At a recent work meeting, one topic of discussion was the shortage of exam rooms for residents in the former city hospital where I practice. Should residents clean the rooms between patients to improve patient flow? Most of my colleagues were opposed to this idea. Wouldn’t it be yet another deterrent for residents contemplating primary care?
Later that morning, I had my annual physical with the primary care doctor I’ve been seeing since my own residency. Her urban office had been flooded over the holidays by a burst pipe, so she was seeing patients in a temporary location, in a tony suburb west of Boston. I drove into the office park and noticed a Morgan Stanley building. I stopped to let two young men, who looked like walking clichés of financiers-in-the-making, cross. One of them turned toward me and smirked. What did that mean? I wondered. I pulled into an open parking space and entered the building that was temporarily housing my PCP’s practice.
While it wasn’t a concierge practice, it gave every appearance of one: classical music was playing, the waiting room’s large windows faced the woods, artwork hung on the walls. I was placed in exam room 35 (35!). My doctor entered and explained that a large academic health system had lured 10 PCPs away from another large academic health system and set them up in this fancy office. As she used a foot pedal to raise the exam table, she marveled at the upscale furnishings. “Yeah,” I said, “we have these in my office, but they’re mostly broken.”
It was an unusual visit. I wrote down the name of the resort in the Dominican Republic where my PCP goes every year; she claimed she ate fresh fruit and vegetables and never once got sick. I resisted her suggestion to get a bone mineral density test (I’m not yet 65, and the U.S. Preventive Services Task Force doesn’t recommend it until then). Both of us primary care doctors, we “agreed to disagree.”
On my way out, I noticed a basket full of navy-blue umbrellas in perfect condition, imprinted with the Morgan Stanley logo. For a second I was tempted to borrow one—but didn’t. A concierge was watching.
I drove into Boston on the Mass Pike, back to the city’s so-called “Mass and Cass” area—also known as an “open air drug market”—where my primary care practice is located. I felt as if I’d just visited a wealthy friend’s lavish country house and was now returning to my modest urban apartment.
Karen E. Lasser
Chestnut Hill, Massachusetts