Customer Service Skills for Health Professionals

It’s a thing that should exist.

People think customer service office work is low end mindless work.

But if you do it well, if you want to be good, it requires skills.  Interpersonal communication skills that require effort and intention.

And I think those skills should be REQUIRED learning for healthcare professionals.  Particularly doctors and nurse practitioners.

A huge amount of diagnosis is getting the relevant information from the patient. That requires guided discussions and active listening.  That requires making sure that both people are sharing understanding of what is being discussed.

Another huge part of healthcare is communicating clearly about diagnosis and plans for fixing problems.  Again, that requires that both parties fully understand what is being discussed.

And finally respect must be communicated.  Fully 80% of what is communicated in a person to person conversation is inferred by body language, tone and assumptions about shared meaning.  Respect is part of that 80% but it is also a pivot in how a person accepts the information they are being given.

There is a reason that some people look at a news story and see truth and others see fake news.  We filter information through our feelings.  The feeling we have about an interaction quite literally changes the understanding we have about the information.

Customer Service, when it is done well, is not so much about happy customers.  It’s about clear transmission of information.  It’s about solving a problem with communication.  Because a person doesn’t feel their problem is solved unless that customer service person made them feel confident that it was solved, regardless of whether or not it was solved.

Studies have shown that people sue doctors that they don’t like, not doctors who screw up.  In other words, if a doctor is likable but makes a bad diagnosis they are far less likely to be sued.  Because people trust the communication more than they trust the ACTUAL SOLUTION.

Insurance companies try to leverage this point to reduce malpractice by teaching doctors to be likeable.  But I think a much more salient point is my original one.  The one that is buried in why people don’t sue doctors they like.  Because HOW people understand what is said is deeply embedded in the feeling of respect and understanding they get from a doctor.

Shared understanding is sitting on a platform of respect.

Medical Schools need to require, at MINIMUM, the level of customer service skills that get taught to the best customer service centers.  And frankly they ought to be taught at the level of a counselor.  If they were, I would bet that the outcomes would be markedly improved.


Capitalism is the Heart of Christmas

It’s not God.  It’s not Jesus. It’s Money.

And that’s not a horrific thing.  It’s an annoying thing if, like me, you dislike crowds and don’t particularly participate in Christmas.

But this is the season that feeds the Western Economy.  Indeed, because of globalisation, it feeds the world economy.  It’s the engine of spending that employs most of us in one way or another.

I find this idea that there is a war on Christmas amusing.  The strongest power in the world is firmly entrenched in the idea of Christmas.  The power of money.  Christmas isn’t going anywhere.

Even today, most Christians have melded the holiness of the day with decorating, buying, cooking and commenting on people who say Happy Holidays instead of Merry Christmas.

But, sadly for those who still think it’s about religion, Money is all about leveraging for more money.  And so it’s inclusive.  It wants there to a gift giving Hanukkah and it wants Kwanza to be about gifts as well.

Mark my word – it wants Mawlid to be about gift giving too.   Someone, somewhere is working on a way to change a festival for Mohammed’s Birthday into a retail bonanza.  Christmas used to be a festival holiday too.  Now it’s a season of shopping.

AND I bet if they pull it off, the division between Muslims who celebrate Mawlid and those who don’t will disappear.  Because big business always trumps religion.  ESPECIALLY if it can somehow leverage religion into it’s drumbeat.

100 years from now imagine the incredible booming economy that would exist if we could add in a gift exchange for 2 billion Muslims!   Imagine if you gave it a nice unique set of colors and symbols that they would display each year, creating entire industries out of decorating for the holiday.   Almost everyone benefits when the economy is booming.



I have no room left in my brain for empathy over mass shootings.

I can no longer process it.

My empathy doesn’t matter, of course.  Indeed, the dead people don’t matter.

All that matters is that people get to keep guns.

It doesn’t matter if people die because of guns.

What matters is that people have a free right to own a gun.

That’s all that matters.

I just read that 20+ people died and I thought Yup, seems normal.  Unsurprising.

Tomorrow more will die.

Yesterday a bunch of people died.

Next week, last month, next year, 2 years ago.

None of it matters.

That was crystal clear at Sandy Hook.  The US defined itself that time.

There is no moral good in the owning of guns, but people cling to it like it’s the fire that light’s their souls.

Kids mean nothing compared to the ability to own a gun.

Hobbies and Fear

That’s all that holds up their position.  But they keep winning.

