Thank You, Come Again

I have noticed that an increasing number of places (mainly food places that lie somewhere between fast food and restaurants) require all their employees to thank the customer as they exit.  It is a good customer service practice to thank the customer, but the way these places do it is completely misguided.  When I finish a transaction somewhere, I expect that the cashier or whoever is helping me says "thank you" or "have a nice day" but when it is forced, or at some places is required, I'd rather them just not say anything. 

One place that I've seen this for a long time is a pizza chain.  I do like their pizza and their service is generally very good, but they do have that problem of the forced thank-you.  When a customer leaves, the person at the counter says something like "pizzas going out" and everyone else in the place says "thank you," in a sort of monotonous unison.  Sure, it would be nice if a few people showed their appreciation of the customer's business, but when they are prompted to do it for every single person that comes in, it gets really impersonal and is pretty meaningless.  I would much rather have the one person waiting on me thank me or wish me a good day in a sincere way. 

I was at a place that did this on Saturday, too.  It was a sushi restaurant that offers both take-out and sit-down dining.  Every time the bell at the front door rang to indicate that someone was exiting, the whole staff said something all together.  Some of them spoke Japanese, some English, and they all said different things so the conglomeration of voices was usually quite unintelligible.  Again, a sincere "thank you" from the cashier would have meant a lot more than the disjointed (and probably management-mandated) remarks from the rest of the staff.  (These types of gestures remind me of when parents tell a kid to say "thank you" or "sorry"
 when they don't want to, and it is obvious that it is forced and not sincere.)  I'm not sure what they teach in retail management classes, but as a consumer, quality of sentiments is much more meaningful to me than quantity.

Thanksgiving weekend was a nice break from school.  I started the weekend without any plans, but as I heard from more and more people who were home from school for the holiday or who also didn't have plans, I ended up not having any free time.  It was nice to see everyone, some of whom I hadn't had the chance to talk to very much since the beginning of the quarter.  I also saw J. Edgar, the first movie I'd seen in a theater in well over a year.  It was a very good movie; good acting and directing, and showed a side to the FBI's history (and Hoover's personal life) that I hadn't known much about.  All-in-all, it was a busy but relaxing weekend, which makes going back to school for these last three weeks all that more dreadful.  But Christmas break will come soon enough…

Thanksgiving

I just got back from a lovely Thanksgiving dinner at my aunt and uncle's house.  Thanksgiving is one of my favorite holidays because it is an excuse for the family to get together and enjoy each other's company, plus there's always great food.  This year we had the usual foods, including turkey (of course), green bean casserole (with honey bunches of oats on top instead of corn flakes), brussels sprouts with bacon bits, stuffing, potatoes, and gravy made from the turkey drippings.  A couple new things this year were a Quinoa casserole-type dish that my sister made (very tasty) and a different pumpkin pie recipe.  The spices were a bit different than usual plus the crust was to die for.  It was made with half vodka in place of water, which allows for a moister crust when rolling it out, but then it bakes out, leaving no flavor and making the crust with just the right amount of fluff.  Overall, a fantastic dinner.  I made an appetizer (with the help of Martha Stewart) of a blend of cheeses, formed into a log, covered in roasted pistachio nuts.  It took about 2 hours to make (which included shelling and chopping about a pound of nuts) but turned out great.

One thing we do every Thanksgiving is the Christmas grab-bag.  It can be called other things, like Secret Santa, etc. but basically, each person draws a name from a hat (we actually used a top hat this year) of a person to buy a gift for.  It is a little complicated, since the only rule is that you cannot select yourself or any member of your household.  With one family of five, we usually have to draw a couple times to get it right.  Amazingly, though, this year we got it right in one try.  This was after we got the rules straight, though.  My grandpa's sense of humor (when we can't tell if he's kidding sometimes – he's a master of timing and keeping a straight face) is always a highlight of family gatherings.  He played along as if he didn't understand the rules and it took us three or four minutes before we realized he had us in a "who's on first"-type circular conversation about who he was allowed to draw out of that hat.  For the second year in a row, I didn't draw my cousin Daniel (who I drew almost every year before that, only to buy him "dangerous" gifts like knives or zippo lighters).

