It is difficult to manage the patient load of a physical therapy clinic in an Air Force hospital. A physical therapy clinic is like most other hospital clinics in that many patients—such as those with chronic problems or requiring long-term treatment¾ can be scheduled in advance for their sessions with the caregiver. But physical therapy clinics are also like emergency rooms in the sense that they must attempt to accommodate those who are suffering intense pain from acute injuries on a ‘same day’ basis. This means that those who walk in unannounced must be squeezed between scheduled appointments or taken care of at the end of the day, when all scheduled appointments are over.

Captain "Poplar" is a therapist working in one of these Air Force physical therapy clinics, which is run by Major "Hickory." On one particular Monday the clinic is extremely busy. The base softball tournament took place over the previous weekend, and there are more walk-in patients than normal. In fact, it is getting toward the end of the day, and there are three walk-in patients still waiting to be seen. Patient "A" walked in around 1100, Patient "B" walked in around 1315, and Patient "C" came in about 1350. All have roughly equivalent injuries suffered while playing softball.

Major Hickory approaches Captain Poplar and asks which of these walk-ins he intends to treat next.

"I was about to call in Patient ‘A’," says Poplar, "he has a sprained lower back, and his physician has directed a ‘hot-cold’ series for him."

"Guess again," counters Hickory, "I want you to see Patient ‘B’ next. Let ‘A’ wait."

"But Major," says Poplar, "Patient ’A’ has been here since before lunch time and Patient ‘B’ didn’t get here until 1315. Don’t we operate on a ‘first come, first served’ basis with our walk-ins?"

"Ordinarily, yes." Hickory agrees, "but this is a special case. Patient ‘B’ works in the hospital lab, and we always take care of our own first. Do ‘B’ next."