It’s obvious that nothing will stop them.  They will cling to their belief and their fear and their bizarre need for a gun and insist that had nothing at all to do with the ongoing national crisis of humans needlessly dying.

There is no fixing a bias like that.  It’s too deep.

People will die tomorrow and the News Media will make money on it.  And the Gun Manufacturers will make more money with every mass shooting.

It’s the insanity of these Fucking United States.  May the hell fires of the Universe obliterate us.  We certainly have earned it.

Creepy Behavior

Friendly Man walks into the room and asks a woman he finds attractive if she she was up all night with her boyfriend.

Friendly Man walks up to a woman at work and tells her she looks hot today.

Friendly Man walks up to a woman he knows casually and give her shoulders a rub.

Friendly Man walks up to a woman and asks her if she’s ever been to the Porn Shop downtown?  They have a sale on today!

I could probably fill a post with these generic examples, or the women reading this could fill up the comments with the hundreds of examples of behavior that is frankly part of a normal life for  woman but is CREEPY BEHAVIOR.

Women are expected to think that all these things are compliments to us.  And many of us have internalized that expectation.

And because it’s supposed to be a compliment, a woman who raises any issue on the subject will be perceived as a bitch.  Unfriendly, rude, hysterical, feminista, hard to work with, angry,… the list goes on.

But believe me, we KNOW that we will be considered the bad guy in any effort we make to keep men from giving us unwanted attention.  And the vast majority of us say nothing during those uncomfortable moments.  Some have become so inured to the culture they manage to feel complimented.  But most of us feel the creepiness wafting off the guy like a stink.  But we will still give an awkward laugh, a stilted comment or an abrupt change of subject.

If you are a straight man, and you want to avoid being a creep, run your interactions with female acquaintances or casual friends through the following filter – Would I say this to a man?

If you wouldn’t say it or do it to a man, don’t do it to a woman you aren’t romantically involved with.

It’s really that simple.

If you are fine with women thinking your a creep, calling you a creep when you leave the room and just generally agreeing behind your back that you have a creepy stink, then ignore the advise.  But one day you will run into someone who will call  you a creep to your face.  And believe me, they will only be echoing the words that have been said behind your back dozens of times.

If you want to approach a woman for a possible romantic encounter, treat it just like you would treat approaching a friend to do a thing neither one of you have done before.  Not your best friend, just a guy you know but don’t socialize with.  That level of distance and and friendly deference to their situation and interest in the thing.

Don’t use movies as your playbook.  We do not want to be “pursued” when we say no.  There is a reason we call that stalking, it’s because it feels predatory to us.  You only hurt any future chance you might have had with that kind of action.

Creepy behavior is so normalized that we pretend it doesn’t exist.  But it does.  And it’s harassment.  But no one wants to say that.  Women certainly don’t because we will NOT be looked on favorably for saying it.  And men don’t want to because there is a indefinable sense of entitlement to treat women as beings designed for their pleasure.

Libraries – The Soul of Civilization

There is a group of people who honestly think that no one uses libraries anymore and they are a waste of tax dollars.

These people obviously don’t use libraries.  They therefore assume that no one does.

They are wrong.

They also don’t understand the function of a library.

They think libraries are places where people borrow books.  Because they either don’t read or buy their books, they assume there is no need for libraries.  They have never looked beyond their own noses.

Well, as someone who does use the library – I strongly disagree.  And I do use it to borrow books for my entertainment reading.  But that use only represents PART of a library.

A Library is a place where we accumulate knowledge.  Free, accessible knowledge.  We all like to brag about how the internet is just a huge repository of knowledge.  But NOT REALLY.  A lot of that knowledge is hidden behind paywalls.  It’s hidden behind search algorithms.  It’s not indexed.  It’s buried under mounds of useless or erroneous facts.

But at a library, someone has collected, thoughtfully indexed and cataloged all the knowledge.  And then they give you free access and assistance in using it.

Scholars don’t own all the reference material they use in their researches.  They go to the Library.

Libraries are also community centers.  Places that encourage the best in us.  They encourage reading in children.  They encourage sharing and responsibility through borrowing programs.  Libraries are an important part of how we teach children in a practical manner how to manage as adults.

