So if you’ve been following my blog posts over the last couple of weeks, you know that my fractured foot has traveled the world! The accident occurred in Canada, the foot was cast in India and I spent a couple of weeks traveling there; then I visited the United States and finally came back to Canada. By then, it had been almost three weeks since the cast had first been put on, and I figured it was time to make arrangements to have it removed.
First call was to my regular doctor in Calgary. “Sorry, we don’t have a cast saw,” came the response. “You’ll have to call the cast clinic at a hospital.”
Second call was to a nearby hospital’s cast clinic:
“I’d like to make an appointment to have my cast removed.”
“Which doctor?”
“It doesn’t matter. The cast was put on while I was on a trip in India, it just needs to be removed and probably x-rayed once again.”
“Sorry, if you didn’t have the cast put on by one of our doctors, then we can’t give you an appointment.”
“Really?! So then what is my alternative?”
“You’ll need to visit the local emergency ward.”
“Really?! You want me to tie up a spot in an emergency ward for something that’s not an emergency?”
“Yes, ma’am.”
“And then what?”
“Once they’ve assessed you, they’ll send you to the cast clinic.”
“Such as yours?”
“Yes.”
I was incredulous. “You want me to wait in an emergency ward for 6-8 hours with a non-emergency complaint for a final outcome that will bring me right back to you? Couldn’t we save everyone a lot of time and effort if I just make an appointment and come to you directly?”
“Sorry, ma’am, that’s not the way it works.”
Not one to give up easily, phone calls number three and four were to the cast clinics at two more hospitals. No luck! Same song and dance!
Frustrated, I called our local provincial healthcare assistance line and explained my situation. While the nurse on the phone commiserated with me, she too could not come up with an alternative. I persisted, driven largely by my desire NOT to spend 6-8 hours sitting in an emergency ward waiting for attention to a non-emergency complaint! About 5-10 minutes into our conversation, she offered to put me on hold while she conferred with a supervisor. “Please,” I responded. A few minutes later, she returned.
“Call your regular doctor and ask her to make a referral to an orthopedic surgeon at one of the cast clinics. You should be able to get an appointment then.” Phew!
Phone call number six was back to my regular doctor and I am pleased to report that she was able to make a referral. A few days later I made an appointment at the local hospital’s cast clinic. My cast was removed on June 21. Woo hoo!
But this whole interaction left me puzzled and bewildered. No doubt this administrative nightmare … er, I mean process … was put in place for the greater good – perhaps to ensure that the orthopedic surgeons and staff at the cast clinics are only dealing with legitimate ailments. But in a situation as obvious as mine, someone at the cast clinic should have been able to make a judgment call to bend the rules for the sake of efficiency and common sense. Alas, “following procedure” trumped good old-fashioned common sense. As it was, I spent an inordinate amount of time on the phone trying to avoid the bureaucracy. Not to mention the time of my doctor and other professionals. But what if I hadn’t succeeded? What if I had given up and simply gone to the emergency room to have my cast removed? I would have wasted even more of my time, but just as importantly, I would have tied up valuable and scarce emergency resources while their staff triaged and dealt with my non-emergency situation. Bottom line: the administrative front-line staff at the cast clinics had not been empowered to make decisions and take action.
Do you have any such bureaucratic inefficiencies in your organization? What are you doing to empower your people to take action to overcome them?