How low process efficiency made my Easter a torment

It was the day before Easter this year that I noticed a weird pain under my tooth. This tooth had troubled me in the past. It had suffered from tooth decay and a crown had been placed on it. Later on, the roots had started becoming inflamed, and I had to get a root canal and a new crown. The dentist confirmed that they had taken all of the nerves out of the tooth, so I would never feel pain from it again. But yet, here I was again. Hurting.

So I went to the dentist on Thursday, the last workday before Easter break, and they took a picture of my teeth. The dentist said that the tip of one of the roots had apparently not gotten bacteria free, and I should go the dental surgeon for help. He wrote me a referral and enclosed the picture for the surgeon.

The first thing I did when I came home, was to call the nearest hospital. They told me that I should wait for about 8 weeks for them to have a spot for a surgeon to do an intake with me. Now, I wasn’t in a lot of pain at that time. But still; 8 weeks is a lot. So I decided to call another hospital that is also close by. They had a spot for me much faster; the Tuesday after Easter. That sounded a lot better to me, so I booked the spot.

Then, in the night from Thursday to Friday, the pain got worse. It got a lot worse. In a matter of an hour, the pain was so strong that I could no longer sleep, think or focus my attention on anything. I started taking household pain medication for it, but after a day, the pain still hadn’t gone away.

The First Way: Step One

I knew something needed to be done. So, I called the emergency doctor’s office on Saturday 7:00 AM. They immediately told me that they would not and could not help me, because teeth were a special case where I would have to call the emergency dentist. The emergency dentist had a spot for me on Saturday at 11:20 AM. So I went there, now not having slept, eaten or being able to take care of my little newborn daughter for 1 day and 2 nights.

Something had gone wrong though, and I had to wait until 1:20 PM before the dentist had time for me. This was because the dentist was fully booked, and the assistant had been stuck in traffic. Once it was my time to see the dentist though, he quickly assessed that he could not help me and that I needed to see a surgeon. He asked me what I was doing there. I replied that I had read on the internet that getting antibiotics was a good idea and that he could help me with that. Then I pointed out that he could also prescribe me some better painkillers. After about 3 minutes, I walked out with a prescription for antibiotics and stronger ibuprofen.

Step Two

The pain did not go away that night. Instead, it got worse. I could do nothing but scream and cry. I got a fever of 39 °C (102.2 F), my cheek swelled up and I could no longer keep a decent posture from the pain (falling on the floor). This was unacceptable, I thought, so I called the first aid department of the hospital on Sunday at 8:00 AM, pleading for help. The nurse I spoke to promised me to call the dental surgeon. I had hope. Until she called me back: “The dental surgeon will not help you unless your dentist makes direct contact with him.”

I was baffled. I had just seen an emergency dentist who had seen how much pain I was in. He even worked in the hospital. How could this happen?

Driven by pain, I called the emergency dentist again explaining the situation and how badly I needed him to contact the dental surgeon. The lady on the phone said the following: “The dentist is completely booked today. You will have to wait until tomorrow and hope he has time for you then.” That broke me. I was going through unimaginable pain and the only person that could help me couldn’t make time to prevent this suffering because he was fully booked.

Halfway through Monday, the antibiotics started kicking in bringing the pain level back to where it had been on Friday. I decided to not try anymore and just wait for my appointment with the surgeon on Tuesday. These people were obviously not sensitive to my pleads or the pain I was going through. Even though it would cost them almost no time, they had a schedule. So I suffered through Monday.

The Second Way

On Tuesday at 8:00 AM, I called my own dentist. Now reduced to tears, I told them my story and asked if they could help me. The lady on the phone immediately took my case to heart. She told me she would take care of everything and would check if I could get the appointment switched from an intake to a direct treatment.

At 8:15 AM, about 5 minutes after I hung up, she called me back. The appointment was now a direct treatment. She also asked if I could call her after the treatment to let her know if she could be of further assistance.

At 2:10 PM, I had my appointment at the hospital. They took another picture and I met the surgeon. He analyzed this new picture and told me my dentist had been wrong. It was not the tip of the root that was bad. The root of my tooth had broke, and I had developed an abscess under my tooth as a result. This meant two things, he said. One, I must have been in unimaginable pain, because painkillers don’t work well on abscesses. Two, the tooth could unfortunately not be saved.

Quickly I replied: “Get it out then, I just don’t want to hurt anymore”. And about 10 minutes later, the tooth had been removed. Not a pleasurable experience, since the abscess meant that the anaesthesia didn’t work as well. But it was over with. Finally.

Process efficiency

Today, the Wednesday after Easter. I couldn’t help but think about the difference in process efficiency between these two processes. And together with that, the feeling that I had as a patient.

In both steps of the first way, the process efficiency was low. I got very little care or value-added time from the people that were supposed to help me. It felt more like they wanted to get rid of me than it felt like they wanted to help me. Especially in step two, where I got no help whatsoever. It felt like the system was designed to not help people, but to maximize resource utilization. A thing that made me angry, because I would have needed only about one and a half hour of value-added time to have no pain at all. But no. That is not the focus of the way we organize our healthcare. We focus on resource utilization, not on process efficiency or throughput optimization.

In the second way, I felt like someone cared about me. They wanted to help me. They made happen whatever needed to happen and they took away my pain. I am very grateful to both my dentist and the surgeon that helped me. They worked together to make the life of this patient a lot better.

The Takeaway

I would like to ask you, people in companies all around the world, the following question:

“How do you want your customers to feel?”

and I would like you to think really hard about what your answer means about the way you organize your company culture.

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