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?