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Doctor, My Eye

Christopher Caldwell, man on a plan.

Oct 3, 2011, Vol. 17, No. 03 • By CHRISTOPHER CALDWELL
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Three or four years ago, during the Neronian decadence that preceded the financial crash of 2008, we got a glossy brochure in the mail from one of our doctors. It announced that for a modest fee—about a hundred dollars per person—our family could enjoy a whole range of special perquisites known as the Platinum Recognition Plan. What would we get with Platinum Recognition? Well, for one, our doctor would return our calls himself. If any of us got really, really sick, he would see us within days. Not only that, he would come up with a “personalized” health regimen to suit whatever symptoms and conditions we might develop in his branch of medicine. 

Caricature of Hippocratic Oath changed to Hypocritic Oath

DAViD CLARK

My wife checked the postmark to make sure it was not April 1. Listening to one’s patients talk about their symptoms, treating them in sickness and in health, recognizing that they are suffering humans and not just chess problems—surely this is what being a doctor is. What today’s doctors call “Platinum Recognition” is what doctors of the old school called the Hippocratic Oath. But almost every doctor that our extended family uses has an answering-machine message that runs “If this is an emergency you should go to the hospital,” pedantically enumerates the hours he works (which don’t coincide with any hours when you would actually call him), and implies that you should jump in a lake.

Apparently Platinum Recognition (a name I have embellished slightly) is part of a growing trend known as “concierge medicine.” There is something particularly shocking about seeing a doctor try to peel a bit more money out of you this way, but it seems to be in the spirit of the times. Consider banks. Banking used to mean borrowing short term at low interest and lending long-term at high. But banks don’t lend any more—they just shave money out of their depositors’ accounts through various penalties and hidden charges. The other day it occurred to me that banks no longer return the checks you write, either. Apparently this allows them to save money by firing the people who used to sort the checks and mail them out. You would think that would make your checking account cheaper, but no! My bank now charges me a “check safekeeping fee” for not mailing back my checks. They are charging more for providing less. 

Having watched levels of service erode in almost every walk of life in the past decade, I have begun to detect certain patterns. Seldom does a company or a contractor tell you he is going to do crummier work and charge you more for it. Instead, from check-free banking to Obamacare, his work deteriorates by a confusing multi-step process, many stages of which appear at first to make things better.

Step 1 is a pure advance for freedom. There’s a new, better way of doing things—let’s say, paying your bills online—and you can participate, if you want, for a premium. You don’t have to embrace it if you’re going to be an old fuddy-duddy and still pay your bills by check. You can just keep doing what you’ve been doing. It’s your choice. You can “keep the plan you have.”

Step 2 comes when you are informed, as you inevitably will be, that the old way of doing things is being canceled, having become so uncool that no customer in his right mind any longer wants it. If that assertion is too manifestly fraudulent, a semi-honest argument will be brought out: The old way of doing things has become “inefficient.” It is inefficient in the sense that it cuts into the profits the business can now make by ceasing to worry about the customers. 

Step 3 comes when the elimination of the old way of doing things means there is no longer any alternative to the new way. At that point, every incentive to keep it running efficiently disappears. You get service of lower caliber than you got under the old technology, but with higher fees. To take one example, at my bank, ATMs were an attractive alternative to free checking because they told you your recent transactions. Now that most people have been lured out of their checking accounts, these ATMs demand a fee for that service. 

I mentioned my gripe to an editor at the Standard, and she asked me to write a Casual about it. When I didn’t hand it in, she got all bent out of shape. But she shouldn’t have. She just needs the Platinum Privileged Editor Plan. For only a few hundred dollars on top of what I am already paid, she would be entitled to copy filed on time with 100-percent beer-stain-free hard copy! You know, those little extras that are the sign of professionalism. As a bonus, I might even agree to spell-check it.

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