An Odd Anecdote

Long ago when I was a medical student, a woman came to our gynecology clinic to have an IUD removed.

Five years earlier, when abortions were still illegal, she had had an abortion. For some reason, the woman believed that IUDs were also illegal. The abortionist said that he would insert an IUD for an extra $180, and she agreed.

When the resident looked inside, he didn’t see a string hanging out of her cervix. All IUDs have this string, so they can be easily removed. He ordered an X-ray. It showed a bobby pin.

The resident removed it in the operating room, rusty but intact. It had served her well for five years.

Gratitude is All I Get

The Adventure is a large motel near the airport that caters to foreign tourists on a budget. It’s full of colorful, young Europeans and Asians. The owner-manager phoned to inform me that his girl friend was sick. Could I see her? He would pay.

That was the third time he had asked me to see the girl friend who had a tendency to get sick. I like calls from general managers because it gives me a chance to do public relations.

After my first visit, I waved off his money but suggested that I’d like to be the Adventure’s doctor. He expressed gratitude and promised to tell his employees that I was the man.

Six months later, after the second visit, I refused his money and reminded him of his promise. He expressed gratitude and swore he would give my name to everyone.

Doing favors for general managers has won me new hotels, but it’s remarkable how often it hasn’t. Most of the time, gratitude is all I get. On my third call from the Adventure’s manager, I accepted his money.

Frustration

I drove to care for a woman with a respiratory infection at the Georgian, a boutique beach hotel in Santa Monica. My phone rang as I pulled up at the entrance. The caller was JI, a Japanese travel insurance agency with a patient in a downtown hotel. Ten o’clock is perfect for driving downtown. Freeway traffic dips until noon when it begins a steady climb toward the evening rush.

“I can be there within the hour,” I said only to hear that the patient wanted someone between 4 and 6. I explained that people don’t realize how quickly I arrive. I could be there in 45 minutes. She checked but informed me that the guest wanted to go on a tour. Disappointed, I agreed to arrive at 4, a very inconvenient hour.

The phone rang soon after I returned home, a lady at the airport Westin whose husband was coughing. Did I accept Blue Cross? I didn’t. American insurance pays skimpily for a housecall, and billing requires skill and patience; foreign insurers do better. I gave directions to a walk-in clinic a mile away. Many Americans decide that paying for a housecall is preferable; she assured me she’d call back if she wanted a visit.

Night of the Concierge Doctors

Hotel doctoring has always been a dog-eat-dog business, but after 2010 another tiresome phenomenon appeared: concierge doctors.

These provide a personal service for a large fee in cash, no insurance -- American insurance -- accepted. Google “concierge practice” for the creepy details. When asked, these doctors insist that they’re not in it for the money which means that they’re in it for the money.

Building an office concierge practice from scratch takes a long time, but hotels are low-hanging fruit. Ambitious concierge doctors visit the general manager, something I never do. Even more effective is telling the staff that every call is worth $50. It’s illegal for a doctor to pay for a referral, and all deny doing this, but bellmen and concierges have begun hinting that, maybe, I’d forgotten something when I walked by on my way out.

I charge $300 to $350 for a housecall. Concierge doctors charge between $600 and $3000…. $3000?! Who pays $3000? The answer is: foreign travel insurers. Everyone in the world knows about America’s rapacious medical system so when an insurance clerk in Spain or Japan gets a bill for $3000, he probably assumes that that’s the going rate. This is no small market; insured foreigners make up a third of a hotel doctor's business.

At the lower end, American hotel guests will usually pay $600 to $1000, although they grumble. There is no free market in hotel doctoring as in all other areas of medicine. If guests want a housecall at a hotel served by a concierge doctor, that’s what they pay.

More Free Services

A guest from the Avalon phoned; her husband had been vomiting. Learning the fee, she decided to transmit my advice (stop drinking fluids; suck on ice) and wait a few hours. When I checked back later, he was feeling better.

An elderly man from the Beverly Hills Plaza lost his luggage and needed a supply of half a dozen medications. Rather than endure the lengthy process of learning the name, dose, and instructions of everything, I told him to sort things out with a pharmacist who would phone, and I would approve it.

A man at Le Petite Hermitage wanted a chiropractor. I could have told him to find one on the internet, but it’s better P.R. if I do it. I found one.

I was pleased at these contacts because the Avalon and Beverly Hills Plaza and Le Petite Hermitage never phone. They belong to my competitors who are not so easy to reach and unwilling to provide free services over the phone.

Doing stuff over the phone is easy, so I don’t object, and hotels that call now and then sometimes decide to call regularly.

The Get-Out-of-Jail-Free Card

“Our flight leaves at nine. My son was vomiting all afternoon but stopped a few hours ago. Is it OK to go?”

If I came to the hotel and found nothing wrong, I couldn’t promise that the child wouldn’t resume vomiting. I’d be more confident after a day, but the family didn’t want to hear that.

“There’s six of us going to Australia. We can’t miss the flight.”

Long ago you went to the local airline office and exchanged your ticket. Today airline offices are a distant memory, and ticket exchange with its expensive penalties strikes fear into the heart of any traveler.

Some get on the plane and hope for the best. Others ask the airline for advice. No carrier wants a sick person on board, and every customer service agent knows what to say. 

“They want a doctor’s note,” explained the same caller later. “Can you come?”

Most “doctor’s note” visits are a snap because the guest has already recovered, so I’m simply handing over a piece of paper. This is never true while the illness hasn’t run its course. Guests yearn for me to clear them, but I almost never do. Failing that, they hope my note will persuade the airline to reschedule everyone gratis. This sometimes works, but the era when my note served as a get-out-of-jail-free card is long past.

In this case, they were lucky. The airline insisted that four proceed on to Australia, reticketed the mother and child for the next flight in four days with no penalty but also no reimbursement for the extra days in the hotel.

When Guests Drop Hints -Part 2

        Guest:  “I try not to.”

        This means “Yes” in answer to questions like:  “Do you cheat on your diet, stick Q-tips in your ears, consume too much food, alcohol, tranquilizers, salt,  or laxatives?.”

        Guest:  “I try.”

        This means “No” when I ask if someone has obeyed instructions that are almost impossible to obey (take a pill every four hours, stick to an exercise program, ignore a crying baby)...

        Guest:  “Everyone tells me what a great doctor you are….”

        My heart sinks when I hear this because it precedes a request that I’m not likely to fulfill.