TIME WAS OF THE ESSENCE

So impressed are they with their greatness, and so overwhelmed with their popularity and burgeoning patient rolls and fees that doctors have forgotten or prefer not to acknowledge that the waiting elderly cherish time. Because for those of us with only five or ten years of breathing remaining, time IS of the essence. So for a 70 or 80 year old, 10, 15, 47, 90 or 290 minutes lost in time is not the same as it was when the patient was in his '30s or '40s. Losing those minutes brings him that much closer to the man with the scythe. It might not mean much to a 30-or-40-year-old. But what does it mean to a flourishing physician who logs in three times more patients than he can handle in a day? And keeps the old pigeons waiting in their cubicles?

Moolah, that's what.

David arrived early for his appointment at a prestigious medical clinic adjacent to a Hospital in Waterville, Maine. The nurse shuttled him to an examination room, one of those cubicles built for two, where she said, melodically, "Doctuh be in soon."

His appointment was for !0 a.m. So patient waited: Ten minutes. Fifteen minutes. Thirty minutes passed. Not even a knock on the door to say the "doctuh" was late getting off the golf course or overslept from last nights cocktail party. Forty-five minutes and no knock on the door to say, he's running late and will be in soon. At 47 minutes after the scheduled appointment the physician, whom David had scheduled two months earlier, entered, arm out to shake hands.

How are you? he asked, cheerfully.

David is simmering. Is this guy kidding?

"Pissed off," he growled. "You're 47 minutes late. Not 10, or 15 or 20, but 47 fu*kin' minutes after the fact."

From the doctor, not even a "Sorry 'bout that" or a touch of remorse. No explanation; then, a pause and "Do you want to reschedule?"

David sizzled and with 47 minutes of his 79-year-old worn down clock in limbo, barked a word familiar to all doctors: "Abort! Let's just abort this event."

To avoid mayhem, the physician backed away, opened the cubicle's door wide and David glared a syringe full of disgust as he strode past him from the room.

It's the way of today's modern day medical lords. Pack 'em in, make 'm wait, "Payment due for services rendered, Have a good day."

It shouldn't require an efficiency expert to advise the physician and multiple numbered staff of nurses and schedulers to knock on the patient's door and say, "doctuh's runnin' late. Be in soon."

Might even add: "Heavy fee schedule today."

David's diagnosis for the nation's uncaring 814,000 physicians and medical providers in the U.S.: complacence; prescription: attend school for physician behavior, Heal thy selves. And follow the guidance of some Veterans Administration hospitals and clinics where signs say, "If you have been waiting 15 minutes, tell us." Or, better yet, knock on the patient's cubicle and say, "We're running late, old boy. Cool it."

And as for the doctuh's fee? Nada..

Then we have a cardiologist, a member of another clinic (Rocky Mountain Heart Associates, P.C., Wheat ridge, Colo.), who reviewed David's heart condition and supplied a written response in acceptable English after conducting an ultrasound test, He even urged the patient to "call me." But when he learned that the patient was also a patient of the Veterans Administration's Medical Clinic, he instructed his aide to phone and demand that I either pick and stay with him and not rely on VA medical care, or withdraw from his care program. Because, he said, the VA's prescription formulary required drugs other than those he (the cardiologist) prescribes. (And two opinions are not better than one?)