Spend a little time in a doctor's waiting room. You'll see and hear a lot that may concern you; it did me.

Although the waiting room I write of was in a physician's office in the northeastern United States, I suspect I could have had a similar experience in some waiting rooms in physicians' offices in Washington, D.C. I came away from the experience very concerned about the behavior of the office staff and how that behavior could have an adverse effect on the physician's patients and reflect poorly on the physician's management of his or her office.

This is not good, and in these days of increasing numbers of physicians and doctor shopping, it could have untoward effects on the physician's practice. We physicians are deeply troubled by our profession's declining public image. We are extremely upset about the negative press concerning medicine.

However, we should remember that our collective public image derives from millions of one-on-one encounters with individual patients. These individual encounters most often begin in our waiting rooms. We all know that first impressions mean so much and frequently shape the patient-physician relationship forever. . . .

It is a well-known phenomenon that patients frequently wait to see the physician far beyond the appointed time without any explanation. . . . During my time in the waiting room, I heard specific patients' names, medications and other pieces of what I considered personal information. This is a breach of confidentiality and is not in the best interest of the patient. . . .

Each of us ought to remember that our best public relations is a result of our compassion, concern, caring and the practice of good medicine. . . .