Everywhere we go, Americans are used to getting the up-sell: “Do you want fries with that burger?” … “Would you like to buy an extra coffin while it’s on sale?” … “How about a silencer for your new handgun?” It seems that we can never escape the hordes of people telling us that we want more, need more, must buy more. As every truism is brought to life by a Beyonce song, it’s fitting that salespeople always want to Upgrade U.
So, instead of buying a regular package, we’re compelled to buy the Gold, the Platinum, the Supreme, Extreme, Marginally Better But Has a Cool Metallic Name So Must Be Worth It package. And with aggressive salespeople pushing the up-sell, we’re often shamed into buying things we don’t actually need. We buy two ShamWows instead of one. We send a letter with delivery confirmation, insurance coverage, and a limited-edition stamp featuring Roseanne Barr. We get mozzarella sticks.
The up-sell… it fools us every time.
Are there any places where we don’t get the up-sell? I used to think so. I used to think that doctors were honest people, filled with good intentions and the sole ambition to save lives. And for most of my life, this belief held true. But then I moved to New York City, and I was proven wrong. Doctors are just salespeople with advanced degrees and the ability to scare you with a scalpel.
Last August, I decided that I would go in for a check-up. I had just recently moved to New York, so I found a doctor through my health insurance company. The guy seemed legitimate enough: undergrad at University of Pennsylvania, med school at Michigan.
The first red flag was when I entered his “office” — located in the basement of an apartment building. Basement offices are not uncommon in New York City, except that most are occupied by tarot card readers and dog fighting rings. But I disregarded this as a product of the recession, and introduced myself to the doctor’s secretary as “the 9 AM.”
The next red flag was when I met with the doctor himself. He was a kind, older gentleman, who seemed like the type of guy who would end up in a nursing home and forget his grandkids’ names. He took down all my information by writing it on a blank yellow legal pad. “Name?” … “Age?” … “History of diabetes?” Now, I know that digitized medical records may be a thing of the future, but the doctor wasn’t even filling out some kind of standardized form. He didn’t even measure my height and weight. I could have told him that I was 6’4″ and weighed 300 lbs, and he would’ve written it down on his trusty notepad.
After the doctor penned an essay on my medical history, we finally got to the examination. He used a stethoscope to listen to my breathing. All of a sudden, the doctor stopped, looked at me with concerned eyes, and told me that I had a heart murmur.
A heart murmur.
This is what happened next:
I ask the doctor what that is. He says that it’s a condition that could lead, eventually, to death. I ask the doctor if this is something that I could just develop. No, the doctor says that I probably had it since birth. I ask the doctor why no one has ever caught this before. Well, it’s very delicate, he says, and it’s hard to hear it sometimes. I ask the doctor if, perhaps, he should turn off the fan in the examination room. The doctor says I should get an electrocardiogram.
Ah, the up-sell.
I didn’t get an EKG. But, it’s hard to say no to extra fries when we’re dealing with our health. (Especially when the fries are getting paid for by insurance companies.) If I dropped dead from a heart murmur, I would feel terrible for not listening to my crackhead doctor. I would also be dead. Lose-lose.
So, that’s why up-selling doctors do it — it prevents them from getting sued, and the bill is covered by someone else. But the practice isn’t just to cover the doctors’ butts: it’s also immensely lucrative. Last December, I went to the dentist to get a simple cleaning. A month later, my insurance company got the bill. One of the items listed on the invoice was $146 for “Oral eval”… the dentist had used a digital camera to take four pictures of my mouth.
Of course, I ordered the Dentist Supreme.
