Random Thoughts from a Restless Mind

Dr. Darrell White's Personal Blog

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Posts Tagged ‘phil’

It’s Masters Sunday; I Want One More Round

It’s Masters weekend in the golf world. Today, for one day of the year, I will allow myself to want.

You see, golf, like baseball and other games, is woven into the fabric of certain families. Taught either game by our fathers, we are filled with memories of times spent in and around our game. Mileposts are tagged with golf-related markers for the men in my family. Some are from outings of our own, and some from trips to watch others play. Most simply revolve around the simple act of watching a tournament together on TV. Fortunate are those who have something like this.

My Dad was very generous with his sons when it came to golf (one sister took up the game after she grew up and got married). Generous with access (club, equipment) and generous with his time. The golf course was the one place where we knew he’d be OK with us. Oh sure, our shenanigans and occasional tantrums provoked every bit of his Dickensonian parenting style, but still, the golf course was where we eventually bonded as 3 adult men. Joined by my sister’s husband we made up a very special foursome, indeed. We 3 younger men repaid my Dad for his generosity by taking him on epic golfing boondoggles, and by sharing that space in front of the TV as often as we could.

What does this have to do with ‘want’, you wonder. Alas, no one needs to play golf, save perhaps for a few hundred pros of course. Over the years our family foursome was buffeted by the economic winds of life, just like all other families, but we were able to sail through and continue our odyssey. We all wanted to play, and our respective families wanted it for us, too. In time, at least for two of us, our bodies failed and what it would take to play impinged on true family needs. Worse, my Dad’s mind has failed him as well, and the memories that tie this story together are as lost to him as the proverbial duck hook into the woods.

There, in a nutshell, lies the ‘want’. I’ve long since lost the desire to play golf, and I can honestly say that I do not miss the game itself. I’ve played thousands of rounds; I’ve had a good run. The game of golf owes me nothing. No, it’s not the act of playing that I miss, the physical aspect of the challenge that I allow myself to want on this one day. What I want, of course, is one more round with my Dad, my brother Randy, and my brother-in-law Steve.

On this one day I allow myself to want the surgery that would return me to the game regardless of all the needs that would suffer because of it. Just for one day. I pretend. I imagine the joy on Steve’s face as he shoots even par on the the back nine of the hardest course we ever played together, winning the family grudge match. I can see the evil grin on Randy’s face as he gets deeper and deeper under my skin and beats me for the 1000th consecutive time, his game as flawless as ever. I hear my Dad cackle as he drops yet another long birdie putt on top of one I’d just sunk, sure that I’d beaten him this time, cringing at the thought of him telling and retelling the story for years to come.

In the end that would be enough, I think. When I call my Dad late today and we “watch” the back nine of the Masters together it would be enough to know that he remembers. We’ll talk about our adventures with Randy and Steve, and we’ll pretend that he remembers those times when we marked our journey by the exploits of the golfers on TV. Jack’s putt on 15. Tiger’s improbable chip in on 16. Ben sobbing on the 18th. Pretend that he remembers laughing at me after dropping that putt on top of mine, that one fine day when all we wanted was to play golf together.

Today…just today…club in hand, phone to ear…I will want.

 

 

The Ultimate Consumer Service Business

I’ve been thinking a lot about health care recently. Real health care, not Health Care as in “Health Care Crisis” or “Health Care Reform”, but the kind of health care that is provided by doctors and nurses and all kinds of other health care providers. You know, like making sick people better, and keeping healthy people healthy. The kind of health care that old guys like me (I’m 49, in case you were wondering) got from pediatricians like Dr. Roy in Southbridge, MA in the 60′s, or like my sons get from Dr. Gerace in Westlake, OH today.

I did a lot of thinking about this some 5 or so years ago, too, when I developed the concepts that eventually resulted in Skyvision Centers. My mini-epiphany at that time is that medicine is the ultimate consumer service business. At its core medicine is about one group of people providing a service to another group of people who either want or need that service. It’s the most intimate type of service, too. One to one. Face to face. You and me.

There is a remarkable lack of difference between doctors (and hospitals, for that matter) when you look at the outcomes that arise from that service– how many people get better after receiving medical care for their illnesses. The difference between the top 1 or 2% of doctors and the 50th percentile in terms of real medical outcomes is remarkably small, and much smaller today than it was in the days of my Dr. Roy.

