Blog | Tuesday, January 14, 2014

Physician Fee Schedule 2014 uses frequent flier model


Whistleblower readers know that I have spewed some vitriol toward the airline industry, where customer service goes to die. Indeed, in a prior post I contrasted their routine harassment of frequent fliers with the individualized stroking that Apple customers routinely receive. For sarcastic scriveners like me, the airlines are the gift that keeps on giving. The target is so large that one can hit it from miles away with a blindfold on at night.

Some, but now all, sources of customer angst include:
• the convenience and rationality of the TSA process (“Out with those dentures, Granny!”)
• the sumptuous meals served aboard. (“Exact change for the pretzels is appreciated.”)
• the plush and spacious seats which easily accommodate those with BMIs less than 18
• on-time performance (Do we really know what time is?)
• truthfulness with regard to the occasional flight delay (Pinocchio would nasally impale customers if he worked as a gate agent.)
• the simplicity and predictability of ticket pricing (Do any 2 passengers pay the same fare?)
• the reasonable cost of changing reservations (Why does it cost $100 for a keystroke?)
• the ease of reaching a living, breathing human being when calling the 1-800 number
• their priority of storing your carry-on stuff on board to avoid checking your bags. (“You mean my shaving bag needs to be checked?”)

Earlier today, as I penned this post, I read that airlines are increasingly picking our pockets in search of ancillary revenue.

Let’s define some terms.

Ancillary revenue: noun phrase, gouged funds extracted from helpless customers

Usage: The mugger obtained ancillary revenue from his victim.

Ancillary service: noun phrase, stuff that should be free that is now provided at surcharges to customers who have no recourse

Usage: The client was surprised that the handshake offered by the consultant at the first meeting was an ancillary service that was itemized on the billing invoice.

Airline passengers are now charged for seats with an extra inch or two of legroom, designated aisle seats, special posh lounges where the honey roasted peanuts are always free, priority boarding so there will be overhead bin space available and a complex baggage fee schedule. I wonder that if circumstances resulted in oxygen masks (which I hope truly exist) springing out of their hiding places, that we wouldn’t need to swipe our credit cards before the life-saving gas would flow. (Premium members are guaranteed 3 minutes of free oxygen and a clean mask.)

Imagine if the medical profession—or your job—was reimbursed in this fashion?
• We will be happy to reschedule your appointment for $100.
• Sedation is included in the price of colonoscopy. If you want a sterile needle …
• Waiting room reading material is available for rent.
• Pay toilets.
• Elite waiting room for premium patients where a registered nurse will serve you a cocktail.
• Free waiting room chairs that can comfortably accommodate leprechauns. Upgrade available.
• Rewards program. Each gastro procedure earns valuable points that can be used for a future colonoscopy, enema administration or rectal exam. The points are not transferable, will expire in one year and face a labyrinth of restrictions that will ensure you’ll never cash in as promised.

I’ll bring up these ideas at our next medical practice meeting. Why should our small private practice leave money on the table? Are you ready to reach for the “stomach distress” bag now?

This post by Michael Kirsch, MD, FACP, appeared at MD Whistleblower. Dr. Kirsch is a full time practicing physician and writer who addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.