<div>Dr Tara Chaitanya was stunned to see the installation engineer walk out of her clinic casually. After much drama — and four week’s delay — the AA-SW13, a top-of-the-line ultrasound machine, had been installed. But uniquely, when she tried to fiddle with its keys, the machine had failed to respond! <br /><br />Tara, who had to deal with so many problems during the purchase of the AA-SW13 from Company A, had been alarmed. This had been a huge purchase, made with her life’s savings and her husband’s...Why were the keys not responding? What else was going to fail? But Rasesh, the installation engineer, had pressed a few keys and remarked: “Just press two or three times, it will be all right, slowly-slowly...” And when a stunned Tara had protested that it was not normal, Rasesh had shut shop saying, “My job was to unbox the machine and set it up. I have done it. You please call the company and log in a complaint...” All Tara could do was refuse to sign his installation report.<br /><br />Tara called Company A’s Awasthi, the regional sales head who had sold her the machine, and told him stiffly how shocked she was. Awasthi tried to placate her, saying: “These things happen. Keep using, over a few days the machine will settle down....”<br /><br />That same refrain! “What do you mean settle down,” she asked. I have unboxed similar machines in the past, they never behaved like this! I am not using a whimsical machine! The AA-SW13 is a healthcare device, not a plaything. I don’t buy this ‘settling in’ logic! There is clearly a malfunction, please come and fix this!” <br /><br />She waited for a day, and a week, then a month. Her attention now shifted from her patients to the machine and its whims. Press the keys gingerly... look at the screen, did keys respond? No?... This was not how the machine was meant to work!<br /><br />Company A did not jump to attention and Tara kept calling Awasthi asking him to change the keyboard. Yet Company A kept stonewalling, call after call. Till one day another service engineer Paul Anand landed up for a probe calibration. Young, bright and just out of college, he immediately acknowledged the problem. Testing the keyboard, he agreed that several keys were unresponsive. Thereupon Paul called the call centre and ordered a replacement. And within seconds, Tara even got a confirmation SMS! <br /><br />And sure enough in two days, the new keyboard arrived. The simplicity with which the problem was fixed astounded her. Paul had called the call centre, not his boss, and ordered replacement with confidence. It took him 20 minutes to open the machine cover, unplug the old keyboard from its connector, replace it with the new one, and screw back the cover. <br />Dr Tara: Why was your colleague unwilling to admit there was a problem? <br /><br /><strong>Paul: </strong>Just different people, I guess. (Then dropping his voice) Please don’t quote me, but sometimes engineers do not withdraw spares since they are appraised and evaluated on how low their spares consumption is! That’s also the reason my boss would not have supported me if I had called him for the new keyboard. But I made the call directly to the call centre. That call from a field service engineer cannot be buried...”<br /><br />Tara was further stunned. Company A’s service-ability was clearly person-specific! She had been compromised in order to aid someone’s appraisal! Company A prided in being a world-class organisation, but its service team could tweak the system to ignore her pending service calls, and even her refusal to sign off on installation closure, which were less important than the value of spares withdrawn? The scales fell from her eyes. <br /><br />Anyway, the AA-SW13 was now working fine and her practice was back to its pleasant hum. <br /><br />A year later, Awasthi asked to meet Tara to present to her why she should consider upgrading to the new model, AB-SW15. He chased her, left numerous messages... This was the same man who had absented himself when she was in difficulty. <br /><br />But Awasthi was a salesperson and knew where to mine his commissions. He followed up repeatedly to tell her about the special offer: Company A will take back the AA-SW13 at nearly 40 per cent of the cost of the SW15. He hard sold that the SW15 featured not only a new software version and a faster processor but also boasted of a new feature, cavito-sonometry. Tara had been hearing of cavito-sonometry — Company A had been drumming up its benefits for over six months at every conference. The new feature will be a good addition, she thought, a scanning modality for the future.... She was familiar with the series too and some leading specialists had recently upgraded to this model. Tara accepted the offer. <br /><br />And so the premium SW15 was ordered. Of course, it arrived late yet again! And with a fresh bag of problems! Unbelievable! <br /><br />This time the keyboard worked fine — but the touchscreen did not. The touchscreen, which was designed for the doctor to mark points and select areas on the image for various measurements, was now mere cosmetic. But this time, there no Paul who had left for higher studies. Another young service engineer, Aman Yadav, had taken Paul’s place. Tara again logged in her complaint, stating the touchscreen malfunction. <br /><br />Aman did not acknowledge the touchscreen as a problem. Even as he entered, he looked at the machine from afar and told Tara it was likely that her hands ‘got greasy through the day’ and touchscreens do not work if hands are unclean. His tone was offensive.