Car dealerships have something to teach hospitals

A couple of weeks ago I took my car in for its regular servicing. I’ve always had excellent service at this dealership and have gotten used to some pretty high standards. But on this particular visit, I was about to receive a dose of new technology as well. After I pulled my car into the garage, I was immediately greeted by a welcoming and friendly customer service agent. She had an iPad-like smart device with her, using it to promptly check my details and confirm exactly what I was bringing my car in for.

A question came up regarding whether a certain part had been replaced previously — my mileage meant that a replacement would soon be required — and she went through the old records to look into this. When I told her that I wasn’t entirely sure because I lived in Florida for a year, she replied, “No problem, we can pull up all of those records as long as it was performed at a dealership!”

As she explained what might be needed, she was pulling up pictures on her screen and showing me all my car’s previous service details. After this, I was politely shown the way inside to sit down, where I enjoyed complementary tea and muffins while working on my laptop. Just over an hour later, the same service agent came back and went over what had been done, again using the smart device. I paid what I owed, and went outside to where my car was waiting, fully cleaned with mints left on the passenger seat for me. I may be lucky to be able to take my car into such a terrific place, but the technology experience also made me think, why on earth don’t we do something similar in health care? It was a quick, interactive and seamless experience.

While office-based doctors have made full use of the computers at their desks for a very long time, the same cannot to be said for how hospital doctors work with them. What I saw that day at the car dealership quite frankly serves to highlight how behind our technology is. All hospital doctors should be able to round on patients with portable devices by their side. As well as pulling up records and placing orders, we should also be able to use our smart devices as an aid for educating our patients.

The current typical scenario is for a patient to ask the doctor something such as; “What is my white cell count this morning?” or “What exactly did the test report say?”, and for that doctor to be forced into saying, “Oh, I’ll have to go outside to the computer to check on that.”

This shouldn’t be happening in today’s day and age. Hospital doctors need real time access to data while they are on the go. In an instant we should be able to pull up the patient’s past history, medications, tests and investigations. A handful of institutions across the country are already trying to do this, but it needs to be universally adopted. The ideal scenario would be for the doctor to sit down, have a good face-to-face conversation with their patient, while making full use of their smart device at the same time.

Hospital medicine doctors are best placed to utilize this most effectively. Eventually, we could even efficiently incorporate medical documentation into this. As well as the obvious convenience factor, easy access to complete records has another huge advantage. At a time when health care waste is estimated at $750 billion, or 30 cents for every dollar spent, the potential cost savings are enormous.

Barriers that we face include the fact that not all hospitals are fully computerized, and those that are have slow and inefficient computer systems with poor network connectivity. The current IT systems come between, rather than add, to the doctor-patient interaction.

I noticed on the day my car was serviced how user-friendly and ultra sleek the display was. Even in the restaurant industry, I’ve seen many hosts and hostesses working with smart devices that have great user interfaces. There are undoubtedly better health IT systems being developed, but frontline clinical staff need these now, not in another decade. Doctors (and nurses) are ready and willing to work with new and improved technology when it becomes available. Nobody would be more delighted when this happens. Unfortunately, many doctors are too jaded with their experiences of health care IT to even contemplate how the right kind of technology could improve their practice.

It may seem strange that car dealerships have something to teach hospitals. Perhaps a bit ironic, because this industry is often considered the diametric opposite of what doctors do (anyone heard the joke about the car salesman?). The benefits of using new technology in health care are multifaceted, including better patient experience, and also provider satisfaction too. While this will never take away from the face-to-face conversation, optimal technology can greatly enhance what we do. Physicians, patients, and the health care system — we will all be winners when we get this right.

Suneel Dhand is an internal medicine physician and author of Thomas Jefferson: Lessons from a Secret Buddha and High Percentage Wellness Steps: Natural, Proven, Everyday Steps to Improve Your Health & Well-being.  He blogs at his self-titled site, Suneel Dhand.

