Advanced Modernity vs. Degrading Hospitality – The Irony of Present Days Outpatient Services

Having on and off sore eyes for the past three days, my husband and I went out looking to get them checked by a doctor. I initially intended to just go to any 24-hour clinics or community clinics nearby, hoping to find an eye specialist in one of them. But apparently, ophthalmologists are not common in the outskirts that even after we resorted to dropping by a mid-scale hospital, we still couldn’t find one. So we continued our ride, knowing a large, first class hospital was up ahead, in a high-class, neighbouring suburb.

As we rode into the parking lot, I noticed the extreme gap between the motorcycle area and the car park. The motorcycles were cramped into about one-eighth of the car area, and riders — who were, I bet, mostly the employees — had to skillfully navigate around finding an available spot without knocking others’ rides down. Except for newbies, who might bump onto barriers at the parallel parking section, drivers, on the other hand, can luxuriously glide through without worries. How disparaging!

One question after another kept popping up in my head while we were heading towards the main entrance, where they setup valet drop-off at. “Are we cool enough to be here? Can we afford the bill? I’m not even properly dressed up.” Out of my ordinary habit of wearing a graceful long dress and trendy boots, I was then in my not-so-shabby, slightly dull, long-sleeved shirt, unmatching baggy pants, and an old pair of Crocs. Do you see my dilemma?

My hubby reminded me to enquire if my insurance card could be used for such specialist service before I agreed to register for a session. Apparently, he and I were tuning to the same frequency. He was also worried that it would cost us way beyond our budget. I tried to ease both our minds, saying we should first ask if they offered the service I had needed and whether there was any specialist scheduled at that time.

Anyway, we received positive response from the concierge staff and were directed to registration. Before I filled up the form, I encouraged myself to ask, shamelessly in details, of the charges. She quoted me a jaw-dropping sum of 260,000 rupiahs, which was about 9 times higher than similar service at standard clinics. Then I showed my insurance card, asking the officer to check if my insurance covered such expenses. She said no. Then I verified if there’s a nearby ATM which I could withdraw money from, to finally settled with the idea of swiping my credit card at the cashier instead, knowing my company does reimburse such expenses for their employees’ welfare.

Throughout this whole process of ascertaining I could eventually pay the bill, I tried keeping my cool despite the cold sweats, pretending that the sum didn’t matter; the invalidity of insurance didn’t matter; the resorting to CC didn’t matter. Besides, there we were, at the registration desk, too embarrassed to retract. Agreeing to queue for the particular service, I completed my registration details while at the same time constantly persuading my mind to be OK with the mind-boggling charge.

While waiting for my turn, my hubby and I were constantly justifying the high charge — air-conned rooms, relaxing ambience, plenty of staffs at every point: security, concierge, front desk, nurse stations, cashier, pharmacy, canteen, convenience store, gift shop, and not to forget the humble janitors … With all the facilities many visitors — the elites especially — seemed to fancy being there. The extremely health conscious individuals who perform regular check-up; the control freak mums who take their children to the doctor every now and then due to a simple flu; the middle-aged to elderly who begin consulting for serious illnesses, submitting to the doctor’s theoretical advice of periodical come-back and various restraints; some due to the fear of death. And certainly, some were like me, who just happened to be there because they couldn’t find the service elsewhere nearby. I started to observe people’s attributes — trendy ladies in jeans or shorts, carrying designer’s bags, women in high heels, young professionals looking cocky with their gadgets…. So, my hubby and I took out our Androids too. It seemed to be the right move considering where we were. (Like anyone actually cared. What a vanity!)

In my mind though, the justification intent continued. I was eager to be called for my turn, excited to experience what a 260,000 service would feel like. What kind of treatment would I receive? Are the doctor and nurse sincerely friendly, genuinely concern, and passionately caring? Will I be treated like a king? Will I feel special?

