Another Failure of Communication

 “My son with pain in ear. Maybe he need a doctor.”

“I can come to the hotel.”

“Not today. I give medicine. Maybe if he has pain tomorrow.”

“So you’ll call me tomorrow?”

“Yes. Can you come in the morning?”

“Yes.”

 “When.”

 “I can be there between 10 and 1.”  Strictly speaking, I can come at any time, but I like to avoid driving during the rush hour.

 “Three hours is too long. We want to visit the city.”

 “You said you’d call tomorrow. When you call, I’ll tell you exactly when I’ll be there.”

 “OK.”

Most guests who promise to call never call, so I put the matter out of my mind. After noon the following day, the phone rang. It was the concierge at that hotel. “I’m afraid we’ve had a complaint, Doctor Oppenheim,” she said. “Mr. Desai in 403 says he and his family have been waiting over three hours. Are you going to come?....”

 

 

Good Insurance

The caller spoke with a Hispanic accent, so I assumed he was a travel insurer, and I was right. It was StandbyMD, one of the good insurers. It phones; I make the visit; I fax an invoice; it sends a check. Latin Americans make up most of its clients, but anyone can sign up.

A guest at the Sheraton Four Points had been awake all night with an earache. The call arrived at 4:30 a.m., but that’s almost my time of rising, so I was not unhappy. Freeway traffic was light. I was at his room in half an hour.

One thing seemed strange. His name sounded American. This is not rare in Latin American countries, but he also spoke flawless English. He told me his pain began soon after he boarded a plane in Managua.

“So you live in Nicaragua?” I asked.

“No. Vancouver,” he said.

The light dawned.

“Of course,” I added. “You’re Canadian. No American would have such good insurance.”

American travelers buy American travel insurance. When they fall ill, they obtain care and then submit a claim to the insurer which pays as much as their fee schedule pays. Our insurers take a dim view of housecalls, so their reimbursement is not generous.  I can’t remember caring for an American hotel guest and then billing one of the dozen travel insurers that use me.   

 

Converting Two Visits Into No Visits

A man at the Bonaventure was suffering an earache. The pain was not severe and had been present several days, but he wanted it checked. This seemed like an easy visit.

But it was 5:00 on Friday. My traffic app showed a solid red line for the ten mile freeway drive downtown, converting a half-hour trip into… I hated to contemplate it. I explained that I could be at his room between 8 and 9. That was fine with him.

I had barely hung up when the phone rang again. A guest at the Warner Center Hilton had diarrhea. The Hilton is fifteen miles in the opposite direction from the Bonaventure with an equally red freeway. I could have scheduled it for later, but if a third call arrived….

The guest was not terribly ill, so I pointed out that most diarrhea is self-limited. I gave dietary advice and recommended an over-the-counter remedy that was a good as the one I hand out (actually the same), and suggested we talk again in a day. Happy to get free medical advice, he agreed.

At 6:30 the Bonaventure operator called to inform me that the guest wanted to cancel the visit. When I phoned both guests the next day, they were doing fine.