How to Collect a Doctor Bill.

by Frank P. Davis.

PREFACE

My excuse for presenting this little book to the profession is that I have often felt the want of just such information as is herein contained. In fourteen years of practice I have made it a point to study my patients and the business problems that confront the man in our profession. Some of the things that I have learned are embodied in this book. Taking my professional experience as a whole I have collected over =ninety per cent= of my accounts.

If this book shall be the means of causing any physician to study the business side of professional life, and get what is due him, I will feel that I have not worked in vain.

Enid, Okla., June 6, 1912.

FRANK P. DAVIS, M. D.

CHAPTER I

THE SUCCESSFUL PHYSICIAN.

A man with a bulging forehead once said that "Life is what you make it."

This is very true in the profession of medicine. The successful physician must live in the manner of successful men. To do this, most men must live upon the income from their practice. If the physician properly cares for his wife and children, he must realize on his investment--his medical education. A man's first duty is to his own, and it is written that the man who fails to collect that which is due him, and "provides not for his own, and especially for those of his own house, is worse than an infidel."

To successfully conduct any enterprise it is necessary to adopt business methods. System is the key-note of modern business, and the simplest system is the best. A cash system is by far the simplest.

No man can succeed in practice, nor can he be considered a safe medical adviser so long as he is handicapped by poverty, a worried mind or poor health; or if he is compelled to dodge around corners to escape his creditors.

There are men who tell us that they are not in practice so much for money as for the glory and honor of the profession. If these men are sincere, I pity them from the bottom of my heart, and feel sorry for their wives and children. Nor can I understand where the profession can gain much honor from men who are financial failures. Not that money is the only thing for which we should strive, but that the man who provides not for his own, cannot be representative of the n.o.ble profession of medicine. Also, I have observed that the path of glory leads in the direction of the cemetery, and checks on the National Bank of Fame are generally protested when the rent comes around.

The applause and compliments of the mult.i.tude are no doubt sweet, but it only lulls to rest the voice of duty, and fails to provide sustenance for those dependent upon us. Man cannot live on air alone--even though it be flavored by the ambrosia of sweet compliments and the hypnosis of applause. Again, I have observed that a larger crowd will turn out any time to see a man hung than to compliment him on a duty well performed.

The man who answers calls at all hours of the day and night, for any and every one who may request his services; with no a.s.surance of ever receiving pay; and who is afraid to demand settlement for fear of losing practice, is not competent to conduct his own affairs, much less to practice medicine. It is this cla.s.s of men who make dead-beats of our patrons, and thus reduce the income of physicians to a point where a bare existence is all we can hope for.

To be a safe medical advisor requires that the mind be free from the petty cares of life. He should live in a manner in keeping with the dignity of the profession to which he has given his life. He must have a neat office, wear good clothes, have a happy home and a contented mind.

It is well to achieve the reputation of being an indefatigable and shrewd collector. It pays. It will influence your regular patrons to pay more promptly. It will also help to keep away those who trespa.s.s upon your time and never pay you. The only sure way to hold practice is to require your patrons to pay their bills promptly. If they do not owe you they are not so liable to avoid you and cease to employ you. Let a family once get greatly in arrears, then it will happen that--not having the cheek to face you--they will call another physician, and give every reason but the true one for deserting you. Thus, through your own neglect you lose patronage, friends and your good name and reputation.

The public will never place any higher value on your services than you do yourself. The death-knell of any physician's success is tolled when he becomes known as a "cheap doctor."

Not only must you require others to pay you, but you must also pay your own bills. Physicians, as a rule, are considered poor pay by business men. It is a very good rule in life to discount all bills that you owe, and never to discount a bill due you. Make it a rule to never owe any man anything, and to have as few owe you as possible.

Many physicians will cut their bills to whatever the debtor cares to pay. In this way they lose a large part of their fees, and achieve the reputation of being poor business men.

I heard an old Arkansas doctor relate his experience in discounting a bill that well ill.u.s.trates the weakness of many physicians. A client owed him $60, and after the account had run about six months, the man came in and said, "Doc, I hain't got the money, but if you will cut that bill in two I'll borrow it from my father-in-law." The doctor thought $30 would be better than waiting, so agreed. Three months later the man returned and said, "Doc, I couldn't get the money from my father-in-law, but I have a fat hog I can sell and get some money if you will cut that bill in two." The account was growing old and the doctor thought he had better take the $15, so he said all right. Six months from that time the fellow hove in view again. This time he said, "Doc, my wife thought we needed that hog for meat and I couldn't get her consent to sell it, but I have a job now, and if you will cut that bill in two, I'll pay you."

This time the doctor thought he saw $7.50 in sight, so again he agreed.

"All right, Doc," said the debtor, "as soon as I get in a few weeks work, I'll be in and pay you." The doctor said the fellow did come around a few months later and began a similar story, but he told him to go to a country where rotary snow plows are not much in demand.

One of the greatest mistakes is in allowing accounts for different cases to acc.u.mulate until the amount becomes so large that it is difficult to pay. It is always best to require settlement as soon after each case is dismissed as possible. In sending statements, be careful to itemize by cases only, as "John, fever, $15," "Wife, confinement, $25," etc. I seldom give the disease unless it is some special case that required much attention. In some cases it refreshes their memory when reference is made to the disease.

