What Doctors Can Learn from Hotel Resort Fees

Years ago, the medical profession adopted its own version of this legerdemain.

Some time ago, I booked a hotel in New York City to spend a few delightful days there with my progeny. During the booking process, the hotel’s representative read off a dizzying list of taxes and fees that I would be paying. I don’t think I’ve ever been saddled with so many tax surcharges on any transaction in my entire life, except for the last time I booked a NYC hotel. I felt that I needed to call my accountant, or even my lawyer, for guidance.

Many hotels have become green with envy (or should I say greed with envy?) over state and local taxing authorities that fleece hotel guests. Why should hotels be left out of this grifting opportunity?

Permit me to acquaint you with the Hotel Facilities Fee, also known as the Resort Fee. When I first confronted this shakedown years ago, I felt that it was a nonviolent stick-up. This is a mandatory fee that a hotel charges that can be applied to products and services that you didn’t request and may not want or need. Sound reasonable?

Indeed, the Resort Fee is so odious that the president at the time referred to it in one of his State of the Union Addresses, stating, “We’re going to ban surprise resort fees that hotels charge on your bill.”

The daily Facility Fee at my hotel included nothing I wanted. For instance, it included a one-time $15 dry cleaning credit. In NYC, this might permit me to dry clean one of my socks. An enterprising guest could arrange for the 2nd sock to be cleaned the next day!

An opportunity to clean one sock!

Imagine if all retailers adopted this principle of forcing customers to purchase a gift card in addition to their desired purchase. The gift card would only be valid for a brief time interval and could only be used for a short list of specified products, which you probably didn’t want. (If you actually wanted one of these items, then you would have purchased it, right?) Would you patronize such a store?

Fortunately for me, and unfortunately for the hotel, I won’t have a car. Anyone familiar with NYC knows the insanity of bringing a car there. Beyond the expense involved and the seemingly impossibility of finding a parking space, there’s the sheer joy of driving through Midtown, crawling through gridlock with horns bleating while receiving lovely hand gestures from happy fellow motorists. So relaxing!

Had I decided to drive to my hotel, the daily self-parking fee would be a modest $45-$55, with a higher rate charge for valet parking.

The medical profession, years ago, adopted its own version of a Resort Fee, called a Facility Fee, which I forcefully criticized. These fees were traditionally applied by hospitals to cover infrastructure and other costs. Enter Operation MISSIONCREEP! These fees were also applied to doctors’ offices and specialty outpatient clinics that were now owned by hospitals.

Hence, the new designation of these offices was hospital outpatient departments. So, patients who would have sworn under penalty of perjury that they were in a routine doctor’s office were charged a hospital facility fee even though their feet never entered a hospital! Patients loved this legerdemain!

What if I incorporated my own Resort Fee into my medical practice? Each patient would pay an extra $100, which could be applied to a sigmoidoscopy, whether the patient needed it or not. Offer valid for 14 days. This would be an ideal strategy to decimate a medical practice.

As an aside, I have no intention of monetizing these essays. However, I wonder if I created a post while I was within a hospital or a hospital outpatient department, if I could….

Because of public outrage, legislators have trimmed many of the facility fee’s excesses, but it still exists. Readers may wish to find out what the current status is in their individual states. In my state of Ohio, a facility fee can no longer be charged for a telemedicine visit. Further restrictions will be triggered in 2028.

I wrote a respectful note to my hotel expressing my disagreement and displeasure with the Resort Fee scheme. I received an equally respectful response communicating that the policy would not be waived. Hotel guests have very little leverage against the Hospitality Industrial Complex. Do readers see any parallels between the hotel industry and the medical universe?

It’s not a total defeat. I emerged from the experience with one clean sock!