The one-stop vibe

There is something almost sci-fi about Orthopedic Associates, the prominent local joint ‘n bone shop with garages in Poughkeepsie, Kingston, and Rhinebeck. It begins at the computerized induction terminals with insurance-card scanning. It proceeds from there with a kink-free, unbroken sense of managed experience and patient custody.

Perhaps it is the clean, labyrinthine complexity of the floor plan, the continuum of care represented in the musculoskeletal design of the facility, sight lines controlled with an almost Disney-like attention to the integrity and confidence of the patient experience.

It is the color-coded waiting areas and signage, the synchronized, station-to-station circulatory flow of a typical visit in which the patient is handed from scrubbed personnel to personnel in a spatial dramatization of a medical decision-tree, deposited in waiting areas, fetched by a new face that already knows your name and progress: tagging by joint of complaint, fact-gathering and date entry, preemptive scans, consultation and diagnosis, treatment plan, and discharge.


There is a feeling of no cracks to fall through. Behind the scenes, the articulation of payers and payees is tested and cleared with at least the same attention to detail.

In truth, this futuristic quality is common to all corporate, end-to-end medical specialty facilities with that one-stop, under-one-roof vibe. It is the opposite of a romanticized old-world office experience, where the maverick, clue-hunting Sherlock of a doctor sees beyond the textbooks and AMA guidelines and saves the day, your day.

Do you believe more in the latitude and prerogative of individual genius or in compounded, error-proof wisdom of tested systems? Do you experience this particular future as a triumph of design over disorder or a depersonalized, post-industrial dystopia on whose scans your soul’s slickness will never show?

I was there to get my shoulder checked out. They think it is just bursitis.

Read more installments of Village Voices by John Burdick.