clinic · ethics · MS-4 · narrative medicine · neuro

I spoke too soon. Last night’s class was the best yet; the debate was really intense, and even the really quiet ones had a lot to say. See, that’s the power of a really great story — it attacks you and forces you, sometimes against your will — to pay attention. Moments like that really make me love teaching.

Today, workwise, I was down on the Eastside practice with my preceptor, and then seeing patients on my own in the residents’ clinic.  It ran the gamut. The Eastside is private, very classy with paintings on the walls, patients who have done their homework, pleasant staff. The residents’ clinic is in the old, old part of the hospital, with cinderbrick walls and tiiiiny little exam rooms — I think the one I was in used to be a closet. Not even joking.

Of course, the quality of care is no different, because these are the same doctors, with the same brains. But I can’t help but wonder how much the ambiance affects the patient’s perception of the visit. It really disturbs me, the extent of the rich/poor dichotomy here. (Fun fact: our ED is in a different building from the hospital because the donors apparently did not want the uninsured rabble being too loud for the private patients. And don’t get me started on the Fancy Rich People’s Ward.)

I suppose that in the end, it doesn’t really matter, because the doctors are the same, the medicine is the same, even the computer system is the same. How much difference can a pretty painting make, when you’re sick? Both practices have access to Really Smart People, and both function very smoothly. But as a patient, I definitely know which one I would rather go to — even if that induces a fair amount of middle-class guilt.


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