Doctors Are Always Late

At 6 p.m. on a Friday, I learned that a flight attendant in Costa Mesa had a cold. I prefer not to drive 46 miles during the rush hour, so I promised to be there between nine and ten. That was acceptable. Airline crew are not demanding.

Five minutes later a guest at the downtown Doubletree asked for a visit. This was a bad juxtaposition. Scheduling it for after Costa Mesa meant an arrival time near midnight.

Reluctantly I told her to expect me at around eight. I gave myself over an hour for a 25 minute drive, but traffic was not so bad, and I arrived early, but she was there. The freeway to Costa Mesa was also not so bad, and this time no one answered my knock at 8:30. The front desk was unhelpful. 

Airlines have strict rules about sick crew, so this guest required a visit. If I waited an hour and then left, I might get a call on the way home. If she was out partying, I might get it several hours later. I did not acquire my peerless reputation by refusing calls, so I’d have to make the return trip.

As I fumed and paced, the guest returned. I expressed relief, but she did not apologize. She was present at the appointed time, and no one expects a doctor to be early.

 

Easy Visits, Mostly

Every day a thousand airline flight crew spend the night in a Los Angeles hotel. Sometimes they get sick and call their supervisor. If they’re American, he tells them to take their American medical insurance and find a clinic. If they’re foreign, he tells them to stay put and wait for the doctor.

That will probably be me. I average half a dozen of these visits per month. I enjoy them because airline crew are young and healthy. Three-quarters suffer respiratory infections and upset stomachs. Since a doctor must certify if they’re fit to fly, I see plenty of ordinary colds.

A minor drawback is two pages of forms to fill out in addition to my medical record. A more serious problem is vomiting: the most common symptom. I hate driving during the rush hour, but vomiters don’t like to wait, so I often find myself creeping on the freeway.

Easy Visits, More or Less

My phone rang as I walked into the gym. A guest at the Sunset Plaza wanted a doctor to “check out” her 9 year-old daughter who’d awoken with a fever and vomited once. This was a good call. Multiple vomits can be worrisome, but one is OK. I jumped at the chance to skip my morning exercise.

Sunset Plaza parking is indoors and free, a bonus on a hot day and on the Sunset Strip where street parking is impossible. The daughter was recovering, so I reassured the parents, a pleasure for everyone.

As I returned to my car, the phone rang again. This was a perfect time for a second call. Lunch was two hours away. Late morning traffic is the day’s thinnest. I could thrill the guest by announcing a speedy arrival.

The caller was a national housecall service. The patient was a Quantas flight attendant at the Hilton. While there is a Hilton at Los Angeles airport, this one was in Costa Mesa, 45 miles away. This was not so good, but there were compensations.

As I’ve written, in the old days airlines called me directly, and I billed them directly. No airline does that now. They call a national housecall service which, of course, calls me. I’m happy to work for the service because, being a better marketer, it’s acquired far more airlines, so I receive more calls. It also pays much more. This is possible because it charges airlines triple my former fee. You may wonder why airlines are willing to pay so much more, but I don’t. I’ve long since stopped believing that bad decisions by people who seem intelligent have a good explanation.  

Trying to Reach the Doctor

A flight attendant in Costa Mesa was suffering flu symptoms. The news arrived at 7:30 a.m. After writing down the information, I delivered my mantra to the dispatcher.

Costa Mesa is 45 miles away in Orange County. I can go but not during the freeway rush house. Was it OK with the patient if I arrived between 10 and 11? Usually it’s OK. If not, I suggest calling one of the Orange country doctors.  

The airline agency knows doctors in Orange County, but when its dispatcher calls one, she reaches voicemail or a receptionist or an answering service. She leaves a message and waits…and waits… You know how it is when you want to talk to your doctor.

I’m probably the only doctor in the world who answers his own phone. Harassed dispatchers from all my clients soon learn this, so they ask me to make housecalls throughout California.

Some destinations are too far. When they’re not, some agencies don’t want to pay extra. I don’t solicit distant hotels for the same reason. But the airline agency pays generously, so I go regularly to Orange County.

Who's Taking Care of Avianca

Coris, a travel insurer, sent me to the Crowne Plaza to care for a Spanish lady with stuffy ears. She turned out to be a flight attendant for Avianca airlines. Airline crew can’t fly if they suffer a host of minor ailments, so they provide plenty of easy visits.

