Short Takes

Usual and Customary

I have become a usual and customary physician. I didn't plan on it, and it happened without my paying much attention. Since I get paid the usual and customary fee, I must be a usual and customary doctor. Strange—I thought I was better than that. I thought that because of my experience and apparent success, at least as determined by the number of patients who want to see me but whom I must refuse, that I was better than average. I guess not. I thought, too, that when I referred my patients to surgeons that I was being careful to select the professionals who were the best for my patients—the ones with the most experience, the best results, and the best doctor–patient relationships. Then, I discovered that these surgeons, too, were just usual and customary. I guess there is no difference among doctors.

At least I know that my lawyer and accountant are not usual and customary. Both are senior, skilled members of their profession and cost more than many of their colleagues. I'm glad to pay them more than some others in the Yellow Pages because they are very good at what they do.

I'm not yet accustomed to this notion, but it may be changing. I now find out that I can be a discount doctor rather than a usual and customary one. As I understand it, in return …