Early in my career I worked in medical research and our unit did chemical analysis on patient blood samples
The machine would perform multiple tests simultaneously at no added cists as part of the analysis and output the results from the full suite of tests automatically.
We actually had to perform extra work to suppress the reporting of the tests not specifically ordered a given physician for a given patient on a given day.
Rather than simply sending the entire suite of test results to the doc which would have given him the best information about the physical condition of the patient, we had to suppress any thing not on the write up.
Worse, the hospital charged for each individual test parameter, despite the fact that they were done automatically at the same time on the same instrument and all for one cost.
If the doc specifically ordered one of the tests whose results we normally manually suppressed from the report, the patient was charged up to a thousand dollars EACH for reporting and not suppressing each of the additional test results requested.
Patients died, did not fully recover, had longer hospital stays and experienced less successful and satisfactory outcomes because nobody could afford to pay the piecemeal prices for the results of the of the full suite of test despite the fact that the results were all generated automatically at the same time for one cost and it actually cost labor time and money to suppress the results when the full suite could have been provided faster and cheaper while proving vastly improved patient care with better outcomes.
Call me a bad, disloyal employee but I was press ganged into working the night shift alone as a student supporting intensive and critical care units due to staffing shortages and I ran my own show.
I made sure the docs and interns were aware of the situation and I was always overworked and under time pressure. Lets just say I was usually legitimately far to over worked and busy to spend the time suppressing the the test results and when not busy I became amazingly inept at suppressing the test results.
Patient outcomes improved due to better diagnostics and mortality and complication rates dropped, so much so that the medical staff began demanding the other shifts follow suit and begin handing out the full reports.
Now that the cat was out of the bag the situation came to the attention of administration
Much hilarity ensued as I became embroiled in the most enjoyable dispute in my entire career.
Went to work that night and met at the door by administration and security. Administrator informed me I was terminated on spot and would be escorted from building by security. Also was told they were petitioning for my expulsion from the university.
Unfortunately, the genius admin staff was unaware I was covering the shift alone and had failed to line up a replacement, which there wasn't. Security did not even get me as far as my car before admin was calling him asking him to bring me back.
By the time I hot back the admin suits were surrounded by angry and loudly complaining docs and they sheepishly had to beg me to come back and cover the shift - and then be put on administrative leave pending investigation to be fired. If I did, they would not pursue expulsion. Which I accepted
My suspension lasted about one glorious and peaceful week where I got my first full nights sleep in almost two year, became fully caught up on homework and actually had time to hit a few bars and go out on a date
The medical staff was agitating for my return and admin was discovering that my job function was an emerging specialist discipline self taught by by staff with very few qualified replacements and none that they could hire, much less capable to work the night shift solo.
Was really enjoying freedom to be a normal student . They tried to recall me to work - all dins forgiven Didn't want to go back and refused to even meet with admin pukes but the docs convinced me to come back to work - at professional pay rates instead of student wages which amounted to a $30 per hour pay raise - with benefits (both if which which I should have been getting before)
After a few months, admin realized that not only were the improved diagnostics really improving patient care, the revenues from the testing were , paradoxically, increasing exponentially.
Turned out the cost - benefit for the individual test results caused the docs to ration testing to minimize costs and nobody could afford to order multiple results at piecemeal billing rates.
However, publishing the entire suite of results at price of what was previously the cost of one result was so compelling from a cost - benefit that docs could easily justify frequent testing as SOP. Revenues skyrocketed and they invested in several more if the expensive analytic systems to meet demand while further reducing price per test due to improved economy of scale
There are some lessons there. Some I learned from, some i’ll probably never learn.
One take away is that reducing costs and improving and expanding service to provide best quality care at lowest possible price beats trying to soak customers for money using high prices and rationing of services and care when it comes to revenue growth and profitability
Interesting times for kid just turned 21.
Quite a story!