Last month, I underwent planned but significant surgery. In the process, I “enjoyed” a bird’s eye view of the U.S. health care system, which in itself looks like a bird. A vulture. Makes me wonder, in fact, whether there’s room for healthcare and customer-care to co-exist, considering the aggregate narcissism and greed of many players in our healthcare system.

Here’s just a sampling of the recent goings-on.

§         I was referred to a “reputable” orthopedic surgeon in a multi-site practice because of pain in both shoulders. Following a five-minute “history” and a subsequent MRI, Doc McChopShop told me both shoulders urgently needed rotator cuff surgery, with the left one having priority. After five minutes explaining the supposed MRI outcomes (without me seeing them) he instructed me to go to his scheduling nurse’s office to “get on the calendar.” The only place I went was for a second opinion.

§         Next I saw Dr. McShoulder, who happens to minister to the delicate arms of a major league baseball team. Looking at the same MRIs, but walking me through them, he showed me that my right shoulder was a mess. However, considering my age, he didn’t see much value in surgery to correct a long-ago high school pitching injury to my left shoulder, since it doesn’t seem to be getting any worse over time and can be dealt with through physical therapy and occasional meds. But he wanted to do the right shoulder “yesterday.” Unfortunately, his next open surgery slot at the only hospital where he has privileges and I have insurance coverage was In three months. So “yesterday” turned into three months.

§         Prior to surgery, McShoulder’s PA (physician’s assistant) referred me to a PT (physical therapist) who also specializes in shoulders so I could loosen things up and manage pain before getting cut. When I arrived for my first session, Mr. PT-shoulder told me, “you’ll be working with APT (assistant physical therapist) so-and-so, after which I barely saw the PT except when the APT had to ask him what to do. Yah sure. Helluva recommendation.

§         When Dr. McShoulder finally operated, he discovered that things were in much worse shape than shown on Dr. McChopShop’s MRI (health insurance wouldn’t pay for a second MRI), very likely because my right shoulder had continued deteriorating over the three-month interval. Consequently, he had to perform a different and much more extensive surgery than anticipated. He informed my wife immediately after, and she caught some of what he was saying, but he didn’t talk to me until my post-op appointment 10 days later. That might have been okay, except in his haste he forgot to change my post-op care instructions. So I did potentially injurious stuff until I saw him. Fortunately, I survived (or rather my shoulder did).

§         And then there was the nursing. I did have several knowledgeable and helpful nurses during my stay. During the day shift. But overnight, nothing but NAs (nursing assistants) who were left on their own to dispense and adjust serious pain medication, despite an obvious lack of training or nursing temprament. And then there was the recovery room nurse who kept me in the post-op room for about an hour while chatting up everyone in sight. Too bad they don’t serve post-op pain killers there. And when I asked her when I was going to my luxurious suite, she responded, “When I have time.”

I’ll leave things there, without regaling you with stories like my previous physician declining to authorize a sleep apnea test because: “You just need to lose weight.” And C-Pap machines (the common remedy for sleep apnea) rarely work, anyway.” When he finally did authorize the test because I couldn’t get through the workday, the hospital started recording “normal” sleep patterns, only to stop in less than an hour because my blood oxygen level was “in the red zone,” putting me at risk of a stroke or heart attack. And when I got to the pulmonary clinic to get set up with a C-Pap machine, the pulmonary PA just exploded hearing the story, saying (literally): All the jerk had to do was point a flashlight into your mouth to see that this has nothing to do with weight.” All this after I’d had to put my consulting on the back burner for a considerable time while I tried to get healthy (I recovered completely in a week using the C-Pap machine – and fortunately they don’t count against carry-on baggage limits).

Okay, I’m regaling. But I’ll stop after saying that in our cost-cutting times when doctors and clinics are rewarded for keeping patients away from expensive tests, two different doctors told me my right shoulder problem stemmed from “arthritis.”

Okay, so why did I belch out all this sordid stuff? Because I’d like you to wear your patient hat while you try to answer two questions. First, “How would CRM software functionality (imbedded in medical practice systems, of course) fix any of this?”

Huuuuhhhh??

You betcha. We actually have CRM yahoos out there pushing use of CRM software functionality to improve relationships with patients But why should healthcare be any different. Isn’t it always about software?

Second, what, in your opinion, will it take to put the patient in the center of the health care circle (well-applied 2X4s aside)? Personally, I don’t believe our health care system is capable of behaving better of its own volition. I believe reform will only result from customer push-back – as in constantly reminding practitioners that we’re customers, not patients. And very vocally taking our business elsewhere when they can’t grasp that. Moreover, when some surgeon tries to pay for his daughter’s wedding or whatever by cutting open both my shoulders, starting with the wrong one (do you know that statistical research proves that Ob-Gyns are far more likely to deliver via c-section when they have a daughter getting married?), we’d better start filing complaints – with clinics, hospitals, insurance companies, HMOs and even state medical boards. Which is exactly what I’m doing.

Or do you think I’m being too cynical?

Okay, time for a giant reality pill. Maybe a whole handful. I’m already hearing boasts from the social networking set that Sprint’s downturn results from a single blogger who learned a Sprint secret he wasn’t supposed to know – and spread it far and wide over the web. The secret, in case you haven’t read or heard, is Sprint covertly creating a hit list of customers who “overused” customer service and proceeding to “fire” these annoying customers. But did one blogger sharing the secret over the web really make Sprint trip and do a corporate face plant? Yah sure it did.

