Doctors Earn a Lot, Part 1

The average family doctor earns about $220,000 per year. My peak income came nowhere near, but I’m not complaining. When friends suggest that we earn a great deal, I agree that America pays doctors generously. 

There’s no need to defend myself. Among problems of our health system that upset Americans, the size of our incomes is well down the list. 

Other doctors insist that they’re underpaid, and I wish they’d shut up. Their excuses sound whiny. Every complaining doctor beats two dead horses.

The first is what I call the Oprah Winfrey defense.

“Oprah Winfrey (or Tom Hanks or the chairman of Disney) makes. . .  How many lives do they save?”

Similar excuses include:

“A plumber charges. . .”

And the traditional:

“Lawyers make three hundred dollars an hour, so. . .”

Doctors aren’t the only ones comparing themselves to lawyers, plumbers, and celebrities. Everyone does. Worse, almost everyone who uses this argument earns less than I do. People who feel underpaid for their own honest labor are unlikely to agree that doctors are in the same boat.

Number two, equally feeble, is the trash compactor defense.

       

 “The average American pays more for alcoholic beverages than. . .” 

       

“My last malpractice premium was. . .”

“The consumer price index proves that doctors incomes haven’t. . .”

       

“Ten years ago, Medicare paid ... for a cataract operation.  This year it paid a mere. . .”

The trash compactor is a machine that converts a hundred pounds of trash into a hundred pounds of trash. A physician using this defense doesn’t grow less prosperous.

My blogging book says that readers lose interest when posts are long, so I’ll stop here and finish next time when I explain why we deserve a high income.

The Five Actions of a Hotel Doctor

After the door opens and an exchange of greetings, my first action is to look down at the floor. If I see a pile of shoes, I remove mine. You may think this is a quaint foreign custom, but some Americans have adopted it. When you consider what people and animals deposit outside, it seems terribly unsanitary track it onto anyone’s rugs.

My second action, on entering the room, is to identify the patient. A doctor making a housecall is an exotic event even for Americans, so I often encounter a large, attentive audience.

My third is to brush off apologies as guests rush to clear a space for my bag, clipboard, and buttocks. Apparently no one reads or writes while traveling, so desk and chairs are piled with belongings.

My fourth action is to suggest that someone turn off the television. Time and again, a patient begins talking – and I can’t hear. Guests often seem startled at this request – and occasionally miffed. What’s the problem?.....

It’s surprising how many people around the world turn the TV on before breakfast and leave it on. It’s the background to their daily life.

My fifth, after listening to the patient and before the examination, is to announce that I will wash my hands. This produces more apologies as guests rush to tidy up the bathroom.

I hope this held your attention. You should realize that any competent blogger must write at least once a week, or his audience drifts off. Being a hotel doctor may be a great job, but it’s not always exciting.

It's Just a Stomach Virus

“I’m worried about sunstroke,” said a guest at Maison 140. Her husband was vomiting, and they had returned from a walking tour of Beverly Hills. The temperature was in the 90s.

Sunstroke is life-threatening, and it takes more than a hot afternoon walk in Los Angeles to bring it on. I’ve never made the diagnosis, but hotel guests worry about it.

“I think someone put something into my drink.”

You’d think no one outside of a B movie would say this, but I hear it perhaps once a year. It’s alarming to fall violently ill after a night on the town, and Los Angeles is an exotic locale to many travelers, so anything can happen.

“The sushi tasted funny…”

It’s common sense that food your stomach rejects must be noxious, but if you’ve been paying attention you know that using common sense to explain an illness is proof that you don’t know what’s going on.

Food poisoning is not rare, but the responsible toxins are tasteless. Also, infections such as Salmonella and hepatitis are not the result of spoilage but contamination of perfectly good food with feces.

It’s almost impossible to diagnose food poisoning unless more than one person is sick. Almost everyone blames an upset stomach on the previous meal, but it’s most likely a virus. Google “viral gastroenteritis.”

Being Awakened Twice

 "How quick can you be in Costa Mesa?” asked the dispatcher for Expressdoc, a housecall agency. The call had gotten me out of bed at 11 p.m.

“In about an hour.” 

“Can’t you make it earlier?”

“Costa Mesa is forty miles away. How sick is he?”

“He has back pain. He wants to go to an emergency room, but we said we could send a doctor. Let me see if he’ll wait.”

After fifteen minutes had passed, I phoned the agency.

“I’ve been trying to reach him, but it looks like he’s gone to the hospital. If he comes back, is it OK to call you?”

“No. If he comes back, tell him I’ll be happy to see him in the morning.”

I have no objection to being awakened to make a housecall, but I don’t want to be awakened twice. After breakfast, I phoned the guest. He hadn’t gone to the emergency room, but he was feeling better.