I am not a designer, but I am a collector of bad design. Often, bad design masquerades as a wonderful idea, but people can’t seem to make it work. These days, you can elevate bad design to heights previously unknown, what with digital technology.
For instance, it seemed like a very good idea that my mammography office should text me (from a number that is already in my address book) with a reminder to make an appointment a year after my last mammogram. So far, so good.
My first response, a reasonable one, was to reply to the text and begin to make an appointment.
Then I realized half way through that I hadn’t yet been to my doctor and gotten an order for the procedure. I can’t have a procedure done in my system without an order. So I exited the appointment system and made an appointment with my doctor for my annual checkup instead.
At that point, the mammography office automatically started nagging me, telling me that I had not finished making my diagnostic appointment. It was specifically designed to do that. It was trying very hard to people-proof the process of making an appointment. It was doing it very badly.
Despite getting increasingly annoyed and stubborn from all the nagging, I eventually got an order from my doctor, and, as one does, I put off making the mammography appointment even longer, because it involves slamming my breasts into a vise four different ways and standing there half naked and not breathing while a chirpy technician exhorts, “Don’t move! Don’t move!”
(Mammography machines, though they have been beautifully designed to be ultra-sensitive scanners, have never been comfortable. I would argue that from the point of view of someone with breasts, they are terrible design. From the point of view of radiologists, of course, they are divine.)
Yesterday, I finally clicked on the link in the latest hectoring text, and made an appointment. That was a mistake.
I belong to a large medical system with a portal, in which I have an account that contains all my medical history and all my credentials, and the mammography office is part of that large medical system. I have also been this mammography office before, though when they were in the old building, so I was startled that they asked me to re-enter all my information. Not just the usual disclaimers, but all the information. They asked me to re-upload images of my insurance cards, for instance, and to tell them all the people in my family who had breast cancer, and what my allergies were.
With the usual uneasy certainty that something was going to go wrong, I headed off to the mammography office, in its brand-new high-rise building.
It is a glorious building. The building glitters, it is so new. It should have helium balloons and doves all over.
However, there were Xeroxed signs taped hastily to the beautiful front doors, saying, “Pull, don’t push.”
Those signs are an indication of Norman doors. A Norman door is very common; it is simply a door you can’t figure out how to open just by looking at it. Push? Pull? Twist? Some Norman doors don’t even have hardware, so people try to push on the hinges. (They are named after the guy who identified the problem.)
If you have to put a sign on any door (“Use other door,” for instance), it’s bad design. Doors should indicate in a very clear way what you’re supposed to do with them, or you end up with everyone struggling to open them, while the people who work in the building, and have learned how the doors work, watch, make fun, and eventually put up paper signs.
The lobby, once I got inside, was spacious and busy, with beautiful escalators and people moving briskly everywhere. it looked like the future.A row of automated podiums invited people to check in for their appointments. They also looked like the future.
The podium didn’t find my appointment.
I went over to the human beings who were sitting, bored, inside a reception desk area. They looked at my printout, which I had brought with me even though the information was on my phone, because otherwise I would have to hand over my phone for them to stare at.
“Oh, you don’t have to check in for that,” said the lady I had shown my appointment to, and gestured toward an elevator bank at the back. “Just press the number of your floor on the pad in the elevator lobby,” she said.
Luckily, I figured out that the dolmen (two pillars with a cap over them) next to the reception cubicle was supposed to be a security scanner, and so I passed through it (without setting it off for a change) instead of walking on the other side of it. A woman attempting to go to the elevators at the same time as me was not so fortunate, and had to back up and go around again.
I pressed “4” on the pad, but the first elevator’s doors closed swiftly on the last entering passengers, and then tried to shut on them again, as if the elevator was in a hurry. It certainly got away without me, which seemed to be its goal.
I pressed “4” again and managed to get into the next elevator, which now refused to close for some time, announcing “First . . . floor” over and over again. Then its doors tried to eat me, just when I thought maybe it was stuck and I started to get out.
I finally got to the fourth floor and asked someone standing under the “Mammography” sign where I was supposed to go, because the arrows were unclear, and she said, “Oh, you check in all the way over there,” and pointed. I walked another fifty feet. it was still not clear where I was supposed to check in, but eventually someone looked up and beckoned.
The clerk asked me if I had an order for the procedure. I had printed out a copy of that, too, because, again, I didn’t want to hand over my phone. “I’m not seeing an order in your portal account,” she said. Then, because she was no fool, she suddenly said, “Do you have two portal accounts?”
Aha. The automated system of the mammography office had created a new portal account for me when I clicked on the text link to make an appointment. That was why I had to upload new copies of my health insurance IDs and tell the computer about my grandmother’s breast cancer.
The clerk left me there for ten minutes or so, and came back, having merged my duplicate account, under the supervision of someone more senior, who had the permission.
“You are my hero,” I said to her, and she looked very tickled.
After that, everything went as designed, up to and including the horrid gowns, the awkward placement, the four terrible squishes, the glowing humming machine, and the technician calling, “Don’t move! Don’t move!”
However, I went to the bathroom after I changed back out of the horrid gown. The bathroom, like the whole building, was very new and very shiny.
There was a hole in the wall where the doorknob had hit it, because nobody realized that would happen if you opened the door all the way.
it was a very shiny doorknob, however. Beautifully made. It was the bathroom that was a bad design.
I made it out of the building-of-the-future, and got on the bus to go home. On the way I got a text telling me to check the patient portal, and when I did, I found out my scan showed no problems.
That, at least, was good design, of a sort, though I also got three more texts, two emails, and a bunch of notifications, all telling me the same thing, and several of them requiring me to log in (again) with 2-factor authentication (again) into the patient portal.
I didn’t dare ignore any of the notifications, because I have another appointment with my doctor next week and I don’t want to miss any of the questionnaires they ask me to fill out every time with the identical information.
I am hoping that next year they will not have improved all the design beyond my ability to cope. I will continue to print out everything and take my physical insurance cards with me, because who knows where I will end up otherwise. Eaten by an elevator, maybe.