The Office Visit

Jimmie Lowe cautiously opened the door to the clinic and peeked inside before opening it wider to enter the reception area and look around.  It was his first visit to this clinic, having switched health plans because of the the increase in his health insurance payments.  The reception area seemed clean and well-maintained but looked somewhat Spartan with off-white walls hung with posters promoting healthy life habits, exercise, and good nutrition.  The seating was generic office chairs positioned along the walls.   Half of the seats were taken by other patients.  There were none of the potted plants, paintings and soft lighting he was used to at his old medical office.  He approached the receptionist’s desk.  The receptionist looked up from her screen.  

“Good morning,” said Jimmie.  “I have a ten o’clock appointment, but I’m a new patient and my appointment notice didn’t say who my doctor is.”

“What’s your name and date of birth?” asked the receptionist.

“James Lowe, that’s with an ‘e,’ and my birthday is March 7, 1963.”

The receptionist spoke softly into her earbuds mike, waited a short time while staring at her screen and then looked up.  “Okay, I have your file.  Since you’re a new member, one of our member coordinators will be here to guide you through your first visit.  Please have a seat and Ken Jones will be with you shortly.”

Jimmie took a seat between an older woman and a bored-looking teen who was thumbing through her phone.  It was only twelve minutes, but seemed much longer as Jimmie fidgeted with his own phone.  

“Welcome to our office Mr. Lowe, I’m Ken Jones,” said a soft voice.

Jimmie looked up, and was very surprised to see a smiling, white-haired senior citizen, straight back, standing in front of him. 

“You look surprised, Mr. Lowe,” observed Ken Jones.

“To be honest, yes,” replied Jimmie.  “I thought that I might be seeing a younger doctor, not someone closer to my age, and not that I mean to insult you or your abilities.  I mean you must have a great deal of experience and knowledge.”

“Oh,” said Ken with a laugh.  “I’m not your doctor.  I’m your care coordinator, and I was assigned to you just because we are somewhat close in age, thinking you might be more comfortable talking with me than with a younger person.  Shall we get started with your orientation?  I’ll take you to an examination room and we can go over the details there.”

“Will I meet my new doctor there too?” Jimmie asked, following Ken through the door leading to the exam rooms.

“Well, in a manner of speaking, yes.”  They paused in front of the intake room.  “This is Will, the clinic assistant who will check your weight and vital signs.”  Will asked Jimmie to step on the weighing square on the floor, placed the telemetry band on his arm to measure his temperature, heart rate, blood pressure, oxygen saturation, and blood sugar all of which were immediately entered into his file.

“Thank you Bill, said Jimmie as Ken led him away to an exam room.

Unlike the waiting area and hallway, the exam room walls were a warm beige, and there were landscape photographs hung on the walls.  Jimmie noted that there was no examination table, just three comfortable chairs and a large monitor as well as the mandatory sink.

Ken placed his palm on the monitor to activate it.  He said, “I know this must probably strike you as different from the exam rooms you’re accustomed to.  We get that reaction from most new members.  Do you have any questions before I start to show you how all of this comes together to take the very best care off your health?” 

“Just about my new doctor.”

“I’ll bring up pictures of the doctors that you can select from,” said Ken.  “Also I want to assure you that we take personal privacy very seriously.  Before you leave today I will help you register your palm print as you saw me do just now, so that only you and your doctor will have access to your medical file.”  Ken spoke to his earbud and the screen switched from a soothing abstract pattern to display twenty-four persons, neatly dressed in white coats.  They were of different ages and ethnicities, equally divided male and female.  “They will introduce themselves so that you can hear their voices.  And remember, you always have the right to change doctors if you find that you and your doctor are not on the same wave length.”

Each of the doctors spoke in turn stating their name and welcoming Jimmie by name, which impressed him.  “I’m amazed that each of them was so well prepared for this interview that they knew my name,” he said.

“We try to make your first visit go easily.  But did anyone of them stand out for you?” asked Ken.