Expressionless, the nurse in charge on the ophthalmologist’s point called my name. Noticing her not-so-welcoming face I felt a minor turbulence in my stomach, “This won’t be good.” The doctor was, well, not so bad. At least she had done some ice-breaking, asking me how I’d prefer to be referred to. After that first, preliminary interaction, the rest of the procedure I went through were strictly business. No interpersonal conversation. No effort to entertain me in between examination flows. I was simply transferred from one station (read: equipment) to another, to another, like a product being manufactured in the factory — prepped, cooked, finishing touch-up, wrapped, and so on.

Worse still, while waiting for the doctor to give me the prescription — which she turned out not to give any — I was left feeling dumb on my seat, in front of the beautiful doctor, wondering what I was to do or to expect while she was typing ‘what’ on her computer. Ignored for a good 3 minutes, I was forced to find a distraction from simply watching her, thinking why in the world she hadn’t said a word but kept looking busy facing her monitor. So I looked at the sink; then at the hazardous bio-waste trash can; then at the three computers in the room, two of which connected to some special equipment; then at the printer under one of the computers, deducing that photographs of eyeballs might be printed there; then at the doctor again, but this time only at her typing hands; then elsewhere; then back to her; then… The point is I completely felt ignored and, worse, unimportant. Am I looking that poor and undeserving? Is it my dress? Is it my sandals?

The only time the doctor personally handled me was when she used this device for a good 1 minute. I spent about 3 minutes on two other equipment with the nurse, and a not-so-good 3 minutes feeling awkward and dumb waiting for the doctor to, at least, say something while finishing up my session. (Photo credit: PFrankoZeitz, Wikipedia)

A nurse ushered me to the cashier, where I made payment and finally saw my prescriptions on the payment receipt. There, I instantly knew that the doctor had keyed in the prescriptions into the system instead of writing them on a piece of paper like the conventional way done by my doctors in the past. It’s cool indeed that no additional paper waste was required, and that the cashier could automatically prepare the receipt from what has been recorded in the system. Then, I was instructed again to proceed to the pharmacy, where my prescriptions had been put in queue and I simply had to wait till they’re ready. Cool! Everything was automatic! I no longer needed to bring the prescriptions from one station to another for settlements.

Last time, even our blood pressure was taken by our doctor. This created more opportunity to entertain patients with casual conversation. (Photo credit: Wikipedia)

Waiting for my prescriptions, I pondered on what I just went through — the expensive charge, the facilities and automation, and the interactions with the medical personnel. I didn’t mind the production line style of passing me through stations: registration, nurse, doctor, equipment, equipment, nurse, cashier, and pharmacy. Nevertheless, I found the services provided by the medical attendants were entirely bland and didn’t feel genuine at all. I much preferred my old doctor, who entertained me with simple conversations and a bit of humour while personally examining, providing diagnose, and writing prescriptions for me. I liked my old doctor, who didn’t mind giving me directions to certain stations instead of passing me to the nurse or, worse, leaving me clueless and asking around myself. And, I honestly fancied being handled personally by my doctor and not passed from one equipment to another, handled by the nurse.

It’s true that doctors’ job is made easy by having various equipment do most of the analysis, and hence the jacked-up price to include equipment maintenance. And for the management, there’s no doubt that such semi-automation has improved staff’s productivity, i.e. staff can serve more patients and do more chores. However, with the increasing number of tasks they are required to do, personal doctor-patient or nurse-patient interactions are generally scarred. Such semi-automation does tend to reduce human interactions. And to me, outpatient service becomes as rigid and cold as the iron and steel equipment they use.

Well, maybe the lack of hospitality was only encountered from certain doctors, not all. Maybe it didn’t have anything to do with semi-automation, nor with the high-class premise. And perhaps, my skepticism and negative observation were unfair because of the relatively high charge and my past records of encountering much friendlier doctors who treated me like I was somewhat a VIP at low to medium class setups. However, the whole encounter did get me to think that perhaps to acquire excellent and more personalised outpatient service nowadays, I need to either be relatively poor, or not rich, to only afford services from standard community clinics or village doctors; or, I have to be extremely wealthy to be able to get a personal home-to-home medical service. In between, I shall be part of the fast-pace, less friendly semi-automation. What an irony!

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