title: My personal experiences at the BEST Medical Center: A day in the clinic-the afternoon.
abstract: Dr. Ida Lystic is a gastroenterologist who recently began her new faculty position at the BEST (Byron Edwards and Samuel Thompson) Medical Center. After completing her MD degree at the prestigious Harvey Medical School (recently renamed the Harvey Provider School), she did her internal medicine residency and fellowship training at the OTHER (Owen T. Henry and Eugene Rutherford) Medical Center. Her morning in gastroenterology clinic was highlighted by: (1) being reprimanded by the clinic nurse manager for a patient who not only arrived early, before clinic had opened, but also neglected to schedule the anesthesiologist for his colonoscopy; (2) the continued challenges of LEGEND (also known as Lengthy and Excessively Graded Evaluation and Nomenclature for Diagnosis by her colleagues), the new electronic medical record system after the BEST discarded the SIMPLE (Succinct Input Making Patient's Lives Electronic) system; (3) a nurse's interruption of an office visit-once the egg timer on the examination room door ran out-because she had exceeded the allocated time for the appointment; and (4) her chairman's unanticipated arrival in the clinic to visit with the clinic nurse manager. In addition to seeing her patients, Dr. Lystic's afternoon is occupied by attending a LOST (Laboratory OverSight and Testing) Committee meeting and a visit from a wayfinding and signage specialist to depersonalize the doorpost plaques of the examination rooms. Her day ends with a demeaning email from her chairman regarding the poor results of the most recent patient satisfaction survey and being personally held accountable to develop solutions to improve not only her performance but also that of the clinic. Although Dr. Ida Lystic and the gastroenterology clinic at "the BEST Medical Center" are creations of the authors' imagination, the majority of the anecdotes mentioned in this essay are based on individual patients and their physicians, clinics in medical centers and their administration, and actual events, though details have been modified to protect the guilty.
authors.affiliation: Department of Dermatology, University of California San Diego School of Medicine, San Diego, CA.
authors.forename: Philip R
authors.initials: PR
authors.lastname: Cohen
authors.affiliation: Division of Hematology and Oncology, Clinical Science, and Center for Personalized Cancer Therapy and Clinical Trials Office, University of California San Diego Moores Cancer Center, San Diego, CA.
authors.forename: Razelle
authors.initials: R
authors.lastname: Kurzrock
mesh_terms: D000046:Academic Medical Centers / Q000592:standards*; D005762:Gastroenterology / Q000458:organization & administration*; D006801:Humans; D010044:Outpatient Clinics, Hospital / Q000592:standards*; D017060:Patient Satisfaction; D014925:Wit and Humor as Topic