I've been having major internet issues lately (Seattle area), have had 4 techs come try to figure it out. Yesterday's tech finally correctly diagnosed the problem as happening before the connection reaches our home but was unsure of the cause. He called his supervisor to investigate, and they found that the capacity for our neighborhood's node was nearly at 100%, while ideally it should always be under 80%. Fortunate…
Last ISP I worked at would have email and SMS notifications going to On Call staff.