Wednesday, January 28, 2015

Canceling a Housecall

The phone woke me at 11 p.m. A guest at the Doubletree in Santa Monica wanted a doctor to examine his son’s ear.

I had dressed and was preparing to leave when the phone rang again.

“I’m really sorry,” said the guest. “The hotel called another doctor, and he’s on his way, so we have to cancel.” That was a shock. The Doubletree is one of my regulars.

I asked the doctor’s name. The guest wasn’t certain. What was his phone number? There was a long pause before the guest came on the line and gave a number. I know all my competitors, and this was unfamiliar. Was someone new poaching my hotels?   

After hanging up, I googled the number. It was an urgent-care clinic. The clinic was closed at this hour, and no one answered when I phoned. It didn’t offer housecalls.

To my relief, I realized that the guest had simply changed his mind and wanted to cancel. He assumed that a blunt cancellation would upset me, so he invented an excuse and looked up a number on the internet – not realizing that his excuse was more upsetting.

Saturday, January 24, 2015

A Perfect Start to the Day

A flight attendant at the Anaheim Hilton was vomiting. The call arrived at seven a.m. on a Friday, and Anaheim is forty miles away. I hate creeping in rush hour traffic, so I try to delay those visits for a few hours.

Examining the Sigalert map on my computer, I was surprised to see my freeway route green most of the way, so I left immediately and enjoyed a tolerable drive. Traffic was worse on the way back, but I have more patience after a visit.

I arrived home after ten, tired from driving but in a happy mood. Two housecalls make for a good day. Since I’m paid extra for long trips, I had earned my quota and could pass the time without feeling disappointed if no more calls arrived. I had changed out of my suit when the phone rang.

“A flight attendant at the Anaheim Hilton is vomiting,” said the dispatcher for the airline agency.

“I’ve already seen her.”

“It’s another one.”

Tuesday, January 20, 2015

Why I Hate Appointments

“We have two clients with the flu, but they’re at a conference. They’d like you to come at three.” This news arrived at nine.

I love seeing two patients at the same time, but I prefer going immediately. Things happen if I wait….

Sure enough, at one-thirty another hotel called. There was time to make both housecalls if I hurried, so I hurried into Hollywood, pretended I wasn’t in a hurry when I cared for the guest, hurried back to my car, and drove fifteen miles into the suburbs for the appointment.

“No one asked for a doctor,” said the person who answered the door. Shown the names, he recognized them but added that they were at a meeting. He phoned and reported that they had lost track of time but would hurry back. Their conference was at a university three miles away. Their transportation was by city bus. 

Another hotel had called. I didn’t want to wait, but there was a problem: I have an exalted view of the medical profession. We are noble humanitarians, a superior breed.

All doctors agree but many (generally Republicans) feel that if someone treats them badly (the government, insurance companies), their humanitarian obligations vanish, and they’re free to become jerks (google “concierge doctor”).

This housecall came to me from a travel insurer, so (unlike calls directly from hotels) I get paid if patients flake out. Leaving would be no material sacrifice, but how would I feel if I refused to care for them?....  After weighing my options and taking no pleasure, I drove to the university, picked them up, drove back to the hotel, and performed my exam.

Friday, January 16, 2015

The Superiority of Alternative Medicine

At the Ramada, I cared for a lady whose eyes were red and itchy. She had no allergies or evidence of infection. I suspected something was irritating them, and she was using over-the-counter eye-drops. Drops themselves can irritate eyes, especially with persistent use, so I told her to stop.

She looked uneasy at this suggestion, so I left a bottle of antibiotic drops but told her to call in two days if she wanted to use them. This is another occasion why so many patients prefer alternative medical practitioners (herbalists, nutritionists, acupuncturists…). No alternative healer tells a patient: “There’s no treatment for this; it’ll go away.” There’s always a treatment.

Monday, January 12, 2015

A Case of Domestic Violence

A lady’s arm injury seemed straightforward until she explained that her husband had twisted it during an altercation the previous night.

“It was a case of domestic violence,” she said in exactly those words.

That was disturbing news. California law requires that a doctor who suspects a patient is a victim of domestic violence must inform the police. When I told her, she merely shrugged. The husband looked depressed.

I returned to my car, took out my Iphone, and asked Siri to find the nearest police station. She complied. Although the nearest, it wasn’t the correct police station for that area. I was directed to another where an officer told me a car would be sent.

Thursday, January 8, 2015

Security Hell

I’ve been to Park La Brea Towers a dozen times. Navigating its maze of twisting private streets, tall apartments, and rows of bungalows is not exactly a nightmare but always difficult.

It was after midnight, so the drive passed quickly but a barrier blocked my entrance. For security purposes, Park La Brea apparently restricts access during wee hours. I drove until I found a barrier with a kiosk and a security officer. 

Another car was ahead of me. Checking out visitors turned out to be no minor matter, so several minutes passed before the officer handed the driver a pass and waved him in. I pulled forward only to encounter a problem. My patient was visiting, so her name was not on the list of residents, and there was no answer when the officer phoned. Nervous about speaking English, foreign guests often don’t answer.

He explained that regulations did not permit my entry. The sight of my doctor bag, suit, tie, and elderly appearance did not change his mind, but he assured me that his supervisor had been summoned. I parked behind the kiosk and waited. The supervisor never appeared.

My patience exhausted, I phoned the travel insurance office in Miami to warn that I might have to return home. Urging me to wait, the dispatcher contacted the lady on her Brazilian cell phone. She contacted the security officer and vouched for me.

Describing the pleasures of wee-hour visits, I always mention easy parking. This applies everywhere except large apartment complexes where everyone and their guests are at home, so all spaces are occupied. After a long search, I parked illegally.

Sunday, January 4, 2015

The Hotel Business in 2014

My records show 685 calls during 2014, slightly fewer than 2013. This represents my first decline since 2001 (the months after 9/11 were bad for tourism).

In my defense I took more time off because we bought and remodeled a house in Lexington, Kentucky where I plan to retire in the future. The distant future.

While this is comforting, the painful truth is that hotel doctoring has grown brutally competitive.

If you google “Los Angeles house call doctor” half a dozen names appear but not mine. Furthermore, these newcomers are amazing: Christlike in their empathy, compassionate, brilliant. For proof, read comments on Yelp or Healthgrades: five out of five stars every time, unanimous praise.

These doctors market aggressively. They have web sites. They visit hotels, speaking to concierges, bellmen, and desk clerks, undoubtedly emphasizing their compassion and brilliance.

Most hotel managers ignore this area, so when a guest asks for a doctor, the choice is up to the employee. While I’m the best choice, most doctors are adequate although you must google “Jules Lusman.” He arrived, acquired a flourishing hotel practice, and left the country in 2003 in a flurry of publicity and minus his license.

Every Los Angeles hotel has called me. About twenty call exclusively, but even their employees are not immune to the charm of these newcomers.

Luckily, calls directly from hotels make up less than half my business. I’m the doctor for half a dozen travel insurers with offices around the world. I also work for national housecall services which solicit the general public as well as hotels. I care for airline crew when they lay over. When Frenchmen living or passing through Los Angeles get sick, they call a French lady who calls me.

These businesses pay attention to the bottom line: quality of service and fees. They have less interest in charm or the amenities that appeal to hotel employees. I don’t foresee a problem with them.