A Dirty Trick

In 1993 I opened a letter from the California Medical Board announcing a complaint against me.

The days when state boards went easy on doctors were past. In response to persistent criticism, California had joined others in raising license fees, hiring investigators, and issuing press releases boasting of doctors it has disciplined. Every month I receive a bulletin listing names of those punished with license revocation, suspension, or some humiliating probation. These doctors seemed sad cases: incompetent, alcoholic, dishonest without being clever. Was I about to join them?

Although Los Angeles is the largest city in California, my hearing took place in Diamond Bar, thirty miles east, and it was a gloomy drive. The investigator ushered me into a room where I sat at a long table, bare except for the evidence. He told me the name of my accuser who turned out to be a competing hotel doctor.

The investigator held up a tiny pill box labeled with my handwriting. The name on the box belonged to a guest I’d seen months earlier. My rival had visited her, noticed the box, and realized it offered an irresistible opportunity.

I carry dozens of medications in little boxes. Handing them out, I once wrote the name of the drug and the instructions. This violated California State Pharmacy laws, the investigator informed me. Whenever anyone (not only a pharmacist) gives out a prescription drug, its container must include the patient’s name, the date, the drug’s name, dose, quantity, expiration date, and instructions plus the doctor’s name and contact information. For violating these laws, he added, the board would levy a fine and issue a written reprimand. This was not, however, an offense that endangered my license.

The reprimand announcing my three hundred dollar fine duly arrived. For months I scanned the bulletin, dreading to read my name, but the offense apparently didn’t qualify. It also never appeared on the California Medical Board’s web site when I checked for transgressions (you can look up me or any California doctor at http://www.medbd.ca.gov/Lookup.htm. Other states have a similar arrangement.

Obeying the pharmacy law required a great deal of writing on that tiny box, but I went along. As for repaying that doctor for the dirty trick, my only recourse was to continue setting foot in his hotels. Hotel doctors hate that.

A Doctor for Cheap Lodging, Part 2

I had seen a guest at the Banana Bungalows, a budget motel near the Hollywood freeway converted into a hostel. It was my first visit, so I wanted to introduce myself. I caught the eye of the desk clerk, a youth with a shaved head, tank top, and jeans.

The quality of front desk personnel varies directly with the quality of the hotel. Since hostels are a nonprofit enterprise, their employees fall below the bottom of the scale. 

“Could I speak to the front desk manager?”

“I guess that’s me.”

“I’m Doctor Oppenheim. I took care of the man in bungalow ten. Did you call me?”

The clerk shook his head no.

“Maybe one of your colleagues?”

“I’m the only one on duty.” It’s a mystery how often I find no one willing to admit referring a guest. I began my sales pitch.

“Who do you call when a guest wants a doctor?”

“Nobody gets sick. We send them to an ER.”

“You must call someone. Someone called me…. I’m a fulltime hotel doctor. All the hotels use me.….”

At chain hotels, staff maintain eye contact and a smile as I speak. I often sense their lack of interest, but at least they remember their manners. The Banana Bungalow’s clerk kept nodding to encourage me to get to the point. He flicked an impatient glance at a guest standing nearby.

“I’m always available.”

“We don’t really need a doctor.”

“Here’s a number anyone can call 24 hours a day. Could you post it?”

“No problem.” The clerk snatched my card and then turned to the waiting guest.

A Doctor for Cheap Lodging, Part 1

The Banana Bungalows consists of cabins strung out along narrow alleys off the Hollywood Freeway. I parked near the largest.

A desk clerk directed me to a cabin a hundred yards up a hill. Its Spartan interior slept eight in four bunk beds, all unmade. Papers, food cartons, luggage, and clothes littered the floor, and there was no furniture, not even a table where I could write. The air smelled of French fries and unwashed bodies:  a typical youth hostel.

Sitting on a vacant bed, I introduced myself. One glance under the man’s shirt confirmed the diagnosis. Chicken pox can be serious in an adult, but this was a mild case. He wanted to go home. I told him not to get on the plane until all his pocks were scabbed over. That might take a week, and I suspected he wouldn’t wait.

Walking down the hill, I puzzled over the appeal of youth hostels. They charge thirty-five dollars a night, a bargain, but cheap motels begin at fifty dollars and offer privacy as well as an unshared bathroom. Perhaps young travelers like to clump together.

Something to Knock It Out, Part 3

Her vacation had been a disaster so far. Worse, when she tried to buy amoxicillin to knock out her bronchitis, the pharmacist told her she needed a prescription. This was obviously a scam to line the pockets of American doctors, the guest added. She didn’t need my services except to provide the amoxicillin, so I should not take up her time.

This monologue occurred in Spanish. I don’t speak Spanish, but I’ve seen thousands of Latin American travelers, so I got the drift.

This lady appeared upset as soon as she opened the door. Apparently accustomed to this behavior, her husband and a child sat in a corner, trying to look inconspicuous. Following my rule (see the post from March 16) I had no plans to refuse the amoxicillin, but first I had to deliver good medical care. I phoned the travel insurance office, and the dispatcher agreed to interpret.

I asked the usual questions; she answered at great length.

The dispatcher translated but summarized her interruptions with: “she’s mad about something.”

The guest rolled her eyes when I put a thermometer into her mouth and seemed impatient during my exam.

When I concluded that she would recover in a few days with or without an antibiotic but that I would give her amoxicillin, she slammed down the phone and waved off my prescription.

“If you don’t think I need an antibiotic then I don’t want an antibiotic. According to you I should continue to suffer. Thank you very much!….”  I’m not certain those were her exact words, but they were close.

I laid the prescription on the bed. The door closed behind me with a deafening slam.