“The first thing we do, let’s kill all the lawyers,” Shakespeare, Henry VI.

No small feat considering the number of lawyers. Rather than take such a radical step, let us begin with something more achievable.

Let’s close all the health system call centers. Customer experience may go up, and customer access may not be affected negatively.

Now that everyone is paying attention, perhaps we could spend a minute or two looking at why that may not be such a bad idea—the call centers, that is, not the lawyers.

A few warm up questions for the executives in the audience. Do you know the location of the call center? Have you visited it in the last year? When was the last time you eavesdropped on a few calls?

I have done this so often that at times I feel like Frank Bruni, the gentleman who writes the restaurant reviews for the New York Times, trying to surreptitiously offer a sensible review without being outed.

Most of the hospitals I have visited whose leadership believes has a call center, does not have a Call Center. They have a place people call. In ninety-percent of those centers what they actually have is a place for people to call to schedule appointments. They have a scheduling center, and rarely does the scheduling center even do a good job of scheduling calls.

It is worth noting that only twenty to thirty percent of callers call to schedule an appointment. The other seventy to eighty percent of calls have nothing to do with scheduling. And the people answering all of those other calls know very little about providing the caller with the correct answers to all of those other calls.

That means if your health system receives a million calls a year more than three thousand calls each day have to be transferred to someone who may know the answer and who may have the tools needed to help them answer the caller. (The daily number would be less if callers could speak to someone on Saturdays and Sundays, but then I would be being silly even to suggest that.)

On the flip side, we have two hundred thousand people calling to schedule something or another. I would guess that less than sixty percent of those callers have their needs met the first time they call. Adding the two categories of disappointed callers gives a number of around 900,000 calls that result in an unsatisfactory experience. At a fully-loaded cost of around thirty dollars a call, which means that health system will spend about twenty-seven million dollars to underwhelm its customers and prospective customers.

Surely less money can be spent to achieve the same result. One way to do so would be to close the call centers and disappoint everyone at zero cost to the health system.

Here is what I observe health systems are doing to try to improve the caller’s experience. They hire more call center agents, and they throw technology at the problem, technology like scheduling applications. Applications that do nothing for the other 80% of calls. Applications which without an understanding of the business problems, without a strategy and a plan, will get in the way of creating a great caller experience across the enterprise. They debate centralizing or decentralizing the places from which they answer calls. They debate implementing a single number for anyone to call about any thing.

“We don’t know where we are going, but we are making really good time.”

Perhaps the time has come to decide what the business reason is for having a call center, to decide what business problems the health system wants to solve through the call center.

People are going to call the health systems whether or not the health system has a real Call Center. There are real costs associated with having a call center that can do what needs to be done. The good news is that those costs pale in comparison to the costs of having a call center that does not do what needs to be done.

The best reason for doing this correctly is that a functional call center is the health system’s most valuable point of contact for retaining patients. Or it isn’t. chances are that the one currently being operated by the call center is not doing the health system any favors.

And once you have fixed the call center, then we can think about what to do with the lawyers.