I SENSED THE TENSION as I came through the front door of our office and strode past the two people sitting in the waiting room. While I was on a hospital call, an elderly patient had been referred to our office without an appointment. Rather than schedule an appointment for another time, he and his daughter had chosen to wait until I returned. Their body language and the glance I exchanged with the office administrator communicated clearly that the wait had not been pleasant for either party. In a brief hallway discussion, she informed me of the reason for the referral, and I escorted the patient into an exam room and began the encounter within a few minutes of my arrival. The daughter chose to remain in the waiting room (I assumed it was out of an abundance of frustration) while my encounter with the patient proceeded pleasantly and without incident.