=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.
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