My youngest cousin had the idea this year to make a "family turkey," which was a turkey she drew, to which we each added a feather that said what we were thankful for.  I had a slight deja-vu moment when we read them aloud after dinner, reminding me of when John Lithgow's character's family did this on Dexter, but since there was no serial-killer vibe, all was good. 

I hope all my friends and the family who wasn't there had a good Thanksgiving.  If not a good visit with family, then at least a nice break from work or school.  It's sure nice to have a long weekend.  Who knows, maybe I'll even start getting ready for Christmas, my favorite time of the year.  We already have the stuff to make the first batch of fruitcake (good fruitcake, not like the bad reputation it usually gets) and pretty soon it will be time to start making cookies.  I think I made at least 20 dozen last year; I don't know if that will be possible again, while working full time over break, but we'll see…

Your brain gets smart but your head gets dumb

One class I am taking right now involves reading 3 or 4 studies or journal articles each week then writing a summary of the strengths and limitations of each.  Then, in class, one student presents the article over 10 minutes, then we discuss it.  This could be a good way to learn how to critically analyze the primary literature, but it seems to be just a waste of time.  We have to read the articles as preparation for the discussion, yet we are also forced to sit through a ten minute presentation over the article.  It feels very redundant.  The presentations are usually pretty bad, too.  Many people write a good outline, but then just read it, almost word-for-word.  The only thing worse than listening to someone do a presentation word-for-word is having a copy of the outline in front of you so you can see all the things they misread or present incorrectly.

The organization of this class is also very higgledy-piggledy.  There seems to be a disconnect between the lead instructor/"course master" (I have always thought this term to be pretty funny – makes me think of a Darth Vader- or Voldermort-type arrangement) and the people who lead each discussion section.  Expectations are often unclear and only given to students hours before a deadline or just after the assignment has been turned in.  As someone who is so compulsive about organization, this bothers me to no end.  I'm just glad I got the section leader who is most lax about assignments.  As long as we get the gist of the assignment, we get close to full marks.  Other sections' assignments get nit-picked for each little technicality.  I feel bad for them, but I can't complain since I'm not in that boat. 

I had to give a presentation today about a review article on Chemotherapy-Induced Nausea and Vomiting.  For some background, we just got done with a grueling 4 weeks of lectures on Chemotherapy and an exam (mere hours before I prepared this presentation) that was 22 pages long.  The outline we are supposed to use to present our articles is designed for such things as randomized-controlled-trials, which are much more complicated that this article I was assigned to present (which was just an overview of a topic).  So the last thing I wanted to do after a solid weekend of studying and a long exam was to read an article giving basic information about a topic for which I had already memorized all of the guidelines.  I managed to write my presentation outline without even reading the article.  I thank the IB program in high school for teaching me that skill (when I mastered the art of participating in discussions and writing papers about books I hadn't read).  I don't feel too bad about not reading the article, though, since last week when someone asked a complicated question about one of those studies we were supposed to have read, our instructor admitted that she "ran out of time and didn’t actually read it."  I can't see any reason that I should read all these articles when the instructor isn't going to take the time to do the same.

It's too bad that this class was such a combination of useless busywork, circular discussions, and wasted time, since the subject matter could actually be useful in the future.  I did learn some things about how to evaluate the scientific literature, but I think I could have learned a lot more with a better-designed course that was founded on better organization and inter-instructor communication.  Throughout the quarter, I felt like I learned nothing and that the only purpose the course served was to drive me crazy, but looking back, I guess I did get a little smarter.

One more paper to write and 5 more hours of class until Thanksgiving…I can't wait for 4:30 tomorrow afternoon!

E-Prescriptions: A good thing?