<br /><br /><img width="300" vspace="4" hspace="4" height="175" align="right" src="/image/image_gallery?uuid=4306be07-0e7d-48e6-9bb4-2e3b58d4ff77&groupId=520986&t=1399976564765" alt="" />He hadn’t even tested the screen himself! And what was that about greasy hands? She had been working on touchscreen machines for years at her previous jobs, including the SW13! This man hadn’t even inspected the screen, let alone try it. And the next thing she knew, he was leaving. <br /><br />Tara was beginning to find all this surreal. Just then, her husband Shiv called to ask, “Did he fix it? What did he say.” He was worried. After all, they had just coughed up another Rs 25 lakh to upgrade! <br /><br />“Shiv, something is weird. The touchscreen is clearly not working and I have used these machines before, but this new service engineer they sent has come up with an absurd verdict!” And she narrated it to him.<br /><br /><strong>Shiv:</strong> Arre, but you use touchscreens all the time, your Nokia touch phone, your iPad... <br /><br /><strong>Dr Tara:</strong> I have been thinking. That man’s response was based not on reason but on conditioning. He spoke to me like he would to a woman in his environment, an unequal. <br /><br /><strong>Shiv:</strong> Then he shouldn’t be allowed to get away, whether he’s showing his incompetence, or poor attitude. <br /><br /><strong>Dr Tara:</strong> I am very angry. This is a top drawer machine manufactured by a Fortune 500 company. That automatically comes built with values, and must assure me right attitude and right approach. So, where does this guy come in? Oh, damn! <br /><br /><strong>Shiv:</strong> Perhaps you are right. He may be from a place where women are not seen in positions of decision-making and control. Hence, he lacked the script to speak with reverence. But... that does not exonerate him. So, he will learn on the job, Tara! I tell you this time and again, don’t be overwhelmed by the situation, instead overwhelm it. Climb above his disdain and tell him where he gets off! Never mind the machine.<br /><br />Sadly, Tara’s problems were only just resuming after a pause. For Tara, the machine was verily an extension of her brain. It ‘talked’ to her, performed the commands she ordered, while the patient merely lay down, placing total faith in the doctor, to find the problem areas…<br /><br />Tara was at a loss. In the absence of the touchscreen’s proper working, she was forced to use the keyboard, losing speed and precision. Presently a new quirk showed up (even as Tara promised herself never to touch Company A again and also warn all her colleagues). This one was a shocker. <br /><br /><strong>Read Analysis: </strong><a href="http://businessworld.in/news/case-studies/analysis-care-without-compromise/1362190/page-1.html" target="_blank"><strong>Harish Natarajan</strong></a><strong> And </strong><a href="http://businessworld.in/news/case-studies/analysis-be-aware-be-very-aware/1362155/page-1.html" target="_blank"><strong>Dr Uma Nambiar</strong></a><br /> </div><div> </div><div>break-page-break<br /><br />Tara used two printers to print out the high-resolution colour images of the scans (which she gave her patients as part of her report), and it had worked fine with the earlier AA-SW13 machine. Now, the printers had been connected with the AB-SW15 on which the printer driver software files had been successfully installed. But now, the new machine would intermittently not print the scan images. Patients had to be told to come the next day. They grew worried...<br /><br />But Aman blamed the printers, not the SW15. But the printers had worked fine with the SW13, then what was the problem? The printer was a DD790, manufactured by Dustin Dempa, a world class name in printers. DD’s service engineers checked and serviced the printers thoroughly and gave both printers a clean chit. If anything they felt that the new ultrasound machine was likely not rigged up properly to download its data to the printers, however Aman again stonewalled, “Ours is a world class machine, it is sought after by doctors and works successfully everywhere. Only at your place there is a problem. I suggest you buy a new printer,” he ended confidently.