At the end of every month I enter my data into the computer. It takes an hour during which the past flashes before my eyes. I re-experience its pleasures: calls from new hotels, dramatic cures, wee-hour or distant visits (extra money with the tedium a distant memory), and gratitude but also the pain: visits that didn’t turn out well, regular hotels that should have called but didn’t. At the end I punch F10 and the screen displays the month’s events: total calls, total visits, and income.
Few things besides wine and cheese improve with time, but a database is among them. Since 1984 I’ve answered the phone over 30,000 times and made 16,634 visits.
Of those visits, nearly 12,000 requests came directly from a hotel, but hotels are only the first of five sources of calls.
My second source is agencies that insure travelers visiting America: 2958 visits. Sick guests phone the agency’s US office; the agency phones me; I make the housecall and send my bill to the agency. I like these calls. Foreigners defer to doctors more than Americans, and patients who do not pay directly are less demanding. Sadly, some insurers are adopting the American system of requiring elaborate forms, itemization, and codes for every procedure. Others pay very slowly and only after many reminders. When my patience runs out, I ask for a credit card number so I can pay myself. If they refuse, I stop accepting their calls.
This doesn’t mean I stop seeing their clients because they switch their business to the third source that I call “competitors:” 1213 visits. These are national housecall services with names like Expressdoc, AMPM Housecalls, Hoteldoc, Housecall MD. If you live in a large city, they’re available, but their fees may take your breath away. All claim to provide a prompt housecall, but this is hype. None employ doctors, so when a request arrives, the dispatcher consults a list of local practitioners and begins calling. Finding a doctor willing to make a housecall at a moment’s notice is hard except in Los Angeles. Since I collect my usual fee, I don’t care if a travel insurer calls directly or calls a housecall service.
Category four is foreign airline crew: 655 visits. American airlines have no interest in what happens to crew when laying over. They have medical insurance, but with no transportation or knowledge of facilities in a strange city, they are out of luck. Occasionally I deal with their pitiful calls and treat them as charity cases. As with American insurance carriers, billing an American airline for a housecall is hopeless.
A minor fifth category is what I call “private-parties:” 55 visits. These are people who learn about me from another source. That includes locals as well as former patients who return to the city and call me directly.
In a few days, I’ll extract some interesting statistics from the database.