What I Learned From Making My Own Underground Map

I always have many promotional emails that pop up in my inbox, and I usually delete them at the end of the week, but this week one caught my eye. Chen of Cadensee, Let’s Talk Medical, a sciences communications company, doesn’t usually disappoint, and last week’s blog was especially relevant since it involved the London Underground (the subway system) and this week I found myself in the United Kingdom!

The London Underground map is famous for its simplicity, clarity, and being a model for all future subway line maps. However, back in 1908, when the original map was released, it followed the above roadmap and was extremely confusing for travelers. Click here to see the original map.

So an engineer redesigned the map based on the needs of the subterranean travelers, creating the famous map we know so well. The reason that map was so clear? It was targeted/simple/clear/geometrical. Chen goes on to apply this to medical communication but it got me thinking about how that message is so apt for health navigation. So much of what I do is simply clarifying an existing message that someone has received from a healthcare provider, but in a way that the client can ‘see’ the information. My clients, those English speaking immigrants, need to see the system in a completely different light. So then I had the brilliant idea to make my own map! For navigating the two, sometimes parallel, sometimes intertwining lines of private medical services vs. kupat cholim.

I was doing quite well until I realized that I am not a mapmaker. However, other than my lack of graphic skills, I did learn some things along the way.

The devil is in the details, or, better yet, I do need to know which to stop to take

When we receive explanations about the health system, it usually is in generalities. “You need a referral from your doctor to get that ultrasound.” But we actually need to understand the subtle nuance of “for that ultrasound you only need a referral, but for that type of ultrasound you will need a referral and a hitchavyut (payment voucher); and for that ultrasound from the private doctor, you will need another referral from your kupah doctor, and a hitchayvut.” Of course, that’s much more of a mouthful and people (medical secretaries) rarely go to that level of detail. To be fair, that’s because there’s usually another seven people crowding her desk, her telephone is ringing, the computer is binging, and her manager is also asking her a question.

We need to ask where we are

During this same trip to London, I very cannily purchased a through ticket for the train, then the subway, then another train, as a day pass to the London Underground and final trip to Heathrow. I, then, very smugly, got on the final leg of my journey, asking the conductor, casually, “this train to Heathrow?” to which he nodded yes, and I boarded. I should have been suspicious when each seat came equipped with a charging port and USB connection, but hey, I just thought the British were generous. It turns out that I needed to show the conductor my ticket and say ‘Am I on the right train to Heathrow with this ticket?” since I ended up having to dish out 20 more pounds for my ‘express train’ instead of the local for which I had paid in the morning. I get this complaint a lot from clients. “But they told me my referral was fine.” Yes, they did, but unfortunately, you didn’t press and they didn’t continue that it would be fine if you wanted an ultrasound in the kupah but if you want that more complicated ultrasound, in the private doctor’s hospital ultrasound department, you will need another type of referral, and a hitchayvut. That is why, unfortunately, you need to always ask the medical secretary, “for this appointment, I have this referral, and I need this test. Do they all match?” The doctor does not always know these bureaucratic differences, and I would not want you to arrive at an appointment in Sheba hospital after traveling two hours only to find out you don’t have the correct paperwork.  Don’t be shy. Ask away.

Private does not always equal ‘better’

Through an extremely complicated web of circumstance, some accurate and some marketing fluff and myth, I think we have come to believe that the head of the department or the private neurologist who charges 1,200 shekels a visit, is obviously a more qualified, better physician, and diagnostician. Not true. It all depends on what you are looking for (bedside manner, follow up, diagnosis, new treatment plan, etc..) and type of complaint. This means that we need to use our resources wisely, and not just automatically choose the private option because we think that will guarantee us better service, or treatment, or outcome. Every case is unique and we need to ask questions, figure out what our end goal is first, and then choose accordingly.

Happy travels! Keep your eye out for my ‘private vs public underground map’ and feel free to share your experience and ask your ‘map’ questions.

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