Sign of the time

Since my sole-practitioner internist closed up shop a couple of years ago, I’ve used the Palo Alto Medical Foundation (PAMF) as my primary healthcare providers. They’re part of Sutter Health, they sport huge facilities all over the Bay Area and they have more physicians of every stripe than the entire state of Iowa.

To tell you the truth, it’s medicine on an industrial scale, and reminds me a lot of the National Health Service (NHS) in the UK, except they’re slightly more flexible, and I trust the state of their knowledge base more.

By “industrial”, I mean that even for a PCP—the physician who should be most familiar with a patient’s history and care—these guys swan in and out with the least amount of history-taking and person-understanding of any class of doctors I can recall. My PCP of record knows nothing more about me than any of the specialists to whom I might be referred. I have to introduce myself every time.

It’s kind of like the old Free Clinic. Or the Army. But at least with those institutions, you weren’t expecting to see the same person twice in a row. Here it doesn’t matter—every time you see someone, you’re introduced as though for the first time. Even if you saw her two weeks earlier.

They don’t even bother to look at your history until they’re actually in the exam room with you.

Well, but I’m not really here to complain about that—just to note it in passing. I use PAMF because if necessary I can get a referral to any type of medical specialist known to humankind; although getting an actual appointment to see one in a timely manner is a different matter altogether.

(Apparently orthopedic surgeons are in very high demand here in the Valley They Call Silicon.)

No, I’ve just been setting you up for my point today. I needed to get a fasting blood panel done, so since I had an appointment with the hand surgeon in their Mountain View facility at 0845 (finally seen around 0920; but I always go armed with some heavy history tome to read), I decided to get the blood drawn at that location’s lab when they opened at 0700.

Now, you’ll recall me using the term “industrial” before. Here’s one reason why. At 0700, when they opened for business, they had this sign on the wall behind their reception desk:

If they start out setting expectations for that kind of wait (when they got more phlebotomists than Montana) at start of business, you just know that there’s not a lot you can hope for.

As it happens, I was seen sooner than that, and it turns out that their little cafeteria serves amazing hash browns. I mean, absolutely first class. I have no photo of them, because I wouldn't delay eating long enough to pull out the camera.