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“The ATM is closed.” That’s the punch line in hundreds of video stories I’ve read on YouTube.

It means the hero – the only financially stable person in the family – has come to a last-straw moment. No more paying rent, subsidizing vacations, and sharing cellphone services with deadbeat relatives. No more getting treated with scorn by the very people you’re helping.

The hero now finds freedom and extra income. Divorcing the family once seemed drastic. Now they shrug when their entitled relatives get stranded or even arrested.

What surprised me in the videos I watched:   

• The hero is single, occasionally widowed, but never a married couple.
• The stories were obviously AI-generated, yet they garnered thousands of views and hundreds of comments. Even knowing the stories were fake, the audience rooted for the hero. 
• The theme, “Entitled ungrateful relatives get their comeuppance,” has infinite variations.

 Why does this particular plot resonate with so many people? 

It ties to another element of storytelling: People like to see justice done. They like to see the altruistic hero rewarded and the entitled relatives punished. 

In a real story told on an Internet show, a single person buys a house with a swimming pool. He won’t allow his brother’s family to come over and bring their small children; he doesn’t want the hassle or the liability. When they sneak in while he’s gone, he calls the police, who cite them for trespassing.

Compare this to an imaginary story on video.  A man invites 12 people to a birthday dinner. Another twelve of his uninvited relatives show up and take over the assigned table. They order the most expensive food and wine and try to say they’re with the hero. 

The hero not only refuses to accept the charges; it turns out he owns part of the restaurant and he sets up his party as a separate event in another room. When the uninvited guests can’t pay their bill, the restaurant calls the police to arrest them on charges of theft of services. 

The comments on these videos strongly support the hero. “I wouldn’t have paid for them all those years” or even, “I’ve been there, and I did the same thing.”

Family members are often assigned roles based on their economic power.

High earners can be the fairy godmother who donates large sums, or they can be the wicked witch who sets boundaries and holds back.  

While I was writing this article, a columnist for the Washington Post  published an article by columnist Michelle Singletary:  “Why your wealthy friend does not owe you a luxury lifestyle.”
She could have called it “Why your rich relatives don’t owe you a lifetime subsidy.”

She writes about a friendship between Savannah James, the wife of LeBron James, and her friend April McDaniel.  The column talked about the fact that on a plane trip, Savannah chose to fly first class and April paid for her own ticket in business class. (Several comments pointed out that business class is also pretty good, but still…)

Some people were horrified at this arrangement, but I think it’s an excellent example of setting limits. Savannah didn’t want to fly unless she could go first class.  Given that she’s married to a legendary athlete, we might assume she could easily afford an upgrade for April.  

But as Singletary pointed out, boundaries like these make the friendship sustainable. I’ve never seen articles on this topic, but I suspect boundaries make it possible for people of different income levels to sustain meaningful family relationships, too. 

Singletary makes several practical suggestions. The “rich friend” should be aware of the other person’s budget, but should not assume the other person needs money. The person with less income should not expect to be subsidized. 

She even adds that anyone who borrows money from a wealthier friend or relative should establish a payment plan, not assume it’s a gift. And, of course, don’t borrow from them in the first place, if at all possible.

What impresses me is how much the video stories resonate with readers. I suspect a lot of people out there feel like they’ve been treated like the family ATM.

I suspect that most of the time boundaries are invisible but very firm: “We wouldn’t think of asking Aunt Mabel.” But a lot of times it’s, “She’s single, so she won’t mind.” Or worse: “We deserve it.”

True, sometimes helping friends and family can be meaningful and satisfying.

But it’s hard to deny the satisfaction that comes from keeping those entitled people out of your hard-earned swimming pool. Thousands of people voting “thumbs up” say these videos are onto something.

The post I’m Done Being Your ATM—and That’s a Good Story appeared first on .

