People often ask what sort of contract I had with hotels. The answer is none. Staff called because I was easy to reach and quick to respond. Once they called a few times, they were not inclined to change.

I and three colleagues had been in this business for decades. We were well known and popular, but hotel doctoring is a glamorous occupation, so plenty of doctors yearned to break in.

How could they do this? Guests who want help ask a concierge, desk clerk, operator, or bellman. You might think that they received the name of the house doctor, but there is often no such person. Except in luxury hotels, selecting a doctor is not a priority, so the choice may be up to the employee.

This is no secret, so entrepreneurial doctors know who to approach. But how can he phrase a sales pitch? Pointing out that he is a caring, compassionate physician who provides superior medical care sounds creepy. Doctor web sites and housecall agencies always proclaim this, but you should be skeptical. I've worked for dozens; they may check my license and malpractice history but never my competence.

The new doctor might offer to charge less, but he never does. The free market doesn't apply to medical fees.

So what's left? Services selling to a hotel (florists, tours, masseurs, limousines) often pay a kickback, and there is a long tradition of hotel doctors doing the same. It's illegal for a doctor to pay for a referral, and I hasten to admit that I have no evidence that any on the Los Angeles scene does that, but when I started hearing "have you forgotten something?...." hints from bellmen et al, I knew that a new competitor was making the rounds.

Mike Oppenheim