I started the day thinking “all I need is a physical, how difficult can it be?” The situation: a work physical with an immediate deadline, and like many men, I avoid doctor visits at all costs. It helps that I’m in overall good health, not on any prescription meds, and visit the gym religiously.

The day started with a call to my primary care provider—he was booked for weeks, a physical would not be taking place in his office on this day. I decided to try all avenues, next up: MinuteClinic. My search started on-line at the MinuteClinic website—I was impressed with what I found: a menu of treatment options, the prices clearly labeled, and even a few different options for physicals. MinuteClinic seemed like the perfect logical option, fast and convenient.

After taking a careful look at my physical form, I knew it would be helpful if I gathered some old medical records (immunization shots, etc.). The form itself seemed straight-forward and basic enough for MinuteClinic: height, weight, blood pressure, some “basic” blood-work. I called my mom, inquiring about my shot records.

“Shot records?” she said. “What shot records?”

I sighed, wondering, what happened to the on-line personal health record?

I replied “Remember…. my shot records…?” She drew a blank.

Fortunately, my mother lives about 25-minutes from my home. I dug through a few dozen files at her home, and came across what I was looking for—original shot records, in perfect physician script, circa 1980! I had some paperwork, I felt like an empowered patient—that feeling would eventually fade.

I drove to a MinuteClinic and walked inside, of course the nurse practitioner would be on a lunch break for another 20-minutes. I decided to follow-through with the registration process—high tech touch screen, the navigation was simple, as was the information requested: name, address, phone, e-mail address, and a general reason for the visit. After registering, I was taken to a screen where I saw that I was third in queue. I noticed my name was listed with the other patients’, first name, with my last name initial. I did not like having my name so visible, in such a public place. I found myself wishing the screen had prompted me for some privacy option beforehand. I assumed the practitioner would spend 20-minutes per patient, leaving me with an hour to kill.

On my way to MinuteClinic, I passed a small family, urgent care clinic, just a 3-minute drive away. I decided to visit, to see if they would be able to handle my physical request. I spoke to the receptionist, explained my situation, and she handed me a clipboard with several sheets of paper. As I sat down to write what seemed to be a journal entry, I took note of a young patient (about five-years-old), accompanied by his father. The father held a stack of medical records about an inch thick. I overheard the nurse calling the doctor—he was out at the moment and would return to the practice “soon.” The young patient and his father had already been waiting for an hour.

The clinic’s medical questionnaire was more specific than the MinuteClinic version. The form requested: my medical information, my mother’s medical history, my father’s medical history, my mom’s parents and my father’s parents. I couldn’t help but think about how convenient it would be if I already had this information online. It didn’t help that I had already checked my Facebook and Twitter in the few moments that I was sitting in the waiting area. After filling out the forms, I handed them to the receptionist. Then I waited. I checked my time. The antsy five-year-old patient made me feel antsy. I decided it was time for me to head back to the MinuteClinic.

As I walked inside the MinuteClinic the patient ahead of me in queue was just leaving. The nurse practitioner checked the touch screen panel to see the next patient—it was me. I handed the nurse practitioner my physical form. He informed me that “Yes, MinuteClinic performs physicals, but at a much lower-level.” He could draw not draw blood and there would be no urine sample. I referenced the physical test mentioned on the website where urine samples were mentioned—he shrugged his shoulders and gave me a list of urgent care centers that may be able to provide the need tests and information. The empowered patient turned into the disenfranchised patient. I thanked the nurse practitioner and went back to the family practice.

The doctor was back in the office. The five-year-old patient was replaced by a much older gentleman, with a stack of papers about an inch thick (he put my five sheets of paper in an envelope to shame). The receptionist showed me to an exam room, then she transformed into the nurse-receptionist—she took my basic vitals and blood-pressure. The physician entered the exam room; he was quite professional and distinguished. He made time for conversation, gave me an efficient medical interview, and he took time to read the paperwork. I was told I had to return to have my PPD read, at which time I could also possibly have my tests returned and physical complete.

On my way leaving, I heard the older gentleman discussing his insurance matters, he recently changed providers. In his seat, sat a middle-aged woman with a stack of medical papers—at least an inch thick.

I left the physician’s office thinking about my medical experiences. In the wake of healthcare reform I could not help by think about what needed improvement. I thought about the macro-level:

• how many physician offices across the United States operated just like this, and

• how would these operations network/connect to hospitals, large insurers, and pharmacists?

• I thought about the convenient care industry, wondering if the nurse practitioner model could be improved upon. Could nurse practitioners be given additional medical responsibilities? Should nurse practitioners be given additional responsibilities?

• I also started thinking about medical school training—are doctors in training given a complete picture of the office experience prior to residency? If so (or not) should they be given this opportunity?

I also considered the micro-level:

• how could I have been more prepared as a patient;

• how can I organize my full medical record (without a platform like GoogleHealth—I’m an online guy, but I just don’t want my e-mail sharing the same platform as my health record);

• how can I find a physician that can utilize my medical record in an electronic format;

• what are the five things a patient should know or do before an office visit?

I decided to Google that question “What are the five things a patient should know before a doctor’s visit?” The query results were varied and included information about emergency room visits, specialist visits, and some video. I found the following links helpful:

• How to Talk to Your Doctor, Jennifer Frank, Family Physician at University of Wisconsin School of Medicine and Public Health Appleton, Wisconsin

• Five Tips for Your Next Doctor’s Visit, Good Morning America’s, Dr. Marie Savard

• Your Guide to Choosing Quality Health Care, Agency for Healthcare Research & Quality (AHRQ)