Healthcare Consumerism: $871,”And Hold Your Breath”

To be transparent, when I enter a hospital as a patient I should probably hang a sign around my neck, “You may be in my next blog.”

Did you know that if you shuffle a pack of cards properly, chances are that the exact order of the cards after shuffling has probably never been seen before in the history of the universe? Another fun fact is that 10! (factorial) seconds is exactly six weeks–twice as long as the average time required to schedule an appointment.

Patient access blog fodder. Sometimes the simplicity of what is dysfunctional is so obvious as to make me wonder why we cannot just set aside five minutes a fix it.

“Be here at 8 A.M.,” I was told.  8 A.M. had come and gone several minutes ago.  I was thinking about stepping out for a haircut and a massage when my number was called.  The entire process about waiting to be served reminded me of being at the Department of Motor Vehicles.

The admissions clerk at the hospital told me the charge for my ultrasound would be $871. 871 is not a prime number, but since the admissions process had run beyond fifteen minutes, I thought I would add a little something to the discussion just to entertain myself during the doldrums. “Take the number 871,” I told her, “And reverse the digits to create a new number; 178. Subtract 178 from 871. Add the resulting number, 693, to the result of its inverse, 396, and you get 1089.” This actually works with any three-digit number whose digits are decreasing, but I did not tell her that.

Eight hundred and seventy one dollars. Not $870; not $900. It struck me as a bit odd to be able to pinpoint the cost to a specific dollar, especially since health systems do not know what any procedure costs. I asked a supervisor about the price.  “We do not know what something costs, we only know what we charge.”

“Does anyone know what it costs?” I asked. She told me I was wasting her time and mine with my silly questions.

Anyway, the outpatient admissions process, at a hospital where I was already in their computer, took seventeen minutes. I gave her my phone number 4 times, my address twice, and the name of my first girlfriend once.

I asked if I could have pre-admitted myself online. She said she did not know, but she told me that the pre-admit process should have been done on the phone to save me all of this time. I asked if the process would have been shorter had I done it on the phone and she said it would not have been. “How then would that have saved me any time?” I asked.

By then, her eyes looked like she was in a death spiral. My eyes looked the same.

She escorted me to the waiting area. The television show, “What’s My Price” was playing loudly through the television speakers. A collection of Vietnam-era magazines was scattered among the waiting room’s Formica side tables. I turned on the ceramic, avocado-colored lamp and waited.  I started to calculate each of the periods of waiting just to see how much of my time I was investing in doing nothing.

The rest of the ultrasound went smoothly, more or less. “Hold your breath….” A new radiology technician was undergoing training. Apparently the person doing her training had glossed over the part of the training relating to the bit where she was supposed to reply, “Okay, breath.”

Note to health system executives: Try and schedule an appointment—mine required three phone calls and several minutes on hold. After that, go through the admissions process and see what that teaches you about the issues of consumerism facing your patients.

The scheduling and admissions processes haven’t changed since Betty White was a baby.

They should.

A remarkable experience for every person at any time on any device.

Or not.

None of this is rocket surgery.

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