When did the primary care physician become an answering machine?  Today’s Column in the Star…

I’m so pleased to hear about the rebound in housing prices, and am not at all bitter that I sold my two most precious pieces of real property at the absolute bottom of the market at the absolute worst possible time. I realize that real estate markets experience certain unpredictable cycles, like broken washing machines or perimenopausal females, and that those out of sync with their circadian rhythms run the risk of being bitch-slapped by whichever fickle goddess controls the global economy.

As the market becomes increasingly robust, I anticipate the return of one of my favorite phenomena: the Heights effect. Certain developers believe that by simply attaching the name “Heights” to any neighborhood, its value will instantly triple. Pacific Heights and Presidio Heights are two examples, but my favorite occurred when Marin County discussed selling San Quentin prison to developers for luxury waterfront housing, causing locals to nickname the neighborhood: “San Quentin Heights.”

Here in the Napa Valley, we have no real heights to speak of, since building on a visible hillside is considered a capital crime. Still, some of our older neighborhoods might spark buyer interest if they christened themselves “Crinella Heights” or “Angwin Heights,” or if the local mobile home park adopted the somewhat-confused name “Vineyard Valley Heights,” which, quite frankly, fits the perplexing personalities of some of its more outspoken residents.

Another way to increase the value of your brand is to call yourself a “Concierge” anything. Concierge Doctors are simply capitalists focusing on high-paying clients and consigning the lower end of the market to others. But they do hold out the promise of providing more personal attention to patients, plus fewer instances of confusing one’s prostate exam with another’s pregnancy test.

For those unable to engage a Concierge Doctor, most health care is managed by an answering machine. It generally responds: “Hello. You’ve reached the office of Doctor so-and-so. If this is a life-threatening emergency (and we all know what a hypochondriac you are), hang up and phone a friend. We will be unable to help you if your illness cannot be treated in the 4.7 minutes we’ve allotted per patient appointment, and besides, the last thing you want is to have our receptionist telling you where to apply the tourniquet.

“Our office is open Monday through Thursday except every possible holiday (including St. Mondavi Day) from 10 a.m. (it used to be 9, but the local pharmacist sleeps in so why shouldn’t we?) to 12 p.m. and from 2 to 4. We turn our phones off between 12 and 2 sharp because (a) by that point in the day we are sick and tired of hearing about your problems; (b) we’ve scheduled a nooner with a particularly attractive pharmaceutical company sales representative; and (c) we can’t eat lunch at our desk and listen to you complain about your bunions at the same time.

“On Fridays we work half-days, so if you call after 12 you’ll be on hold listening to the Love Theme from ‘Titanic’ until Monday at 10 (unless it falls on St. Mondavi Day, in which case ‘My Heart Will Go On’ until Tuesday). We wouldn’t work at all on Fridays except that some high-priced consultant said we need to become more ‘customer focused’ if we are ever to realize our dream of becoming Concierge Doctors.”

Now I ask you: In what other profession is it acceptable to completely turn the customer service obligation on its head? Still, you have to admire the forthright way in which they so quickly and decisively lower their customers’ expectations. Perhaps other professions should do the same.

We lawyers could say: “Hello. We’re busy overbilling someone, but we’ll listen to your message with one ear while listening to another client through the other, which is how we generate 20 billable hours in a 10 hour workday.”

Retailers might say: “Hello. We’ve closed at 5, even though you keep telling us that you prefer to shop after work, because we tried staying open late to accommodate you, but you didn’t come and you didn’t call and we got terribly depressed, sitting there all alone chewing wet cigarettes in the dark.”

And of course, wineries should simply say: “Hello. We can’t come to the phone right now because we’re out back drinking up the excess inventory.”

If only newspaper reporters could choose to cover events occurring between 9 to 12 or 2 to 5, and restaurants, stores and other businesses could be opened when convenient and profitable. But that would leave only Private Chefs and Personal Shoppers, and Concierge Editors reporting the news third-hand from their homes; sitting in their pajamas wondering whether the AP newswire editors realize that St. Helena is in California, and not in Washington state.

I understand that doctors use these message machines because the pressure of medical practice, with its labyrinthine regulations, recordkeeping duties, insurance forms, and malpractice insurance requirements, has transformed the venerable medical profession into a thinly margined volume business, lacking the glamour, prestige and financial stability of — say — a small-town newspaper columnist.

