What Happens When Patient Experience Meets Ultimate Frisbee?

I had the good fortune this week to spend three days getting oriented with about a hundred other new IBM consultants. Included in the mix were roughly fifty new college hires, all kitted out for their first day of work. Empty Dooney Burke and Coach carryall bags for the girls. Equally vacant backpacks for the boys. Seeing them reminded me of getting my children ready for their first day of school; gelled hair, teeth brushed. I suppose a bit of me wondered whether their mothers had taken them to Staples to get them their first-day-of-IBM supplies—a shiny, new pencil box, Crayola’s 64 piece coloring set, and a Flintstone lunchbox and Thermos.

Most wore shiny new shoes that hinted of a European design; the front fashioned to a point like the shoes of a jester from some ancient court. One guy’s suit, the trouser legs so narrowly tapered that it looked like if he bent his knees he would quickly end any mystery about the answer to the question, boxers or briefs, still had the tag sewn on the sleeve.

The kids had their whole careers in front of them. To a person they looked to be filled with wonderment and aspiration. Mini Lou Gerstners—freshly minted B-School graduates. They were ready to go forth and slay dragons, to go solve any of the problems that came their way, provided those problems presented themselves before mid-afternoon. For by two-o’clock each of the kids looked like they were ready for a nap. I know each of them wondered, “Do you mean we have to work nine hours a day? Nine in a row? Every day? They didn’t tell us that during the interview.” The boy with the overly-gelled hair who had brought his lacrosse stick to class had just grasped the fact that recess had been cancelled for the rest of his life.

Many of them had spent their summer traveling and trying hard to purge any remnant of their college lifestyle from their system. Several had just moved to D.C. Their minds were doing Keynesian calculations regarding the duration of their new wardrobe, wondering how long they would be able to hold out before they would run out of clothes and have to learn how to do their laundry. Life’s first big challenge. I suggested they could make a field-trip out of doing laundry; everyone could meet at the nearby Suds-for-Duds and have a kegger, and yes Skippy, you may bring your lacrosse stick.

One chipper young girl with perfect skin, who was wearing about a dozen more earrings than I would have worn had I chosen to wear the same outfit as hers, addressed me as ‘Sir.’ Her voice sounded crisp, like the sound a fresh Granny Smith apple would have made if apples knew how to speak.

“Really?” I asked. “Really what, sir?” And then she understood. “I didn’t think I should call you ‘Dude’.” I think ‘Dude’ might have made me feel better.

The New-Kids-On-The-Block. On my block. If these Mensas of the blackboards only knew how quickly their lives were about to change. There would be a phone call. For some it would come tomorrow. For others next week. They would be sitting in a cube trying to look busy, trying to look like they were consulting on something. A power-bar and their Thermos would be placed an appropriate distance from their shiny new laptops. Their Coldplay ringtone would jolt them awake, and their halcyon days would be over.

College, from what I recall, was a series of one hour wind-sprints; calculus, English, organic chemistry. Four or five sprints a day filled with hours of intermittent boredom. The only time you had to excel was during exams or while playing Ultimate Frisbee.

Consulting, they would learn, is different. In some consulting firms, consultants eat their young, and they do it smiling the way a fish does that has been laying on a bed of ice all day. Some clients make their consultants walk ten paces ahead of them, requiring the consultants to shout ‘unclean’ (Old Testament) as they make their way down the hallways.

The kids come unbidden to their first project. They will be told what they need to do and by when they need to have done it or have it done (I’m not sure about the proper syntax). Some project managers, those who believe learning works best under pressure, may not even try to translate the assigned task into English. The newbies will spend the first hour trying to figure out how to apply their undergraduate studies to the task at hand. Trying to figure out how some aspect of poly-sci, Voltaire, or the mating ritual of the African newt, could help them understand how to create a journey map of the hospital’s admission process.

The most creative ones Google, “How to create a journey map.” The most highly ranked response was, “Ask your manager.”

After an hour of letting them stew, the project manager will sneak up behind their new charges and observe their stupefaction first-hand. “You may want to consider starting with a piece of paper and a pencil,” she’ll say with all of the authority of Moses delivering the stone tablets (Also Old Testament). And then she’ll leave, returning an hour later to see her Mensaesque cadet staring at a blank sheet of paper—a note for my clients; we do not charge you for these early hours in the life of a consultant, or at least we do not charge a lot.

A lot can be learned by throwing someone, like our new consultants, into the deep end of the pool. Unfortunately, throwing someone into the deep end does not always work when it comes to healthcare patients. It often can be made to work for simple things, and it hardly ever works for complex things. More often than not, people who are sick or injured don’t have a clue about what to do first or second, and even if they had a clue they don’t have a clue how to do it.

For example, I did not agree to let my wife call 911 until I had collapsed to the floor and wondered why it felt like someone had placed the couch on my chest. I had been watching a new episode of the Soprano’s and did not want to miss the ending. Did I need a hospital, or should I crush the rest of my cigarette.

In my twenties I was working on a consulting project in Amarillo—that’s in Texas. The local news was doing a two-minute bit on the warning signs of testicular cancer. I had been having dinner with a dozen of my colleagues. I walked out of the room, entered my apartment, and looked around until I found the Yellow Pages. I found the doctor who had paid for the biggest ad, and told his answering service to wake him.

Fortunately, and unfortunately, I had guessed correctly. Twenty-five, and having my doubts about making twenty-six. Cancer, I soon discovered, doesn’t give a gosh-darn about how smart you think you are.

Patients are only faced with these kinds of challenges once every decade or so. They have no more understanding of what to do and how to do it than my newborn consultants. And being told to take out a blank sheet of paper is of little solace.

Patient experience starts before patients become patients, and it lasts long after they leave the hospital. I can’t be sick because I feel fine and I eat kale. Is the cancer really gone? How do I know it’s gone? What kind of tests do I need? Don’t tell me it is going to take you two days to read my cat scan. “I have cancer!” I remember yelling. “I am not leaving this room until you tell me if it is still there.”

There are thousands of questions, the answers to which will generate more questions. The care team may consist of a dozen people. People who wake you, and people who tell you to get some sleep. The person who gives you a menu of breakfast items that do not mix well with cis platinum. The nurse who knocked your wig off the end table and then rolled the IV stand over it.

And here is why these experiences are so important. You know you have cancer, and your doctor knows you have cancer. But the person who answers the phones in your health system’s call center has no idea that you are even a patient, let alone a patient who’s anti-nausea medicine is having such a negative affect on you so as to make you do something that may have you appearing on the late edition of CNN.

The person answering your call has no tools to help them know who you are. That person will speak to eighty to a hundred people each day. Too many healthcare executives think of these people as callers, not as patients. Pretty soon this problem will self-correct. It will self-correct because at some point these callers will have had one too many bad experiences, and they will never call back.

And the really silly thing is that the problem can be fixed in such a manner as to deliver an exceptional experience to every person who calls, every time they call. So why not fix it? Call me. I have some brand new consultants who are just itching to show you what they learned at B-School, and who could probably beat your entire staff in a game of Ultimate Frisbee.

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