My respect for American doctors, which was generally high in the first place, has gone up exponentially following my first doctor’s visit here in Ireland. A medical examination was required as part of the green card application, so my employer scheduled an appointment for me within days of arriving in Ireland.

This doctor’s office could best be described as “bare bones.” The receptionist staffing the office had no computer, and the waiting room consisted of a hodge-podge of old conference room chairs. There were none of those comfy overstuffed couches that you would typically see in an American doctor’s office, and the waiting room was freezing!

When I checked in, the receptionist informed me that I would need to provide a urine sample as part of my physical exam. For this most unpleasant of tasks, I was sent down a narrow staircase lit by a single bare light bulb. I managed to [ahem] do what needed to be done, flushed and then turned to the sink to wash my hands. Gasp! There was NO SOAP in the doctor’s bathroom. I was horrified and completely grossed out by this unhygienic turn of events.

After a rather ineffectual rinse of the hands with very cold water, I trekked back up the stairs gingerly holding the sample cup. Instead of discreetly passing off the sample to the nurse (there was no nurse), I was instructed to take my urine sample in to the waiting room with me while I waited for the doctor. What does one do with a urine sample in a room full of patients? Do you hold it on your lap? Do you set it on the table with all of the magazines? What is the proper etiquette in this situation, I ask you? I finally opted to set it carefully on the floor next to the wall and prop a notebook in front of it so the rest of patients wouldn’t have to look at it.

After a few minutes the receptionist prompted me to move from my chair in the waiting room to a single chair in the hallway. I felt like a school kid awaiting a stern lecture from the principal. I heard a man shout from the office, “Next!” and assumed that was my cue to enter the doctor’s office. I handed over my urine sample to the doctor’s ungloved hands. There was no sink in his office for hand washing, and in addition to handling my urine sample he took blood during my visit. Shocking, isn’t it? Universal Precautions, apparently, aren’t universal. Since my visit, I have seen commercials on television prompting patients to ask their doctor, “Have you cleaned you hands?” It is a sad state of affairs when John Q O’Public has to prompt their doctor to practice basic hygiene techniques.

Next it was time for the doctor to listen to my heart and lungs. Ladies: You know how American physicians discreetly drop the stethoscope down the back of your collar to listen to breath sounds? Not this man. I was instructed to lift my shirt over my head for this procedure. It was an awkward moment to put it mildly.

I have since chosen a different physician based on a recommendation by another American who works at Cope Foundation. After meeting her, I have a much better feeling about her level of competency than the fellow who did my physical. Her office is a converted house in a pleasant neighborhood. The waiting rooms are slightly warmer, patient records are kept on a computer, and, most importantly, she has a sink in the exam room for hand washing.