Libraries are also useful in lending other things besides books.  They already have a system set up.  So many libraries have expanded their inventory to include things as diverse as:

  • animal skeletons for learning.
  • snow shovels and sleds
  • Santa Suits
  • prom dresses and tuxes.
  • tools
  • cake pans and related items
  • Halloween costumes
  • toys
  • musical instruments
  • museum and park passes

Libraries are places where we can offer inclusion through sharing.  They are the very soul of what makes civilization.  We cannot let them die because people who have sufficient money to spend on things they don’t reuse don’t think they are important.  We cannot let them die because people who think that information is magic on their screens have never considered how it gets there or how people who research this information actually found it.

Libraries matter.  Don’t let ANYONE tell you otherwise.


Or – the Wrong Word

Have you noticed that people often feel that the opposite of someone they like or support is wrong or bad?  It’s a strange assumption.

And not just the obvious things like Politics & Religion.

Everyday things.

If they like Coke, Pepsi is bad.

If they are vegan, meat is wrong.

If they have children, then someone who chooses to be childless is wrong.

If they have trucks, small cars are bad.

There is this strange sort of OR mentality.  Like the world can only tolerate ONE and all other things must be bad.

But life doesn’t actually work like that.  Why do we do that?


The Delusion of Patriotism

I am not a patriot.   I think George Bernard Shaw captured it’s essence quite well by saying

Patriotism is, fundamentally, a conviction that a particular country is the best in the world because you were born in it. ~George Bernard Shaw

I will got farther and say that Patriotism is a sickness to a country.  In order to feed a delusion of this nature, it’s necessary to exclude negative information from your mind.  Or worse, far worse, to reconstruct the negative information into positive information.  As a result many problems get ignored or created.

A great many national mistakes happen when people sell a horrible idea under the guise of patriotism.   The Third Reich comes to mind.  But don’t delude yourself that this is the only or the worst example.  Humans have been using patriotism to sell hate and war for millennia.   Horror after horror gets committed and still we pretend that being patriotic is the best thing we can be as a citizen.

Patriotism is a way to make people stop thinking.   If something is labeled Patriotic, it is to be considered good.  Full Stop.  No questions must be asked.  So much so that people are now labeling Trump’s followers a Nationalists to distinguish them from Patriots.  Because the idea of Patriotism itself must not be sullied.  It’s an illusion that must be carried by a country.

Patriotism is a state sanctioned religion.  People are encouraged to feel an emotional attachment to the state and to identify so fully with it that they will support the country even when it does things that hurt them or others.  They are discouraged from questioning the intrinsic goodness of their own country.

Patriotism is an essential lie that keeps armies in service.  People go off to fight wars that have little or no impact on people in their country out of “patriotism”.   In American we often tell our military that they are defending our freedom.  But it’s hard to see how that gets swallowed when they get sent to Iraq or Afghanistan.  Well, that’s the beauty of Patriotism.  We just label it and package it and everyone just nods and agrees.

I refuse to be patriotic.  I like my country.  I want to keep living in this country and indeed I have no choice but to continue living here.  But I do not think this is the best country and in fact I am often ashamed of it.

  • I want this country to be better than it currently is.

I think that sentiment has more potential to be good for the country than all the patriotic foolishness that gets blathered.

Patriotism is a con.  Work, honesty and improvement are the only thing worthy of my country.  Patriotism is only worthy of fools.



Christianity’s Emotional Vampires

Using other people’s pain and suffering as leverage to proclaim your God is disgusting to me.

I think that is why I find Missionaries so unsympathetic.

When the real world is in real trouble and a person trots out a well worn and useless statement about how if we all trust God it will be OK, I want to scream.

NO.  No it won’t. Practical and real changes have to be made in the real world.  Systems need to be changed.  Prayers are not going to change things.  People doing things differently will change things.

And, frankly, when you pivot a national tragedy into a method of evangelization, you disgust me.

Believing in God.  Sharing your faith and comfort with people you know who already believe and would like to share that comfort with you. That is a normal and human thing to do.

But when you take the tragedy in someone’s life and twist it into a way to evangelize your God, you become an emotional vampire.

I’ve been a Christian.  You will not be able to fool me into thinking you are evangelizing for any other reason than to support your own self definition of being a “Spiritual Christian.”  Of being seen by your fellow Christians as being spirit filled.

You are taking another person’s grief and fear and tragedy and turning it into a way to feel better about you.  You are an emotional vampire.

When you manipulate the national events of shame and anger and fear into a moment to evangelize, you are an emotional vampire. You are NOT holy.  You are self involved and deluding yourself into thinking you are being righteous.  Or maybe you know your own hypocrisy but thought no one else knew.

Either way.  I really wish you would stop.

