Patient satisfaction is an important element of medical care. It was always important, but it has taken on a new significance since hospitals and physicians will be graded on their bedside manners. And, these grades count for cash. Money motivates. Who believes that a leopard can’t change its spots? Throw a leopard into the pay-for -performance arena, define spots as inferior quality, and watch what happens. We would all witness a Darwinian tour de force as leopards would become spotless in just a few generations.

Recently, I was exposed to 2 models of customer service. First, I endured the experience of setting up cable service for TV and wireless internet. Sounds easy, but I would not advise this task for anyone who has a heart condition. What should have been easily accomplished in one phone call took multiple calls to screw it all up. Of course, every single call ‘was important to them’ and required a generous amount of waiting time for me. With one exception, every customer service agent I reached was located in another continent. I am not railing against outsourcing here. Companies make products and hire workers abroad because it is in their economic interest to do so. However, since my specific and simple question was best answered by one of their local folks in Cleveland, none of the reps in India or the Philippines could answer it.

Try also explaining to them that it is hard for a working person to be home to greet the local installer when you are not given a specific time of their arrival.

I can’t wait when I need to contact these guys when the system is malfunctioning. I don’t yet have coronary disease, but I might pop a nitro under the tongue then just in case. The headache the pill might give me will nothing compared to the throbbing migraine the phone calls will cause.

In addition, different reps offered entirely different advice, which I think were total guesses. This is always fun for the customer. See excerpt below.

Rep #1: I recommend that you do this

Rep #2: I recommend that you do not do this.

Rep #3: I recommend that you contact Rep #4.

I tried to beg or bribe them for a local Cleveland phone number to contact, but this classified information was on a ‘need to know basis’, and my need to know didn’t cross the threshold.

And then, there’s the Apple Store. My beloved iPhone unexpectedly suffered a cardiac arrest, a total meltdown without warning. Cruised over to Apple and was immediately greeted by an affable rep who actually seemed to care about my misfortune. I was siphoned over to another rep who in a few minutes recognized that my iPhone’s soul had already ascended to heaven and would no longer enjoy an earthly existence. He provided me immediately with a new device and waited by my side until he could verify that it was operational. I’ve been to this store on other occasions and am always impressed with the courtesy, efficiency and competence that their outstanding staff show to their customers. It reminds every time me how inadequate and undervalued customer service is in the marketplace.

Is Apple simply doing what all companies should do, or is this standard unreasonable? Do other companies make it tough on us on purpose to discourage us from complaining or asking for refunds or rebates? How many gazillions of dollars to insurance companies reap because we simply give up seeking relatively small amounts of money that we believe we are entitled to?

Which model of customer service do we physicians use with our own patients? Do we emulate the airline industry? Or, do we look to a group of young and energetic geeky types for guidance?

Remember the adage, an apple a day keeps the doctor away? I suggest that we doctors keep an apple on our desk to remind us why we come to work.

Michael Kirsch is a gastroenterologist who blogs at MD Whistleblower.