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A letter to an advice columnist made me think about the topic of friendship.  The LW’s brother died of an overdose following a long addiction and the LW’s friend disappointed her:

“I expected the things close friends do in a crisis: checking in, asking how I’m doing, offering to come over or bring dinner, suggesting we spend time together, or simply asking what I need.”

My first thought was, “These days it’s hard to know what a close friendship requires. We live in an age of microcultures – not commonly shared scripts. People may lack the capacity – not the will – for supporting friends in difficult situations.” 

The columnist got it right: he said the absence could be due to “ghosting grief,” where people don’t know what to say. Or the type of death made them uncomfortable. Or simply “because of their own limited bandwidth or emotional capacity.”

I’ve had a friend lash out at me because she felt my response to the death of her dog was uncaring. That definitely cooled the friendship. I’ve also had a more casual acquaintance tell me that a card I sent on the death of her dog was particularly meaningful and helpful. 

So when I read this letter, I was reminded of what I believe is true about friendships: expectations matter.

People have limited bandwidth. You don’t know what else is going on in their lives, even if they’re close. A lack of response doesn’t always mean “I don’t care.”

So expecting specific actions from a specific friend can be disappointing at best, friendship-ending at worst.

And in today’s world, we live in microcultures. At one time, in some communities, people knew what was expected. A casserole. A hug. A visit. Now we often don’t know.

I think the columnist made a particularly helpful suggestion. Sometimes the best source of help comes not from close friends and family but from strangers and acquaintances. A casual neighbor will show up and mow your lawn or take your dog for a walk. 

And you will do the same for someone else. I wasn’t a close friend of the person when I sent a sympathy card for her dog, but it worked…almost by chance.

As Bella DePaulo says, we single people have the “ones,” not the “one.” We have many friends, not one source of support. It seems that friends play different roles in life: some people are great for a fun evening but just not the type to help in a crisis. 

And I have a friend who’s perfect in a crisis but not for sharing a fun time: she can be critical and judgmental, but you’d want her around if you were abandoned on a desert island. 

In these days of microcultures, we all have different expectations of what we’d want from a friend. Some people want nothing more than to be left alone. 

And sometimes it helps to dig out that casserole recipe…and hope your grieving friend doesn’t feel insulted because you didn’t know about her food allergies.

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Sunday morning, I woke up to dripping sounds. No big deal, I thought. I live on a top floor and love to hear the sound of rain pattering on the roof.

But this time there was water pattering in my kitchen. Luckily it wasn’t doing any damage: it was dripping into the sink and onto the floor. Still, I’ve never had a roof leak.

Our maintenance guy lent me some buckets and I called the emergency help line of our management company. It’s their issue because it’s from the roof…and that’s when I discovered roofers don’t work in the rain. Well, at least we didn’t get heavy rain and the dripping stopped for now. 

But as I went on with my day, I thought about an article I’d read about the hassles of hiring help instead of DIY. The article warned that getting older would mean hiring more help and that was bad. I’ve also read about single people whose first thought was, “I wish I had a partner to deal with this.” 

My first thought wasn’t, “I wish I had a partner,” but, “Who do I call for help?” And for me, that’s a familiar one.

Among my friends are two kinds of single-at-heart people: those who DIY everything and those who are very good at hiring for everything. I’m the latter.

Having no domestic skills, I’ve hired cleaning services all my life. Some have been (if I can put this delicately) better than others.

For the last eight or nine years, I had a fantastic cleaning guy. He didn’t just clean: he organized, fixed, and moved things. We were friends. But a few weeks ago he had a family crisis and now I have to start over, which is especially hard if you are a bad housekeeper. Some cleaning services prefer clients who keep house so well you wonder why they got help. With me, nobody ever wondered.

Given that changing a light bulb can be taxing for me, I also hire help to fix things. Frankly, I think it’s better: I once moved into a house where the previous owners were avid DIYers and I had to pay to undo everything they did.

