Lucky for Alice that the U.S. Post Office didn’t set up shop in Wonderland, because this is exactly how my latest visit went down, no lie, no exaggeration.

 I went to take care of my passport renewal first thing in the morning on a weekday and found a long snake of a line filled with grim, simmering citizens. There were three post office workers manning the battle stations. One was wearing a surgical mask and, oddly, winter gloves, and spent 25 minutes (damn right I clocked her) berating an elderly man for not understanding the eight or so options she spat out for sending his box.

He kept saying repeatedly he wanted to send it express, and then had the temerity to tell her he couldn’t understand what she was saying. That led to her start shouting over and over “I’m speaking English illegibly!” and just when I thought they had everything worked out, she sent him to a kind of penalty box off to the side of her station because he allegedly made a mistake on the shipping form.  His problems were exacerbated when he couldn’t find something to write with and she launched into a diatribe about her plumed pen being personal property and not something she was obligated to let a customer borrow.

Me? I waited for 45 minutes, and when I was finally cleared to approach the counter the attendant yelled “Sir, I don’t do passport renewals, step out of line!” and then when I told her I needed it expedited, she said “Why didn’t you tell me that?” and then walked into the back room. She was gone for 10 minutes. I asked her co-worker at the next station what was going on, and she told me to please learn to be patient, and then she announced she was going on break and walked away, leaving one postal employee in a room with more than 20 customers waiting their turn.

Eventually my attendant came back and after a delay because her label printer broke and then she couldn’t find her stapler--which she needed, she said, to apply one more critical staple to my headshot on the form. I wasn’t watching when she used that stapler and then slid my forms into the expedite envelope. But I just got a letter in the mail yesterday from the Passport Services office that said my renewal couldn’t be processed because my picture was damaged—she had put that last staple right in the middle of my head. So here we go again.

How does this apply to health care?  I’m sure none of you work at an organization that has fallen so low, because I doubt any other enterprise can, to be honest. If I really wanted to dissect the issues here with lack of employee and management accountability, disparate data and other technology shortcomings, I wouldn’t know where to start. But here are a few things to consider in customer-facing settings:

1. Ask staff to try to find that middle ground between treating each patient/customer like a mortal enemy or a long-lost friend who needs to be brought up to speed about the last decade’s joint/bowel problems or change in marital status.

2. When the going gets tough and volume is heavy, remind employees that the tough don’t go to the break room or go for a walk around the neighborhood to clear their head.

3. Make sure advertised prices match up to the actual prices of services, and forms from 2005 aren’t in the service areas, so customers who took the initiative to calculate their charges and fill out forms aren’t greeted by a rolling of the eyes or a big, heavy sigh when they try to get their business done.

4. Make sure managers know that, when they’re called over to mediate a customer complaint, that “Sir, you’re going to have to settle down or I’m going to call the police” is just one, not the only, possible response to the situation.

5. Remind employees, hourly if necessary, that trimming cuticles and applying make-up are grooming tasks that are best done when customers aren’t standing in front of them and waving their hands for attention.

6. And people, I can’t stress this enough, make strategic investments in pens and pencils.

Applying these steps would create absolutely massive efficiency gains at the post office. Do you have anything to add based on your own experiences at the post office, or a hospital or group practice, or with your insurance company? Let’s try to come up with solutions here.


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