Doctors, nurses and members of the medical profession are an incredibly hard working lot. The long shifts that they pull, and the efforts that they go through to treat patients, are often heroic. Their increased ability to save lives are attested to by the expanding number of near death experiences that their patients sometimes experience. Combined with advances in medications, such as antibiotics, and new medical procedures, doctors and their support staff have helped to increase the much longer life span that we now enjoy. I believe that most of us are very grateful to their entire profession.

Yet, speaking as a consumer (not a medical expert, for I am not one), I believe that the medical profession is in need of reform. What bothers me is the arrogance that some members of the medical profession have toward their patients. It is a mindset that in my opinion has been engendered by a fundamental misunderstanding of the identity and role of patients.

Many doctors seem to think that they are doing their patients a favor by treating them, rather than serving customers who are doing the doctors a favor by paying their fees. The marketplace may contribute to this problem, because of a shortage of doctors. If there was a surplus of doctors, they would have to work a lot harder to obtain and keep patients.

How does the above attitude compare with the customer service standards of fine hotels? Good hotels know that their guests are at the heart of their financial survival, and often do everything in their power to keep them coming back. The very word "guest" implies that the customer is there to be served and waited on hand and foot. Doctors' offices, on the other hand, often have a very different perspective toward their customers, starting with their standard toward appointment keeping. Some doctors' offices will cancel the appointment if the patient is more than fifteen minutes late, no matter what the reason.

Yet, when a patient arrives on time, it's typical that the patient/customer is kept waiting for a very long time; first in the lobby, and then in the patient room. When the doctor does come in, he or she is often gone in a flash, leaving behind a hefty bill and many unanswered questions. How many doctors have spent more than ten minutes with you? We get more attention from used car salesmen! We put up with what really amounts to crummy service because of customer service standards in medicine that have gone too long unchallenged.

We have developed such a subservient attitude toward doctors that we even put up with the indignity of wearing backless hospital gowns. Let's make doctors wear them once a day and see how fast they're replaced with nice warm terry cloth robes! On the communication side of customer service, doctors don't take kindly to detailed questions about their treatments and don't expect or like it if we challenge their recommendations. Yet, it is we who pay their bills! We are the so-called "boss", the client who can fire our doctor consultants at will. Patients should feel comfortable to challenge doctors and nurses when the need arises.

Part of the attitude that doctors have toward patients stems from their medical school training. Dr. Rachel Remen, the author of Kitchen Table Wisdom, recounts that she was taught in medical school to maintain a "professional distance" from grieving relatives. She recalls with shame the time that a couple apologized to her for their tears of grief for their dead child. The couple was conscious of the fact that Dr. Remen was standing there without participating in their grief, and they became embarrassed.

What will change the current attitude of medical professionals toward patients? I believe that two action steps are required. The first step is for medical schools to alter their curriculum and train doctors to treat their patients as honored customers and guests. The second step may be harder. What can we, our schools and our government do to increase the number of new medical graduates each year so that there is no longer a doctor shortage? I don't know the answer to this question, but I believe that when the "market" has more than enough doctors, the quality of medical care will dramatically rise due to natural competition among doctors to find and keep their honored customers.