I have a financial advisor and haven’t filled out a tax return in years. They find money in hidden places so I think I come out ahead. 

So I’m afraid I can’t relate to the people who write about the challenges of hiring help as you age. I relate even less to those who turn to their partners when they hear a noise or see a mouse in the living room. 

In the end, this is just one of the ways being single has prepared me for getting older.

I try to choose helpers who aren’t too disruptive or judgmental when they come into my home. I try to shrug when I make a mistake and have to change helpers. I’ve learned that you can’t always be friends with people you hire and you should never, ever assume your truest friends are those who can be unpaid helpers.

The only thing that bothers me is people who offer me help or wonder how I “manage.” People smother me with concern because I’m single and because I’m getting older: two categories that scream “helpless” to those who stereotype.

 I’ve had complete strangers ask, “Do you need help?” when I’m waiting for a bus, trim and fit in my gym shorts. I tell myself they have some pathological need to help people, and if they can’t find anyone needy, they get desperate.

And I’ve often heard  that single people have to learn to be self-sufficient, more than those who are partnered. But I’ve come to believe that knowing how to ask for help and how to hire specialists is also a form of self-sufficiency.  Not neediness. Not compensation for being alone or getting older.  And I wouldn’t have it any other way.

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Many years ago, I told a teaching colleague that I’d signed up for a course on understanding ballet. I was just making conversation. She looked daggers at me and said, “It’s nice that you have time for these things. I have a relationship.”

Now that I’m further along on the journey, I’d be tempted to say, “Oh, I’m sorry! That must be so time-consuming.” Perhaps it’s just as well that I was too surprised and bewildered to say anything. I’d have been eaten alive

.In her book, Single by Choice, Annette Smith describes a single person she calls “Suzanne.” Suzanne loved family gatherings until her “Aunt Tina” would swoop down with “ticking clock” warnings and invitations to meet her dentist’s son.

Smith concludes, “It’s about standing your ground with charm and wit and sometimes, even transforming awkward encounters into moments of genuine connection.”

That works most of the time, but sometimes you have to use humor and snark.

Craig Wynne, a scholar who’s studied single people and a member of our 10K-person Facebook group, answers the  “Are you married?” question with, “My cat is named Chester.”

And as a twenty-something with a travel-heavy job, I would answer that question with, “Why be a maid when you can have one?” 

These examples showcase the different  ways that we single people deal with verbal  microaggressions, which  Mental Health America defines as “indirect, subtle, or unintentional discrimination against members of a marginalized group.”

Don’t let the term “micro” fool you. Small actions and words can have enormous impact. It’s especially hard for newly single people who are unprepared for the avalanche. NPR titled an article bluntly, “Microaggressions are a big deal.” 

The fact that they’re often unintentional doesn’t make it easier. 

Microaggressions tend to be based on misguided assumptions about single people, rather than simple prejudice. 

 I think they’re based on the deficit narrative: assuming being single is all about what we don’t have and what we’re missing. Many people – or most people in certain environments – are completely unaware that being single can be desirable, joyful, and fulfilling.

People who initiate micro-aggressions often honestly believe that being single is a lesser state, born of necessity and leading to misery. They genuinely pity us. 

Once, after an injury, a doctor asked me nervously, “But how do you get groceries?”

I like to think I don’t exactly look like a starving specimen. And we’re living in one of the largest cities in the US with at least half a dozen grocery delivery services. Sometimes it’s hard to keep a straight face. 

Happily single people prepare for microaggressions. 

I have an article, “12 questions never to ask a single person.” Almost every single person I’ve met is familiar with those questions. They’re annoying. They can seem invasive, especially if they’re family, like Aunt Tina in the example above.. 

What I think is important is recognizing the thought process behind verbal microaggressions – the beliefs people hold when they encounter single people. 

I’m encouraged by the increasing number of people writing books, making YouTube videos and Facebook reels, writing articles, and even creating courses. Hopefully, we will benefit from the increased exposure.

