If you're a small business owner, a customer is a customer is a customer. Or are they? Today's New York Times ran a feature about dermatologists who treat their two types of patients—those who are seeking cosmetic procedures and those who are there for conditions like psoriasis or acne—entirely differently. One dermatologist in Northern California not only has a different and more luxurious waiting room for cosmetic patients, but he actually offers a shorter waiting period for appointments. On the flip side, patients who call in with conditions like acne and psoriasis often end up going straight to voicemail and have to wait weeks for an appointment.

The idea isn't a new one—airlines have had first class and coach for years—and there's plenty of other instance where the "have and have nots" model seems to work fine. That's because from a business perspective it makes sense to aggressively go after the customers who pay the most (duh). Says the Times:

"According to a presentation for doctors from Allergan, the makers of Botox, a medical dermatology practice might have a net income of $387,198 annually, but a dermatologist who decreased focus on skin diseases while adding cosmetic medical procedures to a practice could net $695,850 annually."

Still. Something feels more than a little jarring about such overt classicism, not to mention that 60% of most dermatologists business remains standard skin issues—not the cosmetic stuff like Restylane. And just because you offer such cosmetic extras, does that mean it makes sense to treat those patients differently? Consider the effect that has on [still paying] customers with run-of-the-mill skin issues who call up knowing (at least after this article) that they may talk to a recording, while someone seeking Botox will get a real person. Frankly, our reaction would be to get a new derm.

What do you think? From a small business perspective does it make sense to pamper the people who pay more?