As we move into the future of computers and the internet (I know, that started a long time ago, but it's a long process, especially when lawmaking is involved), it is becoming more and more common for doctors to send prescriptions to pharmacies online.  Originally, the only way to transmit a prescription was via a hand-carried piece of paper or a direct phone call.  Then, faxing prescriptions became commonplace.  This is still one of the most widely-used methods of transmission, especially for refills.  But now, doctors can instantly send prescriptions to be filled without depending on outdated facsimile technology or encountering the possibility of a hard-copy prescription being lost (or modified) on the way to the pharmacy.  Seems like a good idea, right?  It is.  But there are quite a few issues with the system.

The first issue is the ease at which a doctor can submit a prescription.  They can pick a drug from a menu, enter directions, and press "send."  They can also approve refill requests with the press of a button.  These things that make it easier and faster for the doctor also increase the possibility for error.  I received an e-prescription last week that was for a routine medication for a patient that had been on it for a long time.  I started to enter it, but then looked at the date.  It said it was written 07/24/2009.  The patient was due for a refill and the doctor had sent five or six other prescriptions at the same time (with the correct date), but I called to verify the prescription.  The nurse said they didn't receive our request for that refill and that she did not send authorization.  Yet somehow, I had, in my hand, a prescription sent 11/17/2011, but written over two years earlier.  It seems they inadvertently pushed a "refill" button on an old prescription and unknowingly sent it to us.  I caught it because of the date, but if the date had been auto-entered as today, I surely would not have noticed anything out of the ordinary and it could have resulted in a prescription being dispensed that the doctor did not mean to request. 

The other issue with the ease of use is drug selection.  I haven't seen it as much recently (maybe they have made some improvement to this part of the process), but sometimes we get an e-script for a drug that seems really odd.  When we call to verify, they say they actually meant to order the drug that is listed one line earlier or later, alphabetically.  They can apparently pick drugs from drop-down menus and if they simply click a little too high or low, it could result in a major error.

The second issue is the lack of clarity in directions.  This is sometimes a source for a good laugh, but is also sometimes worrisome.  Most of the time, the directions are clear enough that we can interpret them, but they're not what they say they are.  I'll give an example of an eyedrop e-script I got last week: the directions said to insert 4 capsules in the right eye four times a day for a week.  It also said I was to dispense 1,000 mL.  I can't imagine inserting a capsule in my eye, let alone 16/day.  Plus this is the first time I have heard of dispensing a liter of eye drops at once (they usually come in sizes from 2.5-15mL).  It got a good laugh out of everyone in the pharmacy and I could make sense of what they probably meant, but if they can make an error this big without noticing, it must be very easy to make a smaller error that may not be caught and ultimately result in harm to the patient.

E-prescriptions are also supposed to be a step towards becoming less dependent on paper.  However, we are required to keep paper copies of all the prescriptions we fill, so it doesn't do the "paperless society" much good for the doctor to save a piece of paper when we just have to print it out anyway.  Also, there's a feature where we can import the data from the e-script right into the pharmacy software, but by the time you correct all the little errors it is faster just to enter it from scratch.  For example, directions that intend to say "take one tablet daily" may come across as "1 PO QD by oral route daily (tablet)" which you have to clear completely out and enter directions that can be easily read.  Also, when you correct something, it clears what used to be there, so you have nothing to refer to if you forget what it said originally.  Thus, printing it out is necessary for one more reason and no paper has been saved.

E-prescriptions are a good idea and are an improvement over faxes in many ways.  They are not dependent on cleanliness of the scanner or quality of the printer, and don't have to wait for an open phone line, so can be transmitted much faster and reliably.  However, we still have a long way to go in improving software and designing better safety measures and double-checks to ensure that what is being dispensed is just what the doctor ordered.

Courteous, Cheerful, and Friendly

Why is it so hard for some people to be courteous?  I understand that everyone isn't in a good mood every day, but even when you're having the worst of days, it is still usually possible to manage the "please" and "thank you" that most of us were taught to use from a young age.

