I finally had my chromosomes mapped. It should not come as a big surprise when I tell you that I lacked the chromosome for patience and had a duplicate of the chromosome that is most closely associated with cynicism.

Nota bene. I am on my eighth American Airlines flight in the last two weeks. Each of them has been delayed by at least an hour and a half.

Water off a duck’s back. For some, perhaps. But, I’m not your average mild-mannered duck.

And so on the last of my eight flights I pulled out two sheets of paper, one sheet for each side of the plane. Across the top of each page I wrote, “List three things that you would do if you were an executive of American Airlines to improve the flying experience.”

And off they went to Row 1, seats a through C and Row 1, seats D through F. By the start of Row 4 I had received a request for more paper. I hired a small child who was seated across the aisle from me to be my courier. Back and forth he went, dispensing blank sheets of paper and retrieving the completed sheets. On his second trip forward his return trip was delayed.

“What took you so long?” I asked.

“A bunch of people wanted to make videos of their experience,” he told me. “And I had to show someone your age how to Instagram their trip.” (My age?)

I looked up and saw a flight attendant marching posthaste towards me. She was carrying several sheets of paper. The ammonium nitrate was about to hit the oscillating air device.  I gave her my best smile and a wink.  She looked me in the eyes and said, “The captain asked if he was permitted to share his recommendations.”

The wink gets them every time.

Flying.  Bad experience.  ‘Nuff’ said.  The blog could end here.  Healthcare reform could end here.  Neither one will happen.

Most airlines offer two types of seats; first class and no first class – steerage.

First class exists for only one reason—to let the rest of us know that we are not in it.  Airlines hang a shower curtain between first class and coach.  They do this to make it clear to those of us in the bleacher seats that everything beyond the curtain is off limits.  But they do make passengers flying coach walk through first class to get to their seats.  Now each coach passenger has a barometer to measure just how bad their experience is.

“Don’t even think about storing your bag there,” she notifies me.  “This bin is reserved for our first-class passengers!”  Blocking me with her body, the flight attendant turns to the person in seat 2A and asks “May I hang your jacket, sir?  Would you mind if I refill your Crown Royal?  Be sure to leave room for dinner—we’re serving steak and lobster tonight.”  I wished I had purchased the thirty-dollar bag of Gummy Bears.

The bad experiences of coach class are particularly bad simply because first-class exists.  If there were no first class, flying coach would not be so a bad because we all suffer together. Southwest Airlines figured that out.  They do not offer first class.  And despite that, they are always among the highest rated airlines for customer experience.

Healthcare patient and customer experience.  How good was yours?  The scoring is binary —a 1 or a 0.  You either sat in first class or you sat behind the shower curtain.  Did your healthcare experience compare to having surf-and-turf, or did it make you wish you had bought the Gummy Bears?

Bad customer experiences are not insoluble.  Very little is.  For most companies, bad customer experiences are simply a failure of imagination.  For providers, their failure of imagination comes at a high price: poor care management, lost patient acquisition, and poor patient retention. And if that is not a real mess, it will do until the real mess comes along.

Just so you know, none of us likes flying coach.