Sure, there are differences in how people arrive at getting better. Some very instructive studies from Dartmouth have shown dramatic regional differences in the U.S. in how much money is spent on treating heart attacks, for instance. By and large, though, the same number of people get the same amount of better no matter where they are treated or from whom they received that treatment, and the quality of those treatments is several orders of magnitude greater and better than it was in my youth.

So what was it about Dr. Roy that people in my generation seem to have so much trouble finding in medical care today? If the treatment of diseases is so much better now why do so many people complain about medical care today? Why is it that Dr. Gerace has people lined up waiting to see him while other doctors don’t? Why do people rave about their experience at Skyvision Centers and complain so bitterly when they need to have a consultation at some of the most famous medical institutions in Cleveland?

I think it’s because Dr. Roy, Dr. Gerace, and I were all, once upon a time, caddies.

Seriously. We spent the earliest part of our working lives on the lowest rung of the service ladder, providing one-on-one service for a single customer. Because of that I think each of us realized that what really sets doctors (and hospitals) apart is what a patient experiences when they visit. The most successful doctors and the most successful medical practices are those who have realized that the central character in the play is the patient. The most successful caddies never forget that the most important person on the course is the golfer. The job of the caddy is to help the golfer perform a well as possible (maximize the health of her game) while at the same time making sure that she has a wonderful experience on the golf course.

Ben Stein wrote a recent column in the NY Times about his first real job; he was a shoe salesman. Imagine, at 17 years of age, selling shoes. Days filled with all manner of customers and handling the foot of each and every one of them. Customer service and sales is “learning the product you are selling, learning it so well that you can describe it while doing a pirouette of smiles for the customer and talking about the latest football scores” no matter who that customer might be. Tinker, tailor, soldier or spy, junior partner or janitor. Be they humble or haughty, gracious or grating. Totally focused on that one customer in front of you in order to provide them that service. The same can be said for any front line service job. Waitress in a diner, car mechanic, you name it.

My first summer job was caddying, and I caddied for parts of each summer through medical school. As I think about it now after reading Stein’s article it’s amazing how many parallels there are between my first job as a caddy and my career as an eye surgeon. I toted the bags for one or two golfers at a time; I usually have a patient, patient and spouse, or parent and child in the office. I was a better golfer than almost all of the men and women for whom I caddied; I know more about the eye than every patient who visits, google notwithstanding. In both circumstances my success was/is determined by my customer’s (golfer/patient) outcome, their “score”, as well as their view of the experience. Even a career-best round doesn’t feel quite as enjoyable if it took place over 6 hours in the company of a surly caddy!

I’ll tell the story of how this turned into Skyvision Centers another time; it’s a neat story and I love telling it. For the moment, though, I have a little experiment for anyone who might be listening, and a modest suggestion for the powers that be in medical education (who most assuredly AREN’T listening). The next time you visit a doctor ask him or her what their first couple of jobs were. See if you can predict which of your doctors or dentists or nurses had what kind of jobs before their medical career based on the kind of experience you’ve had in their offices or institutions.

Let’s add a little time to the education of the folks who take care of our medical problems, especially our doctors. How about 6 months selling shoes at Norstrom’s. Or a year of Sunday mornings slinging hash at a local diner. Better yet, let’s get all of those pasty white interns out on the golf course with a bag on their shoulder and a yardage book on their hip, golf hat slightly askew and Oakleys on tight (for the record, even people of color end up “washed-out” after a year of internship). Let ‘em learn how to take care of a customer without the huge advantage of all that medical knowledge. We’ll take the best of them and turn them loose in offices all across the land. Those who can’t hack it, the ones who can memorize the history of Florsheim but can’t bring themselves to touch a foot, who are scratch golfers but can’t bring themselves to congratulate the hacker who sinks a 30 foot double-breaker, those we’ll hide in the lab, or put them in huge, anonymous medical centers, one more anonymous member of an anonymous team hiding under the brand umbrella of some “World Class Clinic”  where one-on-one customer service never really happens.Because the ultimate consumer service business is medicine.

Just ask a caddy.