The Devil is in the Details

May 1, 2019
A case for sweating the small stuff.

There was a popular personal development philosophy that originated in the late ’90s. It suggested there was no need to sweat the small stuff. And, that in the end, everything was really small stuff.

When it first surfaced, I was already deep into my chosen profession and had created my own personal development philosophy. I called it MAD: meticulous attention to detail. For all intents and purpose, it was the very antithesis of “don’t sweat the small stuff.” In fact, it suggested that anything and everything worth doing was important and deserved your best effort to achieve perfect work. It recognized that perfection was a goal not often achievable, but nevertheless more than worth the effort.

I became obsessed with “the small stuff,” knowing that if ignored it could quickly and easily become “big stuff.” The devil was really in the details and that “big stuff” could quickly and easily come back to hurt you.

MAD, as a philosophy, served me well both in life and in business. It helped avert, or at least mitigate, countless crises. After more than 50 years in business, it’s easy to spot when detail is not addressed and “small stuff” is ignored, especially when you are aware of the chaos that normally follows. It is costly in terms of both productivity and profit when it occurs in your organization. But it can prove devastating when you are its victim. I know. I just lived through three weeks of it.

A little more than three weeks ago I was prescribed the only FDA-approved drug to mitigate the symptoms of my disease. Its cost is insanely expensive—enough to take a nice European vacation or purchase a late model sub-compact every month. But, more than that, it is the only drug to help reduce the debilitating impact of the laundry list of symptoms that continue to present.

It is what is classified as an oral oncology specialty drug and requires prior authorization before the prescription can be filled. It isn’t very different from what you and I have to do when seeking authorization for an extended service warranty claim while working on behalf of one of our clients, only more exacting.

The prescription was written on January 3 and was accompanied by the doctor’s prior authorization submission. I should have received it within just a few days. As with all cancer drugs, timeliness is critical. In the case of my drug, there is evidence that, when taken for more than 30 days before stem cell/bone marrow transplantation begins, it can greatly reduce the likelihood of graft versus host disease, a potentially life-threatening consequence of the transplant.

When the drug did not arrive as expected, I waited until Monday before beginning my search for a reason. I started with my prescription drug coverage pharmacy only to find that the prescription had been denied for previous authorization, which I knew had accompanied the original script. After three days of unanswered queries to the hospital, the insurance company and the pharmacy itself, I was finally able to determine that someone at the hospital had failed to enter the correct diagnosis in the appropriate box: “myelofibrosis,” as opposed to “primary myelofibrosis,” and, as expensive as this medication is, that’s all it took.

I alerted the hospital to let them know what was going and why, and then depended upon them to send in a prior authorization that filled out accurately. The form had to be submitted three more times before the prescription could be filled because they couldn’t see their own error and it took 21 days before the drug actually could be delivered.

Don’t sweat the small stuff? Really?

How many times have you seen one of your techs scratching their heads as they stood there wondering, “What the heck was I doing?” after having been distracted.

It doesn't take much to send the entire shop into a dangerous downward spiral. Just a momentary lapse of consciousness before everyone in the place is racing around trying to figure out what just happened and why.

One word left out of one document that revealed a lack of process and systems failures that could have proven deadly. The individual responsible could not see why their submission was rejected and kept re-submitting it until the fact the diagnosis was incomplete was pointed out to them by the patient. But how different is that from the tech that gets a cell phone call while working on a head gasket replacement and fails to finish the final torque sequence leaving the bolt loose and the clamping pressure inadequate?

The devil is in the details and none of it is small stuff!

Sweat the small stuff and there won’t be any big stuff. Pay meticulous attention to every detail in both your personal and professional lives and watch the stress that accompanies every unnecessary crisis in your world evaporate.

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