I just moved to Portland, Oregon. Nobody here has a tan. I’ve discovered twelve new species of moss. It’s the only place I’ve run where I’ve seen moss growing in the streets. I’ve been thinking of getting a dog but I’m concerned that when I let him outside that if I leave him out too long, he’ll come back green.
Consumerism Axiom: Experiences that don’t create value from the perspective of your patients will never create value for your health system.
There are two types of people; those who will try something until it works, and those like me. I may try something once, but if it’s too much work, or if it doesn’t work, I won’t even consider trying it a second time.
Last weekend my wife and I did the grocery shopping. Not my favorite activity, but there I was pushing the cart. We shop differently from one another. I approach grocery shopping in much the same way a NASCAR pit crew approaches changing refueling and tires.
Speed counts. Efficiency counts. Up one aisle and down the next. Bypass the aisles I don’t need to visit. No grazing. Not stopping to view the items highlighted by flashing red lights. I don’t pause to taste the toothpick-skewered mini pigs-in-a-blanket offered by a maternal-looking employee. Squeezing tomatoes to test for ripeness is forbidden.
And if someone unaware or indifferent to my need for speed, parks their grocery cart in the middle of an aisle, blocking my path, a cold sweat appears on my forehead, and my eyes are sweeping the aisle to hunt down the offender.
Anyway, back to my wife and me. My wife does not shop the same way I do. She’s not into NASCAR. She’s a grazer. She approaches shopping with the notion that if the store thought an item was important enough to sell that it is probably important enough for her to view. Grocery stores have lots of items. I do not have lots of patience. No sooner had we made it past the fruit and vegetable supplies the blood pressure app on my watch was sending me alarms. While she was searching for something skewered on a toothpick to taste, I was looking around for a rest area for husbands, thinking perhaps I could watch an entire baseball game and take a nap while she grazed.
We had finished our shopping and went to pay for our groceries. She immediately directed me to push our cart to the self-checkout aisle. I tried to warn her off. “Those things are a waste of time,” I told her. (Did I mention patience was not my strong suit?) I began to turn the cart towards a checkout line that had someone with a pulse to scan out items. In a flash, she blocked my path and gave me the look. You know the look—nice try, but we are doing this my way. I demurred. Big mistake.
There we were. Us against the self-checkout scanner. And then she reached into her purse and withdrew the envelope—the envelope with the coupons. Coupons take time, and they require the patience of a saint. I was so far back in the line for canonization that it would require another two or three papal conclaves before I might hope to see the front of the line. (Did I mention patience was not my strong suit?)
The self-checkout process failed at the scanning of the very first coupon. She pushed the button to ask for help. A red light flashed above our register. The store’s hallway monitor made her way to our register, inserted her fail-safe key, and the red light stopped flashing. The monitor began to return to her station.
I did not want to see her leave us alone and helpless. I begged her to stay. “We both know this is not going to go down well. She has more coupons. We have fruits and vegetables that do not have barcodes that can be scanned. We are going to be here for hours,” I whined.
“If you think you are going to need that much help, you should go to one of the lines where there are checkers.”
I looked at my wife. The expression on my face was one of pleading. The expression on her face was one I knew well—get over yourself. At this point, I would have been calmer had I been giving myself a root canal. Feeling like my head was about to explode, I again started to look for the rest area for husbands. Other husbands were doing the same thing.
Two kinds of people. People who believe processes are supposed to work and people who know processes won’t work.
Those kinds of people bring those same aspirations and prejudices to healthcare. Some believe that if they go to their health system’s website enough times that sooner or later they will be able to do what they need to do. That if they call the call center enough times that someone will be able to help them.
And then there is me. You get one chance to meet my expectations, to give me the experience I want. I am not going to beat my head against a wall hoping that things improve. Fool me once, shame on you. Fool me twice. Shame on me.