I want to tell you something important about your Athens, GA medical practice, and I want you to sit down first, unless you are already sitting down, in which case, good, because that is exactly the kind of alert, prepared thinking that will serve you well here. Your patients are judging your armrests. I know. You went to medical school, or dental school, or you run an outpatient clinic where actual healing happens, and you assumed your patients were sitting in your waiting room thinking deep thoughts about their health. They are not. They are running a forensic investigation on your reception desk, and if they find so much as one (1) suspicious dust bunny lurking near the Highlights for Children magazine from what appears to be the Clinton administration, their confidence in your entire medical operation drops by what researchers — meaning me, just now — estimate to be 43 percent. I am not a scientist. But I am fairly confident in the 43 percent, because I made it up with real conviction. Here is the premise, and I am going to press on it hard: patients cannot see your clinical excellence, so they grade you on your baseboards. They don't know if you're a brilliant diagnostician. They do know if the exam room smells like it's been marinating since the Obama years. To them, a dusty vent is basically a diagnosis. Beat one. A patient walks into a waiting area with wiped-down seating, organized magazines, and floors you could perform minor surgery on. Reaction: mild, unconscious relief. Blood pressure cuff hasn't even come out yet and they're already 12 percent calmer. Beat two. A patient walks into a waiting area with a coffee ring on the end table that has achieved permanent geological status. Reaction: quiet panic. If they can't keep the lobby clean, the patient reasons, what ELSE aren't they keeping clean? Is that a used cotton swab or a very small, very disturbing sculpture? Beat three — and this is where it gets unhinged — the patient now assumes your surgical instruments are sterilized using the same standards as your carpet, which is to say, vibes only. This is not fair to you. It is also, according to actual human behavior, exactly what happens in the brain of every person clutching a clipboard in your lobby.