One of the things that I do at work is transferring prescriptions between pharmacies.  This is a process between two pharmacists (or interns) and I would think that at least some professional courtesy would be shown, or maybe even some friendliness.  I have noticed a trend that many chain pharmacists do not show this basic courtesy when calling another pharmacy.  I got a call last night that started with (in an abrupt tone) "This is Costco.  I need a transfer."  I gave the pharmacist on the other end the information he needed as he asked for everything in as few words as possible.  There was not a hint of cheer or anything friendly in his voice, and the call ended with an unenthusiastic "thanks."  (I don't mean to single out one pharmacy, as this happens with many other chains; Costco is just the one I spoke to last night.  I also don't mean to generalize without foundation, but it is a definite trend; the same process is much different between most independents.) Would it have been so hard for him to start the call by saying something like "Hi, this is so-and-so from Costco in Woodinville.  I would like a transfer, please." or ending the call by saying "thank you" sincerely or wishing me to have a good evening?

There is also sometimes a lack of courtesy with customers.  Whether someone comes up to the counter or drives up to the window, I always greet them with a sincere "hello" or "good evening."  About one time out of three, the person just barks their last name, indicating that they have a prescription to pick up.  It doesn't take much more effort to say, cordially, "Hi, I have a prescription to pick up for so-and-so."  There are also those who I have never seen smile, throughout the many years they have been coming in.  I wonder how people, like that, who are never cheerful or friendly can live a happy life.  Or maybe they don't.  Obviously they were never scouts...  I just continue to be courteous, cheerful, and friendly with them, even if they never are in return, and appreciate the majority of people who still remember the basic sincerity of "please" and "thank you."

Sometimes when I deal with someone who just doesn't seem capable of smiling or exchanging basic pleasantries, I think of this poem we learned in preschool:

        How d'ya dootee, how d'ya dootee, how d'ya do today?
        Do you live where you used to live, or have you shifted away?
        I'm sorry you're so disagreeable, I only stopped to say...
        How d'ya dootee, how d'ya dootee, how d'ya do today?

Where did the work ethic go?

I was being rung up at QFC last night by a guy about my age who was the only store employee to be seen.  A line was forming behind me (apparently the 9:30pm rush) and no other cashiers were to be seen.  I made some comment about that and he said, "do you ever look around and notice you're the only one working?"  I smiled and agreed as I get that feeling all too frequently.

I've noticed, since I started working, that many people don't have much of a work ethic.  I have always thought that when I was being paid to work, that is what I should be doing.  Sounds pretty obvious, but apparently it's not to some.  When it's slow, especially in the late evenings, it isn't uncommon to see someone doing something completely unrelated to work: checking email, chatting with a co-worker, etc.  I'm not saying you can't have a conversation with a coworker about something other than work, but it is possible to multitask, even if it's just something mindless, like filing, that needs to be done.  This kind of thing is frustrating to those of us who work hard from the time we start a shift to the time we are off.   It makes more work for us, plus we are both getting paid comparable amounts of money but not doing nearly comparable amounts of work.  Also, it is very annoying to be waiting for help when you go to a store and you have to wait for someone's conversation about their new shoes to end before they even acknowledge your presence.

I'm thankful to work at a place where this work ethic deficiency is rare.  Most of the people I work with are fantastic, which is part of what makes my job so enjoyable.  It's too bad, though, that this problem is spreading.  More and more people at different places you go just don't have the motivation to get to work on time, to do the job they're there to do, to search for other tasks when their regular duties are complete, or to go out of their way to help the customer.  It's too bad that so many of today's kids are being raised to be lazy; I'm just glad there are places to work like Camp Parsons that can teach you how to be a useful member of society and a hard worker.

As an aside, I started rereading all of the Harry Potter books last week.  Listening to them, actually, at the suggestion of my favorite Harry Potter expert (there you go, Chris, you've been mentioned).  The audio books do have a couple advantages over reading: I don't have to carry the heavy book everywhere and can listen while I drive around or walk through campus.  Also, I have the tendency to read more quickly during exciting parts of books and miss details.  Plus, Stephen Fry's voice is just delightful.  I just hope that I still pass my classes while listening to the books for such a large portion of the day.  I guess if I could pass the first midterm while watching the entire series of Scrubs the first half of the quarter, I can manage this…

Is classroom technology really an improvement?

