Few things besides wine and cheese improve with time,
but a personal database is among them.
It didn’t seem significant when I began in 1983, but
now I can look over 18,316 visits. So when I claim to have made more housecalls
than any doctor now alive, I have the evidence . It’s a fascinating trove of
information. I saw 967 patients from Brazil, for example; 42 of them suffered
skin problems. Of those calls from Brazilians, 70 arrived between 11pm and 6am,
getting me out of bed.
Of the 18,316 nearly 12,000 (11,849) were of calls
directly from a hotel. The remainder came from four other sources.
The second source is agencies that insure travelers
visiting America: 3490 visits. Few come from Europe or Australia whose insurers
follow the American strategy of insisting that clients pay up
front and apply for reimbursement later. Asian and Latin American carriers do
better. Their clients phone the 800 number of the agency’s US office; the
agency phones me; I make the housecall and send my invoice to the agency which
pays exactly what I bill (American carriers undoubtedly roll their eyes at this
archaic behavior).
Inevitably some insurers are less easy to deal with
than others. Some have adopted the American system of requiring elaborate
forms, itemization, and codes for every procedure. Others pay slowly and only
after many pestering phone calls. When my patience runs out, I stop accepting
their calls.
This doesn’t mean I stop seeing their clients, because
they transfer their business to my third source of calls: competitors with 1760
visits. That includes other Los Angeles hotel doctors who ask my help or cover
for me when I’m busy as well as one of the national housecall services. They
have names like Expressdoc, AMPM Housecalls, Hoteldoc, Global Med. If you live
in a large city, they may be available, but be warned that some are reasonable
but others charge fees that will take your breath away.
Foreign airline crew make up the fourth source: 913
visits. American airlines have no interest in crew who fall ill when laying
over. They have medical insurance but with no transportation or knowledge of
facilities in a strange city, they are out of luck. Occasionally I deal with
their pitiful calls and treat them as charity cases. As with American insurance
carriers, it’s hopeless to bill an American airline for a housecall.
A minor fifth category is what I call
“private-parties:” 293 visits. These are people who learn about me from another
source. That includes locals as well as former patients who return to the city
and call me directly.