That evening a call arrived from Traveler’s Aid, a national housecall service, and I returned to the Crowne Plaza. The guest, a Columbian man with a cold, was also an Avianca flight attendant.

That was puzzling. Foreign airlines once called me directly to see their crew. They don’t do that today. They call a more traditional provider organization who then calls me.

But what was Avianca doing? I theorized that it calls Coris, and the Coris dispatcher consults her list for Los Angeles. If she decides to call me, Avianca will pay Coris perhaps double my charge. If she calls Traveler’s Aid, the additional middleman will increase it still more.  

I’ve long since stopped trying to see the logic.

An Unsatisfied Customer

A Quantas flight attendant was vomiting, so I drove 49 miles to the Radisson in Newport Beach.

Fortunately, she was already getting better. She hadn’t vomited in six hours but was still queasy. I told her that she should continue to improve and advised her to suck on ice chips. I went to the ice machine and filled a tub. Normally, I would have left antinausea pills, but she was pregnant. She thanked me effusively as I left.

Soon after, a nurse from the airline phoned. Tactfully, she explained that the Quantas crew member had expressed concern. In her original call, the crew member had requested medicine for vomiting. A doctor had come but left without giving anything.

I explained that she was recovering and didn’t need medicine. In any case, she was pregnant, so taking drugs was not a good idea. The nurse expressed complete sympathy.

Later, the director of the housecall agency phoned. Tactfully, he explained that a nurse had passed on some concerns expressed by a flight attendant. I repeated my explanation, and he expressed complete sympathy. The following day he phoned again to assure me that I had done the right thing and that he was working hard to make Quantas see the light.

My Best Customer

I’m the doctor for scores of Los Angeles hotels, but even the largest (the Bonaventure) rarely generates five visits per month.

National housecall agencies and international travel insurers provide more business. My leading client is Inn House Doctor, a national agency run by an entrepreneur based near Boston. You can google it.

He solicits hotels, including mine, but they are not an important source of business. Since Inn House collects a cut of the fee, guests who call hear a large quote.

Many travel insurers use Inn House Doctor for their clients in America. It would make more sense for them to call me directly, but I earn my usual fee, so I don’t care. I prefer Inn House when guests live far away, because insurers often refuse to pay a larger fee. Inn House understands.

Its biggest clients are foreign airlines who need doctors for sick crew. In the past some airlines called me, but I’m happy to work for Inn House because it handles many more.

I don’t solicit distant hotels, but airlines, always searching for the best deal, may house crew fifty miles from the airport. I make half a dozen very long trips every month, but airline crew make excellent patients – not demanding and rarely very sick.

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.

A Week's Vacation

Returning from a week’s vacation, I took my phone off call-forwarding. Knowing that I keep detailed records, the colleague who covered E-mailed me the information I needed.

Seven hotels phoned; he made four housecalls and took care of three over the phone.

Universal Assistance, a travel insurer, called once. He asked for their credit card number which they gave, and he made the visit.

World Aid, another travel insurer, called twice but refused to give a credit card, so he refused the calls. I fax my invoices to World Aid which usually pays in a month or two. When they don’t, I phone to remind them. Many hotel doctors hate pestering agencies for payment, so they insist on a credit card.

International Assistance called three times, and he declined as soon as they identified themselves. IA still owes him for visits in years past. International Assistance has a poisonous reputation among hotel doctors because it often took six months to pay when it paid at all. Institutions such as clinics and hospitals can deal with this (state-run Medicaid programs are not much better), but individuals soon give up.

Ironically, my patience with IA has been rewarded. After the latest change of ownership a year ago, it got its act together. It now pays reliably every month and provides a great deal of business, but a long time will pass before it lives down its reputation among my colleagues.

Inn-House Doctors called five times, and he made two visits: one to Hollywood and one to the airport area. A national housecall service, Inn-House serves a few hotels and travel insurers but many airline flight crew. In their eternal search for better hotel rates, airlines have been boarding crew further and further from Los Angeles airport which is twenty miles from my colleague’s home. He declined two visits to Long Beach (45 miles) and one to Anaheim (60 miles).