<br /><br />The printing roadblock was a huge hurdle for Tara. Patients could not take a scan image with their report; most patients had onward appointments with their gynecologists or their physicians. Tara was struggling to be fair and helpful to her patients. So she made a quick decision: she asked Dempa to send a new colour printer at a cost of Rs 25,000. <br /><br />But oh! No. The AB-SW15 continued to malfunction ­—the print command would invoke the printer, then midway printing, the print would begin to get distorted. Expensive photographic paper and even more expensive ink cartridges were wastefully consumed. Time was wasted as images had to be printed twice, three times, to complete a satisfactory report. Tara was confused.<br /><br />But by now, she sensed that the trouble lay with the SW15. Dempa’s service engineer, who waited while she tested the new printer on the SW15, was surprised that she was buying a new machine at all, when both her current printers were perfect, and, in fact, one was still within warranty period. Now, when the third printer too did not respond, Aman was again called. This time he asked her to move to a different brand of printers justifying that with some exotic explanation. <br /><br />So, here was Dr Tara Chaitanya, having just upgraded to an even more expensive AB-SW15 after trashing two printers, bought a new one also costing a small fortune and had gotten nowhere. She looked at Aman and saw there a novice, who knew nothing. He had no trouble-shooting skills, nay... he had no installation skills to begin with. He was using her as a guinea pig to try anything that came to mind. She could not help recalling Paul — same age, same skill set, but what a difference in their approach and effectiveness at problem resolution!<br /><br />Meanwhile, another situation had quietly arisen. Just eight days after the new machine had thrown her life out of gear, Tara noticed that the SW15 had started to hang or restart while the patient was being scanned. <br /><br />This is what happened. Mariam, a 25 year old suspected to have an ovarian cyst, was being scanned. Tara was explaining to her about the cyst that was likely not growing, but there were some darker areas on screen that needed to be investigated ... and then, the machine just froze, the probe stopped responding, the screen image disappeared…and all too suddenly, the machine restarted on its own after 20 seconds.<br /><br />This happened again with another patient. And again. Twice in the first week. Four times in the next week. Tara felt like she had been handpicked for disaster. Like the printing problem, this too was intermittent and clearly pointed to some problem with the machine’s hardware or software. <br /><br />Tara knew machines. She worked with them all the time. Something was not right. She called Awasthi, who promised to get more technical help to probe and address the issue.<br /><br />But her clinic was in trouble. All in all, work had become such an unusual challenge — caused not by lack of clientele, or funds, or lack of wisdom... but because of the most critical aspect of her practice — the ultrasound machine — which helped the patient’s body communicate with her. Tara was waking up to her worst fear: probable loss of patient confidence in her. It was no use telling the patient, “Sorry, this is the latest, best machine...” Especially if the machine was suddenly shutting down and the patient was reading the error message. How would they trust her? <br /><br />Tara was in her clinic one Saturday, the busiest day of the week, when the printers again malfunctioned. Patients had been waiting for two hours and more were landing up at their appointed times. Given how poorly the machine worked, the time per scan had risen significantly and she had begun to work weekends as well. She called Company A’s service line and Aman’s mobile several times. Her patients left, unhappy, but also confused. She moved some of them to Sunday morning in the hope that by then a solution would be found. <br /><br /><strong>Read Analysis: </strong><a href="http://businessworld.in/news/case-studies/analysis-care-without-compromise/1362190/page-1.html" target="_blank"><strong>Harish Natarajan</strong></a><strong> And </strong><a href="http://businessworld.in/news/case-studies/analysis-be-aware-be-very-aware/1362155/page-1.html" target="_blank"><strong>Dr Uma Nambiar</strong></a><br /><br />Shiv knew when enough was enough. He did not call Awasthi but left a most menacing message for him: You get an hour from now. If I do not see you at the clinic the AB-SW15 will be up on Pinterest with this caption: Don’t trust this machine. <br /><br />Tara only marvelled at why men worked best when treated like a beast. For, Aman and Awasthi arrived within the hour making poor excuses. Together they reinstalled all printer drivers, taking till midnight to do so. As Shiv kept vigil, Tara printed a few pending reports but with problems. <br /><br />Patients had to be texted in the middle of the night to please come on Monday, their Sunday appointments now rescheduled. Tara was totally unhappy with the way things were going on. This was never how she worked. But what ailed the SW15? <br /><br />To be continued...<br /><br />casestudymeera@gmail.com <br /><br />(This story was published in BW | Businessworld Issue Dated 02-06-2014)</div>
