Cheap, Fast, Or Good

Last week I was on vacation, the centerpiece being a small family reunion of sorts at the

home of my mother and stepfather. My sister and her husband flew in for the weekend from out of state. They booked a flight on one of those new airlines offering cheap tickets with a la carte prices, charging you for every little thing beyond a seat on the plane. My sister joked that even the seats were cheap: they did not recline. Passengers sat in full upright position the entire flight.

On Sunday afternoon, we dropped them off at the airport.

An hour later, my sister calls saying their flight is delayed two hours. Soon it was delayed two more. This went on for six hours. Finally they were told their plane was delayed due to mechanical problems in Las Vegas. The passengers asked for the flight to be cancelled, and their money refunded so they could make other arrangements. They were told the flight would never be cancelled. Flights were only cancelled due to weather conditions, not for the lack of a jet. They were not allowed to leave the security area. They were not provided with dinner vouchers. Glasses of wine cost $15.

Sky Law had been declared.

What, you ask, is Sky Law? It’s a reference from the TV show 30 Rock, spoken by Matt Damon playing Airline Pilot Carol:

“Sky law, it’s when I turn on the fasten seat belt light and nobody’s allowed to talk until I get ten minutes of silence. I made it up, but people are stupid.”

Eventually my sister and her husband made it home, but not until 2 am the next day. Between the food tab, and missed time at work, any savings from the inexpensive airline tickets was forfeit.

You can get it cheap, or you can get it good.

After vacation, I returned to work to find my coworkers complaining about how another department’s lagging is causing treatment delays, appointments to overlap, and general dissatisfaction among the nurses, and patients. These complaints from nurses and patients seem sucked up into the Bermuda Triangle of hospital administration.

You can get it fast, or you can get it good.

The airline industry has been cutting back services and raising their prices for a while now. Pop up airlines offer lower prices at the expense of customer service: fewer flights, possibly less crew. Perhaps it takes longer to access a new plane and flight crew when the unexpected occurs, creating long flight delays.

I suspect the delay in service to our patients may be connected to recent layoffs. Although I’m not aware they directly affected this department, layoffs mean that those of us remaining with jobs that impact patient care are doing more work with fewer resources. It takes longer to provide services when a department is unexpectedly short staffed, or hospital census rises unexpectedly.

Once again health care imitates the airline industry. You can get it cheap, or you can get it fast. It’s still possible to get it good, but you can’t have all three.