that the ratio of employees to customers is probably something like one to five.

What I am asking is have you ever spoken to someone outside of the hospital, someone who was trying to schedule an appointment? To someone who wanted to understand their bill? Get a refill, and so forth and so on. Outside of the hospital the ratio of employees who speak to customers is astronomical; probably something like one to several thousand.

It is not a fair fight. And the employees do not get much better at it over time even though they answer the same questions day in a day out. Their failure to speak well with your customers is not a reflection of their skills or their motivation.

The people who answer your phones speak with more of your customers each day than most people speak to in a month. They are usually the ones with the lowest compensation. They have little or no authority to meet the customers’ needs, and they have no tools to help them present the health system properly.

If asked, hospital executives would tell you that people (customers) call the health system to get answers to questions about billing, refills, and scheduling. They would tell you that, and they would be wrong. They would be wrong because they have never spoken to their customers outside of the hospital.

In the last month I have spoken with two non-provider healthcare executives. We were discussing patient access, patient engagement, and patient experience. I did not ask them what they thought of their health system. But they availed themselves of the fact that they had a captive audience; me. Paul’s 12-Step program for disgruntled patients.

One of the executives mentioned that the experience was worse than what he imagined Beirut was in the 1980’s. The other, who is friends with the CEO of a large health system in our nation’s capitol told me that trying to do business with his friend’s health system was the worst business experience of his life. He continued by saying, “These people have no idea how bad it is because they never have to interact with the system as a customer.”

The people who call the health system, your health system, are actually calling to answer for themselves one of two questions; will I buy healthcare from this health system, or will I buy healthcare again from this health system?

My first novel has yet to be published, but I remain hopeful. My agent died. And no, I did not do it.