A comparison can be drawn between the differing tiers of Tech Support and the differing tiers of Medicine. Here’s my jaded first attempt:
Tier 1 – the most direct customer facing tier. In the medical corner we have Nurses and in the Tech Support corner we have Customer Service Reps.

HELLOOO NURSE! You can put your thermometer where you like!
Nurses, endowed initially with people skills and doing most of the medical work with the least pay and the least recognition also have their failings – after years they tend to get sassy (not a failing in my book, but others see it differently and label it as arrogance), and they also have an inate ability of being horribly portrayed on horrible programming, like Shortland Street and ER.
Customer Service Reps put up with idiot calls like “paper isnt coming out of my CPU!” and filter out most of the stupid that reaches the 2nd tier. I’d feel sorry for them, but I don’t. Plus they send me such amusing spam.
Also this is where the sexy-but-vapid are employed, unfortunately after 20 years in the same sort of role, they become haggard-and-annoying.
Conclusion: My mum’s a registered nurse, but I have to work with CSR’s. This is a draw.
Tier 2 – When the CSR’s just plain give up (or have their hands politically bound), or when the nurses don’t want to look at what’s oozing out of your urethra, you get directed to the second tier.

“ma’am, you have full blown AIDS” | “haha luser, you have full blown NIMBA!”
Welcome to the second tier. If you get a doctor, you have 20 seconds to rush through a list of symptoms before he stops caring and gives you an interrogation and a wheel of fortune diagnosis. Count yourself lucky, second tier IT geeks will not listen to you at all. If you’re fortunate enough to have an on-site geek, he’ll abruptly tell you to move and fix your insignificant fault in 2 seconds, followed by 5 minutes of mocking you. If you have a phone based geek, he’ll feign caring long enough for his boss to look away before fobbing you off so he can go back to reading CAD and Penny Arcade.
It’s not your fault, they entered their respective careers all wide eyed, innocent and with the best of intentions. However politics, workload and having to deal with stupid people has brought out the misanthropistic worst in them. Your IT geek has probably been in the job like.. 8 months.. which is, like.. 30 IT years. And your doctor is tired of treating non-issues and secretly wishes his sworn enemy, natural selection, would try a bit harder.
You want to get the best out of us, give us something interesting… Like extreme stupidity. See the doctor with a size 10 boot stuck firmly in your rectum, set your computer on fire and call the geek, telling him you just installed a firewall.
Conclusion: My favourite doctor is Dr House, and I work on the second tier. So another draw.
Tier 3 – Heaven forbid if the second tier can’t be bothered fixing it, you get to pass go straight to the third tier! They don’t want to talk to you, they just want to fix the problem and get you out of their hair so that they can go back to.. oh I don’t know, a fast paced life of fast cars and sexy lovers.

“I pull this cable and your porn goes bye bye”
If Nip/Tuck is to believed, surgeons are cool. And the last surgeon I saw was wearing gumboots just like the ones I wore when I was a butcher. Then he fixed my hernia, which gave me a new lease on life. Plus the whole mask and gloves thing is like a modern day ninja. You cant trust those surgeons, they may appear to be in front of you.. but like a ninja, they’ll surprise you. Like.. leaving scissors inside you.
Third tier IT guys just want to avoid office politics so they can go back to watching movies. That’s really their only motivation, apart from the interesting jobs that the second tier couldnt figure out. Piss them off though and you’ve got hell to pay. Then again, you don’t want to piss off a surgeon. You might wake up without kidneys.
Conclusion: I dunno… one is as volatile as the other. I’ll stick with the status quo and call a draw.
Unfortunately behind all of this is the business layer. The layer that keeps common sense out of the working tiers, tying us up with silly proceedures and creating roadblocks to providing services. This ultimately keeps us all stuck in the vicious karmatic cycle called “Dilbertonian Hell.” There is also an old Slashdot saying “Management is where geeks go to die.” Aaahhh PHB’s, you either love ‘em or you hate ‘em.

If you’re in the medical industry, the message from management is the same: “Make us money, and by the way, don’t kill people”
If you work in IT, the message from management is the same: “Make us money, and by the way, don’t kill people”
Conclusion: Everyone loses when there is a layer of manglement ruining things with overbearing policies and a restrictive hierarchical nature. Collaboration technology? Would work if manglement didn’t demand restrictive access rights.
Having a hierarchy is nice, but if it’s too overly structured, the output is affected. I think what I’m saying here is that I agree with the Cathedral and the Bazaar. However, in business you need structure. Just loosen it back a bit, perhaps a good halfway point between both styles could be found… like Google which appears to have great employee satisfaction.
I can’t in good faith call this a draw, because due to this layer there’s a lot of losing in the working tiers, of which I’m part of. So let’s call this a disqualification.
Then you’ve got the Vendors. They’re the same, no matter the industry; Making great products and charging an arm and a leg for them, be it cancer-killing drugs or cancer-inducing routers. They also have a habit of bedding the management layer to sell more products. As it is us, the working layers, that have to do the use and support, why arent they sleeping with us? Cisco, the last seminar I went to had a cute chick, let her try to sell me on some wireless gear!

“BUY OUR CRAP! WE LOVE YOU LONG TIME ^_^”
Conclusion: If you’re hot and not a first tier lacky, chances are you’re in sales. Points given for being attractive, points lost for sleeping with manglement instead of me. In the wider picture of this rant, drug companies save lives, no doubt, but they charge so much and they can’t route OSPF packets, so the hardware vendors win. Also, the hardware vendors provide hardware that enables communication that can be used to save lives – vital service dispatch for example. Hardware Vendors win this round.
Finally you’ve got the rogues/mobile consultants/freelancers. These are the geeks-on-wheels college students, or the ones who were so tired of office politics that they decided to scratch out their own living as a consultant, or the wannabe medicine-(wo)man who caters for people silly enough to live in the middle of nowhere.
They’re rough, they’re raw, and they can sometimes cause some havoc – especially if they’re amateurish or into some kind of hippy spiritual cultish side of their industry. Like Macintosh, or Homeopathy.

Do not be fooled! Looks can be deceiving! That guy on the right cannot configure the correct IRQ settings on your archaic dial up modem! And the hot chick next to him, she kills puppies!
Conclusion: Kim from the Vengaboys didnt really kill puppies, and she’s hot. Win-win.