Daily Movement

What is “fair evaluation”?

You want to be able to determine without experiencing it yourself
(saving time, trouble, cost, pain, suffering, etc.) the qualities of an
experience that are important to you.

An experience in the general sense means a service provided by a
person, device, institution, etc. Such as health care, insurance,
entertainment, dining.

Some aspect of experience is subjective and different individuals will
rate differently. Other aspects of experience such as price and time,
incident occurence (such as failure) could be thought of as objective,
but different individuals will rate differently due to memory recall
error, variation of experiences over time with the same service.

Statistical correctness is one aspect of fairness — that ratings are
not biased one way or other, or if they are, that bias can be noted so
the end-user can evaluate.

Coverage is another aspect — if you are rating x,y,z and leave
out a,b,c which are measurably better than x,y,z, you’ve limited
information. The decider may be unaware of a,b,c because no
information is provided about them. On the other hand, we can argue
that if a,b,c are worse than x,y,z, then the decider’s situation is
not any worse if no information is provided about a,b,c.
I.e. information regarding good experiences is better than information
bad experiences.

Perhaps a fair evaluation is one that tells the author’s biases and
experiences more verbally in addition to or instead of a number
ranking.

Here’s an example of bad experiences (and the requisite comparison of
good experience):

My personal experience with Mills-Peninsula medical group has been
inconsistent. For some services, I have received “marginally
acceptable” treatment — a physical that took heart and blood tests
and “come and see me again in N [N > 1] years”.

For other services, I have received questionable treatment. Surgery
without a second opinion is always risky, but then again, the risk is
due to the variance of doctor competence in diagnosis. A second
diagnosis is more like a comparison of (and search for) physician
competence rather than a “vote” on the recommended treatment. You
could say that some physicians are consistently more competent than
others, such that for certain good physicians you don’t need a second
opinion. I.e. successfully treated patients are the evidence — if
such information could ever be made publically searchable.

My wife’s experience with Mills-Peninsula ER team has been fairly poor
the one time she was taken to the ER after passing out after
having blood drawn. In Dr. Google’s estimation, she
experienced syncope.
Now that in itself is no reason to be alarmed about the quality of
health care at Mills Peninsula. However, when in the ER (which she
was for over 2 hours), no diagnostic tests other than listening to the
heart with a stethoscope were performed on her. However, 4 more vials
of blood were drawn to complete the blood test panel. The blood was
continued to be drawn from her while she was sitting up even though
Dr. Google recommends href="http://www.medterms.com/script/main/art.asp?ArticleKey=5612">to
lie down for blood drawing

Here’s some symptoms and search-engine-driven diagnosis:
* Her blood pressure was 90 over 60 and later 107 over 70. The blood
pressure was taken from different arms. Dr. Google thinks this is
somewhat significant. The ER doctor didn’t ask about such in their
observations.
* In href="http://www.annals.org/cgi/content/full/126/12/989">another
reference, Dr. Google states that “Although the yield of
electrocardiography is low (5%), the test is risk free and relatively
inexpensive. … Electrocardiography is therefore recommended in
almost all patients with syncope”. However, no EKG was performed
during the 2+ hours in the ER. Such a test takes no more than 10
minutes of pasting on electrodes and letting the computer run.
Instead the ER folks persisted in taking the rest of the blood
samples.
* There is a family history of fainting in her immediate family.
Again, no such questions were asked although href="http://www.annals.org/cgi/content/full/126/12/989">patients with
a suggestive history should get more testing..

You can’t expect ER (triage) doctors to know everything. But you
might reasonably ask how sick do you have to be to get attentive
treatment by a knowledgable doctor? i.e. the process of treatment by
Mills Peninsula is somewhat lacking in depth or conclusion.

Here’s an example of a good experience:

After over one year of wound care after surgical removal of a
retrorectal abscess with a wound that still wouldn’t heal and before
an upcoming third surgery with no planned presurgical tests or
communicated surgical plan, I got a “second opinion” at UCSF where I
was scanned with an MRI to determine that a tiny hole in rectum
(perhaps newly appeared) was causing the chronic infection preventing
the wound from healing. I had originally asked for an MRI two years
earlier before the initial surgery, but Mills Peninsula only had CT
scan facility. This in itself isn’t a bad mark against mills
peninsula, but reluctance to refer to a more capable facility is one
bad mark. Dr. Google thinks MRI is href="http://www.fascrs.org/displaycommon.cfm?an=1&subarticlenbr=154">slightly
better than CT scans.

When I was examined initially at UCSF, the first person I saw
wasn’t even a doctor, but a second year medical student. She
interviewed me for about 30 minutes to take a complete medical history
of the particular condition I was asking treatment for. This goes to
show that experience does not necessarily indicate quality, but
process is an indication of quality. i.e. inexperienced, but
following a good process (of detailed interview) produces a good
experience and I think a good result.

