Two scientists were recently awarded the Nobel Prize for the development of CRISPR, a gene editing technology that could revolutionize how we treat cancer. Next year, I hope the Nobel Committee awards two management consultants a prize for making every hospital's back office actually function.
As an entrepreneur and cancer survivor, I wish hospitals would focus on the basic blocking and tackling of running a business. It would save lives.
The first red flag came in December 2016. As the sun inched over the horizon, I paced back and forth, waiting to be called back for surgery. I decided to check my phone one more time to make sure my email out-of-
office reply was worded correctly. I had debated just being honest--"Thanks for your email. I'm currently out of the office. If I survive a craniotomy, I'll get back to you. Otherwise, please contact my colleague. I'm dead."
I decided to stick with the ambiguous version, leaving out the drama. However, while checking my phone I noticed an email from the hospital I was in. It was from its development office, asking for a donation. I burst out laughing, grateful for comic relief. After being rolled into the operating room, I waved off a nurse trying to place the oxygen mask over my face. First, I had a question for my surgeon.
"Before we get started, I want to let you know that I got the email asking for a donation. Do I need to pay now or after the surgery? Admittedly, I'm used to paying after I get the thing I'm buying. You wouldn't pay a restaurant before they served you, right? But given the circumstances, I'm willing to pay in advance. Someone grab my wallet!"
While everyone was laughing, my surgeon rolled his eyes. He wasn't surprised by the story. The worst-kept secret in the medical industry is how terrible most back offices are run. As a patient, I received world-class care. As a customer experiencing complex trauma, I was and continue to be treated horribly.
I spent the first three decades of my life hanging out on the periphery of America's health-care system. As both a patient and customer, my engagements were always one-time transactions. When I got the flu, the doctor gave me medications. When I cut my hand, the doctor gave me stitches. Every time I had a problem, the doctor solved it, and I received one bill. It was simple.
That all changed one day when a subtle tingling started in my arms and legs that quickly escalated to violent muscle contractions. I was having a seizure, and was grateful that someone was there to call 911. Minutes later, an ambulance arrived. From the moment the EMT picked me up off the floor to the moment I woke up confronted with bad news, I remember the constant flurry of communications around me: 32-year-old male, acute headache, no significant medical history. I no longer had a name. My symptoms were my identity.
In the weeks and months that followed, my medical team would learn that I go by my middle name. I shared bourbon recommendations with my neurosurgeon and Spotify playlists with the radiation oncology team. Because my neurologist ran track in college, I texted him screenshots of the Nike running app on my phone, sharing my progress from struggling to walk around the hospital dragging an IV pole to running a 200-mile relay race in Oregon.
These relationships vanished the moment I found my mailbox stuffed with envelopes. This is how the back office communicates with patients. There is no empathy in these envelopes, no attempt to understand what's happening to the patient. Once again, I didn't have a name. I was an account number. It's the first thing customer service asked for when I called to report the first billing error. They didn't know I go by my middle name.
When I finally began opening the envelopes, I was shocked at the number of different companies billing me. One was charging me for MRIs, while another sent me a bill for bloodwork. One stack of bills was for hospital facilities, while another was for physicians. Buried somewhere were overdue bills from that ambulance ride.
Overwhelmed, I quickly created online accounts and set all payments to auto-draft. I didn't have time to think about this. There was a staff meeting in the morning followed by a noon dose of radiation.
In hindsight, it was so easy to justify not touching the stack of envelopes. I didn't have the energy to figure out the labyrinth of medical bills. Every ounce of willpower was devoted to enduring radiation and chemotherapy while pretending to have everything under control at work. If I could justify devouring a pint of Ben & Jerry's every night, I could easily justify setting the bills aside. I'll deal with them later, I told myself. Besides, I have great health insurance.
Several months into my treatment, I discovered that having health insurance is not enough. The errors were piling up and costing me thousands. There was a breakdown in communications between the health-care system and my health insurance provider. There were technology problems. There were long lapses in getting a response. One of my neurologists joked that he's also been overcharged before.
These mistakes are not unique to one hospital. After my diagnosis, I traveled to Texas, California, and New York, meeting with over a dozen doctors. Each time, I walked away grateful for them patiently answering my questions, helping me better understand this new life with cancer. Each time, I walked away with a new account number. And each time, there was a trail of mistakes coming from the back office.
In my experience, it takes multiple phone calls, emails, and visits to these hidden back offices, meeting nameless customer service reps in person, and finally finding the unicorn willing to cut through the red tape and fix the errors. Now I could fully focus on fighting for my life, but always waiting for the next back office error lurking around the corner.
Cancer is expensive. I'm lucky and privileged to have the resources and support to fight the back office. As an entrepreneur, I'm angry at being forced to buy from an inept multibillion-dollar company with terrible customer service. As a cancer survivor, I'm even more angry when I think of all the other patients fighting for their lives with one hand tied behind their back.
Our health-care system treats patients well. It's way past time it treats its customers well, too.
J. Eric Wilson is an Arkansas native, entrepreneur, and Presidential Leadership Scholar.
Email: eric@nobleimpact.org.