Ten years ago, George, chief concierge of the Ritz-Carlton, called. He suffered multiple allergies; during an attack he often asked me to phone a prescription. He could have contacted his own doctor – that is, call the office, leave a message, and wait for a return call in an hour, a few hours, a day, maybe never. I have no better luck with my doctors. In my hotel work, I routinely hand out my cell phone number; several thousand guests and every employee in Los Angeles hotels has it. I receive a few calls per week that don’t involve new business, mostly to answer questions or learn that someone is not getting better. I want those calls.

I regularly see alarmingly sick patients who have tried in vain to reach their doctor. I also see many with trivial problems that could have been solved over the phone. I can’t understand this fierce, stubborn refusal of doctors to respond to phone calls. At my busiest, I’m not in the presence of a patient ninety-five percent of the time over twenty-four hours, so I answer directly. Otherwise, I call back within a few minutes. Now and then a patient phones when I wished he wouldn’t, such as during a restaurant meal or movie, but doctors make a lot of money. We should tolerate a little inconvenience.

Back to George. This wasn’t a personal call, he explained. It was an awkward situation, but he hoped I’d understand. A complaint from a guest, I thought. I racked my brain to think who I’d seen recently.

Everyone liked me, he continued. I would be the Ritz-Carlton’s doctor no matter what, but several other concierges were putting pressure on him, so he wanted to discuss something. Another hotel doctor had approached, offering twenty dollars for every referral. He had responded that the hotel preferred Doctor Oppenheim. No problem, the doctor said. If anyone wanted Doctor Oppenheim, he’d send Doctor Oppenheim – and they’d still get the twenty dollars. George told him he’d think about it.

I knew rival hotel doctors were trolling the concierges, but that did not make his news less discouraging. Here’s a suggestion, he said. Would it be possible to raise my fee twenty dollars and match his offer? I told him I didn’t want to do that.

No problem, he assured me. I would still be the Ritz-Carlton’s doctor. Having encountered this problem before, I didn’t believe him, but it turned out he was telling the truth. This was not the case with Loews, Shutters, The Beverly Hills Hotel, Beverly Prescott, and Marina International which switched allegiance, although sometimes not permanently. It takes surprisingly little money to influence people. A medium size hotel averages three or four doctor visits per month. Since it employs three or four concierges, each would earn only an extra $20 in referral fees.

The call from George reminded me I hadn’t written the California Medical Board in a year, so I sent off another letter complaining about other hotel doctors paying referral fees, an illegal practice. I send them every few years, and the board always responds, assuring me it’s aware of the problem. It’s never taken action, probably because the Medical Board gives priority to protecting patients from doctors. It shows much less interest in protecting doctors from each other.

Mike Oppenheim