A frustrating encounter with a medical specialist’s office has me thinking about the relationship between trust and risk-taking.
The more we trust, the less risky something feels. And as we demonstrate trust, we minimize the likelihood of things going wrong in a relationship and improve the chance that we can resolve any problems that do come up.
I was supposed to have my first appointment with this specialist tomorrow, but the pre-check-in process got my hackles up. First, it was the supposedly nifty-difty HIPAA-privacy-compliant but extremely user-unfriendly system they used.
Then it was the language that suggested that their first concern was that every new patient would be a deadbeat when paying their bills, and demand for a credit card to be left on file or a cash deposit left before any services.
There was no mention that they gave a rat’s ass about listening to patients and providing care –which should have been the first message they conveyed.
In hindsight, this clear indication of lack of trust in their clients, combined with the lack of interest in making sure their patients trusted them, should have sent me running immediately. But I had been waiting six weeks for the appointment, so I kept on going with the pre-check-in.
Eventually I got to the part where I was supposed to accept their privacy policy and then their financial policy. A paragraph repeated their implied assumption that they would have trouble collecting, then directed users to the full financial policy to a link on their website that did not work.
The system then froze. I was able to text them to ask for a pdf of the financial policy since I was not about to sign that I agreed with something I had not read. They repeatedly re-sent me a pdf of the privacy policy, which I did not need –since anyone in the United States gets a copy of these every single time we see a medical practice, killing countless trees in the process.
Then they re-sent the acceptance form with the link to the financial policy, which STILL did not work. Thinking that another medium might work better, I asked them to send the financial policy pdf to my email instead of via phone text. They said email was not HIPAA compliant –even though HIPAA does not cover financial policies, just medical information. They then sent –AGAIN—the non-working form with a demand for me to sign my approval of something that I could not access.
I gave up. If dealing with them was this bad before I even walked in the door, I could not imagine what it would be like when dealing with actual medical issues. I definitely did not trust them to keep credit card information on file. I flashed back to a similarly flaky front desk at another provider a few years back, where the medical care turned out to be just as disappointing as the front desk.
When I lost trust in those specialist practices, they lost a client.
No doubt both had had bad experiences in the past with getting patients to pay, but that was not my fault. And no doubt the practice’s lawyers had warned them six ways to sunrise about HIPAA violations. So they overcompensated on both counts.
Unintentionally Creating New Risks
The episode reminded me of recent conversations about lawyers and risk. This spring, during the Q&A after a presentation I gave on why and how people choose which risks to take, a man in the audience asked, “Do you think lawyers should be doing more to minimize risks?”
In fact, I told him, I’ve found that lawyers try so hard to reduce certain risks to zero that they are prone to creating unintended risks, whether losing clients or contractors, or making already angry clients even angrier. I talked about this more recently with Steve Fretzin on his excellent Be That Lawyer podcast. (Listen below)
If you ever watch medical dramas, no doubt you’ve seen at least one episode in which the doctors make some sort of mistake that raises the possibility of a lawsuit. The lawyers then insist that the doctors not acknowledge the error, much less apologize for it, lest they provide evidence that they are to blame. Yet in so many cases, an apology is exactly what patients need in that moment; it’s what is most likely to prevent the lawsuit.
Intellectual Property Rights
I’ve also noticed recently that more and more podcasts are taking their lawyers’ advice to ask guests to sign forms that hand over every right possible in any form of media known now or developed in the future.
This has been a trend since the landmark Tasini v New York Times Supreme Court case which found that newspapers and other media companies owed freelancers compensation for the quite considerable royalties that the companies had made from making articles available to database companies without permission from the authors. Lawyers responded by adding everything but the kitchen sink to contracts without additional compensation.
Another prospective client’s lawyer tried to do a back-end grab that would have given them rights to the intellectual property on which the insights I gave to them were based. In other words, a license to re-use ALL of my work without additional compensation.
If these podcasts and clients had not changed their tune when I pushed back, they would have lost a guest and an expert because of their insistence on owning intellectual property they might or might not use in the future. Not a good trade-off.
The Risk of Using Intermediaries
Similarly, another company used a third-party contractor processor that demanded private information for which they had no need nor right. I get that the client and the processing company were trying to avoid any possibly regulatory issues including making sure that they did not mis-classify a contractor as an employee. Considering the amount of money involved, any person with the slightest bit of common sense could see that it was nowhere near the 85% of my income threshold that the U.S. government uses in determining who is an employee or not. Their demands would have been intrusive and unacceptable even for much larger sums.
I had a good relationship with the client. But I did not know this processor from Adam, and it was staffed by inexperienced, disempowered paper pushers with no flexibility for using common sense.
Through their unreasonable demands, the processor –and, in turn, my client— had signaled that they did not trust me on a number of counts. In turn, I could not trust them with private information. Nor do I have any interest in working with clients where there was not mutual trust. So I declined further projects. Their loss.
Companies who use third parties to handle relationships should think hard about the risks that a bad intermediary poses to their own reputation, and whether the trade-off is worth it.
A Better Way
What should that medical specialist have done? Their priority should have been to make it clear why patients should trust them. That includes showing trust in their patients by switching from a guilty-til-proven-innocent attitude to an innocent-until-proven-guilty attitude. They could have used much softer language. For example: “If you would like to leave a credit card on file to make payments easier, please let us know. Here are the XYZ things we do to make sure your information is safe.”
To be sure, more aggressive language will scare away the deadbeats. But people who pay promptly really hate being treated as if they are deadbeats. Taking the risk that a company might have to chase some payments is a much easier bet than the near-certainty that they will lose the prospective clients who are most likely to pay promptly.
Similarly, intellectual property lawyers would do well by asking only for what they need; a license rather than transferring copyright, for example.
And companies that use third parties to vet and pay their contractors had better do their due diligence on those third parties to reduce risks to their reputation and the possibility of making it nearly impossible to retain talent. Sometimes, keeping things in house is the smarter way.
Trusting often feels like a big risk. But not trusting can be a big risk as well.
This article is part of my LinkedIn newsletter series, “Around My Mind” – a regular walk through the ideas, events, people, and places that kick my synapses into action, sparking sometimes surprising or counter-intuitive connections.
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