Friday, March 30, 2012

Avoiding the Rush Hour

A guest with a respiratory infection was staying in a Whittier hotel, thirty miles away. The call arrived at 5:00. Driving sixty miles in rush hour traffic is an experience I prefer to avoid if the problem isn’t urgent. I told the insurance dispatcher I would arrive between 8 and 9.

Usually I explain that “I won’t get out of the office till 7.” That’s an excuse patients usually accept. This time I slipped up and merely explained that I didn’t want to get caught in the rush hour. This is less acceptable and, sure enough, the patient cancelled in favor of going to an emergency room. I felt bad, but that turned out to save me from a difficult evening.

At 6 o’clock, a guest in West Hollywood announced that he was having a gout attack. The rush hour was in full swing, but West Hollywood is only five miles away. Before I walked out the door, the phone rang again, and I agreed to see a Swede suffering flu symptoms at the Sheraton in Santa Monica. The Sheraton is ten miles from West Hollywood and not a convenient drive, but I hoped traffic would have diminished.

Gout is an easy visit, and I carry the treatment, so the visit ended happily for everyone. After a passable drive, I arrived at the Sheraton where I answered a call from the Hong Kong office of Cathay-Pacific Airlines. I care for their crew in Los Angeles, and they are a joy to work with. Being young, they suffer simple ailments; all are Asian but speak good English; best of all, every request comes with a credit card number, so I don’t have to send a bill. A mild downside is that every visit also comes with a sheaf of documents evaluating the employee’s fitness to work.

After caring for the Swede’s flu, I drove ten miles to the Airport Hilton to treat a flight attendant’s sore leg and fill out paperwork. I arrived home at 10:30, weary but pleased at the night’s work. No sooner had I taken my phone off call-forwarding than it rang with news that an elderly lady at a Sunset Strip hotel was ill. Not everyone who wants a doctor needs a doctor, and I often convince guests that a visit isn’t necessary. I yearned to do that in this case, but she was vomiting, not a symptom patients can tolerate.

In the room, I was prepared to diagnose a routine stomach virus until I pulled back the covers and saw her swollen abdomen.

“Is this how your stomach usually looks?” I asked.

She denied it. She also had more pain than I expected, and I heard loud intestinal noises through my stethoscope. It seemed like a bowel obstruction, I explained. She needed to go to the hospital. Immediately she reconsidered my question, remembering that she was constipated, a condition that often made her abdomen swell.

Hearing they must go to the hospital, guests often work hard to change my mind, but I persisted. She went off in an ambulance, and I left hoping I’d made the right decision (doctors worry about these things). I phoned the next day to learn she had been admitted to Cedars-Sinai where she remained several days.

Thursday, March 1, 2012


As long as they do good work, doctors assume patients will remain loyal, but hotel doctors learn not to be so trusting. Helping sick guests produces no income for the hotel. Ninety percent are not terribly ill; if rebuffed they rarely make a fuss, so the manager never hears about them. Paramedics deal with emergencies. Years may pass before a GM encounters an imbroglio that only a doctor on the spot can defuse; I’ve recounted a few. Although the best marketing tool, they never happen when I need them.

So how does a doctor keep a hotel’s loyalty? You might think that practicing good medicine is the best P.R. That’s not necessarily so because, ironically, people take for granted that doctors are good. In fact, most are competent, and that includes my competitors. Patients are usually grateful after seeing me, and over thirty years I’ve acquired plenty of flattering letters, but when patients feel the urge to tell the world about a doctor, they are generally less happy. When a GM hears from a guest, it’s almost always a complaint.

Assuring bellmen and concierges of $20 for every referral is a long tradition. It’s illegal, and my last competitor who definitely took advantage lost his license in 2003, but hotel staff continue to drop hints.

Other doctors tour hotels to extol their virtues to the staff, but I don’t. Three or four times a year I write to a hundred GMs but stop once a hotel starts calling. I dislike merchants who keep telling me how much they love my business, so I assume this feeling is general. Perhaps fifty hotels call during a typical year, but I doubt if five GMs know me by sight.

In 1994, I bumped into the doctor who serves a dozen crème de la crème luxury hotels around Beverly Hills. As we talked shop, he mentioned that he knew most of his general managers since he encountered them at social engagements. That’s a marketing tool I can’t match. It turns out that, when a hotel opens, he chats up the manager, and matters are settled. I send my usual letter of introduction, but I never acquire a new hotel in his territory.

During that conversation, he grumbled that a colleague who covered for him recently had left a business card at every hotel. I sympathized, adding that I’d be happy to cover, and I promised not to solicit afterward. Since my leisure time activities are reading and writing, I rarely decline his calls, so we’re both pleased with the arrangement. I still have no answer to the question at the beginning, but at least someone else is responsible for keeping the loyalty of many hotels I visit.