Before hanging up the phone, I tell guests my fee, but this is not universal among hotel doctors. Guests may learn when the doctor hands over the invoice at the end of the visit.

It's often a bombshell. Guests have showed me bills for over a thousand dollars. It takes huge balls for a doctor to do this, but it works. Most people will quarrel with an unreasonable charge if it arrives in the mail but not face-to-face with a doctor in a room far from home.

Long, long ago I made visits for a national concierge agency that boasted it would fulfill a hotel guest's every need. It was a luxury service, but not everyone in an upscale hotel is rich. After collecting an immense fee from several sullen guests, I stopped accepting the agency's calls.

Mike Oppenheim