CHAPTER VIII

=GETTING AT FINANCIAL STATUS=

While, with proper effort and organization, it is possible to ascertain in advance the financial worth of nearly every prospect in the manner already outlined, there are many instances in which this cannot be done through any of the ordinary channels. Some people conceal their occupation by writing under an assumed name on plain paper, so that an enquiry through a commercial agency will reveal nothing, except, perhaps, the statement “party unknown.”

Others will come in on the physician unheralded, without any preliminary correspondence. But, if the physician understands his business, he will get at the facts just the same as if the callers had introduced themselves with statements from their bankers showing their financial rating.

* * * * *

Let us imagine the case of a man who drops into the office and enquires for the doctor. The reception room girl will ask his name so that she can announce his arrival.

“The name doesn’t matter,” says the caller. “The doctor doesn’t know me.”

“Have you an appointment for any specific time?”

“No. Just dropped in to see the doctor.”

“Well, the doctor is very busy just now, but he’ll be disengaged in a few moments. Take a seat please, and as soon as he is at liberty I’ll let him know you are here.”

Don’t overlook this waiting part of the program. It is important. Creates the impression that the doctor is a busy man, and that time is valuable. Always keep a caller waiting at least ten minutes, even if the doctor is engaged in no more profitable occupation than reading a magazine. When the caller is finally shown into the consultation room the doctor receives him with dignified courtesy and apologizes for having to keep him waiting.

This consultation room should be so arranged that, when doctor and caller are seated facing one another, the light should fall on the latter’s face, the doctor being in the shade as it were. This allows of close watch being kept on the emotions which may play across the caller’s face, while those which the doctor may not be able to conceal (these will be few) will pass unnoticed.

After the conventional greetings the caller will undoubtedly outline his case, and ask the doctor for his opinion.

“I must know more about the conditions, Mr. —— by the way, I didn’t get your name? Robinson. Well, as I was saying, I must know more about the conditions, Mr. Robinson, before venturing to give an opinion. I have many cases strikingly similar in which the results were all that could be reasonably expected. At the same time, as a matter of frankness, I must admit that there are others in which I have been disappointed.”

This apparent candor on the doctor’s part wins the confidence of the caller and he talks freely, describing his case in detail. The doctor listens attentively, butting in with a question only when the caller seems to lag in his talk. When the ailment and its symptoms have been fully described the doctor says:

“Yours appears to be a somewhat peculiar instance, Mr. Robinson. There seems to be indications of severe mental strain or worry. Of course, I may be mistaken, but that’s the way it looks to me. Have you had any great domestic or business worries?”

“No, sir. Everything is moving along smoothly, both at home, and in my business.”

“Frequently a man’s business, Mr. Robinson, involves a strain which he does not realize. He becomes so accustomed to its routine that he staggers along with worries that would crush a man not accustomed to them. There are some occupations which are a great deal more trying in this respect than others. One of my patients—of course it would not be proper to mention his name—is a banker who was on the verge of insanity when he came here, through worry over his financial affairs.”

“Oh, there’s nothing of that kind, no worries I mean, in my case. My business—I’m a stock dealer—is flourishing. I’m making money. Cleared $25,000 last year, have a fine home, a good wife and family, and would enjoy life if it were not for this annoying trouble. If it were not for the hope that relief may be found I would be sorely tempted to kill myself.”

The secret is out. Unwittingly Mr. Robinson has disclosed the fact that he is well off financially and able to pay a good fee, which information is of more importance to the doctor than the description of the caller’s physical ills.

The conversation drifts back to the ailment, the caller telling of the various treatments he has taken, and the results. Among other things, he says:

“I have consulted a number of eminent physicians, among them Drs. —— and ——, and they all told me that there was no real cure for the trouble. What do you think, doctor?”

“Naturally I dislike to set my opinion against that of the famous men you have mentioned. They are among the ablest in the profession. Their ability is unquestioned. Still, we may all be mistaken. In the absence of a thorough physical examination I would not like to say positively what the outcome of this treatment would be. It does seem, however, in view of the success obtained in similar cases, fully as serious, if not more so, that there is good reason to feel sanguine.”