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  • Dr. Drake Ramoray

    Ask your car dealer if he is willing to accept a bundled payment for all the services required that may go wrong with your car for the next five years and see what he says?

    Or an even simpler question How much are the Feds involved I’m the servicing if your car?

    The absolute pinnacle example of capitalism in action (the car dealer) except for maybe restaurants in terms of food and customer service, and you use this as an example for the government meddling, and bureaucratic healthcare system.

    Lets mandate that everyone buy your make and model of car and then set up an elaborate system where the government subsidizes those who can’t afford a car like yours. In addition lets mandate that your car dealer can only charge you a flat fee based on the kind kind of car you have and and can only use one kind of service plan (that may include things your car doesn’t need) that is available for your purchase.

    Your free muffins and wifi will disappear really fast. This article is so out of touch with what is happening in medicine its not worth the battery power I used to read it on my tablet.

    • southerndoc1

      It is frightening that someone so out of touch with reality is making life and death decisions on a regular basis.

    • Dr. Suneel Dhand

      Hello All,

      Thank you for reading my article. Unfortunately, I feel that
      the title that was given to it has not set the stage correctly for what I’m trying to say. Let me defend myself!

      On my blog, the title that I have is: “What healthcare can
      learn from car servicing: my smart device experience”.

      One of my clinical interests is integration of technology
      with frontline clinical medicine, an area where we are sadly behind. The article focuses on how I was impressed with their use of the smart device, and that as a hospital medicine doctor, I hope that technology will one day allow us to do the same.

      I’m not at all saying anything else about the comparison
      between car dealerships and hospitals!

      Once again, thanks for reading, and sorry if the title misconstrues
      what I’m trying to say.

      Best Regards,
      Dr. Suneel Dhand

      • Dr. Drake Ramoray

        Your new title doesn’t help. The fact that you think it will just reinforces my position. You are comparing a free market driven commodity that is only available to relatively affluent people provided by a company that has a large amount of leeway from regulation to tailor its products and services to the consumer, to one of the most heavily regulated and meddled in industries by the federal government and third party payers.

        I don’t even need to introduce the government and mandates. If I merely introduced that your car insurance paid for for your car’s maintenance then very little of the positive experience you had at your dealership would have been in existence.

        You are comparing apples to Ebola

      • southerndoc1

        “The article focuses on how I was impressed with their use of the smart device, and that as a hospital medicine doctor, I hope that technology will one day allow us to do the same”

        Do you have any understanding that, as Ms. Gur-Arie says, that the iPad was just a piece of pink fluff to juice up the “consumer experience” (which you obviously fell for) comparable to a fountain in the hospital lobby?

        The valuable work was still being done in the back by a grease-monkey up to his elbows in your car.

      • Suzi Q 38

        “Rough” crowd today, Dr. Dhand.
        I get what you are saying.
        You have to remember that many physicians are reticent to change….especially technology. They don’t like the intrusion of the computer.
        I don’t like it either, but what you are describing would make sense, and improve what we have.

        I can see a physician showing me my radiology report while I am recuperating at home or in the hospital.
        Instead of those body part plastic models in the physicians office, h/she can show me better pictures or films on the smart device.

        It is slow because slow to change physicians are fighting it. I understand but I wonder why the big fight against something that can undoubtedly improve patient care.

        I am still waiting for my medical portal to magically appear on my computer. The nurses joke that it may come to the hospital in about 3 years.

        You are right, we are “sadly behind with the integration on technology with frontline clinical medicine” setting.

        Don’t apologize, Dr. Dhand.
        It was a fair comparison in the way that you had presented it.

        Best regards,
        Suzi.

        • southerndoc1

          “You have to remember that many physicians are reticent to change….especially technology. They don’t like the intrusion of the computer.”

          Sorry, but that’s total BS.

          Doctors love change, but not when it costs them money and when it doesn’t improve patient outcomes.

