Ms. M, a 28-year-old nurse practitioner, worked in a walk-in clinic that was located on the ground floor of a multi-story office building. She had been working for the clinic for the past year. Due to the clinic’s location, many of the patients were employees in the businesses located in the office building. The clinic was primarily staffed by nurse practitioners with the oversight of a supervising physician. 

On a typical day, Ms. M would primarily see business people with minor injuries or complaints of flu symptoms, sore throats, or gastrointestinal illness.

She administered flu and pneumonia shots as well as regular vaccinations, and she performed the occasional pediatric check-up for kids participating in sports activities or going to camp. In the few times that there was a true emergency, the patient was referred to the local hospital for treatment. 

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The office building opened at 7 a.m. each morning, but the clinic itself did not open until 9 a.m. Ms. M arrived at 8 a.m. to help the office manager prepare for the upcoming day. The clinic’s waiting room was open to the building’s lobby, but the reception and exam areas were gated off until the clinic opened. 

One morning, just past 8 a.m., Ms. M was at the clinic looking over some paperwork when she heard a faint knocking coming from the waiting area.

She opened the locked door to the waiting room and saw a somewhat distressed-looking man in a business suit in his mid-50s. The man was pale, with a slight sheen of sweat on his face, although the day was cool. 

“I’m sorry. We’re not open for another hour,” Ms. M said politely. 

“Oh,” the man said, clearly disappointed and with a hand across his stomach. “I was hoping someone could see me. I arrived at work this morning, and I’ve just had this terrible stomach ache that is just radiating across my body.” 

“I’m very sorry,” Ms. M said, still speaking through the slightly open office door. “I can’t examine you until we open. If I came out there, the only thing I’d be able to do is call an ambulance for you, and I don’t know if your insurance would cover that.” 

The man frowned. “I can only imagine what something like that would cost. Okay, I guess I’ll just come back down in another hour. I’m just feeling pretty crappy.” 

“There’s a pharmacy around the corner that is open already,” Ms. M said. “Maybe you want to go pick up an antacid in the meantime.” 

“Good idea,” the man said. “I’ll do that, and will come back in an hour when you’re open.” 

“See you then,” Ms. M said cheerfully.