Tuesday, September 18, 2007

Crisis Management

Credibility is one of the most precious assets a professional has. Like virginity, it can only be lost once. Whereas one’s sexual coming of age can lead to grand adventures, deepening spirituality and a lifetime full of emotional rewards, losing one’scredibility can rapidly transform someone into a personal and/or professional pariah. Contacts – and contracts – can dry up very quickly. In a relatively short period one’s career can disappear down the drain because of a perceived lack of integrity.

Suffering severe setbacks due to a loss of credibility may not be a particularly fatal blow in politics or the entertainment industry. But in a profession like medical transcription it can be the kiss of death. Despite the very best of intentions things can – and will – go wrong. How well an individual MT (or medical transcription service owner) manages a genuine crisis speaks volumes to clients about whether or not they should continue a business/service relationship or start to look elsewhere for support.

Trust is a key element in any relationship – whether it be marriage, a domestic partnership, or a business contract. Without trust, the relationship is on very shaky grounds. People will bend over backward to forgive you if you tell them the truth (especially when the truth is a viable answer). But if you keep lying to them – and if your supervisors or clients ever catch you in one of your lies – it’s going to be very hard for people to trust you again.

In the business world (where so many people succeed by telling lies), it’s extremely important that you have the courage to tell the truth during a crisis. A report was lost because someone failed to save a file properly? Say so. Blanks were left in a report because no one could understand the esteemed doctor’s mumbling? Say so. You can’t keep transcribing because you’re running a temperature, have a splitting headache and think you’re about to puke all over the keyboard? Just say so.

Four years ago my company faced the kind of crisis which could give a small business owner a seizure. Today, my partner and I can look back and laugh at what happened. But when the crisis was erupting, there was nothing very funny about it. Nothing at all. We had just started making plans with our vendor (Versatile Information Products) to upgrade our Digital Voice dictation system. Plans were underway for them to build the system and deliver it in several weeks.

As luck would have it, our digital dictation system started doing very strange things -- and the timing could not have been worse! It was the Thursday prior to the Labor Day holiday weekend and we were up against a wall. When we called Larry Houston (the sales rep for Digital Voice who had been with us from the time we started our business), he wasn’t sure what could be done but promised to get back to us in a little while.

Luckily, Larry had a loaner machine available that could be shipped to us from Southern California that night. Although he recommended shipping it by Federal Express, we were concerned about the time difference between shipping the computer up to San Francisco on a commuter flight that evening or waiting for a Fedex delivery the following day.

Why? We did not want to inconvenience our doctors during business hours (if possible). And, since we knew of situations where musicians routinely purchased an airline seat for their cello (rather than take the risk of having the instrument get damaged in the belly of the plane), we thought itwould be best to purchase a “seat” for the computer, strap it in for the flight, and then pick it up from United in the passenger terminal that evening. Since Tom was flying in from Tennessee on Delta that night, we decided it would be easier for me to meet his flight at SFO and then head over to United to pick up the replacement computer.

Just before leaving for the airport to meet Tom, I sent an e-mail to all of our clients explaining the crisis, assuring them that we were on top of it and telling them that even if they could not dictate for several hours, we expected everything would be fine in the morning. Shortly after that things startedto go horribly wrong. Unbeknownst to us (or to the person who dropped the computer off at United), something happened at the Ontario airport that prevented the computer from being shipped in a passenger seat. As a result, it was reclassified as freight, assigned a tracking number, and stowed in the plane’s cargo hold.

Tom’s plane arrived early from Atlanta, giving us plenty of time for a leisurely stroll through the airport to meet the incoming flight from United. When we explained about our “passenger” to the gate agent, we were told to wait until everyone had left the plane. No problem, we thought. Standard procedure for children who are traveling without adult supervision. But after everyone got off the plane, it was obvious that our computer was not in a passenger seat.

Fearing that the box may have been too big for a seatbelt to reach around it, we took the gate agent’s advice and headed down to the baggage claim to see if our computer had arrived with the flight’s baggage. No such luck.

Were we having fun yet? You betcha!

As we explained the gravity of the situation to the airline personnel handling lost baggage claims, we pleaded for United to contact their personnel at the Ontario airport to see if there was any information that would help us find our computer. Eventually we succeeded in getting a waybill number that we could enter into United’s computer system. But there was a problem: At that point, United had its passenger and baggage data in one computer system and freight information in another. Freight information could only be accessed from United’s cargo handling facility on the other side of the airport.

