Doctor Finds Niche in House Calls for Hotels

If a guest at the Hyatt Regency in downtown Los Angeles asks the concierge “is there a doctor in the house?” the inquiry usually nets physician Mike Oppenheim, who lives near Westwood, 10 miles away.

With a remote telephone answering service and a telephone beeper fielding his calls, Oppenheim has developed an unusual part-time practice treating guests at about a dozen Los Angeles-area hotels for everything from the flu and stomachaches to sprained ankles and burns.

“Most of our guests are surprised that we can get a doctor to see them,” said Robert Rossi, a concierge at the Hyatt Regency.

Oppenheim, who charges a flat $70 for a hotel visit, is one of the last practitioners of the old fashioned doctor’s house call--a healing practice that has fallen prey to urban sprawl, the increasing complexity of health care and the growth of medical insurance.

House calls fell to 0.02% of all patient visits in 1983 from 1.7% in 1971, according to the National Center for Health Statistics. And in the last three years, at least three California house-call services have gone out of business: Housecall M.D. of Santa Monica, Doctors Housecalling Service of Huntington Beach and a house-call service operated by Centre City Hospital (now Harbor View Medical Center) in San Diego.

“I don’t see the economics favoring house calls,” said George Conomikes, president of Conomikes Associates Inc., a consulting firm in Marina del Rey that advises physicians about setting up a practice. “There is not enough demand.”

Only a decade ago, experts had forecast that house calls would increase as the glut of doctors forced some of them to offer more competitive, increased services.

Between 1970 and 1985, the number of licensed practicing physicians jumped 67% to 519,000, according to the American Medical Assn. in Chicago.

Some experts, such as Conomikes, believe that the advent of 24-hour medical clinics hurt the house-call revival. But others say medical house-call services weren’t marketed properly.

“We tried, but I lost a ton of my own money,” said Tony Greenberg, founder of House Call M.D. and director of medical quality assurance at Harbor-UCLA Medical Center. “I still believe a house-call service could work, but you need a lot of money to market the service properly.”

20 Visits a Month

Oppenheim, who worked for Greenberg’s house-call service, started treating hotel guests after Housecall M.D. folded in December, 1983. Oppenheim said he makes about 20 hotel visits a month.

Although he focuses on what he feels is the most lucrative part of the house-call market--hotels--Oppenheim admits that his work is more emotionally gratifying than financially rewarding. He also is a free-lance author and works part time as a physician at the USC student health center.

He said he only made about $10,000, after expenses, last year from the house-call business. Still, he points out, that’s an improvement over Housecall M.D., which he estimates lost more than $25,000 before it folded. (Greenberg would not confirm nor deny the figure but admits that he lost thousands of dollars.)

“The only way you can keep yourself afloat making traditional house calls is to spend a lot of money and constantly advertise for patients,” said Oppenheim. “And the people who really need a house-call service--the poor and elderly--really can’t afford your fee.

“Hotels are different,” Oppenheim continued. “I get terrific gratitude because the hotels know I’m the only one who’s going to show up unless it’s a major medical emergency.”

Oppenheim cites a case at the Miramar Sheraton Hotel in Santa Monica last year when a woman’s finger caught fire after a hotel waiter attempted to light her cigarette. The woman apparently had just put on acrylic fingernails and the fresh cement ignited.

The hotel guest refused to go to an emergency room. But the hotel management, recalling a letter that Oppenheim had written them offering his services, called Oppenheim to the scene.

“Since then, the Miramar has been a regular source of patients,” Oppenheim said.

Most of Oppenheim’s work, however, involves more mundane complaints, such as sore throats, vomiting or the flu, although he said he once treated a member of the Peking Opera for anxiety and chest pains. Oppenheim said he sometimes visits people who aren’t sick at all, such as when a British rock singer wanted a doctor to give him a vitamin B-12 shot.

Jagdish N. Sheth, a marketing professor at the University of Southern California who specializes in health-care issues, believes that serving hotel guests or very wealthy people could be a profitable niche in the house-call field.

However, he said a successful operation would need several doctors working together, and it would need proper marketing and reasonable fees to remain viable.

“The problem is that doctors think of themselves as being of such a high economic status that they are unwilling to structure a house-call service like the sales business that it really is,” Sheth said. “The physician has come to expect $100,000 annual income because he looks at what his colleagues are making.”

Plenty of Worries

As a result, Sheth added, “the $50, say, most people are willing to pay (for house calls) is not enough to take care of what the physicians believe is their value in the marketplace.”

Beyond those concerns, there are other worries: the threat of being robbed of money or drugs while making the rounds of houses, fighting traffic jams and collecting payments from patients whose health insurance won’t cover the higher house-call fee.

For his part, Oppenheim said his $70 fee is “a bargain compared to what hotel guests would pay if they went to a hospital emergency room.”

Yet Oppenheim acknowledges that he could probably quadruple his business by simply applying some rudimentary marketing and sales principles.

“I’m not really a business-type person,” Oppenheim said. “I’m just really pleased that I am doing as well as I am.”

Said Oppenheim: “If you disappoint a patient at your office, he might storm out and never come back. But there’s usually another patient in the waiting room. If you disappoint a hotel patient, they storm down the hall and tell the management. And the hotel no longer calls you again.”