Can I Submit This to My Insurance?

The guest’s symptoms suggested a urine infection, one of my favorite diseases. They’re miserable but respond quickly to antibiotics. This looked like a good visit. I quoted my fee.

“Oh… I didn’t realize it would be so much.”

This happens. I remember guests from the Four Seasons where room rates start at $600 who didn’t want to pay half that. In any case, once I mention the fee, I consider it tacky to refuse someone who complains. I quoted a lower fee. That was OK.

It was a good visit. I tested her urine, announced she had an infection, and handed over her medicine. She was grateful. As I left, she indicated my invoice.

“Can I submit this to my insurance?”

“You have travel insurance?”

“I think so. They made us buy something for this trip.”

It was too late to ask why, if she had insurance, she had objected to my fee. But this also happens. In every developed country except Russia and China, if you need a doctor you don’t first decide if you can afford it, so foreign tourists often pay little attention to insurance.

Really Good Luck

I was leaving the Universal City Hilton when the elevator stopped. The door opened, and a young man rushed in, blood dripping down his face.

“I have to get to a hospital. How do I get to a hospital?” he cried.

I told him to calm down and peered at his bloody scalp, but the light was too dim to make out anything. “I hit my head on the edge of a table,” he added. “I have to get to an emergency room!”

We left the elevator at the ground floor, and I looked more closely but couldn’t see anything alarming. Introducing myself as a doctor, I led him to the men’s room, and cleaned away the blood. There was no laceration, just a long scratch along his scalp that was oozing blood. I patted it dry, applied a dressing, and assured him that it was not serious and didn’t require a trip to an ER. He felt better.

Happiness is Fleeting

The owner of a West Hollywood boutique hotel called to explain that he was suffering another herpes outbreak and needed a prescription for Zovirax. He added that, since outbreaks occurred every few months, he’d like five refills. Would I fax the prescription? After sending it off, I decided I needed to examine him to justify such a large amount. He agreed, adding that he was staying at the Beverly Hills Hotel.  

I perked up. I’ve been the doctor for the Beverly Hills Hotel four separate times since the 1980s. But I don’t market myself aggressively, so four times a more enterprising doctor has snatched it away. It’s been years since it called. I hurried to the hotel; afterward the owner thanked me for my concern. Naturally, I didn’t charge him. Leaving, I stopped by the concierge to inform him that I’d seen a guest and to mention my availability.

“I remember you, Doctor Oppenheim. From the Bel Age a long time ago.” We had a short, pleasant exchange, and he accepted my business card. I walked to my car with a light step. Not only had I pleased the owner of one hotel, there was a chance I’d acquire the Beverly Hills again.

Happiness is fleeting. A few hours later, the owner called. Angrily, he informed me that he’d gone to three pharmacies which had refused to fill the prescription. I was puzzled, and then I realized what had happened. Early that year I had purchased the new, high-tech prescriptions that the law now requires. They look like ordinary prescriptions, but if a thief tries to duplicate one, “void” appears faintly on the copy. Faxing apparently triggers the same process. I apologized and telephoned a pharmacy to give him his medication.

A Guest From Hell

As I introduced myself, the guest suggested we not shake hands because he didn’t want to give me lice. He had lice.

I settled myself to listen. He explained that when he stayed in a hotel he always asked Housekeeping for the temperature at which they laundered bedding. To save money, they often kept it under 150 degrees, too low to kill the eggs. He was susceptible to lice, an affliction that mystified doctors. Treatment only worked for a short time, but this was a cross he had to bear. At home he laundered bedding and clothes daily. Although he fumigated his house once a month, this barely kept the infestation at bay. He concluded by handing me a sheaf of printouts from internet medical sites discussing lice and their treatment.

This was delusions of parasitosis: rare but not terribly rare. I’ve encountered half a dozen over thirty years. Confronted with a delusion, no one, doctors included, can resist the urge to point out the facts, a useless tactic. As anyone familiar with the debate over vaccination knows, faced with a deeply held belief, facts are worthless.

“Can you show me a louse?” I asked.

“I pick them off so fast they’re hard to find. But let’s look.”

I pulled out my flashlight, and together we peered at his pubic area.

“There’s a nit (egg),” he said after a long search.

“That’s a flake of skin.”

We turned up other bits of debris. Finally, I straightened up. “A louse infestation isn’t subtle, and I don’t find one.”

Having heard this from every doctor, he was not offended. “I need a prescription. Over-the-counter remedies don’t work.”

I wrote the prescription and held it out.

“Give it to the hotel,” he said. “They’ll pick it up and pay for it.”

“I’m not sure they will,” I said.

“They’ll do it. I’ve already told them I plan to sue.”

Doctors hate hearing that word. “That costs a lot of money,” I said. “And I doubt you’ll win.”

“Right on both counts,” he responded pleasantly. “It costs five or ten thousand dollars to hire the lawyer and file the suit, and usually the hotels won’t settle. But I can’t let them get away with filthy bedding.”