First Person 

Five years ago, about the time my problems began, my doctor's practice was bought by a larger organization whose managers are far removed and not particularly interested in making things run smoothly as long as the patients and payments keep rolling in. My vet-office insanity is the result of another form of greed. The practice has gotten way too big, and they don't want to put their profits into hiring more front-desk employees. The result is under-staffing, incompetence and long waits.

My latest fury came when I pulled my child out of school for a sports physical and drove 45 minutes to an appointment I'd made six weeks previously, only to discover an empty parking lot and a note on the door saying the doctor's office was closed due to the weather. My generosity of spirit had been eroded by miles of road-paving and, though signs of tornado damage were all around me, I wondered why they'd had time to close down the office but not enough time to print out the list of patients and call them from another phone.

The next day, I called their office and was put on hold three times for a total of 15 minutes before I began to vent to the receptionist. She was defensive, especially in light of my attack (and the many others she'd probably heard that day), and you can imagine how pleased I was when she ended the conversation by connecting me to the office manager's voice mail. That's when I hung up and began to wonder about finding a new doctor. I think I would have been more forgiving if I hadn't had a similar experience at my last appointment.

Last time, I'd waited six months for a physical, only to be told on arrival, "That doctor's not in today. Didn't anyone call you?" Of course, by that time I'd accumulated a laundry list of physical complaints and medication needs. So I told them the least they could do was squeeze in a quick appointment to deal with my immediate concerns.

Here's where the insanity increased. I waited 45 minutes for my five minutes of doctor time and refused to pay the office-visit charges. I'd already paid in time lost and stress gained. They agreed, and told me, "We'll just bill your insurance company and disregard your co-pay." I didn't think that sounded quite right, and I told them so. After scheduling a new appointment for a physical seven months later (the first available, I was told), I went home to call my insurance company to tell them to be on the alert for those charges.

Sometimes the receptionists aren't to blame for these inconveniences, and I am quick to begin my conversations with an apology in advance: "I'm really sorry that you're the person who has to answer my phone call today, because I'm not very happy," I warn them. I feel sorry for those on the front line who suffer the slings and arrows of outraged patients.

But sometimes the receptionists are responsible. A friend of mine with a 14-year-old dog feared a stroke when she noticed that her dog's eyes seemed strangely droopy. A receptionist with no veterinary training told her that the vet could not see her dog for three days, and had she considered it might be a wandering eye? Two days earlier, my feisty pup and I had been kept waiting for 30 minutes by the same vet.

Reception would be comical if it weren't so frustrating. My most bizarre experience occurred last summer when I broke a tooth biting down on a piece of hard candy. Even though the accident was caused by my own stupidity, I called the UNC Dental School emergency desk full of the kind of fear that can only come when a part of your body breaks off.

The receptionist told me, in a singsong voice, "You can be seen only if you need a root canal or if you want us to pull the tooth." After she repeated this refrain three times in answer to my mounting anxiety, I asked to speak to her supervisor.

He must have had the same trainer, for though he was more polite, he'd only learned the same chorus: "Sorry, ma'am, but you can only be seen if you need a root canal or if you want us to pull the tooth."

I responded with a solo that must have unnerved him: "May I please speak to the dentist?" I asked. To protect the dentist's time and possible embarrassment, he grudgingly told me I could come in and see a dentist. After I waited two hours for a six-minute visit, I walked back to the reception room where I waited in line to pay.

As I was waiting, in walked a woman with a tiny infant in her arms. She looked as if she were just out of delivery and wore those qualities of distraction and confusion that come with pain. "I got a toothache," she complained, rubbing her jaw and pointing to a tooth right in front.

Out came the standard line with which I'd become familiar: "We can only give you a root canal or pull the tooth."

"OK, I guess you can pull the tooth," she said, and settled down for a long wait with her newborn in the crook of her arm.

What led her to make this decision? Was it pain or being bamboozled by the front-desk greeting? I'd bet on the latter.

I'm looking for some new doctors who will provide me with the quality of care I'm used to receiving. But I also want to know how their office operates, who owns them and who's at the front desk.