Imagine this scenario:

You’re a car salesperson. It’s a sunny Saturday afternoon and walking around the lot is a couple of different people - all looking in windows, lifting hoods, contemplating a purchase. Each of these people are well qualified, in need, and have come to you for help.

Consumer one comes to you and says, “My car is broken down and it cannot be fixed. I need something new.” You, as the salesperson, give a half-hearted smile and say to the consumer, “I’d be happy to help you but I’m too busy right now. Can you come back next Saturday and I’ll try to be available then? Or I’ll tell ya what, you can just wait here in our waiting room. Maybe I can find time but no promises.” You then roll your eyes and grumble to yourself about how many car lots are closer to this person’s home than yours. You can’t really be expected to serve the entire state’s needs after all! These job expectations are so unrealistic!

Consumer two comes to you and says, “I currently drive a Toyota Prius and we bought a 42-foot camper. We need something bigger and more powerful for the ability to tow our camper.” You, being the astute automobile aficionado that you are, reply to this consumer, “How do you know the Prius won’t be sufficient to tow this camper? Have you tried? I’d be happy to connect you with our parts department to help you get a hitch installed on your Toyota. I guess if they don’t have a hitch, I’ll try my best to help you find something.” You then walk away, patting yourself on the back for preventing the unnecessary purchase and saving this consumer money. A job well done!

Wait, what?

Where will these consumers go from here? They will quickly call an Uber or unplug their Prius and drive to your closest competitor, while telling everybody the ridiculous experience they had with you. Furthermore, and with certainty, in a couple of years when another new car is needed, they also will have unplugged your car lot as a potential place to buy from.

In auto sales, we would never entertain the idea of, “Yes, but not yet.” So why do we allow this in healthcare? How did we get to a place of hours long ED wait times (whether for a medical decision or an inpatient bed), days long transfer times (acute to acute, acute to post-acute), and the similar? In a hospital, we hurry to wait. We rush to the ED and wait for a decision, wait for an admission, or wait for a transfer. If we’re unfortunate enough to need admission, we wait for specialists, we wait for tests, we wait for lab results - we’re always waiting. Not only are we waiting, but we also have very little idea of when exactly that thing we’re waiting on will happen. In all of this, the hospital has told us, “Yes, but not yet.”

Inconvenience aside, let’s not forget that many times an ED visit or hospitalization is not for something that can quickly be fixed. What about those times that somebody has received a life-altering cancer diagnosis with an oncologist appointment weeks away? Here we’re saying, “You have cancer, wait” or “Without treatment, you will die; wait here until I have time to help you.” Where is our compassion for these patients and their families during their life's most difficult time? 

Our healthcare industry is riddled with silos. Process silos, data silos, communication silos, you name it – it’s there. We have technology programs that don’t communicate; we trust and rely on verbal communication for critical messages and we act shocked when patient care is impacted. Patients aren’t the only ones burdened by the mind-numbing normal of, “Yes, but not yet”. It’s healthcare workers too.  We wait for a bed to become available; we wait for the CT machine to be staffed; we wait for a specialist to return their page.  This is frustrating to staff and leaders who strive to streamline their operations but ultimately hit downstream bottlenecks.  I think we can all speak to how demoralizing it can be to go a mile a minute towards progress and get sidelined by others not doing the same.

We’ll eventually emerge from the COVID pandemic with a laundry list of lessons learned and improvement opportunities. This steers me to believe that improving healthcare isn’t something we can do individually; it needs to be accomplished together. Let’s partner together as a healthcare industry to learn from one another and to innovate on a dime. Let’s partner together as a healthcare industry to better quantify, understand, and leverage data. Those that don’t join us in this pursuit will find themselves trying to sell gas guzzlers when everyone’s buying electric.  No more, “Yes, but not yet.” Let's take the wheel and enthusiastically say,

"Yes, let's do this!"

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