Many of us, myself included, have often wondered why it is that when you go to a Dr. you have to make an appointment only to find yourself waiting, sometimes for more than an hour, to have your pre-scheduled appointment. Since I was a kid, I have also wondered why a Dr. needs SO many secretaries. My fathers accounted didn’t have one, his lawyers was part-time, he himself was a mechanic, ran his own Standard Oil station with 4 bays and he never had one. He also was the contracted mechanic for not only the local AT&T service center which had over 100 vehicles but also supported the county vehicles. He did his own billing, collections, scheduling, HR all without a secretary. Why was a Dr. so much different? It seemed to me as a kid and still to this day that it was a combination of inefficiency and ego.
Growing up it would have been unacceptable for me to be a mechanic. I was groomed to be an engineer of some sort period and that was that. I received my bachelor’s degree in something called Engineering Mathematics and Computer Systems, which nobody really knew what that meant. Later it was updated to simply Computer Engineering. Starting with my very first employer, year 1984, an aerospace and defense systems company I have been sent to process improvement training countless times, this included Six-Sigma, Lean Engineering etc... you name it, I’ve been exposed to it. This was due to the global competition environment in which the companies were in. If one wanted to ensure himself a raise or promotion one had to not only do his job but also participate in making the company better and leaner. Leaner meant “fewer employees” or “man-hours” to get the same job done.
In the late 1980’s and early 90’s most engineering design companies, research and development outfits, manufacturers and even the construction industry went paperless. Six Sigma and Lean Engineering became global philosophies. Throughout the 80’s, 90’s and early 2000’s engineering and manufacturing has been optimized and downsized ten times over. This has created better, safer and less expensive products for societies to enjoy. For an example, just look at the automotive industry. Detroit used to make the entire car all in Detroit, from raw material to finished product. Today, it subs out most of the work, finds “cool “ parts from almost any other industry and has been also decimated by foreign completion which has completely different manufacturing standards, employee laws and environmental rules. It is a wonder that Detroit even makes a car today. We find car plants springing up in places like Columbia S.C. which has no major natural transportation anywhere geographically near it. However, I am still walking into the Dr. for my appointment greeted by several secretaries and an hour long wait. I find my records incorrect or they cannot find them, along with errors in my “paper” billing, continuously. At my last appointment I requested them to email me my statement and the expression I received made me feel like I was from a time 100 years in the future. This is accepted or at least seems to be by us as a society.
Now we face something called “Obamacare”. Since, I like everyone else have no idea what this means, do I agree with it, NO. But, if it requires Dr’s to become more efficient and lean like the rest of us, good, let’s make sure that part is not thrown away. Why is it that it is just in the last three years or so that the healthcare industry has become aware of workplace philosophies like Six-Sigma and Lean Engineering. Motorola developed Six-Sigma is the 70’s. Why is it that programs like Medicare and Medicaid continue to fund this overweight decrepit industry with taxpayer monies? We as a society have been leaned and optimized now so that 10% of us cannot find work, while even more, like me, are what is called under employed. At the same time the healthcare industry has continued to grow and construct museums as offices and workplaces. It is time for this to end.
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