Which reminds me, does anybody know a good Concierge Career Counselor?


Has the Napa Valley Wine Train revealed that St. Helena’s slip is showing? Today’s column in the Star…

Tourists are different from us, not just in origin, but in mindset. This was never clearer to me than during a recent cross-valley trek on the Napa Valley Wine Train.

The word “trek” is defined in the Random House Dictionary as “to travel or migrate, especially slowly or with difficulty,” and in South Africa: “to travel by ox wagon.” I’ve never actually traveled by ox wagon, but I suspect that your average well-motivated oxen can haul their keesters faster than the Wine Train chugs its way up and down the valley. And while I would never describe one traveling in the leisurely luxury of the Wine Train as experiencing “difficulty,” the phrase “especially slowly” fits its schedule to a T.

This is not a bad thing. For vacationers wishing to drink in the beauty of the Napa Valley — its lush vineyards, verdant hills and expansive skies, while sampling delectable food and wine — it’s a delightful experience. Guests can choose from the retro skyline rail car with birds-eye view, the rough-n-ready open-air saloon car and luxury dining cars recalling train travel’s glamorous heyday. With stop-and-go traffic a major hassle for visitors, the chance to relax and let the train engineer do the driving must be a treat.

But for a bunch of busy local business-owners trekking in the middle of a workday, it became an exercise in Zen Buddhist mind-control. I’m talking about a recent trip organized by the ever-energized St. Helena Chamber of Commerce, when a phalanx of local leaders, merchants, restaurateurs and other chamber members were invited to enjoy lunch on the train. Like many locals, I had not experienced the Wine Train, so it was a chance to discover why so many call it a highlight of their valley visit and to meet its friendly and knowledgeable staff.

The company was congenial, the wine flowing and the food thoughtfully prepared by Chef Kelly Macdonald. But as I toured the other cars, each brimming with well-dressed revelers enjoying their vacations, I couldn’t help but compare them with us stressed-out locals. Disconnected from our offices and forced to “be there now” for what felt like an eternity, we stewed watching our everyday landscape pass by in slow motion. And while we settled into semi-relaxed conversation, many of us lunged for our cellphones at lunch, seeking an Internet connection like addicts scrambling for a fix.

The train slowed to a crawl approaching St. Helena, so several of us decided to take a closer look at our fair city from the viewpoint of a Wine Train passenger. And I don’t think I’m overstating it to say that what we observed was disturbing. Because like many cities viewed from the train tracks — as opposed to the view from the main highway — it often looked downright shoddy.

Picture a panorama of the backs of buildings with unmatched or peeling paint, punctuated by trash containers, weeds and broken asphalt. A few were well tended, and some unkempt buildings were spruced up with flower boxes and other random decorations. But overall the view revealed an urgent need for a total makeover of the Great Lady of St. Helena’s backside, and the immediate application of the municipal equivalent of Spanx so that her unsightly bumps and bulges might be more completely camouflaged.

I sympathize with the building owners, who likely never expected their backyards to become Napa Valley focal points. It’s as if a magazine offered to do a photo-shoot of your home, but then only photographed that ugly spot right next to the compost bin where you’ve stacked your old skis, rusting hammock stand and unused trampoline awaiting eventual consignment to the dump.

I had a similar experience recently while making my bathroom sparkle, suddenly noticing its unsightly ceiling. What was shiny was now splotchy, and little bits of soap congealed above the shower were now turning colors like specimens ripening in a laboratory. I considered cleaning the ceiling, but for those who have never tried it, let me give you a word of warning: “Don’t.” First you spot-clean, but those spots are now a different color from the rest of the ceiling. So you try cleaning the whole ceiling, but the finish changes and so you need to repaint, which is impossible to do without dripping paint on the walls, so now you are repainting and re-flooring, and you really might as well just move to a new house.

We all have some eyesore, junk drawer or embarrassing backside we don’t want exposed to the public, whether in our cities, in or homes, on our persons or in our personal histories. Luckily the Wine Train tourists experiencing St. Helena’s rearview seemed unfazed. They laughed and ate and toasted and drank, no doubt planning to visit Main Street for a shopping excursion during their trip. As for us locals, we resolved to add: “Tart Up St. Helena’s Posterior” to our to-do lists, just as soon as we were finally able to detrain in Napa, reconnect to our smartphones and retrace our treks — briskly — back home.