You must know your business. Give every man a square deal, and require others to do the same by you. When you have completed your work, remember the advice of old Prof. Joslyn, "Get money, still get money, boy, no matter by what means" so long as it is justly due you for services rendered. If you fail to require your patrons to pay you for your services, you have not done your full duty.

CHAPTER II

ATt.i.tUDE TOWARD DEBTORS.

A fundamental principle in being a good collector is to never lose the good will of your patrons. So long as you are on friendly terms with a man you can approach him and talk over the matter. It will be easy to keep advised as to what he is doing, and when he is expecting to receive money. The time will come sometime when he can pay at least a part or secure your claim. We must not lose sight of the fact that in this country poor men sometimes become rich, and rich men sometimes become poor, and we should deal with them accordingly. It is poor business policy to permit well-to-do clients to run up big bills, and at the same time hound your poor patrons.

One of the easiest ways to collect a bill, when they have persistently failed to pay, is to loan them some money. This plan is fully covered in the following editorial from =Davis' Magazine of Medicine=.

"Let us now consider the investment of the doctor's savings. His fees are received in small sums, generally ranging from a few dollars to a hundred dollars at a time. He seldom has over a few hundred dollars on hand at any one time. And failing to find a good place to invest such sums as he has, he becomes a prey for the stock companies and the land sharks, where he can make his investment on the installment plan. Most physicians are earnestly seeking a safe investment for these small sums of money, but very few have found a plan that appeals to them. Most of the advice one gets from the journals is 'Don't' or to invest in farm mortgages. When he looks around for a farm mortgage he finds that the small amount of money he has to loan will not meet the requirements of the man who desires the loan. Even should he find a small loan that he could handle, the interest would be so low, that it would produce a very small income after paying taxes. I believe the doctor's earnings should net him ten per cent, and be in such form that he can realize on them in case of emergency. To take chances on getting a greater rate of interest would be to accept too great risk, and a less rate would be poor business policy.

"The problem simmers down to about this: How can we invest small sums, from twenty-five to one hundred dollars, so they will be safe, and earn at least ten per cent interest?"

I solved this problem several years ago while engaged in general country practice. In fact, it can be applied better in the country than in the city. The plan is this, loan your money to your slow pay patrons. Sounds risky, don't it? I have found it to prove a success. I learned that most of my poor pay or slow pay patrons were always ready to borrow money, and that they could generally secure me with chattel mortgages, or get good men to sign their notes. The note and mortgage always covered the amount loaned and the amount of my bill. There are few who cannot give you suitable security, and these few should be turned over to the other doctor who is practicing for the love and honor of the profession.

"When it is known that you have a little money loaned out, and that you will only loan to those who have you for their physician, your practice will steadily grow."

Be on your guard and do not permit your old accounts to become "outlawed" by the statutes of limitations of your State. This may be prevented in a measure by getting a small payment from time to time on account, as the law of limitations does not apply until the lapse of the period of time named in the law, after the last payment on the account or note.

The exemption laws of most states are so liberal that a very small per cent. of physician's bills could be collected by law, should the debtor elect to take advantage of the exemption law. The only safe method is to put it up to your client as a debt of honor, and depend upon their inherent honesty and pride. It does no good to sue a man for a doctor bill except in extreme cases. You will lose more than you will gain. Not only will you in all probability lose the account and expenses, but you will make a lot of enemies, who will injure your practice more than the amount of the bill.

Treat your poor patrons with the same respect and courtesy that you do rich ones. Mr. Smith will do his best to pay you, while Old Bill Smith will not exert himself very much to balance your ledger. Then above all treat the woman in the flowered Mother-Hubbard as if she were the Queen of Sheba, and the off-color lady from the red-light district as you would the President of the Purity Society. The child that is ragged and dirty should receive the same cordial attention as the one in silks.

When the time comes that you cannot treat all your patrons as you would like for them to treat you if your positions were reversed, it is time for you to "Fold up your tent like the Arab and silently steal away,"

your usefulness is at an end. The day when you can make money in that location has pa.s.sed.

Be kind to little children. Women and children furnish the greater part of our patrons. Men do not count for much in the practice of medicine,--unless you are a G-U specialist. I have always found that where grandma and the children liked me, that I had no trouble in getting practice or in collecting my money.

Do not pad your accounts. Charge what you consider your services worth, and then stick to it. Deal a square hand to all. The golden rule is just as bright and as true today as it was thousands of years ago, and it is not recorded that any man was ever hung that lived up to it. After you have done your full duty =demand= that your patrons do their duty by you.

Keep after the money that is justly due you. Get money; but get it honestly. You will be criticised by some, and cussed by others, but in the words of Carrie Nation, "Why care for the criticism of men who change and die?"

And finally remember, that in this world there is nothing that will pay dividends equal to smiles--unless it is gall, and do not forget the injunction of the prophet, "Physician, 'heel' thyself," lest in old age the world will say, "Well done, good and faithful servant; enter thou--into the poor house."

CHAPTER III

PROPER TIME TO COLLECT.

"To every thing there is a season, and a time to every purpose under the sun."--Eccle. 3: 1.

The time to collect depends to a considerable extent upon the location and the cla.s.s of patronage. In cities, as a rule, collections should be made weekly, as many patrons move frequently, and you lose track of them. It is proper and wise to present your bill as early after the service is rendered as possible. Bills should be presented to working men at the time of their regular payday. In country practice I have found it best to send statements monthly and to require settlement quarterly by cash or note. I have adopted this rule in a cotton country where it was the rule to only pay the doctor once a year, if at all.