Racism is Rampant in the US

It’s a thing.

Until this year, I thought it was mostly the hidden things that people in the comfort of middle class america didn’t really perceive.  But that changed this year.  It’s out on the lawn of the White House now.

But anyway – let’s look at the ways that it lives and makes black lives matter less.  The following is from Pew Research:

  • Education: 36% of whites have a college degree, 23% of blacks, 15% of hispanics.
  • Median Household Income:  $77K white; $44K blacks & hispanics
  • Black People and Hispanics are 2X as likely to be poor as white people.

The thing is the gap is growing not shrinking. It’s representative of a systemic problem – racism.

You want to blame it on black people, don’t you?  That was your go to thought.

  • they don’t value education
  • they don’t use money wisely
  • they get pregnant as teenagers
  • they use drugs more often.
  • they are lazy and don’t work.

That’s what you were thinking but don’t say out loud.  Do you know why that idea came to your mind?

Because that’s what our culture teaches us about black people.  It’s not true, but that what we culturally get told by TV shows and Movies and Talking Heads on TV and MEMEs and the list goes on.  We don’t see information that doesn’t fit what we already know, because it takes effort and being uncomfortable to process that.  So we just ignore it.  We accept the barrage of information that provides us with unconscious affirmation of our unconsidered beliefs.

It’s worse than that even.  It is an idea that gets perpetuated by algorithms in our criminal justice system, in the education system, in the credit systems,  in the very studies that look at these things.  Because once the perception exists, it’s just gets built into the models and all assumptions feed off it.

This is racism.  It’s real.  It’s living inside of you and me and every system we navigate in our lives. And it’s sucking the marrow out of nearly a third of our population.

This is why we have to say BLACK LIVES MATTER.  Because the entire system is designed to make their lives not matter, all while we are not saying the N word, so we think we aren’t racist.

The N word isn’t the thing that’s killing our country.   It’s an ugly word with a despicable but absolutely clear set of meanings.  But we have coded it with the entirety of racism instead of it being just one symptom.

Racism is hidden in the decay of assumptions that are feeding police violence, poverty and cultural norms. That’s what is rotting the foundations of our country.  The system is rigged against a third of the country.  That is what is killing the country.

Racism is real.  Stop yelling at the Straw Man Patriotism that is this free speech debate.  Start yelling about WHY these people are taking a knee. RACISM.

Approval Economy

Someone finds something they love on the internet.  They want other people to see this wonderful thing that they love.  So they post it on a site like pintrest or tumblr or facebook.  In return for posting something that other people also like they get approval.  Hearts, or thumbs up, or stars… A way to track how many people approved of their posting.

Social Media is heavily driven by approval.  It taps into on the most fundamental human desires – a need for approval, for validation, for status.

We earn approval from other people’s work by posting some else’s creation.  Basically we violate copyright or at least get close to violating copyright on a mass basis constantly.

People who post a photo or a gif or whatever aren’t making money on it, but their use of it may have a negative impact on the market of the original work. Basically, they get approval that should ultimately belong to the creator.   But that approval has value.  Because we all seek it and it is one of major engines of the internet.

Ultimately, most social websites are media trading platforms where people get paid with approval status.  Many of them using some form of reblog feature to create a viral spread of the content.  So even if we never take someone else’s work and post it, we will often reblog a thing because we like it and because we want people to identify and validate us with this thing we like.  dragons, stock car races, classical music, etc.

We all do it. It’s how most of the internet works. Various websites earn money from our approval seeking behavior, so ultimately they make money from our posting of someone else’s work. There’s a lot of ethical implications of that ecosystem which pervades the internet.

I think the law is going to have to evolve a bit to adjust to the internet. There are so many subtle variations to how we slowly suck life out of makers by seeking approval for ourselves through their work. And that approval ultimately belongs to them, but they don’t get it. And in the internet world, approval has a value because we seek it.

It has monetary value because the act of giving approval is the act of seeing and those eyes will also see advertising content.  And there is the actual dollars that big media companies are siphoning off hundreds of thousands of creators all the time.

I think that approval has a value to be considered in some copyright case.  The way the internet works now, each individual creator has to track down each case of their work being used on a site like facebook and then go through a convoluted process requesting that it be removed.  It takes days to weeks.  In that period the website continues to earn money and the person who posted continues to earn approval.  All of it vampired off a maker who is quite probably drowning in these instances.

The internet has offered a great market for lots and lots of makers.  But it also exposed them to millions of vampires.