Industry Update
Opinion Article 4 September 2008

Competitors

By Mike Oppenheim, MD

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Oppenheim

By 1990, not only was I America’s sole fulltime hotel doctor, I was the only one who made a living at it. I wrote with modest success, but that income reached five percent of my total only twice in twenty years. All other individual hotel doctors treated it as a sideline.

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Inevitably, entrepreneurs took an interest. By the nineties, half a dozen national housecall services sprang to life with names like Hoteldocs, Expressdocs, Housecall USA, Travel-Med, Medihelp 24, AM-PM Doctors. All informed my hotels they could send a doctor at a moment’s notice, but they couldn’t. None employed doctors directly. When a request arrived through their 800 number at a central office somewhere in the US, the dispatcher consulted a list of moonlighters in that city and began calling. If she found an available doctor, he or she made the visit, collected the fee, and mailed it to the agency. At intervals, the agency subtracted its cut and sent a check.

Finding a doctor willing to make a housecall at the drop of a hat is not easy, so these agencies quickly learned about me, and I’ve made almost a thousand visits for them. At first, I didn’t feel I could refuse. Their slick marketing made me nervous. They were soliciting every hotel and occasionally sent me to one of my regulars. On the other hand, they sent me to hotels that didn’t call, so I could solicit in good conscience. In the end I gained more business than I lost. It didn’t hurt that agencies charged a great deal – over $200 in 2003.

I hated their payment arrangement. At first I followed the routine, earning a flat fee – about $100 when I was charging $150. However, agency moonlighters could keep a hundred percent of extra charges, and we were encouraged to give out and charge for drugs, injections, and supplies. I came across their receipts when I saw guests who required a second visit; agency doctors showed great creativity in tacking on extras, often doubling their fee. After a few months, I told the agencies I would work for them only if they paid my regular fee. Whatever a guest required, I would provide gratis. That lost me some business but not a great deal. Whenever agencies needed a housecall in Los Angeles, calling me always got one. Dispatchers grumbled about the torments they endured searching for a doctor in other cities.

My fee supported me and my wife. The agencies’ cut had to support several employees as well as facilities I didn’t have such as an office and 800 number. I couldn’t imagine how they made a profit, and it’s likely they didn’t. Several have disappeared. For a business to make money sending doctors on housecalls required an impossibly large volume.

The only alternative would be to charge an enormous fee, and one agency took that route. An entrepreneurial physician founded Enterprise Housecalls during the nineties. At first it charged the usual fee and sent me to mainline hotels, but after 2000 the agency began marketing to an upscale clientele and charging accordingly. In 2002 a visit cost $350.

Not everyone staying in a luxury hotel is wildly rich, and many chains continued to call Enterprise. As a result, some guests were staggered at the bill. Hearing that my share was a mere $150 did not ease their distress. After a few stormy encounters, I never accepted a call until the dispatcher assured me the guest knew the fee.

I don’t doubt their superiors told dispatchers to mention it. I’m also certain that, like me, the dispatchers hated the reaction this produced. Human nature combined with their low salary guaranteed that they became reluctant to deliver bad news and perhaps skipped it entirely. I still encountered guests who insisted no one had told them the fee.

The finale in 2002 came when Enterprise sent me to the Chateau Marmont, a funky art-deco hotel in West Hollywood. Despite its reputation as a media hangout, the Chateau is pleasantly seedy and, and its main building is not really a luxury hotel. John Belushi died in a bungalow a year before I became its doctor, and I made 157 visits before a rival took over in 1999. Anxious to win it back, I looked forward to the visit, after which I would explain to management the advantages of calling me directly.

That opportunity vanished when the guest learned the cost. Outraged, she insisted no one had told her. I didn’t expect sympathy when I explained this was the agency’s policy over which I had no control. My heart still sinks at the memory of her conversation with the front desk when she called to ask them to put the fee on her bill, adding her displeasure that the hotel would send a doctor who charged so much.

As the desk clerk counted out my $350 (probably his week’s salary), I repeated that on this visit I worked for AM-PM Doctors, and the fee was their responsibility…… He nodded politely to indicate he was listening.

Thereafter I refused to make visits for that agency, but the Chateau Marmont never returned to the fold. The last time I checked, Enterprise was still in business.

Mike Oppenheim

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