• Revenue Cycle Management
  • COVID-19
  • Reimbursement
  • Diabetes Awareness Month
  • Risk Management
  • Patient Retention
  • Staffing
  • Medical Economics® 100th Anniversary
  • Coding and documentation
  • Business of Endocrinology
  • Telehealth
  • Physicians Financial News
  • Cybersecurity
  • Cardiovascular Clinical Consult
  • Locum Tenens, brought to you by LocumLife®
  • Weight Management
  • Business of Women's Health
  • Practice Efficiency
  • Finance and Wealth
  • EHRs
  • Remote Patient Monitoring
  • Sponsored Webinars
  • Medical Technology
  • Billing and collections
  • Acute Pain Management
  • Exclusive Content
  • Value-based Care
  • Business of Pediatrics
  • Concierge Medicine 2.0 by Castle Connolly Private Health Partners
  • Practice Growth
  • Concierge Medicine
  • Business of Cardiology
  • Implementing the Topcon Ocular Telehealth Platform
  • Malpractice
  • Influenza
  • Sexual Health
  • Chronic Conditions
  • Technology
  • Legal and Policy
  • Money
  • Opinion
  • Vaccines
  • Practice Management
  • Patient Relations
  • Careers

Travel Costs Revisited


Travel can be broadening, but it can also be expensive. It doesn't have to be costly particularly, though the fact that a private practice doctor won't be producing revenue to cover ongoing high office overhead makes travel an expensive proposition even before the first ticket is bought.

Travel can be broadening, it can be illuminative and it can also be expensive. It doesn't have to be costly particularly, though as I've outlined on multiple occasions the fact that a private practice doctor won’t be producing revenue to cover ongoing high office overhead makes travel an expensive proposition even before the first ticket is bought.

Yes, you can write off certain travel as an "ordinary and necessary" business expense, such as for CME, and you can be a careful consumer to ensure you don’t overpay. But, as I recently re-learned, travel is more expensive these days no matter what you do.

Take the high cost of changing money. It used to be that the wise traveler would charge as many expenses as possible because the credit-card company could get a better currency exchange rate than consumers could get at a local bank or hotel. No longer true, I'm afraid. Card issuers now charge at least 2% for the service, and with ATM fees on the rise it could add up to the 5% to 10% more than if you’d pay in cash at the local exchange rate. Running into the hundreds or even thousands, that's no longer chump change.

Do you want to talk about the airlines? Consider fees, surcharges, baggage and upgrade costs, charges for food, blankets, movies and preferred seating, and the increasingly difficult hurdles you have to jump to score a "free" mileage ticket or upgrade. How about now-routine cancelled flights to ensure that every time the planes lift off they’re profitably full, regardless of your inconvenience, lost upgrades or awkward seating.

Let's talk about cruising. It's a great way to relax, let the cruise line do everything, no packing and unpacking, and you can safely see the world. The industry is overbuilt, so there are quite a few money-saving bargains out there, right? Well, sort of. Yes, you can get a fare for as little as $70 per day, including room, meals, entertainment and the inherent travel. It could be cheaper than living at home!

Some will argue that airfare, gratuities, on-board credits, etc., make cruising far costlier than that. And you really don't want to stay in a cramped, no-window inside room do you? You want a balcony. You also don't want an old, obsolete bucket when there are so many new, feature-laden ships, right? Many would want to go to more exotic locales, as well, to avoid the same tourist-jammed ports that so many other cruise ships visit. And why stay on board, or wander aimlessly through an unknown city, when there are so many glossy, highlight-oriented land tours available?

Unless you’re paying the very high end -- where cruise lines charge big fares upfront to avoid all the nickel and diming -- all of these things cost extra and sometimes a whole lot extra. Excursions especially have been rapidly inflating in price.

What used to be $30 for a land-based tour off of a ship is now $100, and up to $1000, per day, per person. Included is the hefty mark-up that the cruise line tacks on for the "convenience" of doing the leg work. In one port recently, for various reasons, I thought we'd be best served by hiring a private car and guide. The cruise line representative said, "Sure, for $450." I said, hmmm, walked 100' and found that Grayline, a worldwide tour organization, would charge $225. I confronted the cruise line representatives about it and they said they still wanted $450!

Now consider alcohol, which is not included in the price of the ticket and can be a big cost for many on a vacation. You’ll also pay fees for laundry/dry cleaning and access to the Internet, along with the suggested gratuities for stewards and waiters, gambling losses at the inevitable casino aboard, shopping at the on-board mall, as well as in ports, visas (for my wife and I they cost $450), and you may well end up doubling the budgeted "all-inclusive" fare.

This daunting, and by no means complete list, is aided and abetted by the simple fact of human nature: When we are on vacation our judgment ratchets down … sometimes way down. Thrown in with alcohol, encouraged by friends, old and new, to "keep the good times rolling," and endless entreaties from all around for you to spend, we often do. (Sometimes to our chagrin.) That shrunken head souvenir that looked so interesting in that native hut suddenly seems out of place when we get home. Or substitute your own white elephant story of the alleged great find. You get my drift.

Now, you don't have to be so foolish, of course. You can do your homework, plan ahead, set up your own tours and shop carefully. Or not.

Of course, modern travel does have some high-tech related economies. No more postage costs for postcards and no more photo-developing, unless you are old-school. So, avast, ahoy and happy travels. Or, maybe this could finally be the year that you hang up that hammock in the back yard and think about all the money you saved. Memories or money? Ain't free will grand?

Related Videos
Victor J. Dzau, MD, gives expert advice
Victor J. Dzau, MD, gives expert advice