          • Suzi Q 38

            We’ll see what happens.
            Technology will always be changing.
            Some doctors will welcome it, some won’t.
            Same with some patients.
            It will be interesting to see if the smart gadgets that can help with our monitoring and tests win out.

  • buzzkillerjsmith

    This man has been perverted by the worldview of business. Pay him no mind.

    • SarahJ89

      Oh, dear buzzkill, how I wish we could pay him no mind! Unfortunately, he’s the wave of the future for all of us.

      • Suzi Q 38

        You are so right.
        It is the future, like it or not.

  • Physicaltherapize

    Perhaps that’s how it is at the BMW and Porche dealerships, but let me tell you my dealings with my local Nissan dealership have been far from efficient and stress-free.

  • May Wright

    I’m pretty sure that awesome servicing wasn’t covered under your Federally-mandated car insurance policy. If it was, imagine how much all of our car insurance bills would go up.

  • http://onhealthtech.blogspot.com Margalit Gur-Arie

    I can guarantee that the mechanic that actually fixed the car did not use an iPad to fix it with, and the chef at the restaurant was not chopping shallots with an iPad either.
    I’m sure hospitals would be more than happy to waste more money on cute customer representatives, hostesses, muffins, tea, and mints on the pillow, all equipped with touch screens. Some already do.

  • guest

    Sounds like Dr. Dhand is able to afford a nicer type of car than your typical PCP or hospitalist is able to…

  • ninguem

    Do these car dealerships sell cheesecake?

    Or is that the Amazon-dot-com barista with the valuable lesson for medicine?

    I can’t keep it straight.

    • southerndoc1

      No, they run a charismatic airline.

  • NewMexicoRam

    The key phrase for me….”I paid what I owed…”
    Most of my patients really don’t expect to pay anything beyond their insurance premium.
    In fact, my Medicare and Medicaid patients are the worst.

  • TheHangingChad

    That works great for all the services you received at (high end luxury brand) dealerships. But if you had ever broken down and taken your car to a local mechanic, their goes all that nice history.

    I understand the article was intended to address the technology, but I think the author inadvertently touched upon a few other points. Why is that people will pay $200, $500, $1,000 for work on their car but give the clerk at the pharmacy counter a hard time over a $50 co-pay for a script? It really woudn’t matter if there was free coffee, wifi, etc. while waiting. People just don’t want to pay for healthcare, period.

    • Frank Lehman

      You said: “People just don’t want to pay for healthcare, period.”

      The problem is that people have been led to believe that they should not have to pay for healthcare. And now Obamacare comes along and works to reinforce that belief.

    • May Wright

      Good point.

    • Suzi Q 38

      “….People just don’t want to pay for healthcare, period.”
      No, we don’t but many of us do pay.
      We pay $1,800.00 a month for the two of us, because i prefer PPO insurance. My husband’s employer pays half, and we pay half.
      That is a lot of money. I would say that there are others who think like I do…that health care is more important than a house or car payment.
      BTW, this monthly premium exceeds our house payment.

      • Jess

        If your monthly house payment included all routine care, maintenance and repairs (cleaning your gutters, weeding your gardens, replacing your carpets when they get soiled, changing your HVAC filters, annual inspections & touch-ups, repainting every time your littlies got out the crayolas, etc), I imagine it would be pretty expensive as well.

        • Suzi Q 38

          You could add a gazillion other things while you are at it to make it more ambiguous.
          I was comparing my monthly insurance premium to my monthly house payment alone.

  • SarahJ89

    I have one question to ask: How would you feel about all this snazzy technology if there was an error–a serious error–in your records? With no way to correct it. And something that would follow you for the rest of your life and color how the car place treated you?

    We are not cars.

  • Jess

    Here’s one difference: if you don’t take care of your car, it will cost you big money to have it fixed. If you don’t take care of your body, it will cost OTHER PEOPLE big money for you to have it fixed.