The Little Mistakes Will Cost You.

A few days ago, I asked the LinkedIn community about inefficiencies in their workplace and whether they've lost revenue because of them. I used inefficiencies as a polite way to say mistakes. One mistake may not cost you a customer but many mistakes, with that one customer, will cost you, just as it did with my doctor. This article isn't so much an article as it is a copy of the letter that I provided to my (former) plastic surgeon with all the reasons that I cancelled my surgery with him. I also provided a copy to his business partner, another plastic surgeon, because they share the same staff and it was the staff that erred the most. As you're reading it, I ask that you think about your business and the people who work for you, if you have a staff. Are they dismissing requests? Are they undercommunicating to you? Do they represent you well?

18 Aug 19

Dr. [redacted for privacy on LI],

I feel compelled to share with you the sequence of events, from start to finish, and what places in the process lead me to cancel my surgery. July 9th was my initial consultation. At this appointment, you suggested I get a CT to better see what was going on with my torso and fat composition. From your staff I received the many-times copied memo request for the CT and instructions to call them with the date of my CT. That afternoon I called the base clinic and was able to get an appointment with my base PCM to get the actual orders for the CT.

It was at that appointment that I encountered my first hurdle. Your memo states: “without contrast” and I was being asked why you wanted “without contrast” which is a question that I can’t answer. My PCM left it blank but I did leave with the orders and made the appointment at Eden Hill in Dover where, again, I was asked “without contrast? Why?” Again, I had no answer. But I did have an appointment for July 16th and I called your office, as instructed, with the date. During this call, I asked your staff member to call Eden Hill to let them know which aspect I needed—with or without contrast. 

When I checked in for my appointment at Eden Hill, they asked me whether it was with or without. Obviously, your office didn’t call to ensure there was no confusion. That was indication to me that your office appears to not really care about the requests of your patients. Whether this is the case, I can’t say. I can only share my perspective. I got the CT and they gave me a disc; a disc that I hand delivered to your office on July 18th before I went to work at Lands’ End.

The following Monday, I called your office and got an appointment for Jul 24th to discuss the CT. And it was discussed but never viewed because it had been lost in the three business days between when I dropped it off and the 24th. This was another pause in my brain but I pressed on and scheduled the surgery with a pre-op of Aug 7th. I was told that I would need to get CBCs and an EKG before the pre-op and that I would get the scrip for them in the mail. When I returned home, I contacted the base to make the appointment with my PCM for those items. That appointment was for July 31st. By July 30th, I had yet to receive the scrips for my CBC and EKG. Something that SHOULD HAVE been mailed by Friday, July 26th, being that my appointment with your office was on that previous Wed, the 24th.

I called your office the morning of the 30th (after the mail came) and explained the situation. The staff member emailed me the docs that I needed, and I took them to my appt the next morning. In a fun twist, the scrips (and pre-op paperwork) were in the mail when I got home from my July 31st appointment, postmarked July 30th. This was my next indication that you staff is not very timely with getting things done.

Even still, I pressed on. I had my pre-op on Aug 7th. My CT disc had been found and I was able to view it, even though it was never communicated to you UNTIL I SAID IT AT THAT APPOINTMENT, which was concerning because I had said I wanted to view it when I spoke to a staff member the week prior. What was even more concerning was that you and your staff attempted to prescribe me ibuprofen even though I had filled out forms outlining my various allergies. Yes, this was remedied on the spot but it should never had happened in the first place. Even then, I moved forward and paid for the surgery.

Which brings me to the final domino in this game. I was told that I needed to pay for the surgery at my pre-op and that I needed to pay for the hospital the week prior to the surgery. On Monday, Aug 12th, I attempted to pay for the hospital stay. I was told that I wasn’t in the system. The hospital rep said they would communicate with your office and get back to me. On Tuesday, Aug 13th, I attempted again. I knew I’d be traveling Aug 14th-16th and didn’t want to delay anything. But, when I was told that I was still not in the system, that was the final drop. I was done with the whole thing. I called your office, spoke to Kelly, and told her I was cancelling the surgery. She apologized. She said she’d been so busy that she hadn’t been able to call the hospital the week prior but that I was definitely on the schedule. I have to wonder: If I had waited until Thursday or Friday to pay the hospital, would I have had to reschedule because your office hadn’t booked me yet?

Your office gives patients instructions but doesn’t follow up on their end. Your office gives vague requests but doesn’t take seriously the requests of the patient to ensure things are clear for others providing services i.e the CT scan. I don’t blame any one person. Except you. It’s your office and your office is chock full of disorganization, carelessness, and excuses. I would encourage you to look at all the things that I outlined in this narrative and figure out root causes because, if you don’t, at the least you’ll lose money but, at the worst, you’ll kill someone.

Sincerely,

Nichole D. Naprstek

I dropped this letter off this afternoon to the doctor's office. When I dropped it off, the person who greeted me was Kelly, the woman who was too busy to get me added to the hospital schedule. She didn't recognize me, despite having talked to me in person numerous times. This just reinforces my perspective that patients are merely numbers to them. I can only hope that the doctor and his staff does take a look at how things played out like they did and make some changes for the better.