The Veterans Affairs hospital mess is still under investigation but it is clear that willful deceit played a significant role in the mismanagement of veterans’ medical care and its disgraceful, sometimes tragic consequences.
In addition to the deceit, however, it appears that there was a widespread management misunderstanding of what waiting lists and wait-times do for and to an organization.
This kind of misunderstanding is not unusual in organizations, public or private — although deceit, happily, is less prevalent.
Waiting for something or someone is part of modern life for most of us.
It isn’t always bad; being wait-listed for college admission keeps hope alive, as does being put on standby for a flight that would get you home in time for some birthday cake.
But waiting is a waste of time. We are impatient and we don’t like waiting, but there it is, take it or leave it. For many different reasons, people sometimes prefer to take it.
Young people wait patiently behind the velvet ropes and gatekeepers to gain admittance to an “in” nightclub.
Parents or grandparents will wait for hours in line to get tickets to a Disney World attraction for their kids, or for a lottery ticket that allows the winner to buy a child’s dress based on a “Frozen” character costume.
The reason why these young people, parents, and grandparents will wait in these lines is uncomplicated: at the end of the line there is something they want, something they value more than their time and cannot get anywhere else.
Military veterans, too, will wait for weeks or even months to see a physician at a VA hospital, mostly for a different reason: they have no alternative.
Retired Marine Lt. Col. Oliver North recently described his experience with VA medical care after he was diagnosed with cancer.
He got so tired of waiting, and concerned about the impact of delay on his health that he sought and received successful treatment at a private hospital — an option he had because his current employment contract included health care insurance.
The VA hospital situation should not have required whistleblowers. The waiting times at the VA should have set off alarm bells throughout the organization, but they didn’t.
Possibly the VA and everyone else in government had gotten so used to delays and waiting lists that they were accepted as normal, a substitute for productive capacity.
This also happens in the private sector, but businesses that do not hear the alarm bells set off by waiting lists and lead times do not last long in a competitive environment. In the private, business sector, most customers have alternatives and are not at all hesitant to use them.
It is apparently human nature for people within an organization to move inefficiencies out of their area of responsibility and into the fuzzy area of lead times and to blame it all on capacity problems — the equivalent of putting customers on hold.
That is why management consultants are especially alert when they hear the word “normal” applied to things like customer order processing lead times, shipping delays, and aging delivery schedules. Some managers, too, consider lead times as a substitute for capacity or efficiency.
Waiting lists, wait times or other delays are usually a symptom of problems at one or more stages in the process of satisfying customer demand.
A pizza restaurant might have a production problem due to a mismatch between oven capacity and peak demand, for example.
A distribution center might experience shipping backups because of a procurement system foul-up that leaves the warehouse chronically short of the right sized boxes.
Turnover in the order-entry team may cause shipping delays and returns due to address errors or incorrect product identification.
There are some products that are so complex and resource-consuming that long lead times are simply accepted as a kind of industry standard.
Large passenger jet aircraft like those developed by Boeing and Airbus, are examples of this kind of product, and in those industries customers have to place orders months, even years before delivery — especially for newly developed models.
Customers accept that, but consider delivery delays another matter entirely. That can make them very unhappy, sometimes even unforgiving.
If you are the CEO, you have to stay on top of the areas that can create delays and cause customer dissatisfaction.
It doesn’t hurt to take a few customer service calls yourself every week, so that you understand the problems and what went wrong.
Take each unhappy customer as a challenge; fix the problem and convert their unhappiness into appreciation for how much you and your company care about them and about getting it right.
Then fix the source of the problem so it doesn’t happen again.
James McCusker is a Bothell economist, educator and consultant. He writes a monthly column for the Herald Business Journal.
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