Tuesday, May 30, 2017

It's the Law!!

Every sick hotel guest should contact his or her family doctor before calling me. The doctor, being familiar with the patient, is more likely to deal with the problem over the phone and prevent an expensive housecall.  

When I suggest this, almost everyone assures me that their doctor is “unavailable,” especially if they’re calling after business hours.

I point out that, if so, their doctor is breaking the law. Every state requires a doctor (or someone covering) to be available at all times. Not being available is called “abandonment,” and it’s illegal. If you write your state medical board, he’ll get into trouble (or at least they’ll contact him; nowadays medical boards respond to complaints).  

Friday, May 26, 2017

Paying for Paramedics

Hotel guests, Americans above all, do not like paying for a housecall. Many, if they are feeling bad, decide to “call an ambulance.”

Paramedics know their business. If the guest requires urgent attention, they’ll take him to a hospital. If not, they might still transport him because they don’t like to take chances. If the situation is clearly not urgent, they’ll tell him to consult a doctor. Sometimes I end up making the visit.

Paramedics are city employees, so their services are free. But for reasons unclear to me, transportation in an ambulance is not free. If paramedics take you to a hospital, the city will send you a bill. Like all medical services in America, the cost will take your breath away.

Monday, May 22, 2017

Dodging Another Bullet

People don’t like to disturb doctors, so a woman with abdominal pain suffered through the night before calling at 6 a.m. I was about eat breakfast, but I would have changed into my suit and arrived in half an hour if she hadn’t told me that the pain was diminishing.

I told her I’d be there in an hour. After breakfast, I drove to the Airport Marriott and knocked. No one answered. I knocked several more times and then confirmed that this was the correct room. I was about to call Security when the door swung open. No one was there.

Looking down, I saw a woman lying flat on her face. She had crawled across the room to open the door. I dragged her to the bed and called the paramedics who took her to the hospital where she underwent emergency surgery for a ruptured ectopic pregnancy. If I’d dawdled over breakfast, she might have bled to death.

Thursday, May 18, 2017

Why Americans Don't Eat Horse Meat

Doctors grumble at the popularity of alternative medicine, but the truth is that we still have a monopoly. This is not so in other civilized nations. In France and Germany, for example, herbal medicine is mainstream - i.e. health insurance pays for it.

When Americans get sick, almost all head straight for a medical doctor. From a doctor’s view, that’s the right decision. Scientific medicine works. But that’s not the reason. The idea that scientific explanations are the best has always been a minority view, and recent nutty events haven’t changed matters. In a free election, ghosts would win and evolution lose -- by a landslide.       

Americans mostly prefer medical doctors just as we prefer baseball and big cars. It’s an American thing. We don’t eat horse meat because…well, we don’t.

Sunday, May 14, 2017

That Special Drug

Sick people yearn to get better, but hotel guests seem particularly impatient. Many are taking an expensive vacation or business trip, so illness is especially inconvenient.

After hearing how I plan to treat his bronchitis or laryngitis or upset stomach or rash, the guest often expresses gratitude but then makes it clear that this is an urgent situation. Really, really urgent….!

In the guest’s mind, if this plea succeeds, I’ll to say to myself: “Wait a minute…. This is not the usual case. This man needs the special, powerful drug I keep in reserve for deserving patients who absolutely must get better.”

Wednesday, May 10, 2017


Cheap hotels skimp on security. I park, enter, and wander about at any hour, and no one bothers me. Luxury hotels also make my life easy. Visiting the Beverly Hills Hotel, I park on the street nearby and walk toward the nearest door which remains unlocked even during wee hours. When I press a button on the elevator, it obeys.

In between lies trouble. A Marriott, Hyatt, Hilton, or Holiday Inn has innumerable doors because fire regulations require them. But if I want the door to open, it’s the main entrance or nothing. The elevator requires a room key card before it responds. In the past I waited for a guest to enter, but technology is improving, so that often doesn’t work. 

A desk clerk who decides I’m not a suspicious character will make me a card, but I’ve whiled away many hours waiting for a security officer to escort me to the room, and it may take a firm effort to prevent him from following me inside.

Saturday, May 6, 2017

Things Patients Tell Us That Are Almost Never True, Part 2

“It tasted funny….”

Everyone with an upset stomach blames their last meal, and some are right. But the toxins that make you sick quickly (mostly staphylococcal) and the bacteria that made you sick after a few days (salmonella, shigella, campylobacter) have no taste.

“My pressure is up.”

Calls from guests to “check my pressure” arrive regularly. I can’t remember a visit in which high blood pressure was the problem because high blood pressure doesn’t cause symptoms. I won’t mention the symptoms it doesn’t cause because no one believes me.

Tuesday, May 2, 2017

Things Patients Tell Us That Are Almost Never True, Part 1

“I need something stronger….”

It’s common sense that if a drug isn’t working, the doctor should prescribe a better drug. In fact, the usual reason a drug doesn’t work is that you have a problem a drug won’t solve. Mostly, when hotel guests make this statement, they’re taking an antibiotic for their bronchitis. A week or two has passed, and they’re still coughing. I have to explain that these illnesses last a week or two no matter what medicine you take. Similarly most “pinkeye” doesn’t respond to drops, and doctors still debate whether antibiotics help middle ear infections.     

“I’m allergic to….”

As I wrote on March 23, almost everyone who believes they’re allergic is wrong. Another large group claims that they’re allergic to a drug that upsets their stomach. In fact, this is not an allergy – meaning that it’s never fatal. This is important because you should never take a drug to which you are (genuinely) allergic. If a drug upsets your stomach but an alternative is more expensive or less effective, you might choose to feel sick for a while.