Uber is driving taxi
companies out of business. Air Bnb is putting stress on hotels. A stream of
retail chains are declaring bankruptcy in the face of online competition. No
one doubts that this trend will continue. Online services are cheaper if
sometimes inferior. Uber drivers earn less than traditional cabbies – not a
notably prosperous profession. But customers aren’t complaining. They like
cheap.
It’s absolutely certain
that housecall doctors like me are doomed. We’re expensive and often – at least
in my case – the quality of our service is too good.
Los Angeles residents already have a choice
of two phone apps. Tap either one, enter your credit card information, and a
doctor will arrive within hours. The fee will be less than mine – and I charge
less than the typical hotel doctor.
One consequence of a low
fee is that they pay doctors less than the going rate. As a result, they attract
residents in training or just beginning practice, but these seem adequate.
As you know I work for
everyone, and I worked for both. I didn’t care for the low pay, but I’d still
be working if it weren’t that I had no control over the patients I saw.
When hotel guests phone, I
always talk to them. If the problem is minor, I give advice and suggest that a
housecall isn’t necessary. If it requires a simple service such as a prescription,
I take care of it over the phone. If it requires a test, x-ray, or emergency
room visit, I can usually determine that.
If the guest has
unrealistic expectations, I can avoid an unsatisfying encounter. I can warn a
hoarse singer that she probably won’t be better by evening.
Many callers request
treatments that they don’t need. You might think of narcotics, but mostly it’s
an antibiotic for their respiratory illness. I only prescribe an antibiotic if
it will help which puts me at odds with most of the medical profession, so many
patients will be disappointed and a few upset if I don’t treat their
“bronchitis” or “sinus infection” as their doctors do. When this seems likely I
direct them to a local clinic where they’ll get their antibiotic or (if they
stumble on a competent doctor) express their disappointment to someone else.
When hotels phone, I make
a housecall less than half the time. Guests love the free service. Even better,
when I drive off, I know that I’ll be able to help, and – no less important –
the guest will feel helped.
Working for these Uber
services, I had to make every visit they assigned. All I learned was a symptom
(“cough” “allergy”). The result is that I walked into situations where a
housecall was not appropriate (“granny hasn’t seen a doctor in thirty years;
would you check her out?...”). Many had problems I could have handled over the
phone; others required more than a housecall could provide. And there were the
usual unreasonable requests.
My faithful readers know
that hotel visits don’t always work out. I’d estimate that five percent are
less than satisfactory. Working for housecall services, the percentage was much
higher. I didn’t like the stress of wondering what I would encounter.
But I see the writing on
the wall. Hotels that emphasize superior service (i.e. expensive ones) will
continue to refer guests to a specific doctor. Otherwise, ironically, the old
days will return. When I began in 1983, motels and chains (Holiday Inn, Ramada,
Hilton, Best Western…) had no interest in a hotel doctor. At least in Los Angeles, I was the
first to approach them. By the 1990s, they were calling me and an increasing
number of competitors, but managers of these hotels still pay little attention,
so employees are on their own when guests ask for help.
Although my faithful
clients continue to call, I’ve noticed a decline from the great mass of hotels
that never called regularly. But I already collect Social Security, and I’ll be
fine when I retire.
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