A Letter from His Doctor

A VIP had forgotten his medication. Would I prescribe it, asked the manager of a Sunset Strip hotel.

“He brought a letter from his doctor,” she added helpfully.

That was bad news. About twenty percent of guests with letters have complex medical problems that require an explanation. The rest are drug abusers under the impression that an official document will persuade us to prescribe something we ordinarily wouldn’t.

Sure enough, it was a popular narcotic. This guaranteed tedious consequences. The most critical was that, after my refusal, he might ask the manager to suggest another doctor, explaining that I had heartlessly rejected his appeal.

I listened as he described the complex pain disorder he and his doctor were wrestling with. Perhaps I could examine him, he added. While this sounds reasonable, such visits involve an unspoken agreement that if I came and took his money, I would give the prescription. That felt too much like selling drugs. I countered that I would call in a prescription for a good non-narcotic while he contacted his doctor who would phone me to discuss matters.

His doctor wouldn’t call, and I suspected the guest wouldn’t care for my prescription, so I could expect to hear from him in a day or two. But the clock was running. He might check out and return home or move to another hotel and bother another doctor.

A Perfect Housecall

On Sunday I wrote for a few hours and then ate breakfast. My routine is to go to the gym afterward, but as I was leaving the phone rang. A travel insurer asked me to see a guest in Anaheim, near Disneyland, forty miles away. 

That was good news; not only did I have a visit but I could skip the gym. I don’t mind long drives provided the freeways move smoothly which is the case on Sunday morning, and the insurer agreed to pay extra for the distance.

Sure enough, the drive went quickly. The patient was a five year-old with an itchy rash on his legs, obviously atopic dermatitis. I informed the parents, explained how to care for his skin, and handed over a tube of hydrocortisone cream from my bag. They were pleased. I didn't hurry, but I doubt I spent ten minutes in the room. Sometimes this is an easy job.

My Fifteen Minutes of Fame

Every five years or so, the Los Angeles Times discovers the housecall and publishes an enthusiastic article that doesn’t mention me, the nation’s leading housecall doctor.

Another appeared two days ago. As always, I wrote the reporter to point out his error. To my surprise, he phoned yesterday, interviewed me for half an hour, and wrote another article in today’s Times. You can find it at:

http://www.latimes.com/business/hiltzik/la-fi-mh-is-the-house-call-really-dead-20160202-column.html

Getting Help, Part 2

My relations with other Los Angeles housecall doctors are civilized but not close. As a result, when I leave town there’s only one colleague I trust to cover. Mostly this works out. I schedule my trips so they don’t conflict with his.

When I’m in town I’m always available. That includes after bedtime, in the movies and restaurants, and during social events. It includes concerts and live theater, but I sit on the aisle, so I can hurry to the lobby when my phone buzzes. None of this bothers me greatly (my wife is another matter).  

One event causes problems: baseball games. One of my brothers has Dodger season tickets, and we attend a dozen times during the season. We go to a restaurant and then the game: almost the only time we get together; I love it and don’t want to be interrupted. I’m out of commission only about six hours, and occasionally my colleague can’t cover.

I could continue to answer the phone, but crowd noise in the stadium makes conversation difficult. It also reveals that I’m having fun, and patients hate disturbing a doctor during his leisure time. My solution is to change my phone message to announce that I’m unavailable until (whatever time the game ends) and then turn off the phone. Genuine emergencies are very rare in a hotel doctor’s practice, and so far it’s turned out all right. But I’m always looking for help.

A Dog-Eat-Dog Business, Part 10

My last post reported a housecall service that charged an unbelievable fee. By an odd coincidence within a week I came across another new service with an even more unbelievable fee: $99.

A high-tech startup similar to Airbnb, Uber, and Lyft, Heal is clearly the wave of the future. You download its app. If illness strikes, you click on it, enter information, and (according to the web site) a doctor arrives within an hour. Business was brisk, its medical director assured me.

With a “medical assistant,” driving, Heal’s doctors care for acute illnesses, performing complex procedures that I don’t do such as suturing, injecting joints, and even complete physical exams.

Paying the doctor, driver, staff, and investors at $99 per housecall seems impossible, especially since the web site emphasizes that there are no extra charges. On the other hand, taxi companies complain bitterly about Uber, and hotels denounce Airbnb, yet both are prospering. Financial acumen is not my strong point, so it’s possible that Heal will drive me and my more expensive colleagues out of business.

If so, I might to work for them. Pay is low for a doctor but acceptable to me. Having a driver would relieve a major stress, and I might enjoy not being on-call 24 hours a day. This blog would vanish, but you could read Heal’s. It lacks my whimsy, being mostly earnest medical advice and public relatoins, but $99 will not include entertaining literary diversions.

Let me know if it works for you.