These verbal microaggressions may never go away completely, but hopefully we’ll experience fewer examples as the world becomes more aware. 

Meanwhile, as far as I’m concerned, there’s no wrong way to respond. Snark seems perfectly acceptable, especially for the most egregious examples, with a dash of humor and deflection when you want to tiptoe gently around the well-meaning friends and family

The post I’m Single and Tired of People Asking Me How I Get Groceries appeared first on .

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Years ago, when I was living in a different state, I received my one and only summons to jury duty in my entire life. I was pretty sure I’d never be selected for a jury: a relative who’d done time and an advanced degree.  

The crime was violent, the lawyers unimpressive. I privately called them Dumb (the prosecution) and Dumber (the defense). They asked us questions. When Dumber came to me, he began, “Mrs. Goodwin…”

I forgot where I was. He knew I was single from the juror questionnaire. I burst out, “I am not Mrs. Goodwin. I am Ms. Goodwin or Dr. Goodwin.” 

Dumber got flustered for a moment, apologized, and kept going. Needless to say, I was gone from the jury in a matter of minutes. Getting genuinely annoyed with the defense lawyer was added to the list of other reasons.

I thought of this when, in the same week, a dental assistant and a hair salon assistant – both of them strangers to me – called me “Miss Cathy.” We were not in the south. We were in a commercial setting. I was a paying customer, not their maiden aunt. 

This incident bothered me. I don’t know if they were well-meaning people who were addressing my age or my single status or both. 

So I posted in a social media forum: What was this all about? 

Several people pointed out that “Miss Cathy” would be common in the South and in certain cultures. Other people said it’s better than “sweetie.” I don’t think we should have to choose. Still others said it’s better than “ma’am,” which I don’t mind: it’s the equivalent of “sir” in the military and (I believe) the police. 

Of course, some people said the usual “get over yourself” and “it’s a first world” problem. I ignored those.

At least one medical center takes the matter seriously, but with laughable consequences. I get most of my care at PennMedicine, which has a world-class research reputation and a complete misunderstanding of some customer experience.

I’m not sure when or why PennMedicine decided not to call people Mr., Ms., etc., but instead required the staff (or so they told me)  to address patients as either “Last name Goodwin” or by their first names. 

Once a tech tried to bypass the regulations by calling me “sweetie.” I set her straight (she decided to call me “ma’am” since she couldn’t call me “Ms. Goodwin”)  and never went back to that clinic. 

One lab went a step further. They decided to give patients tickets with numbers when they checked in and called people up by their numbers. I felt like a chicken at a butcher shop and never went back to that lab.

To some people it’s not a big deal; a fortyish male told me the medical people call him “sweetie” all the time and he doesn’t mind. And some people from the South may be more tolerant; here in South Philly you’re more likely to hear unprintable alternatives to terms of endearment.

I’d probably have better blood pressure if I shrugged it off, but I believe that what you call me is sending a message.

At least in Philadelphia, when the person calling me that name is a stranger being paid with my good money, I’d like to be called “Ms. Goodwin.” And if you’re trying to win me over, like that lawyer was, I hope you’d consult your records and see what I checked when you demanded to know my marital status. 

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She was a young country music singer faced with what looked like a once-in-a-lifetime offer in the music business. But she still said “no” to Elvis Presley. 

As she tells it, the night before the taping, Elvis’s manager, Colonel Tom Parker, called to say they were ready to record, but Elvis only recorded songs when he held at least half the rights to the song. 

Dolly, of course, was shocked and disappointed. After all, as Business Insider writes,  “In what world does a young, sequined country singer with just a handful of chart-toppers to her name turn down a special request from the King of Rock?” 

 According to that article, she “cried all night,” but she said no.  So the recording was canceled.

Of course, the world knows that Dolly got her validation when she handed a Grammy award to Whitney Houston, for perhaps the most famous and successful cover of the song.

