A friend recently called a doctor to make an appointment for an epidural shot for his sciatic back pain. He was given a date and told to arrive two and a half hours ahead of the appointed time. When the perplexed friend asked why so long a wait, the answer was simply, "That's the way we schedule here -- in case the doctor finishes earlier with some of his patients."
"...in case he finishes earlier? All his patients would have to die for him to finish that early," the friend lamented.
Incredible as it seems, this doctor has a built-in, two-and-a-half-hour wait for all his patients. This is clearly a guy from the old school, the old being the 'Doctor-as-God school.' However, in our modern, Byzantine health care system, doctors are re-cast as 'practitioners' so why shouldn't we patients be re-branded and treated as 'customers'?
This could be a generational concept. If you ask 88-year-old retired Syracuse, N.Y. cardiologist Murray Grossman if he ever thought of his patients as customers, you'll get a decisive "No." Same response from retired 71-year-old Los Angeles rheumatologist, Michael Lutsky. "Absolutely not. It was frowned upon in our training to consider patients as customers." The business of medicine, how to run an office, how to market yourself and the notion of customer-based thinking was, and is still not, a part of medical school curriculum.
"It should be," says 56-year-old Mark Schlesinger, M.D., a board certified anesthesiologist with a practice in Burbank, Calif., "Patients ARE customers, of course!"
Schlesinger is a pain doc, "not just another shot-jockey," he's quick to add. When he first started out in medicine, he ran what's called a 'block shop' in a hospital. That's one of two disparaging terms to describe pain doctors. Block shops are guys who will stick a needle into anything whether it'll help, or not. Pill mills are doctors who write a prescription for anything if you have enough money.
It took a bit, but he eventually came around to the concept of customer-based medicine. The Schlesinger Pain Centers -- note the plural -- offers more than just epidural shots. According to the very slick, four-color promotional cards in his office, Schlesinger offers customers a complete line of services for sale including Medical Management, Full Service Office Injections, Pain Pumps and Stimulators, TENS Therapy, Pain Support Groups, Traction/Inversion Therapy, Massage Therapy, Yoga Therapy and Psychological care.
To ease his customers into all this, the doctor runs I Love Lucy episodes on the flat-screen TV in his waiting room. Music plays during procedures as he works in a faux tiger-skin apron. Oh, and when you leave, you can take home your very own Schlesinger Centers T-Shirt (sm, med, or lg,) imprinted on the front with a caricature of a happy customer, doing a hand-stand saying, "I SURVIVED MY NERVE BLOCK while the back of the shirt proudly proclaims, "IT'S ALL GOOD" -- complete with website and phone number.
"If you go back to the years before lots of insurance, doctors did think of their patients as customers. They knew their patients as people, they had a pretty good idea about their patients' economic situation so they could charge a fair price,"
Schlesinger says. But this is now, and it seems the doctor-patient relationship has morphed into a something akin to speed dating. "We deliver care in ALL its forms," Mark Schlesinger explains. Sure, care is having effective diagnostic and treatment skills.
"...care is also seeing patients as people, and not just as colons, gall bladders or heart valves. Most doctors won't call their patients customers because they think it's demeaning. But I don't think so. I don't think that salesmanship is demeaning."
So if this patient-as-customer concept isn't dealt with in medical schools, what was the spark for this doctor? Schlesinger smiles a bit and remembers, as a 14-year-old in Newark, N.J, watching the way his father, a butcher, treated people.
"The core of the business isn't what you're going to sell Mrs. Murphy today, it was what you were going to sell her next week, and the week after that, and the week after that. He took a personal interest in Mrs. Murphy because she was his valued customer."