So off we went in a taxi to the giant hangar where United stored its freight. By this time, it was nearing 9:30 p.m., most of the red-eye flights to the East Coast had been serviced and there was only a skeleton crew available. A quick check of United’s freight tracking system revealed astonishing news: Our package was nowhere to be found. We went on a walking tour of the hangar with the person on duty. We drove ourselves crazy trying to imagine where our replacement digital dictation system could have gone.

By this time, Tom was crashing from jet lag and I was way beyond cranky. Were we having fun? Not on your life!

It wasn’t until 11:45 p.m. that we discovered that United’s ground crew had failed to unload our parcel when the plane landed in San Francisco. As a result, our computer was now resting comfortably in a freight facility in Portland, Oregon. Tom and I rode home from the airport that night in an exhausted, angry silence.

At about 1:30 a.m. I sent another e-mail to our clients, explaining what had happened, apologizing for the inconvenience, and stating that we hoped to have the system back in place by Friday afternoon. And indeed we did. A relaxed lunch was followed by another visit to United’s freight facility. We finally got our replacement digital dictation system up and running around 2:00 p.m. Shortly after that, an e-mail went out to our clients alerting them that all systems were clear and thanking them for their patience in our time of crisis.

Our experience taught us some very important lessons. First of all, trust your vendor. If he ships lots of computers by Fedex, have trust in his judgment and in Fedex’s track record. Don’t try to reinvent the wheel. Your vendor knows what works best.

Second, your clients will not be afraid of the truth. All they want is some information. If possible, send them periodic updates on the status of the crisis. In those moments when you cannot come to the phone (because you’re talking with tech support – or are pacing the waiting room of an airport freight facility), let voice mail record their messages.

Last, but not least, your clients may shock you with their loyalty. The biggest surprise we got was a phone call that weekend from a physician who was a notorious pain in the ass. He called to make sure we had gotten through the crisis all right and to express his concern and appreciation for the work we did for him.

Our crisis had a certain kind of Keystone Cops frenzy to it. Others are more sudden and severe. Forces of nature (often classified as “acts ofGod”) can have a dramatic impact on a medical transcription service’s ability to transcribe and deliver dictated reports. When hurricanes, earthquakes, blizzards and/or torrential floods strike a region, they place a severe strain on local medical facilities. In most cases, today’s technology makes it possible for work to be routed to remote MTs and delivered electronically without any great interruption in service.

A lack of electricity, however, can be a real bummer. Residents of the Hawaiian islands must frequently cope with rolling blackouts. Several years ago the San Francisco Bay area suffered a blackout that lasted for more than eight hours during a business day. As Silicon Valley’s electrical usage has skyrocketed (thanks in no small part to the growth of the Internet), heat waves have led to threats of rolling blackouts and/or brownouts from utility companies like Pacific Gas & Electric. Reports indicate that power loads in Nevada have soared 51 percent in the past 10 years, helping to absorb the Southwest’s power surplus (which used to be exported to California). Industry experts now predict that demand will soon outstrip supply in the Western United States unless more power plants can be brought online in a relatively short period of time.

There are certain crises which clients will accept without question. Lack of electricity? Understandable. The servers are down? Can’t do much about that. There’s a software glitch? Damn! Let us know as soon as it’s fixed.

But what about the truly bizarre crisis which brought part of India’s medical transcription industry to a halt for several days? On August 1, 2000, work stopped in Bangalore as distraught movie fans rioted in the streets upon learning that India’s beloved film star Rajkumar had been kidnapped by arch criminal Veerappan. The arson, looting and violence which erupted in the heart of India's booming information technology industry (and one of Asia's fastest-growing cities) made it unsafe for people to go to work for two days. By August 3, India’s media reported that many people had returned to work but schools remained closed, a ban on public gatherings stayed in place, traffic was light and anxiety remained palpable.

For business owners in Bangalore, the social unrest created severe staffing problems. Meanwhile, those American hospitals and transcription services that were outsourcing work to India faced a credibility crisis: How would their doctors react when told that reports could not be transcribed for two days because an aging movie star had been kidnapped in India?

My guess is that many physicians would have had severe misgivings about knowing that their work was being sent to a foreign country whose cultural values could suddenly -- and so arbitrarily compromise the quality of patient care for no good reason.

But, as Dennis Miller would say, that’s just my opinion!

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