Beneath all that glitter, Dolly was a shrewd businesswoman. She knew one of the most important skills in business and life: the ability to walk away from a deal that violates your principles with a firm “No.” 

I’m always surprised to learn how many successful people have a history of walking away from something: houses, jobs, possessions, relationships, and often even family or what looks like a once-in-a-lifetime deal.

Several years ago, I was living in a condo which originally seemed like the best deal I’d ever had. I loved the first six or seven years. Then things went sour. The management company seemed to be making bad decisions. The board seemed cowardly. Even the environment changed as the outside got louder.

At first I tried to see if change was possible. I didn’t think I could leave. Too many pets. A challenging market. An unsellable condo.   

Fast forward another seven years and I wonder what took me so long to move. I found a small condo in a well-managed building. The location turned out to be ideal. I moved just in time to grab ultra-low interest rates. Best of all, due to the building’s configuration, it’s as quiet as a retreat house. They’ll have to carry me out feet first.

Walking away doesn’t always feel strong when you’re in the middle of doing it.

You see the obstacles, the hassle, and sometimes the pain. You anticipate all sorts of future regrets. And in most “walk-away” decisions, you don’t get the payoff for a long time – sometimes years…the inner voice that says quietly, “You did the right thing.” 

I’ve walked away from many deals over the years. I wasn’t always right…But I usually was.

Sometimes I see posts like:  “My partner is a jerk. I’m blocked from getting what I want in life.” Or when a single person says, “I felt unwelcome at the family reunion.” 

The writer knows it’s time to walk away, but the obstacles seem formidable. And maybe they’re seeking validation and permission: It really IS worth the scary decision. 

Dolly Parton’s world of country music has always held this wisdom. 

Like the Kenny Rogers song about the old gambler’s advice: Know when to hold and when to fold.

Or when Faron Young told a radio station that didn’t want to play Charley Pride, a black artist, “If you take him off, take all of my records off.”

Or Alan Jackson’s decision to risk going off-script sing a George Jones song at the CMA awards, when Jones himself was slighted by the industry. 

And more intensely, that George Jones song about the man who didn’t get his place out in the  country until everything else – including his own life – was gone. It’s about somebody who didn’t walk away for thirty years…didn’t even set limits.

It’s one of the saddest songs in the repertoire about what happens if you live your life for others and never dare to say no…and what’s waiting for you at the end. 

The post Dolly Parton Knew When To Walk Away appeared first on .

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I wondered about this topic after reading about people who want to hear sounds around them even if they’re alone. I saw posts all over the Internet saying that people – single or otherwise –  talk to themselves, their inanimate objects, their plants and of course their pets. 

I have always been single and always lived alone as an adult.  When I had a dog, I gave her commands. I rarely converse with the cat; she’s not a good listener and she rarely talks to me. I call her over by yelling “Hey cat!” or making scratching noises.  I don’t talk to my vacuum cleaner or any other objects.

It seemed to me that people who are really “Single at Heart” (Bella DePaulo’s term) would want to enjoy silence as well as solitude. So I asked the Facebook group Community of Single People. 

And I was surprised at the answers. I’d always assumed people who liked being single wouldn’t want to hear voices, including their own, when they’re home alone. And indeed a few people said, “Never.” 

But a lot of people talk to themselves in very diverse ways.

Almost 80 people responded to the original question so at least this group found the question interesting. Based on my unscientific, not-too-careful countdown, here’s what I found:

• Some people talk out loud as a way to organize their thoughts, make decisions or plan.
• One person reports singing to themselves.
• Some people yell at the TV during a game. They also yell at other drivers who make dumb moves and they curse themselves when they drop or bump into something.
• Only a couple of people talk to inanimate objects. One person talks to their bike.
• A few people made snarky or humorous remarks. A couple of people say they talk to themselves to have intelligent conversations.
• Three people said they thought talking to themselves was related to their being neurodivergent. Talking aloud helped them process information.

