Our team answers American phone lines from Romania. At some point we stopped treating that as a language problem and started treating it as a cultural one, so we sat down and wrote our own curriculum about America.
Ten volumes. Regions, etiquette, money, small talk, food, healthcare, holidays, humour, work, and the things people are touchy about. Written internally, for us, by people who had to learn it the hard way first.
Volume 3 took the longest
It is about warmth that is not intimacy.
“How are you?” is a greeting, not a question. An American cashier will call you “honey” and mean nothing by it except goodwill. A colleague will say “we should get lunch” as a way of ending a conversation warmly, not as a plan. None of this is insincere, that is the part that takes longest to land for a Romanian speaker, where that register of friendliness usually signals an actual relationship.
Get it wrong in one direction and you sound cold to a patient who is already anxious. Get it wrong in the other and you sound like you are performing.
Why this is an operations document, not a culture one
Because it shows up in the numbers. A patient who feels handled hangs up and does not book. A patient who feels heard books, attends, and comes back. That is not a soft outcome, it is the difference between a filled schedule and an empty one, and it is trainable.
So we treat it like any other operational skill: written down, versioned, taught deliberately, and revised when we learn we were wrong about something. Volume 3 is on its fourth revision.
What is in the rest of it
Regional differences, because New Jersey is not Texas and pretending otherwise is how you sound like a call centre. Insurance literacy, because American patients often do not understand their own coverage and the person on the phone has to be gentle about that. Money, because talking about cost in American healthcare carries an emotional charge that does not translate. Holidays, because somebody calling on the Fourth of July needs a different tone.
None of it is complicated. All of it is specific, and specificity is the only thing that actually transfers.
What Brașov is actually like to work in
The city, the commute, the mountain at the end of the street, and the shift that puts you in the office when everyone else is leaving.
The one-button billing robot
Why Phase 0 of every automation we ship is deliberately, aggressively dumb, and why that turns out to be faster.