Monday, June 11, 2012

Free Enterprise in Action

Visiting Disneyland last week, a couple’s two year-old twins fell ill. The parents consulted the concierge, and a doctor who wasn’t me duly arrived.

The family then traveled to Hollywood to spend a few days before flying home to Australia.

A delightful perk of hotel doctoring is the “clearance to travel” visit. Few conditions make flying dangerous for otherwise healthy people. I usually tell guests to travel if they feel up to it, but some insurers demand an exam and written permission. That’s where I came on the scene.

The children had recovered, and I dutifully wrote my consent. From the parents’ description, they had suffered viral upper respiratory infections with cough, fever, congestion, and general miseries. The hotel doctor had diagnosed: “otitis, tonsillitis, bronchitis, and mild pneumonia.” He had given injections, handed over medication, and written prescriptions for antibiotics, cough medicine, and eardrops.

The parents showed me his invoices. The fee for one child totaled $495, for the other $390. The prescriptions came to over $100, so they paid nearly a thousand dollars for a single visit.

I occasionally see guests after they’ve seen another hotel doctor, and the resulting bills often contain a string of itemized charges and a spectacular total.

Nothing I do in a hotel room costs much. That doctor billed $30 apiece for his injections; those I carry for common problems (vomiting, pain, allergy) cost less than a dollar a dose. A syringe costs a dime. He handed over several small packets of pills, charging $20 apiece. I carry about twenty similar packets containing from three to eight pills. Each pill costs between a nickel and a quarter. A bottle of cough medicine costs $1.50. A week’s supply of antibiotics is usually less than $5.00. I pay about $3.00 for a bottle of antibiotic eye drops. Perhaps my most expensive drug is antibiotic ear drops at $8.00. Doctors charge $30 for a urinalysis, but the dipsticks they dunk in your urine come in bottles of 100 at $40.00. That’s 40 cents a dipstick.

Medicine is a noble profession, and while I’m in favor of doctors earning a large income, it’s beneath their dignity to pay obsessive attention to it. This might not be a majority opinion. Doctors with an office practice often insist that they are businessmen operating in a free market. As such, it’s reasonable to charge for every service they provide; sensible patients will understand. Many of these doctors yearn to charge for phone calls.

You can read more about how doctors and money interact on my blog for February 12, 2010. It’s a depressing story.

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