The largest category –  by far -was people who talk to animals. A few people talk to live animals they encounter on the way to doing other things: the spiders who get into the house or the cows they see in pastures.

But almost a quarter of the respondents reported talking to their cats. A few said they respond when the cat talks first. Two people talked to birds – hummingbirds and cockatiels. Many people talked to their dogs but the cats were the most likely conversation partners. 

So I’m going to have to revise my thoughts. 

I was unconsciously reflecting the stereotypes of happy single people: I assumed that being alone meant wanting to disconnect. 

The book Solitude: The Science and Power of Being Alone,  emphasizes the importance of choice. People who are forced to be isolated, like prisoners in solitary confinement, react very differently to solitude, compared to people who escape to their own space in search of peace and quiet. 

So single people may not necessarily want less connection. They may simply want to control the quantity, quality and timing of their connections. 

And sometimes that’s what we single people want. Not criticism, not therapy, not challenge…just assurance that we’re worthwhile human beings.

So maybe I’m the one who’s missing out on the benefits of communicating with my cat. Alas, when I try to tell her about my day, she’s more interested in playing with her favorite toy mouse. I have to conclude that we’re outliers. 

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“I’m working on a project about being single,” I answered the “What’s your next book about?” question.

He laughed. “I’m seeing lots of videos and articles about single people everywhere! Doesn’t everybody get it?”

In one sense, I agree with his view, which I’ve heard from many people.

But the truth is, you’re seeing a lot of pro-single material because you are identified as someone who’s interested. Readers with a more traditional view — who think marriage is the “normal” way to go — may not be seeing them.

How most of the world treats single people

As a certified lifelong single person, I’ve found that the people you’d expect to be most aware often are the most clueless. It happens whether we’re dealing one-to-one with friends or with faceless organizations.

 I was chatting with a man I’ve known through a mutual group membership. He’s avidly looking for someone to marry. He seems to believe marriage will mean coming home to a hot meal rather than being in love, but that’s another story. He is surprised when I tell him I’ve never married. “I thought you were divorced,” he said. “You seem happy!”

A lifetime single person happy? Imagine!

A medical tech asked me if I regret not having children.

My grocery delivery service features economy-size options. I’ve pointed out that in my city, one-third of the homes are single-occupied and suggested, “Why not a special for singles?”  

Medical staff can be especially obtuse. A few years ago I was preparing for outpatient eye surgery. I asked for post-op instructions. “You’ll get them later,” I was told. Somehow, nobody had ever put together that if you’re too groggy to go home without a ride, you’ll be too groggy to understand instructions, and you might not have someone standing by to go to the drugstore. 

How will things change?

I believe we single people have to become more outspoken as advocates. It can be exhausting and tiresome, but we need to speak up.  From my experience I’m making these suggestions.

First, let people know if you’re single and happy.

You may be the first happy single they’ve ever met — at least, who admits it. Many people can’t use “being single” and “being happy” in the same sentence.

Second, it’s helpful to prepare a response to zingers, like, “Why aren’t you married yet?”

 I recommend a polite version and a snarky version. Polite usually means changing the subject or saying something like, “It’s not my thing.” Be prepared for disbelief and follow-ups.

The snarky answers are more fun. You can flip the script (“Why are you married?”) or be more direct. When I had travel jobs, I used to say, “Why be a maid when you can have one?” Now it sounds a little obnoxious, but it got the point across. 

You can always say politely, “It’s a personal decision” before changing the subject. Rather than educate everyone, I’ve found it helpful to make the point that “this question is intrusive and shouldn’t be asked.”

Third, we need to make our voices heard when we see ads or encounter institutional behaviors that prejudge single people. Craig Wynne of our Facebook group, Community of Single People, wrote to a movie theater that had advertised something like, “Movies are more fun with a partner.” The theatre wrote back an apology: it hadn’t occurred to them that their behavior might be anti-single.

