The Lessons They Learned

     Medical labs are their own industry.  I have a long history of minor medical mishaps and as a result, I've had a front-row seat to the change from "labs" being a matter of going off to Local General Hospital for them, to your doctor's nursing staff drawing a few vials of blood and something happens offstage, to in-office labs run by a third party (still a lot of that around), to needing to drive to one of the lab company's many locations and walking in.

     The pandemic hit the labs hard; they needed to do a lot of testing while keeping their staff and patients healthy.  Office staff jobs were cut to the minimum and made remote or at least moved well away from patient contact; phlebotomists worked alone or in teams of two and they encouraged making appointments, so waiting room occupancy could be kept down.  They rolled out a sleek automated check-in process that used a touchscreen kiosk that scanned your ID and insurance card like something out of a sci-fi film.  As Covid transitioned from being pandemic to endemic, the number one lab company (at least around here) bought the number two lab company.  They kept all of their offices as long as social distancing was mandated, and then--

     Then they did the obvious thing.  They started shutting down the least-used locations, consolidating offices in close proximity, moving out of high-rent locations to cheaper spaces.  They kept the electronic check-in and never brought back human receptionists.  And they consulted efficiency experts on just how many patients a staff of two or three should be able to process per hour, what number of no-shows and walk-ins could be expected, and how much annoyance patients would tolerate.

     --I don't know for sure about that last one, but it seems likely.  If you work the system by its own rules, current medical labs aren't too bad; I signed up online two days in advance, arrived at my appointment time and was in and out in about forty-five minutes.

     Forty-five minutes?  Yeah, I'd be a little irked, too; a half-hour would have been okay, but nearly an hour?  Except for one tiny little thing: the efficiency experts didn't count on human nature.  Three lab techs (one of whom was, I gathered, stuck on the phone, trying to untangle a terrific mess involving scrambled logistics before it became an even bigger mess), nobody on the front desk, two kiosks -- and a lobby full of unscheduled people who were hoping to walk in and get their labs without any effort.  Many of them interrupted the tech as she opened the door to summon the next patient; a few would just pry it open (no handle on the outside)  and walk in, peering into blood-draw stations until they found someone with an employee ID badge and slowing down the work.  Why, their draw would only take a minute and then they'd be out of the way, but that darned machine was telling them to come back in two hours!

     The phlebotomists are not in charge of the kiosk system; it assigns walk-ins to the next available slot, with an option to take the next no-show if that happens any sooner, and that's all there is.  There's no slipping someone in -- the test-tube labels are printed up when your assigned time arrives and the tech has them at the blood-draw station when she calls your name.  And she's working at a pace that leaves very little room for distractions and pointless conversation.

     It would be easy to blame the lab staff, but they're on the same treadmill as the patients; it's easier still (though less immediately satisfying) to blame the lab company, only we'll probably find they bled money through the Covid years (profit margins aren't great and everything shifted under them) and the suits making the decisions are layers and layers (and miles and miles) away from the point of human contact at the lab -- where people are still arriving, wanting to chat with the long-gone nice lady behind the desk and conveniently sneak their quick blood draw in between Pilates and grocery-shopping.  Ain't gonna happen and you might as well think of it as being right back to the time when you had to drive to Local General Hospital and patiently wait your turn.  Look, if you need lab work, you might want to treat that as more important than popping into the Rexall for a roll of Lifesavers.

     I found myself apologizing to the tech for people's behavior while she struggled with my rollaway vein (the obvious one inside my right elbow is uncooperative).  She sighed as if a weight had been lifted and said, "It's like this all day, every day.  They hate those kiosks."

     Might want to start figuring out how to get used to them.