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In a world where its inhabitants are slowly losing the ability to meaningfully communicate with each other, devolving into basic grunt-like tweets or blasting a collection of emojis or memes to convey current moods or emotions, a well thought out formal letter is becoming increasingly rare.

But this makes the letter that more impactful when it is received by its recipient.

I will be the first to admit that if it were not for blogging, I too would likely be relegated to using the modern-day version of hieroglyphics (emojis, etc) on my smart phone to convey my thoughts.

It actually is quite sad because I do think there is a part of our brain that will atrophy without creative literary stimulation, both through reading and creative writing endeavors.

[This is another reason why I think blogging is helping me to preserve my intellect and hopefully stave off the effects of an aging brain as long as possible.

I therefore fully encourage others to consider blogging to reclaim your creative intellectual side before it is too late.

Your brain will thank me for it.]

The $10k+ Letter.

I rarely am moved to write a letter.

It is even rarer that I write a letter of complaint to a company.

But sometimes I get so upset with a particular company that writing an angry letter is exactly what I do.

It may take 5-10 minutes of my time and I usually feel better after voicing my frustrations.

This letter may end up falling on deaf ears (blind eyes?), but ever so often this angry missive sets into motion a chain of events that even I could not have anticipated when I was first putting pen to paper.

One such instance of a letter having such a dramatic impact with a substantial financial reward at the end of it was the inspiration for this post.

Background.

When I first joined my current practice back in 2006, the Radiology department still operated under a film-based system.

Having been trained for the majority of my residency using actual film, this was not a deal-breaker for me when I was considering this practice.

But eventually the practice grew.

Dealing with all the films generated and the inefficient ways of reporting a study became quite tiresome.

So my colleague and I at the time really pushed for the group to transition into the 21st century and revamp the radiology department with a digital system, the centerpiece of which was PACS (Picture Archiving and Communication System).

Being the brain and heart of the radiology department, the PACS system is quite an expensive capital expenditure.

I don’t recall the exact numbers, but I believe the PACS systems we were considering in 2007 were over $300k.

As part of a for-profit, multi-specialty physician owned practice, the biggest obstacle was pushing this request through the Finance Committee which typically considers “bottom line” numbers.

This made the request for PACS even that more daunting as having a PACS system did not really bring in more money for the department.

Insurance companies pay the same for a study whether it was read on film or on a digital format.

Initially there was push-back from several doctors when the request made its rounds as they thought this capital expenditure would solely benefit the radiologists by making their lives easier.

We also had just began transitioning into my current medical building (the one that I invested in on the ground floor and was my grand slam investment to date).

The transition to the new building was being done in phases.

In 2007 we had two bases of operation as part of Phase I, with the radiology department split inefficiently between the two and requiring my partner and I to man each one separately.

To make matters worse, the workload at each location was asymmetric as the majority of the practice stayed in the original location until the final Phase II move.

I thought this was certainly the best reason to have PACS so that the worklist could be split equitably regardless of where the radiologist was.

Some of the partners still balked at the price tag and even suggested that a courier be hired to transport the films to the other location for that radiologist to read at set intervals.

I just envisioned having these infrequent courier deliveries dumping loads of studies to be read at once.

This bolus type workflow would have been incredibly disheartening and certainly have fueled the fires of burnout for me.

Thankfully the finance committee and board of directors did come around to the radiologist’s viewpoint and approval was given to implement a PACS system.

The courtship begins.

Once word got out that our practice was looking to implement a PACS system, my radiology department got wined and dined by vendors hoping to curry our favor.

This was something my partner and I were not used to as radiology typically is the redheaded stepchild of medicine that hardly ever gets courted by drug reps or other vendors.

Even though we play with the most expensive equipment in any medical setting, it is not something that garners frequent rep provided lunches, etc.

This was in stark contrast to when I was a surgery resident and drug reps would bend over backwards trying to make sure we had their products in the back of our mind when it came time to writing prescriptions for postsurgical patients.

We eventually put our trust in AGFA Healthcare who touted a great PACS system that would handle our needs and came in at a competitive price.

The package we purchased included all sorts of goodies that would allow us to analyze data and help improve our ability to interpret images.

It was the promise of one such goody by AGFA that led to the inspiration for this post.

The Honeymoon was short lived.

Nowadays all radiologists have at the touch of their fingertips the ability to quickly pinpoint an area of interest in the 3 standard radiology views (Axial, Coronal, and Sagittal planes).

Back in 2007 this technology was at its infancy but still light years ahead of what was possible with film based imaging.

I forgot what the exact package AGFA had promised was called, but it was a volumetric based imaging add on that was supposed to simplify vascular study interpretation and had other uses as well.

After touting how amazing this package was and how fortunate we would be to have it, I was anxious to put it into practice.

Once AGFA personnel came and set up the entire system and handed us the keys, I came to realize that we never got what was promised (the icon to implement the software for the volumetric component remained greyed out and inaccessible).

No worries.

I informed my office manager to let AGFA know about the issue and thought this would be an incredibly easy fix for them to make this feature accessible.

So I waited.

And waited.

And waited.

Days became weeks became months.

I know my office manager kept on giving them periodic reminders (at my insistence) saying that a promised feature has not been activated by them and that they should rectify this oversight.

Putting pen to paper.

I am not sure when I snapped, but I am sure it was at least 6 months into having the PACS system running with still no access to the promised module.

I finally asked my office manager if she could get the contact details for the CEO of AGFA.

In between cases, I wrote a one-page letter to the CEO indicating how displeased I was about how AGFA has handled the situation up until that point.

I wish I kept a copy of the letter, but I didn’t.

I do, however, recall some of the key statements I made in the letter.

I told how disappointed I was in how we were being treated after the equipment was in place and the check cleared.

I mentioned that, as a 2-radiologist radiology department, we may not be one of their larger clients but that does not mean they were entitled to treat us like second-class citizens because of it.

I highlighted how they bent over backwards doing everything during the courtship phase when we were considering different companies but now we were being treated as an after-thought.

I also mentioned in passing that I would not in good conscience recommend his company to any of my radiology colleagues.

The Aftermath.

It was quite stunning what occurred shortly after I had that letter mailed.

Within two weeks my department was notified that AGFA was sending senior members/executives to my department.

I believe 3 suits showed up and they all profusely apologized for what had occurred.

They promised to rectify the solution in a timely fashion (which I think was accomplished within a month of their visit).

And as a token of apology, they offered to throw in a bonus software upgrade for free that would allow us to enhance bony detail on plain films (X-rays).

I later found out that the software upgrade was normally a $10+k added charge.

To be honest, the missing feature module that started the complaint ended up not being that great and rarely utilized.

The bonus apology upgrade, however, was far more valuable to me in my practice and I still use it to this day.

Takeaway:

A written letter has the ability to have a profound impact on its recipient, especially if it is a letter of complaint to a company.

Even the act of writing a letter of complaint, regardless of the outcome, is quite cathartic.

From a business standpoint, it is important to treat all your customers with the highest level of  service regardless of how small the account may be.

All it takes is one unhappy customer who feels mistreated to lose potential business as this customer is more likely to share this dissatisfaction with others.

Note:

If you are in search of financial help, please consider enlisting the service of any of the sponsors of this blog who I feel are part of the “good guys and gals of finance.”

Even a steadfast DIY’er can sometimes gain benefit from the occasional professional input.

-Xrayvsn