Service With A Sense Of Urgency

Service With A Sense Of Urgency


Leonard Zwelling

That was the mission statement for the Office of Protocol Research when I wrote it in March of 1995—ancient history. It may be an old saw, but it’s not at all a bad one when it applies to organizations and people who serve as the infrastructure to larger enterprises. What I mean is information technology departments, human resource departments, and support departments of all kinds in business entities whose major job is making things or providing personal services, like health care facilities. It’s BASF. They don’t make the surfboard. They make it better. That’s infrastructure.

After all, that’s what my office was. Eventually, when my office became the Office of Research Administration, I was supplying support for all forms of research at MD Anderson while the office did no research itself other than that needed to manage our personnel and processes. Our office was not fulfilling the mission of MD Anderson at all. We were helping others do that and we had no illusions. If we weren’t efficient and user friendly, we were not doing our job.

If you are a home owner, you count on a vast array of companies to service your infrastructure needs from air conditioning repair service, to plumbing, to extermination, to lawn service. Some of the services are routine or routine maintenance. Sometimes something goes wrong and then it requires expert fixing. It is then that the mission statement of any service entity will be tested. Are they prompt? Are they thorough? Are they competent? More and more I find that the answers to these questions are no, no, and no.

Today, after waiting months to have our front door lock replaced (it’s a complicated mechanism that cannot be repaired), the company came to replace the lock. We had worked with our contractor to make sure that he had the right part ordered as two different locksmiths declined to try to fix it. Too complicated.

It took them about five minutes to remove the old mechanism. This was promising. The new one looked right, but when they inserted it, it would not fit into the space allotted in the door. Clearly, the sales rep who had assured our contractor that he knew what part to order, had made an error. We have found similar scenarios have taken place around so many of the service companies that we use to fix things around the house. The care needed to get it right the first time is simply not there.

What I cannot understand is why this has become so prevalent of late.

But, as usual, I have a theory.

It harkens back to the recent blog I wrote about concentrating on doing one thing at a time. People put too great a premium on multitasking and thus do not concentrate when given a new task. Either they don’t listen, or imagine the solution before they hear the problem, or they know they can always come back again to redo what went wrong because they get paid anyway.

When a faculty member took the time to present himself or herself to our office, we knew we had to focus on the problem before us and nothing else. One particular occasion comes to mind. A new drug was being promoted for the treatment of chronic myelogenous leukemia and the faculty member needed a protocol approved in record time or lose access to the industry-sponsored drug. The drug was Gleevec. We got the protocol through quickly. Another time a faculty member had a transplant patient with a systemic worm infection. A small study had shown the benefits of ivermectin for such patients but the drug was not FDA approved for humans. This all occurred on a Saturday. My associate vice president and I chased down an FDA official at home over several hours of phone tag to get the sign-off. We got the approval for compassionate use. That’s what I thought our job was. Service with a sense of urgency.

It’s a pretty good mission statement. For air conditioning services, for plumbers, for gardeners. It’s not a bad one for doctors either. And for those who are supposed to make the doctors’ work better.

How is that working out for you when dealing with IT, HR, or the upper reaches of administration?

That’s what I thought.

Dr. Zwelling’s new novel, Conflict of Interest: Money Drives Medicine and People Die is available at:,

on amazon if you search using the title and subtitle,


directly from the publisher Dorrance at:

2 thoughts on “Service With A Sense Of Urgency”

  1. A sense of urgency is what every surgeon comes to understand. You can’t let a leaking aortic aneurysm leak until next week. You can’t let an arterial embolus form atrial fibrillation sit in the femoral artery until next week. You can’t let a patient with multiple pulmonary emboli on adequate anticoagulation sit until next week to get a vena cava filter. And, those were just three cases in one 24-hour call period for me.
    Thus, I would recommend that ALL services provide 24-7 urgent care for critical things that are NOT working and placing the patient or customer at risk of great discomfort. That’s what used to happen in small towns and villages. Americans have gotten negligent on helping others urgently.

Leave a Comment

Your email address will not be published. Required fields are marked *