Good doctors, bad buildings.

I have a lot of great doctors. As a matter of fact, the group of them I have now I wouldn't trade for anything...the combination is perfect. The majority of them communicate splendidly, there are no real personality conflicts, and I've never had any serious doubt as to whether they're keeping up with advances or acting in my best interest.

And a lot of them are in shiny-new office buildings, or well-maintained older office buildings, or private offices on-campus at large hospitals.

I have a couple of specialists, though...again, really great doctors...whose offices are in creepy 70s-era inner-city rabbit warrens, complete with original furnishings and paint. You know, the really narrow brown naugahyde chairs with the squarish chrome arms, the tan wallpaper sprigged with orange and olive green, the carpet that looks as if a shampooer would leave garishly bright tracks. The only concession to the twenty-first century is a big brown Sauder tv cabinet with Sanjay Gupta blaring at me in 20-minute cycles. Otherwise, I feel as if not much has changed since my late-70s early 80s childhood, except that everything is somehow shabbier and filthier.

I'm not so silly as to think that good care can't be had in these offices, or so naive as to think that a blinding-white environment equals cleanliness and modernity. And I know that often the physician him/herself is responsible for the decorating costs of a leased office, and if you're not in a big practice the money can only stretch so far. I just hate looking down into the nauga-grain of my seat cushion and seeing decades of grime.

If it can't be updated, repainted, recarpeted...could it at least be scrubbed? I always come home and shower after a doctor visit- not really because of the exam, but because of the general oogy feel those dingy waiting rooms give me. Maybe I'm the only one who minds, because a lot of people don't seem to. A lot of people plop down , pick up the dog-eared Dec 2003 People and seem perfectly content to learn about Johnny Depp being the Sexiest Man Alive at 40. I've seen people stretch out across filthy couches under dim and buzzing fluorescent lighting and have themselves a nice little nap. No one else seems to worry about who wiped their nose and turned magazine pages before them or who coughed and touched the bathroom doorknob.

I'm loyal to my doctors, and when I find a good one I stay. If I'm on the fence, though, it can make up my mind for me. I used to go to a couple of specialists (who were related, actually) in separate dirty, dingy office buildings. One had a poster in her office, one of those order-from-a-catalog caricature jobs, with her specialty misspelled. The same dead ants that were on the floor in August were still there in October, with a coating of dust. The other specialist seemed to have constant untended cold sores (herpes happens, but so does herpes treatment) and kept his tongue depressors unwrapped in his shirt pocket. With him, the final straw came when I showed up for a semi-invasive procedure and saw the instruments laid out on kleenex. There was a scope he was planning to use and they washed it by rinsing it off in the hallway water fountain. That did it for me. I refused the procedure and found myself a new specialist.

Please, physicians. I get cost-effectiveness and staff not-my-jobism, but please, hire a cleaning crew, especially for your waiting rooms. Patients are taking all this in, and it would reflect the practice in a much more positive light.