You can infer from these comparisons that I prefer UCSF over
Mills-Peninusla. I have hope for a good treatment result. I also
expect to have my wife see a cardiologist there about her fainting.

My assertion is that poor customer service (bad cash register
skills, lack of help on sales floor, arguing with customer during
sales process) is better than customer unfriendly service (imposition
of lose-lose rules “with a smile”, forcing fliers to throw away their
nail clippers rather than mail them back to themselves, cancelling
flights that are not full enough to pack the next flight, etc.)

As a concrete example, Border’s Books in Union City (maybe elsewhere
too since the workers in the trenches don’t dream up these things
unless they are looking at bottom line numbers — typically done by
managers) has developed a particularly unfriendly policy of:

• not letting customers browse magazines in the eating area even if
  they have purchased drinks and food.
• not letting customers sit at certain tables and ‘study’ even if
  they have purchased drinks and food. The idea of study is
  inconsistently defined to using a computer. To my confirmation,
  reading a book is ok. It might even be a book that has some
  educational use. And the rule isn’t as much enforced as it is bullied
  into compliance. The hard-skinned can ignore the employee requests
  and the softer skinned, more sympathetic customers will reluctantly
  obey.

“So what,” you say. The lack of an empty table discourages newcomers
from wanting to buy drinks and sit down, and consequently reduces
revenue. But is it better overall to let new customers be visually
discouraged from buying food and drink, or to verbally discourage
existing customers from ever patronizing the business again. These
disgruntled customers then make a point of buying books from barnes
and noble (where I haven’t personally experienced any verbal
confrontation at any of the many stores I have been to), amazon or a
local store, and write scathing commentaries online.

So the net effect before and after Border’s Cafe rules:

before:

1. buy food and drink ( + profit )
2. read and work
3. maybe buy book (+ profit)
4. go to step 1 over period of weeks/months.

After:

1. buy food and drink ( + profit )
2. read and work
3. maybe buy book (+ profit)
4. get offended at verbal confrontation (0 profit short term, but -
   profit long term )
5. go elsewhere ( – profit)
6. don’t bring friends (- profit)
7. write weblog commentary ( – profit through influence)

The history of Border’s increasing customer offensiveness is roughly
as follows:

• 1998 – All is well with Border’s cafe
• 1999 – Barnes and Noble superstore with a cafe opens up 1/4 mile
  away and draws away a lot of Border’s customers revenue.
• 1999-2000 Tipping is no longer allowed at Border’s Cafe. This one
  is a surprise, isn’t it?
• 1999-2000 – San Mateo Border’s Cafe starts to verbally discourage
  use of computers by telling customers to not plug their computers into
  the wall. Yes, corporate policy thinks an extra 12 cents of
  electricity is worth verbal confrontation with customers.
• 2002-2003 – Union City Border’s Cafe verbally discourages
  browsing of unpurchased magazines in the cafe.
• 2003-2004 – Union City Border’s Cafe verbally discourages
  “studying” at tables

As far as I know, there is no competing bookstore near the Union City
Border’s Books. Before 1999, my impression of Barnes and Noble wasn’t
so great. I liked Border’s selection better. Barnes and Noble seemed
to have too many penguin classics and science fiction and not enough
current literature. In 1999, they caught up and I think effectively
overtook Border’s in the sense of selection, presence and experience.

As a footnote, cafes all over have had to learn to deal with the
worst customer: the student. There are many ways of various
effectiveness and palatability:

• limiting table time
  during busy periods and doing so in a fairly consistent and insistent
  way
• requiring you to buy some amount of food or drink to remain
  seated
• explicitly banning studying (a most reprehensible rule as
  explained above)
• limiting table sizes or number of tables to
  discourage sitting at tables and rather get food to-go
• making environment unattractive to sit in (think fluorescent
  lighting and linoleum tile that feels like someones kitchen)
• serving all drinks in to-go cups to encourage you “to go”.

Needing a fax, I picked up a fax/scanner/copier unit with no
research at all, just banking on HP’s reputation. It works well as a
send or receive fax, but the auto-feeding makes me nervous. I keep
thinking it is going to grab two sheets at once. Also, as I find out,
the cost per page is something like 9 cents due to the inkjet
cartridge cost. Black and colors are separately replaceable, but ink
does cost.

Also, the PC scanner software doesn’t seem to deal with the
auto-feed correctly, or perhaps that is because I was using lighter
weight sheets cut out of a magazine. The PC scanner software would
also crash every so often.

Another person’s experiences with HP 4110

As a printer, the HP 4110 seems less reliable or durable than other
models. The paper feeding mechanism sounds like the printer is eating
itself alive. In addition, trying to print a one page document using
inkjet weight paper, the paper misfed or fed slightly diagonally about
4 out of 5 times. I.e. I had to reprint about 5 times to get an
acceptable output. I would not recommend this as a printer to anyone.
Likely the fax aspect of the printer would suffer from similar paper
misfeed, so I wouldn’t recommend as a fax for receiving faxes.