I think I've morphed into the Paul Lynde character in "Bye Bye Birdie," only my question isn't "What's the matter with kids today?" but rather "What's the matter with doctors today?"

I've already accepted that they're younger than me (so is our new president). A lot younger. But that's not the issue.

And I certainly recognize that there was something wrong with the pompous, all-knowing, authoritarian figure from our past. Patients should be treated as individuals, should be well and clearly informed and should participate (within reason) in the diagnosis and treatment plan. That's not necessarily what's happening. But that's not even my gripe – today.

I was surprised when the podiatrist entered the room wearing her flip-flops and cracking her gum.

What bothers me about the physicians I've encountered recently is their casualness – in dress, in manner, in attitude. I mean, this is life and death we're dealing with!

And although my daughter's in-grown toenail didn't exactly fit that category, I was still surprised when the podiatrist entered the room wearing her flip-flops and cracking her gum. Call me old-fashioned but it just didn't jive with my image of "professional."

Recently I had a child confronting a more serious issue – not life and death but possibly surgery. Again the emergency room doctor seemed to be from a new era. While asking my son questions and during examination, he used the most slang and vulgar terms for different body parts and functions, words I don't allow my children to say. Call me an old fogy but I found it inappropriate and embarrassing.

We spent a long time in the ER treatment area so I was able to observe a lot of behavior (much more than I desired). As my child lay in pain, waiting for a diagnosis or the paper work for yet another test, the staff in the nurses' area was busy telling jokes and making personal phone calls.

I don't mean to suggest that nurses have to maintain a gruff and grim exterior, only that they were perhaps a little too cavalier. This was the emergency room – where people come in desperation (if they don't feel desperate when they come in, they do by the time they finally leave!) – and the lightness of their tone along with the slowness of their pace seemed out of place.

A further aspect of this casual attitude (at least at the HMO we belong to) is the lack of emphasis on privacy through the facility. Patients are seated next to one another as their vital signs are recorded, with the nurses loudly shouting out the patient's weight to make sure she records it correctly. (There isn't a woman I know who doesn't find that unbearable!) But it's more. Questions about symptoms, the reasons for the visit, and other personal details are asked at the nurses' station within hearing of the other nurses, some of the other patients, and not infrequently, everyone in the waiting room. That's too casual for me.

On the radio these days, there seem to be ads for every type of product designed to cure every type of ailment. The ads are frequently explicit and uncomfortable to listen to. I feel frustrated that I've been subjected to it (do we have to give up the radio too?); I find it invasive. I don't know who or what's to blame – is popular culture influencing society or reflective of society? – but it seems to me that casual has gone too far, that it's come to be synonymous with a lack of modesty – in every area.

Presumably my doctors are capable of tremendous amounts of discipline. It takes will and self-determination to persevere through medical school and internships and residencies. It takes a lot of self-control. I'd just like to see some of them exercise it in their daily interactions. It would be more pleasant for the old codgers like me – and wouldn't be bad for the young whippersnappers either.