English language Uncategorized

Doc in a box

Q: My daughter, an attending physician, is on the hospital floor to advise or assist residents. In OB, her specialty, she also covers for private physicians who are unable to get to the hospital in time to deliver babies. The universal expression there for someone who covers for other obstetricians is “doc in a box.” Any idea where this medical usage comes from?

A: The website HowStuffWorks, a subsidiary of the company that owns the Discovery Channel, has a list of medical slang terms, including “doc in a box,” which it defines as “a small health-care center, usually with high staff turnover.”

A contributor to Urban Dictionary (which is not an authority by any means, but has its finger on the pulse of the blogosphere) defines a “doc in the box” as “any doctor at a walk-in clinic.” Another contributor to this online slang site gives “McDoc” as a synonym.

The expression “doc in a box” was used in the sense of a clinic by participants in an online discussion on the Atlantic magazine’s website in 2007 about walk-in clinics. But this usage has been around for a while, since at least the 1980s, and probably earlier.

The first published reference for “doc in a box” in The New York Times archive is from a May 10, 1987, article about the efforts of hospitals to market their services to the public. One of the efforts was the creation of neighborhood clinics. The writer uses the expression to refer to the clinics, not the doctors working in them:

“Many hospitals now have neighborhood centers – known as ‘Doc in a Box’ – for cash customers who want quick, cheap medical advice on cuts, colds and other problems not serious enough to warrant an emergency room visit.”

The expression “doc in the box” (with “the” instead of “a”) first appeared in the Times in a Dec. 5, 1982, article in which a doctor dismisses clinics at shopping centers: ”They want to put up a ‘Doc in the Box’ sign every place there’s a McDonald’s.”

In 1991, Robert A. Burton, a San Francisco neurologist, published a novel called Doc-in-a-Box, about a failed plastic surgeon who’s had his license suspended and who practices illegally in a seedy street clinic in Venice, CA.

Although we’ve found a few examples of “doc in a box” used to refer to an attending physician and “doc in the box” to describe teaching sessions at a medical school, the two phrases are usually seen in references to walk-in medical clinics, especially dismissive references.

We can’t find anything definitive about the origin of the phrase, but it seems apt for a walk-in clinic. The expression conjures up an image of an instant, anonymous doctor, one who’s ready when you are and available without notice to see you in a nearby cubicle.

No doubt the amusing echo of “Jack-in-the-box” helps keep the usage alive.

Speaking of which, a “Jack-in-the-box” was originally (back in the 16th century) a term of contempt for a Communion wafer in its container or a reference to a thief whose MO was to substitute an empty box for one full of money.

It wasn’t until the early 18th century, according to the Oxford English Dictionary, that the expression was used for the toy with a figure that springs out of a box.

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