Wearing Scrubs Outside Of The Clinic? A Marketer’s Perspective

It’s a debate almost as old as scrubs themselves: should scrubs be worn outside of the clinic? My take: perception is everything so, hell no!

Marketing is essentially the art of persuasion. It is the art of influencing the perceptions of others so that they buy our product, recommend our practice, take the steps we want them to in order to achieve our end goal. You’re persuading your customers that your product is the best, your cars are cooler, or in the case of medical practices (regardless of specialty) you’re attempting to persuade patients that you are professional physicians with high standards and that you deserve a reputation befitting the high quality of patient care you deliver.

Seriously, it doesn’t matter if not changing into your civilian clothing is more efficient when you want to run out and grab that well-deserved bite to eat during a busy clinic schedule. It doesn’t matter if some studies claim that wearing scrubs outside the clinic is not any less hygienic. What really matters is the perception that patients have, and that perception is that clothes worn in the clinic should be clinical, i.e. clean.

I have spent years working directly with medical practices. I know the reality behind the scenes, yet even I cringe a little when I see staff in scrubs huddled in a booth across from me at the Mexican restaurant, getting off public transit, or trudging out of the gas station with their much-needed energy drinks.

If I cringe regardless of my “inside knowledge,” imagine what less-informed patients are thinking and what that is doing to your overall reputation as a practice.

While I’m at it, this same advice applies to beauty salons and any other business where staff wears scrubs. The logo on your scrubs isn’t free advertising: it’s letting those who perceive clean scrubs as part of their care or treatment know exactly where not to go.

I’ll end where I started: when it comes to selling, perception is everything.

The Luxury Of Living At Work?

The Luxury OF Working From Home

I don’t work from home. In this pandemic, I am required by my employer to be in offices 6 days a week. Yet I don’t envy those who have the “luxury of working from home,” because it’s not a luxury. It’s quite the opposite in fact.

Let me make this a simple as I can. Pre-pandemic, the ability to work from home was a luxury. Sometimes reserved for employees as a reward, it was often seen as a perk. As I look around at my friends and family that are working from home, it’s painfully apparent that the only people benefiting from this “new normal” are employers.

Work-life balance is out the window. I see family working extra hours FOR FREE because they are unable to meet the requirements of their jobs during regular business hours due to the pressure of being at home, without a proper workspace, dealing with children who are not at school, other family members who are also working from home, and the myriad distractions that come with that.

“But Paul, shouldn’t they make up the hours for the work they don’t accomplish?” I hear you ask. “Doesn’t the employer deserve to get what they pay for?”.

Yes, they do. But frankly, fuck’em. Let’s talk about what they employer is getting out of everyone working from home, shall we?

In most cases (and yes, I’m sure there are a handful of excellent employers who deviate from the norm,) the workloads have not decreased, but do you know what has? The employers’ costs.

Some have reduced the amount of space they are renting, but others, even if they keep the space in hopes of the full workforce returning to the office after the pandemic, face dramatically reduced costs for that space. Water, sewer, heating (or air conditioning), electricity, office supplies, insurance, cleaning, hardware /furniture /equipment attrition costs have all dropped dramatically. That’s to name just a few.

Those costs are now borne by guess who? That’s right: the employee.

Most people did not have an office in their home pre-pandemic, and those that did usually didn’t have it set up as a long-term work environment.

No matter how cheap you choose to go, it costs time and money to set up a long-term workspace in your home – assuming you even have the space to do so. Who pays for that? Do you get reimbursed for the desk, desk chair, laptop stand, monitors you had to purchase in order to be in any way as efficient as you were in the office?

Who pays for the additional water, sewage, heating / air-conditioning / office supplies / company coffee costs that come with being in your home instead of the office? You know, the normal costs of doing business, those unspoken items that are part of your employment, that are now being dumped on the employees.

Let’s not even talk about the cost of internet usage in America and its “no real choice is an actual choice” approach to broadband providers. I can’t get unlimited where I live. I have a 1TB cap, and we come precariously close every month to passing that cap because one of us is working from home. If we both were working from home, then we would blow through that cap in no time, and then come the overage fees.

And don’t get me started on those who offer advice to others without realizing that their reality is simply not the reality for the majority of folks. Nor could they make it such if they wanted to!

“If you have a standing desk, recreate that at home. You also want to make sure that your chair is ergonomically comfortable and that it’s an ergonomically friendly keyboard,” Mathew said.
But that doesn’t mean working from home can’t convey some extra benefits. For Kvinta, that includes regularly working outside.
“So, I do have an office — a dedicated office inside. But on beautiful days like today, I haul everything out, put it on my table on the porch, and I can work all day on the porch. It’s pretty awesome.”