First—Sprint’s not dead yet. It has a whole lot more customers to torture before it slides all the way down. The board did fire the CEO and bring in a fixit guy, not a good sign. But then a mere 450,000 customers went splitsville in December 07—like ships leaving a sinking rat. So how did the new bloke respond? Predictably, by announcing the layoff of 4,000 employees and the closure of 120 company store outlets. Can this guy even spell “customer?” But hey, he’s a CEO for a reason.

More to the point, Sprint’s been killing itself slowly for years—a classic example of spending gazillions of dollars on brand advertising while treating consumers like crap. Sorry folks, but all the brand advertising in the world doesn’t close the barnyard gate. Fine, Sprint may play nicer with business customers. But from the consumer’s perspective, why put up with an insufferable company-first attitude expressed by un-motivated service employees administering customer-unfriendly billing and service policies? Especially in a ferociously competitive business.

Consider this emblematic customer-complaint from one of the “fired” customers, whose sin was calling repeatedly in response to Sprint continually over-billing her.  

“I absolutely didn’t call as much as they say I did, but I did always have the hang up/transfer scenario–even today calling in I was hung up on twice and transferred at least five times. I mean I DREAD calling in and sitting on hold, why on earth would I do it unless I had to!”
Hey, yo-yos, too lazy to look for the reasons customers like her spent so much time tying up your customer service lines? Ever hear of “single call resolution?” But just firing customers is easier than finding out what’s wrong.
Fortunately, there is a bright side to this whole situation—and least for those of us struggling to persuade business to take customer revenge seriously. Sprint’s misfortune ought to remind the market that customers are in the driver’s seat—and companies mistreat them at their peril. Of course, many companies will resist getting the message, blaming Sprint’s troubles on “an overcrowded market” or “poor operating management.” And in fact, lousy excuses as they are, they’re not as slack as claiming that a lone blogger pulled the plug on Sprint. Still, most companies play in “overcrowded markets” these days. And “poor management” abounds, as does management that continues trying to give customers short shrift. Going forward, only the fittest will survive, and lame excuses no longer fly.

What Sprint has done for us, though, is provide an almost undisputable example of the risks companies take when they mistreat customers. Everyone knows Sprint. Many have used, or tried to use, its services. The company’s troubles are widely known. All of which combine to make damn good testimony to the costs of customer abuse. When pressed, business execs will have a hard time denying that customers are doing Sprint in, not “market conditions” or “operating management.” And you know what? We need every good example we can lay hands on to persuade business that today’s customers can make or break companies—and will.

So let’s all toast Sprint—the latest poster-company for “not getting it” about customers. And let’s have another sip for some really over-the-edge members of the social networking set. A blogger pulled the plug on Sprint? Yah sure and you betcha.

Been noticing any bare spots in the retail landscape lately? Well, expect to see lots more—especially with the economy tanking. Here’s the box score to date:

The once ubiquitous CompUSA was pulled up by its roots in December. A venture capital firm bought the remnants for salvage and promptly closed the remaining stores. The chain started imploding last summer, as customers bought only sale items and ignored full-price goods—partly a result of horrible employment practices that beat employees to a bloody pulp. In fact, the pressure on employees to move merchandise became so extreme that it created the perverse effect of customers who wouldn’t buy at regular prices becoming “the enemy” for some employees. But another contributor was employees not being able to spell the products they were selling.

Circuit City, once at near parity with its category competitor, Best Buy, has been left in the dust. Worse yet, the company is hemorrhaging cash at an alarming rate. To add to the turmoil, the board just gave the heave-ho to the dim light bulb CEO who fired all the experienced sale staff last year to save money. The new CEO won’t have much time to turn things around, but there’s no replacement lined up. And the new sales recruits, fresh from flipping burgers (or from CompUSA)? They can’t sell squat, which led to this delicious headline in the January 3 “Information Week: ”Clueless Circuit City Scrooges Itself Out of Christmas Sales.” Way to go, IW.

Sprint makes the list after announcing on January 18 that it would lay off 4,000 more employees and shutter some 120 retail stores. Sprint’s business customer base seems relatively stable, but consumer customers are fleeing like ships leaving a sinking rat. And no wonder. Consumer service is atrocious. Rate plans aren’t competitive. And the company, which also has a new CEO, is focused on cutting costs rather than finding out what’s wrong on the customer side. That’s what happens when number crunching, C-level execs treat customers as statistics—as if they’re a fixed value in a rapidly deteriorating equation.

Who’s next in line?  Chrysler’s a good candidate. Actually, Ford could be too. So are several retail and investment banks with sufficient hubris to believe they could whip ether into profits, as in make something from nothing. Northwest airlines won’t totally tank, but it’s too weak to stand alone, and the brand’s about to disappear. Radio Shack? A possibility. Macy’s? Sears?

What really fascinates me is what all these retailers have in common. They all built powerful brands—then tried to survive on brand strength rather than responding to customers. They advertised their brains out and relied on fooling and manipulating customers, without grasping that customers will decide their fate based on their own perceptions¬—which all the brand advertising they can shovel out won’t influence.
 
For years customer advocates have been preaching the gospel of customers ascending the dominant position in buyer-seller relationships. But business wasn’t listening. Now, the gospel’s getting very hard to ignore. Nonetheless, the carnage will almost certainly worsen over the next five years—and not just in retail, but in B2B as well.