One of the biggest problems I have had with school in the last 5+ years is the misuse of and overreliance on powerpoint and other "newer" technology.  Don't get me wrong, PowerPoint is a great tool for doing presentations that require visual aids, but that is not what it's being used for.  I've noticed more and more, though, that many teachers who use powerpoint rely on it as their only source of lecture material and hardly add anything.  I find it very frustrating when I go to a class with the printed slides in hand only to find that someone is going to stand in front of us for hours on end and simply read or paraphrase what they have already given us in advance.  That defeats the purpose of even attending these lectures, since the same knowledge can be gained by sitting at home and reading it myself.  The best use of PowerPoint I have seen is when either a very basic outline is put on the screen or even just the visual aids (photos, graphs, tables, etc.) are put up with no explanation.  That explanation should come from the instructor himself.

I find that I learn more from professors who use the "old fashioned" method of teaching, with just notes for themselves and a blank overhead projector.  They will often give us a very rough outline of their discussion with background information and figures too complicated to draw ourselves, but the bulk of the relevant information comes from their lecture itself.  That way, they can teach us something beyond what is in their outline or notes and we actually get something out of coming to class.

The overhead projector is really a useful tool and it is sad to me that the University is encouraging professors not to use it any more.  It can be written on directly as well as can be used to display figures printed on transparencies in advance.   The only thing that can go wrong is a burned-out lamp, which is an easy fix and doesn't happen all that often.  With computers, projectors and screens that automatically raise and lower themselves, laser pointers, and document cameras, there are too many components to go awry, which they often do.  To make matters worse, it is only once in a blue moon that a teacher comes along who actually knows how to plug their computer in and get the image to display on the first try, let alone troubleshoot projector or computer problems.  Most of them can't even get the microphone or lights to turn on properly.

There is one class that stands out in making me lose all confidence in its instructors.  The first lecture started more than fifteen minutes late because they couldn't get the PowerPoint presentation to display in full-screen mode on the projection screen.  After many reboots and a delayed visit from IT Services, they got it running, but lost more than a quarter of the lecture time and didn't ever cover the material that they had to skip.  They were literally unable to give the introductory lecture for this course without their prized PowerPoint presentation.  That really says something about their preparedness for the class and their knowledge of the material beyond what they had mindlessly entered into the slides.  For the second lecture, they tried to use audience response devices ("clickers") for pre-lecture questions.  When they finally got that working (after 15 minutes), they didn't contribute in the slightest to the discussion, and again, a large chunk of time was wasted.  Regardless, the material they did cover was all written on the slides, and nothing was added.  I haven't been to that class since the second lecture.  I just refer to the presentations they post on the website and haven't missed a beat with quizzes or assignments.  

Just one quick note about SmartBoards... 

They had just started installing these $30,000+ devices in classrooms as I finished high school, and one of my current classrooms is the host to a brand new one this year.  For anyone who hasn't had the honor of basking in this device's technological glory (that was total sarcasm, by the way...), it is basically a glorified white board that is connected to a computer.  Because the instructors don't know how to use them, they can't even write or erase with the special expensive pens.  When they finally get the pens to work, they are non-responsive and have the ability to turn even the best penmanship into chicken-scratch.  So rather than a white board that could be used to write and draw, we have this expensive and currently useless piece of metal and plastic that can't even do that most of the time.  So this is where our god-awful high tuition is going...  (Besides, in replacing the old white board, they left unpainted sections of the wall and unfilled gaping screw holes, so now that wall looks atrocious...)

PowerPoint has been more of a hindrance than a help except in the rare cases that a professor understands its intended use and how to utilize it properly.  The only thing accomplished by all this technology (except in a few exceptions) is a crutch that mediocre instructors can use to skate by, lecture after lecture, without really doing any more than reading something off a screen.  Why do we pay so much in tuition and devote so much time just to listen to these people read to us?  I probably sound like an old person, but let's just stick to the basics and stop trying to bite off more technology than we can chew.