American doctors complain about paperwork, but it’s no problem with me. I give guests a copy of the record I write in the room. I fax the same to housecall agencies and foreign travel insurers. American insurers look with deep suspicion on housecalls, so I don’t deal with them, and when foreign carriers feel the urge to adopt American techniques (complex codes, lengthy invoices, deductibles, fee schedules), I stop working for them.
This is less of a sacrifice than you’d think because they switch to a national housecall service, most of whom call me. I earn my usual fee, and the service bills the insurer more, often much more. The logic of this is unclear to me.
Assistcard, an international insurer that has called for twenty years, stopped recently. When I phoned, a representative explained that Assistcard had made arrangements with other Los Angeles doctors who accepted less than I charged. I expressed congratulations, but this seemed unlikely. I charge less than the going rate, other hotel doctors do not work with travel insurers because they pay slowly, and doctors who agree to make housecalls on the side are not likely to drop everything and go. A week after that exchange, Assistcard resumed calling.
Calls from the Biltmore, once a regular, vanished in 2010. Last May the general manager phoned to announce that I was now the hotel’s doctor. I can’t remember the last time a manager did that. Sure enough, the hotel resumed calling. I’m sure an incident in the hotel convinced her that having me as the house doctor would be a good idea. Sadly, I forgot to ask for details.