That’s the ideal situation: You educated them and got a response that shows they learned.

In my experience, health care systems are the worst. They may assume you’re helpless if you don’t have a partner or child. Let the Patient Services department of your hospital know when you’re treated unfairly or insulted; if necessary, write to the Chief of Staff or the hospital CEO. Point out the consequence: research shows that people who don’t trust the medical system will be non-compliant and avoid care.  

Write to politicians about government actions that hurt singles. Point out that you’re a voter who’s left out of most family-friendly programs. They really do read those letters. It will take a while, but eventually it will happen.

So in the end…

 We can answer the question, “Don’t most people get it?” with a resounding “No.” Anyone who’s single will continue to encounter people who think marriage is the “normal” lifestyle and who (often unconsciously) create barriers and obstacles for single people, all the while expecting them to be lonely and miserable. We need to help them discover the truth. 

The post Everyone Knows About Single People. Except Most of the World. appeared first on .

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Recently, my dental clinic sent me a notice to pay, two weeks before the due date. Then they sent me another notice about one week before. This time I called: “I’m supposed to pay this when I come in for my follow-up visit. Why am I getting notices?”
“It’s our software,” she said. “We can’t do anything about it.”

A few weeks earlier, I had a medical test. I talked to the doctor about it afterwards. “No problems.” 

Two weeks after the test, I got a snail mail letter from the hospital, addressed “Dear Sir or Madam.” It said that the test results needed to be discussed ASAP with the provider. 

What happened? Did the machine have a bad day so we needed to recalibrate the results? If it’s ASAP and urgent, why send a snail mail instead of a text message?

When I queried through my portal, a nurse answered cheerfully: “The letter was sent by snail mail because it was intended for the small percentage of patients who weren’t on the internet. Just ignore it.”

So why did these examples really annoy me? I flashed back to my psychology classes, where we studied Stanley Milgram’s famous experiment about willingness to obey. 

Briefly, subjects were instructed to deliver painful shocks to a “learner” who failed an assignment. Of course, the whole thing was a set-up: shocks were fake and the “learner” was an actor trained to emit howls of pain on cue. But subjects believed they were following “orders” of the white-coated experimenter. Would they comply? 

It turns out that 65% of the subjects were willing to inflict what they thought were painful shocks; 35% refused. The experimenters concluded that large numbers of people will obey what they think are legitimate orders.

One of those who refused was a Dutch engineer. He said something like, “I am an engineer. I know this level of electric shock will be fatal. I won’t do it.”  His background made him question the meaning of the whole scene.

So what does this have to do with my stories?

In the modern medical world, nobody inflicts painful shocks on anyone else. But as patients, we are often asked to “obey,” i.e., be compliant. That covers everything from taking recommended tests and medicines to tolerating a noisy TV-filled waiting room to accepting mistakes, both medical and non-medical. 

When the front desk says, “The problem is our software,” many – probably most – people will accept that story. We forget that to many people, software is a mysterious unknown created by the same forces that give us hurricanes and tornadoes. When they hear, “It’s the software,” they nod knowingly and empathize with the practice.

I’ve been working with software for the last 20 or 30 years. I work in a coworking space with people who write software. I know software is just lines of code created by imperfect humans and that some software is better than others. I know that software shouldn’t drive an organization’s strategy: you choose or modify software to meet your goals. 

So, like that engineer in the experiment, I didn’t buy the explanation. I developed a strong distrust of the practice and began looking elsewhere.

In the case of the letter, my degree and research were all in services marketing. I’ve consulted and written about marketing communications. So I am aware that for a relatively small cost, you can hire a professional to write a clear letter with no questions; the letter could explain that it’s primarily intended for people who don’t do portals or internet and everybody else can ignore it. 