Sure Kvinta – We’ll drag the desk, two monitors, laptop, dock, and everything else out on the back porch, and set up a canopy to stop the Alabama sun from glaring off the screens. Let’s have the cabana boy bring margaritas while we’re at it. Christ on a cracker, at least I have a deck. What about all those poor wretches paying through the nose for studio apartments? I’m sure they can drag all their stuff to… Wait, what’s open and safe, with free wifi?

Don’t get me wrong. It’s not all great for employers, but my blood boils when I hear that even the richest of the rich (almost) want to reduce employee wages because they are working remotely.

It’s a fucking global pandemic people, and despite the existence of vaccines, the end is not yet in sight, for so many reasons.

If employers want to show solidarity with their remote workforce, maybe they should reduce expectations and increase pay. I’m certain it won’t inconvenience the shareholders all that much. It will go a lot further than platitudes at engendering goodwill with employees and improve retention when we come out the other side of all this.

Your home is supposed to be your castle, your sanctuary. I find it pretty fucking offensive: that the majority of employers just started squatting in people’s homes without so much as a “by your leave.” Fuck, most squatters would at least offer a reach-around to stay…

Facebook Is Correcting Username Misspellings on Login

Spotted this earlier today, in the Outlook app on Android, while I was reconnecting my Facebook calendar to my Outlook calendar.

Facebook Is Correcting Username Misspellings on Login

It looks like you entered a slight misspelling of your email or username. We’ve corrected it for you, but ask that you re-enter your password for added security.

I see this a potential security issue, especially if someone is guessing which username / password you’ve used but has the password. Thankfully it’s not too much of a problem if you have two-factor authentication enabled, but it’s still a potential security issue.

Fear Is The Mind Killer

Be Brave Enough To Be Bad At Something New - Jon Acuff

Fear of failure, fear of what others may think, fear of being unable to do something. It affects all of us in different areas of life. It can lead to stagnation, not achieving anything from over-preparation, and leads to so much unnecessary stress and lost potential.

You’re not alone. It happens to me more than I’d care to admit.

Let’s be brave! Let’s start that new project, take that trip, ask that person out, learn how to salsa.

There is no failure, because even if things don’t work out we will have new experience to build upon so that we get it right the next time.

Who’s with me? What will you start today?

Facebook App Mis-Attributing Posts To Other Users?

Maybe it was just a glitch in my app, but this morning I received a notification on my Facebook App that Sara had commented on a post (why I got this notification I’m not sure, as I was not following the post) – only to click through and see that it was her own post, except it wasn’t.

The Facebook app was displaying someone else’s post from 19 hours earlier, as Sara’s from three minutes previous.

Facebook glitch - mis-attributing posts
Here is what I saw on my phone.
Facebook glitch - mis-attributing posts - original post
Here is the original post from 19 hours previous.

This issue was not occurring on the website version. Has anyone else experienced this in the app today or lately, or is it a glitch confined to just my app?

She Should Have Flown United – Nothing Serious Podcast #118

Flat Earth conspiracy theories, the excitement in science, Mike Pence vs the Internet, Ann Coulter vs Delta, rocks with religious writing vs Atheist car windows, and Bill Gates vs money.

Doctor Who fans should stay tuned after the episode for some bonus content about the first female Doctor.

Stories mentioned in episode 118 of Nothing Serious Podcast include:

Things To Consider When Buying Computers For Your Medical Practice

Things To Think About When Buying Computer Equipment For Your Medical Practice

Money can be tight when you’re starting up your medical practice or small business, and it can be very tempting to save money by buying cheap computers –  but this decision can end up costing you more in the long run in terms of lost productivity and early equipment replacement.

TLDR; Buy the most powerful PCs (for stationary positions) and laptops (for “mobile” staff)  you can afford, with the pro version of the latest Windows operating system (ie: Windows 10 Pro). Don’t worry about dedicated graphics – focus on getting the best CPU, with the most RAM and a solid state drive.

Here are some things to consider to help you buy the right equipment, keep costs down, but also future-proof yourself and improve your workflow.

Apple or Windows?

Windows. You’ll be hard pressed to find a server based EMR or practice management software that runs effectively on a Mac unless you’re using remote desktop or some other solution to connect to a dedicated server. Even web-based solutions require bridging software to talk to their peripherals, most of which will not work with Apple products. While there are ways around this, and it is certainly possible to have an Apple based office, save yourself a headache and the cost.

Do I need desktop computers if can we use laptops and tablets?

Straight answer – it depends on what you’re using them for:

For the reception, office manager, and other admin staff, which is an essentially stationary position, I would always go with actual PCs.

Check-in, and check-out positions tend to require extra peripherals to be connected directly to the computer such as webcams for taking pictures of the patients, signature pads, card scanners and credit card terminals. These all require extra ports to be available on the machines which laptops typically do not have enough of.

PCs also allow you the flexibility to have dual monitor setups which make working in an EMR considerably easier, especially when you have other programs as well. This increases efficiency, reducing the amount of time your front desk staff spends processing each patient.

