Things Guests Say Again and Again

“Can you come up right away?”

It’s surprising how many guests believe I am sitting in an office downstairs. In fact, I’m at home or going about my daily business when the phone rings. I keep a suit jacket, tie, black bag, and paperwork in the car, a mild inconvenience because I must park in shade on sunny days to prevent the heat from melting my pills.

“I’ll call you back.”

Middle-class Americans are mostly insured. Talking to a doctor willing to make a housecall is already disorienting; hearing that they’ll have to hand over money comes as an additional jolt, so they often reconsider (“I’ll talk to my husband and call you back…..”). No one who says this ever calls.

“Sorry about the mess”

Entering a room, I look for a place to set down my clipboard and bag, so I hear this as someone hastily removes the pile of articles covering the desk. After putting a thermometer in the guest’s mouth, I announce that I will wash my hands, so I hear it again as someone rushes ahead to clear a space around the sink. 

“Do you accept insurance?”

My answer is yes – if the guest is foreign. Billing US carriers is so complicated that offices employ trained billing clerks. I work alone.

Impresssing the General Manager

Years ago Prentice-Hall published The Man’s Health Book, and UPS delivered my ten free copies. Usually I gave those to family and friends who didn’t read them, so I wondered if I could put them to better use. 

I decided to visit general managers of my biggest hotels, introduce myself, and impress them by handing over my new book.  

At each, I approached the secretary in the executive office, identified myself as the hotel doctor, and asked for a minute of her boss’s time. I delivered my spiel, surrendered the book, and accepted their thanks. Some GMs expressed pleasure at finally meeting me, adding flattering words about my service. Others listened politely and thanked me for the book, but it was obvious they had no idea who I was.

I encountered a third reaction at the Los Angeles Downtown Hilton. The secretary had barely replaced her phone when the GM shot out of his office. I began my spiel but he interrupted.

“What do you mean you’re our hotel doctor?” he exclaimed. “This hotel doesn’t have a doctor!”

“I’ve been coming for years….,” I said. My database showed 119 visits which implied over 200 phone calls. The staff knew me; the valets never refused to hold my car (essential downtown).

“This hotel doesn’t have a doctor!” he repeated. “What do you mean calling yourself our doctor?”

“When a hotel calls so often…”

“We don’t have a doctor. You’re not to call yourself our doctor!”

Flustered, I held out my book. He snatched it and disappeared back into his office. I could have made better use of that copy. A few days later the mail brought a certified letter from an attorney informing me that I was hereafter forbidden to refer to myself as the Los Angeles Hilton’s doctor.

I stopped handing out books. Seven years passed before the hotel, then the Wilshire-Grand, resumed calling.

Why Don't They Call?

In my experience, a hotel generates approximately one request for a doctor per month for every hundred rooms. My record, in case you’re wondering, is 208 calls in 1995 from the old Century Plaza which had 1076 rooms.

The Airport Hilton has over 1,200 rooms, but I average a dozen calls a year. When I asked the security officer why the hotel called so infrequently he gave the usual wrong answer (“no one’s been sick”). When I asked who they called besides me, he peered down at his desk where, under a sheet of glass lay business cards advertising taxis, masseurs, florists, limousine services, clinics, pharmacies, et al. I saw my card and none from three rival hotel doctors who prefer the area in and around Beverly Hills where luxury hotels concentrate. They occasionally drive the extra ten miles to the airport, but I doubted they were responsible for my shortfall.

My eyes fell on a card from a national housecall service. Several exist, and I made half a dozen visits for this agency but stopped because guests blamed me for the bill.

“Do you know how much these people charge?” I asked. “Eight hundred dollars!” The security officer expressed polite dismay. Guests rarely complain about a doctor’s fee, so he didn’t care.

That’s the problem. Luxury hotels make sure a doctor is available, but many managers at the mid-level give it a low priority, so employees make their own choices when a guest asks for help.

Now and then, mysteriously, the light dawns, and a hotel begins to call regularly. Decades may pass before this happens, and I’m still waiting for the Airport Hilton. 

Drugs are Cheap

A least they’re cheap for common problems your doctor encounters in the office which are the same as I see in hotels. Here are examples from my favorite internet supplier as of 2018.

Some drugs cost almost nothing, less than a penny a pill. A thousand hydrochlorothiazide (the most popular diuretic and blood pressure pill) costs $6.34. Valium 5mg is over a penny: $12.20 for a thousand. I can buy a thousand Benadryl, an antihistamine, for $11.28.

An excellent prescription pain remedy, Tramadol, costs $1.69 for a hundred; $15.11 for a thousand.

Long ago states began requiring doctors to file a report each time they hand out narcotic pain pills, so I gave it up. Despite the impressive street price of the most popular drug of abuse, Oxycontin, a bottle of a hundred costs $8.77.

Cortisone cream: $0.99 per tube.

Antibiotic eye drops for conjunctivitis: $2.25

Antibiotic ear drops for swimmer’s ear used to be about twice as expensive, but they’ve shot up to over $20. Luckily, it’s considered OK to use antibiotic eye drops for ear infections, so that’s what I do. 

The three day Bactrim antibiotic treatment for urinary infection (six tablets) is about 35 cents. A hundred costs $5.40.

Ten day treatment for strep throat, twenty amoxicillin 500mg: $1.30.

Ten day treatment for pneumonia, twenty doxycycline, is about $1.70.

A big attraction of injections is that a doctor can charge for them. If he writes a prescription, the pharmacy gets the money. Don’t assume common injectables are expensive. To begin, a disposable syringe costs twenty cents.

For allergies and itching, a vial containing thirty doses of injectable cortisone (Decadron 4mg) costs $11.06. That’s about 40 cents a shot.

For pain, a shot of morphine costs about $2.30 if the doctor buys single-dose vials, but that’s an expensive form. Multiple dose vials cost less than half as much per dose if he or she can find them.

Within the past five years, ondansetron has replaced Compazine and Phenergan as the leading treatment of vomiting. One shot costs 15 cents. A vial of ten doses is $1.54

Plain old Valium injectable has skyrocketed. This happens when some companies stop making a drug and the others realize they have little competition. Five years ago I paid $5.04 for a vial of ten shots; it’s now $51.00.