No promise here. No rough, “Sure thing, I can cure you,” such as the cheap $5 fakirs indulge in. Nothing of the kind. The doctor is the very personification of social and professional dignity. His appearance and manner is impressive, and the kindly way in which he takes a hidden clout at those “famous and able specialists” wins the caller to him.

“What would be the fee for an examination, Doctor?” the caller enquires.

“I make no charge for that service,” replies the doctor. “It is an essential preliminary to determining whether the case is one in which the treatment may be administered with reasonable chance of success. My plan is to give every applicant a close examination and reject such cases as appear hopeless. Failures don’t help a physician’s professional reputation any, so what’s the use of wasting a man’s time and money when it is a foregone conclusion that he is beyond help?”

This is the clincher. If the caller had any doubt as to the doctor’s honesty and sincerity this little spiel removes it. He is going to have that examination made then and there, fervently praying all the time that the doctor may find his case one which he would be justified in taking in charge.

But suppose the caller does not broach the subject of an examination fee, and thus give the doctor an opportunity to make his stump speech. It matters not. There are a dozen ways of leading up to the subject without exciting the suspicions of the caller.

“When would it be convenient for you to make this examination, Doctor?” is a question that naturally follows from every nine out of ten callers.

“There’s no time like the present, Mr. Robinson. It will take about half an hour, and”—(here the doctor consults his watch, and opening his engagement book runs a finger over the record) “Yes, I have just about half an hour before the next regular patient is due. I suppose there are some strangers waiting to see me now, but you are ahead of them. I would make an engagement for to-morrow were it not that I shall be very busy and will not have time to give you the proper attention.”

Mr. Robinson steps behind the screen which stands in one corner of the reception room, and when he is disrobed the doctor gives him a very thorough physical examination, stopping now and then to make notes of the case. He asks many questions relative to the ailment, and makes a special feature of testing the sensitive, super-sensitive and non-sensitive areas with a pair of callipers. As every medical man knows there are exterior portions of the human body on which the least bit of pressure will produce a “flinching” on the part of the patient; there are others on which considerable pressure may be applied without noticeable effect.

“Why, did that hurt you, Mr. Robinson?” enquires the doctor as the caller shrinks when the callipers touch a super-sensitive spot.

“Well, yes, a little, Doctor,” is the reply. “Anything wrong there?”

“I hope not,” is the doctor’s answer, but he shakes his head gravely, impressing Mr. Robinson with the belief that there is more serious trouble than the doctor cares to admit.

After some fifteen minutes of this kind of work the doctor says:

“This is a most peculiar case, Mr. Robinson, but there’s nothing, so far as I can ascertain, but what may be overcome by proper treatment. At the same time the conditions are so unusual that I would like to consult my associate, Dr. Thompson. Two heads are better than one, you know. May I call him in? You will then have the benefit of his opinion as well as mine.”

“Why certainly, Doctor.”

Dr. Thompson, who is kept for just this purpose, and to treat outside patients who are unable to come to the office, is summoned by electric call, and comes in. He is a dignified, very professional-looking old chap, neatly clad in dark Prince Albert suit, and wearing glasses—the beau ideal of a medical authority.

“Mr. Robinson, allow me to introduce Dr. Thompson.”

Then to Dr. Thompson: “Doctor I have been examining Mr. Robinson and the conditions are so unusual that I would like to have your opinion and see how it coincides with, or differs from, mine. I think there can be no question but what it is a pronounced instance of _tabes dorsalis_, and yet the conditions are far out of the ordinary.”

During his preliminary talk with Mr. Robinson the doctor has wormed out of him the fact that his ailment is locomotor ataxia, so he is taking no chances in committing himself to the statement that he believes the case to be a “pronounced instance of _tabes_.” Besides, this is a convenient manner of conveying to Dr. Thompson a “tip” as to what his verdict should be.

Together the two doctors go all over Mr. Robinson again, making comment in professional language as the examination proceeds. At the end, while Mr. Robinson is dressing, they sit down together and discuss the conditions in a subdued tone, but loud enough so as to make sure that Mr. Robinson will catch the import of the consultation. When the caller rejoins them Dr. Wilkinson says:

“I am happy to be able to say, Mr. Robinson, that Dr. Thompson agrees with me fully as to the nature of your ailment, and also that, while the conditions are serious, there is every reason to expect satisfactory results, provided proper treatment is administered without further delay.”