Even better, why doesn’t this prestigious, well-funded organization hire a coder to write a program to send letters only to that one small segment? Solopreneurs use mailing systems like KIT that can segment their audience; why can’t they?

Actions like these lower trust, and trust is associated with medical noncompliance as well as other concerns. If you want to reach the least technologically aware segment, why make things more confusing for everybody else?

I once got the run-around about a billing mix-up and (after a letter to the hospital president) was transferred to someone who was actually helpful. She told me she hears all the time from patients who work in quality control and wonder why the hospital can’t do better – people who didn’t fall for the story that “We can’t do anything about this.” 

A lot of my friends can’t understand why I get so angry and mistrustful with simple mistakes.  But I’ve been conditioned by my background and education. I don’t see these as isolated incidents. I see them as signals of how the organization puts energy into creating a positive experience and how much they really respect their patients.
 

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Image downloaded from Depositphotos.

It seems like a small thing, but there’s a big message: We don’t care. You are a number to us.

I’m talking about communication from large prestigious medical facilities that sound like solid advice.  The kind that medical professionals shrug off with, “What’s the big deal?”

I have a background in marketing. Most of my research was in service delivery – the reaction of customers to the services they received.  So I find myself asking, “What does routine communication reveal about the organization’s service philosophy?”

Recently, I had an important test at a hospital I’ll call Y, which is also a major teaching hospital. The doctor had met me right after the test and told me everything was fine and no action was needed.

Two weeks after the test, I got a snail mail letter beginning, “Dear Sir or Madam,” saying that there was a test result that should be discussed ASAP.

If it was ASAP, why did they use snail mail? Was the test result something new they discovered, like maybe the machine was having a bad day and our results call for a review? Was it a one-size-fits-all letter sent to everyone who took the test? Or to a sub-group of patients, based on a meaningful distinction?

I have a portal and I know how to use it. I sent a message to my provider’s office, which confirmed that it was a letter sent to everyone, but intended only for the small percentage of people who do not use email, text or portals. They told me to ignore it. The institution itself acknowledged that the communication was not meant for me.

To them it was not a big deal; to me, it was a sign they couldn’t be bothered to have the letter written by a professional for a few hundred dollars. At the very least, the letter could have said, “We send this to everyone,” and, “If you have a portal, please disregard this letter,” and, “If you have already discussed the results please ignore this letter.”

And how about “Hello” or “Good morning” instead of “Dear Sir or Madam?” I haven’t seen that salutation in years. A prestigious medical institution can’t be bothered to personalize communcations — something many solopreneurs do in their newsletters.

From another local hospital I’ll call X, I received a happy birthday message via the portal. The message suggested I use the day not to celebrate but to review my annual medical tests. I’ve never done screenings but I can think of happier ways to spend my birthday. However, there was a small list of tests attached with a note that I don’t need to have any of them because I was too old.

Surely they have a computer function that can sort on birth date so I wouldn’t get the message at all. If they can’t hire a good systems professional, what else are they not doing?

I also received a large, glossy postcard from Hospital X, urging me to undergo a certain screening test. They wrote in big letters, “This test saves lives.”

That is true. But according to the NNT database, over 500 people must take the test, over a period of years, to save one life. Knowing the truth made me skeptical of the message. I also questioned why a hospital would spend resources on a message that actually undermines informed decision-making.

Messages like these create a lack of trust, which in turn will influence the way people interact with the institution.

I personally find it hard to be even routinely courteous and compliant when I’m treated like a number and sent ambiguous messages that take time to deal with. When a medical professional makes a recommendation, I’m not compliant. I say, “Are you sure? Let me see the evidence.”

Some people may be able to laugh these things off; I can’t help suspecting that some of those people get unnecessary tests and procedures. And there’s a cumulative effect of getting misleading messages over and over again instead of on rare occasions.

For-profit companies understand that customers make decisions based on trust. They understand that communications influence relationships. Why don’t the hospitals? Why are they spending money on things that create skepticism?

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