The Columnist Manifesto

I took B to the urgent care clinic a couple of days ago. The following dialogue occurred at the reception desk:

R[ECEPTIONIST]: What are you here for?
B: Sciatica.
R: What?
B: Sciatica.
R: Could you repeat that?
B: Sciatica.
R: Could you speak up? I didn't --
B: SCIATICA!

[Other patients and receptionists all look up and turn toward B.]

R: I've never heard of that.
B: The doctor will know.

Okay, first of all, that was a sweet smackdown by B. But the incident raises once again one of my many issues with our HMO system. Even at the very moment they hand you the HIPPA forms asserting how extensively they protect your privacy, they ask for a description of your symptoms at a big open counter with multiple receptionists, each with its own line of patients. That setup gives you as much privacy as when you order "six lamb chops, please" at the grocery meat counter.

And never heard of sciatica?? Why is the receptionist even asking -- especially if her medical knowledge is so damned limited?

Theoretically, the information could be the basis for a triage decision, but "what are you here for" is standard protocol even for scheduled office visits. And "urgent care" is not emergency care, but only a walk-in clinic for issues that need same-day service. On this day, the waiting room had only a smattering of people waiting.

More likely, the receptionist just needs to put something on an intake form. But does it matter what they put on the form? Patients don't diagnose themselves, after all, and in any event, you're going to describe your symptoms to the nurse or health aid who takes your blood pressure -- often with no more satisfying response than you get from the receptionist -- and then again to the nurse practitioner or doctor who examines you.

For all the good it does to answer the receptionist's question, you might as well just say: "brain fart. I'm here for a brain fart."

In fact, I'm thinking that's what I'll say from now on.