Dr. Thompson endorses this in a few well-chosen words, and then excuses himself on the plea of being very busy. He will probably retire to the correspondence room and read a magazine until summoned to play the same role again with the next caller, but there’s no use in telling Mr. Robinson so. “Very busy” is always a trump card in the hands of “eminent” physicians.

After Dr. Thompson has left the room Dr. Wilkinson begins to straighten out the furniture in his office, apparently as a hint to Mr. Robinson that he is getting ready to receive another caller. But he is doing nothing of the kind. He is merely using tactics to bring Mr. Robinson to the crucial point of declaring that he is going to take the treatment. Standing up, as if to bid his caller good bye, the doctor says:

“There is one thing I would impress upon you, Mr. Robinson. Such troubles as yours are not benefited by delay. The longer you put off treatment the more aggravated your condition will become, and the more difficult it will be to accomplish anything in the way of relief. You should take treatment from some competent physician right away.”

There is no plea here for Dr. Wilkinson’s special treatment; no solicitation to become a patient of this particular establishment. Mr. Robinson is still further impressed with the doctor’s fairness, and also his professional ability as the diagnosis was the same as that made by other physicians. He does not know that he has told the doctor of the opinions and findings of the others, and is therefore all the more strongly inclined to look upon Dr. Wilkinson as a most remarkable man, a veritable past master in the profession.

“Well, I’d like to take this treatment Doctor, if it doesn’t cost too much, but I am unable to get away from my business just now. I must run back home for a couple of weeks and put my affairs in shape so I can stay here for a while. How long do you think it will take?”

“That’s something I am unable to state definitely. In some instances, apparently fully as bad, if not worse, than yours, the desired results have been obtained in three months; in others these results have been delayed for six and nine months, and in a few cases even longer.”

“What will it cost me, Doctor?”

(This subject—fixing the fee—is treated at length in another chapter—IX.)

There are some specialists who lack tact is ascertaining a caller’s financial responsibility, or in gaining his confidence. Their work is so coarse that it repels instead of attracts. These men rarely, if ever, obtain any considerable number of patients among well-to-do or intelligent people. Their practice is invariably cheap, and $50 fees are few and far between.

One specialist of this description opened an office in Chicago. He was a good physician and his ability had been recognized by his appointment to important professorships in various medical colleges and hospitals. He failed as a specialist because he lacked tact. If Mr. Robinson had called upon him he would have been brusquely received in a cheaply furnished one-room office, and the money feature would have been uppermost in the doctor’s talk. Instead of getting the caller interested in the treatment, by means of a courteous reception, and strict attention to an examination for which no charge was made, the itch for money would have been so apparent that Mr. Robinson could not help but notice it.

Following is an almost verbatim report of the manner in which a caller was received in the office of this physician. After a short discussion of the case and before an examination was made, or even suggested, the caller asked:

“Do you think you can cure me, Doctor?”

“I don’t think, I know,” was the surprising answer. “There’s no question about it. In three months you’ll be as sound and well as you ever were.”

The caller was an intelligent man, and the boldness of the statement, taken in connection with the circumstances under which it was made—the physician having had no opportunity to ascertain the exact conditions—was far from reassuring. It was a bad break on the doctor’s part, but there was worse to come. The caller had made up his mind not to trust himself in the hands of this physician and, as an easy means of escape, asked:

“What will the treatment cost, Doctor?”

“How much money are you earning? Are you working for somebody, or are you in business for yourself?”

“What has that got to do with it? What difference does it make to you how much my income is, or where it comes from?”

“We’re not treating people for nothing here. We must know that you are able to pay the fee.”

“But you have not told me what the fee is.”

“No, and I don’t intend to until I know what your income is. My rule is to get about one-quarter of a patient’s income for the time he is under treatment.”

“Then you have a sort of sliding scale as to fees?”

“Certainly. If you are earning $50 a week the treatment will cost you $12.50 a week. If you are earning $100 a week it will cost you $25 a week.”

It is any wonder the caller went away disgusted? And yet this doctor is unable to understand why he cannot succeed in special practice. He can see nothing wrong in his method of handling callers.