Friday, November 19, 2010

Things I Don't Charge For

Quantas and other airlines recently canceled flights after an engine exploded, stranding a large number of passengers in hotel rooms. Within days I began receiving calls from guests running out of their heart or diabetes medication. They had brought only enough for their trip or the bottles were packed in luggage which the airlines refused to release. Aware of terrifying stories about America’s medical system, they were counting their money, hoping to have enough for the necessary king’s ransom. They were pleased to hear that I don’t charge for replacing legitimate prescriptions.

Most American drugs are available in other countries, but often in different formulations and with different names. Rather than try to figure things out, I tell guests to go to a drug store where the pharmacist will research the matter and phone. I’ll approve whatever he determines. Guests regularly forget to pack medication or find their trip unexpectedly extended, so I do this routinely. My record for replacing prescriptions occurred after 9/11 when all flights stopped, and hotels were packed. Some travelers also fell ill, so my paying business jumped for a few weeks. Then everyone returned home, and tourism plunged for almost a year. That was a bad time for hotel doctors, too.

I deliver plenty of free services. I don’t charge for anything I do over the phone. I don’t charge hotel staff. I’m happy when they consult; it’s a sign they know about me and, after the consultation, they might tell colleagues about the experience. As I’ve mentioned before, no hotel employs a house doctor. Even at my regulars, I don’t occupy an official position, so many employees have never heard of me. “Are you our doctor? I didn’t know we had a doctor” is something I hear even at hotels that have called for decades. This is not good because when guests ask for help, they usually accept the first answer.

Since I am the world’s most successful hotel doctor, you might assume I command respect in my profession. There is some truth in this, but it’s not unanimous. Delivering free care upsets many doctors. Those I know personally don’t mind, but I also belong to internet physician forums whose members feel differently. Although the forums exclude nonphysicians, any clever person can figure out how to join, but I advise against it because you don’t want to hear what doctors say when they believe you’re not listening. I enjoy their medical discussions but avoid threads on business and politics. As in most forums, contributors with strong opinions dominate. I find it unsettling that the longest, angriest discussions concern money. The most energetic participants tend to work in private practice where their income depends on patients or insurance. They detest not getting paid; they suspect most poor people are deadbeats; they hate insurance, the government, President Obama, and healthcare reform.

Recently I contributed a funny story. You may have read it earlier on this blog. An Israeli man at a Beverly Hills hotel needed a doctor’s signature on his request for a disabled parking pass but didn’t want to pay my fee. Since it was a trivial task, I told him I’d sign it gratis if he came to my home. After hanging up, I began to worry. Obtaining disabled parking permits is a scandal in California; eleven percent of drivers have one. If I didn’t believe this man was disabled, I planned to refuse to sign thereby risking an unpleasant scene. I passed an uncomfortable half hour until I heard the sound of someone approaching. Opening the door, I saw a man, one arm around a young woman (his daughter) hopping up the steps to my house. He had one leg. That was a relief.

I posted the story and awaited expressions of amusement. Almost immediately a doctor wrote angrily that I had prostituted my profession, undoubtedly to curry favor with the hotel. Doctors provide a service for which they deserve a fee, he added. Any Beverly Hills hotel guest could afford it; that I blithely gave him a free ride showed that, in my degraded state, I didn’t realize how this damaged hardworking physicians with bills to pay. Other responders agreed, and then, as happens on forums, they wandered off-topic and exchanged of anecdotes about being stiffed: by obnoxious patients, welfare patients, dissatisfied patients, insurance carriers, Medicaid, Medicare, the government. Doctors on doctor forums spend a good deal of time fuming over not getting paid.