One Monday morning, a number of years ago, the administrators at the family health center where I used to work instituted a new and time-consuming procedure for registering patients. They did this in an attempt to satisfy the rules and requirements imposed by the many different insurance plans our center accepted.
There was just one problem: the administrators forgot to tell anyone what they’d done–not even the center’s medical director, who happened to be on vacation at the time.
As the clerical staff stumbled over a brand-new, complex set of protocols that day, a line of patients, mostly poor, snaked around the lobby, out the front door onto the sidewalk. Tempers grew short. A fight nearly broke out. We providers sat in the back twiddling our thumbs, waiting for patients to trickle into the exam rooms.
Finally, after an hour-and-a-half, enough patients had been registered so that the line could finally fit inside the lobby. The exam rooms were all filled, and the doctors and nurses were desperately trying to make up for lost time.
At that moment, the health center fire alarm went off–signaling one of our periodic fire drills.
Needless to say, it couldn’t have happened at a