The worried parents had no insurance and no money but they negotiated for yard work in the summer and homemade tamales at the holidays.

As luck would have it I was in the office again when the tiny family returned for a follow up. The finger, like the rest of the child, was warm and pink. A good sign.

“I didn’t get into this for the money,” Doc Jim had a penchant for the obvious. One look around the office told the story. I think about the time I had to remove chainsaw parts from the exam table or the time Doc Jim showed up at the scene of an MVA I was working as an EMT. He was sporting a full white beard grown especially for the annual stock show. He wore a beat-up straw cowboy hat to compliment grass stained athletic shoes. But pretty or not I was glad to see him. And of course there were those few times when I called him at home on a weekend or in the middle of the night. He never said more than, “I’ll meet you at the office.”

That’s the way healthcare was meant to be.

No, we’re not saying you should post your personal phone number on a billboard. But there may be a middle ground that lies somewhere between routing all calls to an answering service and not having a life.

We’re going to give you a few simple tools for restoring healthcare to the way it was meant to be. We’re also going to give you permission to use them!

We’re going to give you a positively outrageous Service Prescription! Come on, open wide… this is going to make it all better.

Once upon a time… we owned a restaurant. To say that we were doing miserably would be painting a picture that was way too optimistic. We were losing our backsides, going to hell in that proverbial handcart, failing big time. But the oddest thing was that we were doing, according to the experts, everything right.

Our location was the best. Our food was exceptional. Our prices were fair and our operation was squeaky clean.

Customers stayed away in droves.

We were in a sink or swim situation and I was forced into my natural, geeky, back-up style… Mr. Science. I did what good scientists often do: parallel analysis. So you don’t have to suffer: parallel analysis is the act of looking for similar situations in dissimilar industries to see if the way they solved their problem might be adapted or adopted as a solution to yours. Whew! ‘Sorry about that.

Our observations became notes, our notes became principles, and our principles came to be known as Positively Outrageous Service or POS for short. POS was defined as:

• Random and unexpected
• Out of proportion to the circumstance
• Customer is highly involved
• Creates positive, compelling word of mouth

If you look at the definition closely you’ll realize that what we call POS is exactly what great docs and caring staff do instinctively. But the geek in me knows that good science is repeatable science and a good definition helps us do what we know in our heart with intention and purpose. It also serves as a model for folks who want to reach out but don’t quite feel comfortable. It’s the answer to the question: do we shake hands or hug?

So we offer our positively outrageous Service Prescription:

• Often highly personal. Always involving
• Of the moment, from the heart… (Neither requested nor expected)
• A form of unconditional love
• Creates compelling, positive word of mouth

One nice thing about the Service Prescription is that you needn’t be a medical expert to practice this piece of medicine.

T. Scott Gross

About 15 minutes later, still in scrubs and a cap, he came through the double doors and headed straight for the charts. I filled him in while he scoped out the notes and then we went in to see the patient. I knew he was between cases in the OR and didn’t have much time.

Mr. Johnson lay semiconscious on the bed, his pale skin only slightly darker than the hospital sheets he rested upon. I’m not sure rested is the right word—he was pretty much held captive by the vast array of tubes entering and exiting every orifice he had, and then some. Dr. Hinds gently picked up one withered arm and examined it, and then the other. I waited for his diagnosis. Without saying a word, though, he pulled up a chair and sat down. He took the nearest limp limb and resting it over the side of the bed he began talking to Mr. Johnson.

Mr. Johnson couldn’t answer if he’d wanted to. His throat was filled with an apparatus that sounded as if it was gasping and hissing a giant sigh every few seconds. It didn’t matter. Dr. Hinds gently massaged and milked the arm and talked some more. And some more. Not about anything important. Just stuff. How his son Davey was doing in school and about the new bird dog he’d just gotten. I looked up at the clock, a little nervous about Dr. Hinds being late for his next case. Dr. Hinds saw my glance, shrugged and then talked some more. He told a couple of really dumb jokes and massaged the arm some more.

A nurse came to the doorway to let Dr. Hinds know his next case was ready. He nodded. And then he visited some more, continuing his one way conversation as if they were neighbors on a Saturday afternoon commencing to visit over the fence. And finally, when he was ready, he pulled out a large bore angiocath and inserted into a vein that I swear he made magically appear. The flash of blood appeared giving us the sign that the vein was good and ready to go, I connected the tubing and once again we were in business.

As we left the room I marveled at how he had manifested a vein that just wasn’t there. “How can you do that? I don’t know of anyone that can come close to your touch.” Dr. Hinds is one of those people whose eyes really do twinkle when he smiles. He shrugged and said, “It just takes time. Everyone is always in too much of a hurry. That’s the best gift you can give your patient: Time.”

Karyn Buxman, RN MSN