EDITORIAL

Modern menaces

When I was growing up, I lived in Greenwich, Conn., a place that many of the most successful titans of industry called home. Each morning, these scions would drive to the railroad station to wait for a train that, more often than not, was late. It was always amazing to me to see a group of men standing there like sheep, allowing the same operational inefficiency to be perpetrated on them day after day. How could corporate giants, with awesome collective brainpower and responsibility for making decisions that affected people throughout the world, not take action to bring about the change that was needed?

Now, several decades later, I look at the many frustrations that have been foisted upon us by products and practices we encounter in today's modern society and a similar question runs through my mind. Why do we, like the businessmen from my youth, not do what is necessary to improve the quality of our lives? The contrivances to which I refer were created by people who have little regard for us or our convenience and safety. Rather than making things easier, each seems to have its own misery index. On my list of modern menaces are:

• Computer programs that seem to be designed to disable other programs

• Phone answering systems with no human being on the other end

• Unsolicited faxes, particularly the ones that arrive in the middle of the night

• Computer viruses and the people who create them

• Television commercials that blare at a much louder volume than the programs

• Telemarketers who call to sell something or survey me during dinner time

• Credit card companies that sell people's names to other businesses, generating an avalanche of unsolicited mail and phone calls

• Internet sites that pose a threat to my right to privacy

• High-intensity discharge halogen headlights that blind oncoming drivers

• School buses that are late or don't show up at all

• Public places or stadiums that don't have enough restrooms

• Bicyclists who don't obey traffic rules

• Airlines that have long lines at the check-in counter and no one to provide directions

• Patients who don't show up for their appointments and don't call to cancel

• Insurance plans that reimburse less than the cost of care

Being trusting, it would never occur to consumers that the software they are about to buy might disable another program on their computers. If that were the case, the manufacturers would forewarn them, right? Wrong. Unfortunately, some companies view the public as gullible rather than trusting. The solution: Choose software produced by a more above-board corporation.

The people who design those frustrating telephone answering systems usually build in a way around the automation for themselves--but we, the consumers, have to go through the technology to get to it! Imagine this panicked call, from a wife to her husband:

"Brian, I need help quickly. I have sharp pain and I'm bleeding and the baby isn't due for 3 more weeks. Call the hospital right away." And so, Brian calls the hospital and hears: "Hello. You have reached Fairview Hospital. Our telephone answering system has been devised for your convenience. If you have a Touch Tone phone, press 1 to inquire about a patient. Press 2 for patient records. Press 3 for billing inquiries. Press 4 for physician offices. If you have a rotary phone, stay on the line and the next available operator will eventually take your call." And so it goes, while precious moments tick away. The solution to this frustration: Insist that your hospital system have a mechanism for urgent calls.

If your airline doesn't provide help and guidance during high-volume times, simply write the airline president and inform him that the next trip you make will be on another carrier. Include with it the shredded remains of your frequent-flier card and you are sure to get a quick response.

These are but a few of the problems of modern times that adversely affect our daily lives. Some of them impact our medical practices. For every one of these annoyances, there is a simple solution: taking action. If you don't like the blaring volume on television commercials, let the network know that you won't watch that station or turn off the TV. If you have a patient who is a chronic no-show, bill her for the next missed appointment. That's what a hairdresser would do and your professional time and skills are no less valuable.

Insurance companies that reimburse physicians and hospitals at a rate below the cost of care are in a category of annoyance unto themselves. And there is a way to deal with them, right now, today. All of the physicians in the lowest-paying plans should stop participating in these programs as soon as their contracts expire. Voting with our feet is one way to weed out the bad insurance companies while at the same time continuing to support those that are more realistic and cooperative.

Corporations, institutions, and the government have the ability to change and they will respond, but not unless we register our disapproval.

John T. Queenan, MD, Editor in Chief, is Professor of Obstetrics and Gynecology, Georgetown University School of Medicine, Washington, D.C.

John Queenan. Editorial: Modern menaces.

Contemporary Ob/Gyn

2000;7:8,11.