It’s also easier to upgrade components in PCs than laptops which enables you to use the hardware longer and at a lower cost.

For staff who are mobile within the office, such as physicians, mid-levels, and nurses that are seeing patients, I would go with laptops.

Laptops are portable enough that you can bring them into the exam room with you and document while you are with the patient. I’ve seen this save between 5 and 10 minutes a patient allowing for a higher volume of patients to be seen during the day. It also helps prevent issues where a provider may forget to document something that was noted during the exam if they become distracted or are diverted after leaving the exam room and have to document later.

I wouldn’t use tablets. Tablets, while portable, tend to be underpowered and documenting on them tends to be considerably slower, even when they are equipped with a keyboard. – Sidenote – I’ve seen clinical staff almost cry when I’ve asked them to work on a device where the keyboard didn’t have a numeric keypad…

Use of tablets can also lead to issues relating to printing unless you take extra steps to prevent that.

Are you using a server or web-based EHR/EMR?

Server-based EMRs, whether the server is onsite or offsite, typically require you to install dedicated software on your computers in order to be able to use the system. In my experience, this software is typically enough to bog down slower computers, which reduces efficiency, and the requirements for this software only increase over time.

Web-based EHRs tend to have much lower requirements than server-based. Often all you need is a modern browser such as Google Chrome, Microsoft Edge or Firefox, and usually a small lightweight piece of software to bridge the gap between the browser and the peripherals.

Even for web-based solutions, I would caution against skimping here. Your PCs will have a lot of peripherals attached to them, many of which will also be running their own software. The combined load can significantly slow down older or less powerful PCs resulting in reduced efficiency, unhappy staff, unhappy patients, and reduced patient throughput.

What about my network?

Your network is definitely an area not to skimp on – all of your data, print connections, file shares, internet access, streaming audio and maybe even your VoIP phone connections will travel over your internal network so it had better be fast –  although fast doesn’t mean that it has to be expensive. Gigabit switches are cheap these days, and every switch on your network needs to have gigabit capacity or you will create a bottleneck and slow things down.

Your router is no exception. I’ve seen offices with Gigabit networks hampered by poor or aging routers acting as both their firewall and DHCP server. For example, I was recently at an office that despite having a robust network was using an older Cisco Security Appliance as their router and DHCP server. The appliance in question could handle 40000 packets per second, which was causing a bottleneck and resulted in IP addresses not always being released or assigned (which meant devices were sporadically unable to connect to the network). Replacing it with a newer router for less than $300 increased the throughput to 2 million packets per second and alleviated the issues.

Don’t use domestic wi-fi equipment for your office or guest networks. They’re just not built to take the number of devices you’ll have connected to it. For example -let’ss say you have 7 laptops, 10 cell phones (that’s one for each member of staff – let’s be honest everybody wants to use work’s data instead of their own), 4 tablets (used for patient check-in), 2 streaming audio devices such as Sonos (it’s nice to have music that’s not muzak in the clinical area), and you’re already up to 23 devices before you even think about adding a guest network.  Equipment such as Ubiquiti Unifi is as cheap as if not cheaper than many home wi-fi solutions but will be far more reliable with much higher capacity and allow for easier expansion.

What do I recommend?

Every situation is unique but in general,  I recommend that you focus on interoperability, expandability, performance, and cost first.

The easiest way to achieve this is with Windows-based PCs. They’re relatively cheap, work with almost everything and won’t limit your choice of EHR or practice management solution.

When purchasing, focus on getting the best processor, the most RAM (8 gigs minimum but 16 would future-proof you) and an SSD (solid state drive). It doesn’t have to be a large SSD – 128 Gigs should suffice most computers as important file storage should be centralized and backed up. You could go with a traditional hard drive here if storage space was more important to you than speed.

Don’t worry about spending money on graphics cards – the integrated graphics chips on modern PCs are more than a capable of driving dual displays and anything the standard office environment can throw at them. Your staff should not be playing Fallout 4 on them.

Laptops should also fit a similar description, but the important thing here is the form factor and screen resolution. To get the most efficiency out of your EHR you’ll require a screen resolution of typically 1920 x 1080. Smaller screens will start hiding menus forcing you to click around more.

The form factor or size of the laptop is a matter of personal preference. Keep in mind that you’ll be carrying the laptop around all day, so lighter is better, but don’t get too caught up in it. Most laptops, even the larger ones with full numeric keypads, are light enough to tote around all day as most of the time you’ll put them down when you get in the room.  An SSD is essential here though, as they have no moving parts which can help avoid damage which would occur to a traditional hard drive if there was a drop or bump.

Obviously, I haven’t covered everything that you need to think of here, such as implementing a refresh cycle, servers, on-site and off-site backups, redundancy etc, but I hope I have given you a good place to start.