“Well, I think I liked Dr. Gupta,” said Jimmie.  “I’d like to try him as my doctor.  When will I get to meet him?”

“You just have,” said Ken.

“No, I mean in person.”

“Dr. Gupta is—how shall I put it—a personification of our care system, but after you’ve worked with him a few times I am certain that you will become very satisfied with his care and manner.”

“Wait.  Could you repeat that.”

“Dr. Gupta personifies our health care system to you as you interact with it.”

“Personifies?  Wait—is Dr. Gupta a real person?”

“No.”

You mean he’s an avatar?!”

“To be blunt, yes.  But—“

“I left my former plan with a human doctor to now have an avatar as my doctor?  This is insane.  I must have been crazy.”

“Mr. Lowe, please hear me out first.  Scientists have demonstrated that supercomputer-assisted medical care will provide better, more accurate and satisfying results than human doctors working alone can.  I can show you the published scientific articles that have established this beyond a doubt.”

“Good grief.  I shouldn’t have switched.”   

“It was felt that for a new client to come in and interact just with a computer would not be easily accepted by many people.  Therefor putting a face and name in front of the patient would make the visit more familiar.  With your permission may I bring back Dr. Gupta to show you just how easy and natural it is?”

“Oh why not since I’m already here.  This is nuts.”

“Thank you for keeping an open mind.”  Ken called back Dr. Gupta whose smiling face reappeared on the monitor.

“Hello again Mr. Lowe and Ken,” said Dr. Gupta in a warm voice.  Would you rather be addressed as Mr. Lowe or Jimmie?”

“Jimmie’s fine.”

“Now is there anything you wish to talk about or ask about before I review your past medical history with you.  And are you comfortable with Ken in the room or would you prefer that he leave while we chat?”

“Ken can stay.  What medical school did you go to and where did you get your training?” dead-panned Jimmie.

“You have a wry sense of humor, Jimmie,” laughed Dr. Gupta.  “My medical training was all with IBM.  Now, any other questions or concerns?”

“Just that I’m here talking with a computer.”

“Well, I hope that when we’re done you will think of me as your personal care provider  Would you like me to review your medical history with you now?  I’ve looked through your records from your previous doctors.  There are a few questions that I have.”

“Sure.”

“First I’ll put up on the screen the list of medicines that you’re on.  Is the list correct?”

“I’m no longer on aspirin.  I don’t know why that’s still on the list.  I may have had an allergic reaction to it.”

“Were you ever tested?” asked Gupta.

“No.”

“I would recommend that we have that done to answer the question.”

“Would I have to pay for that?”

“No.  And I must say, Jimmie that, as the cliche goes, you are in a remarkable state of health for your age.  So few medicines.” 

“I try to eat a good diet and exercise regularly.”

“Excellent.  Your efforts show good results.  Shall we review the particulars of your diet and exercise regimen first?  Now who prepares your meals?”

Over the course of the next hour and a half, Gupta guided Jimmie through a very thorough review of his life and medical history.  There were no changes to his medications but Gupta did schedule Jimmie to be tested for the question of aspirin allergy, and made an appointment for him with physical therapy to address his complaints of morning back stiffness.

“Will the therapist be a person?” asked Jimmie.

“Yes,” laughed Gupta.  No robots as of now.  And you will be scheduled for a physical exam, which I of course cannot perform myself, with one of our physician’s assistants.  Now any final concerns or questions?” 

“I think you’ve answered them all, Dr. Gupta.  Thank you,” said Jimmie.

“You’re very welcome.”  .Gupta waved goodbye, opened the door behind him and went through, leaving an empty office on the screen.

Ken turned to Jimmie, “Well, how do you feel it went?” 

“I’ve never had such a long and thorough visit with any doctor,” said Jimmie.  “I totally forgot that I was talking to an avatar.  I am impressed.”

“And you’ll find that another nice thing is that you’ll be able to contact Dr. Gupta day or night, 24/7, with your health questions or concerns.  That is after I show you how to access him securely from your home imaging device.  Shall we get started?” said Ken.