Imagine a clinic waiting room at seven in the morning, before the doors are unlocked. It belongs to no particular building and no particular practice; it is assembled from the general furniture of such rooms, and nothing in it describes a place where I have worked. The lights are on and nobody is under them. In a Central Valley winter, for a few weeks either side of the new year, the sun rises a little after seven, so the windows are still deciding between grey and blue. In June the sun has been up for well over an hour, and the room is only waiting for permission to be used. Somewhere a ventilation system has come on with the lights and is breathing for a room with no one in it.
It has the frankest name in the building. Other rooms are named for the work done in them: examination, procedure, consultation. This one is named for what the people in it will mostly be doing. And they are called patients, a word that comes, through Latin, from pati, to suffer or endure. Between the name of the room and the name of its occupants, the language has been unusually candid about the arrangement.
An empty waiting room is not really empty. It is full of guesses. Nearly every object in it is a forecast about who is coming, made by someone who will not be present when the forecast is tested, and seven o’clock is the last moment at which all the forecasts are still intact. This essay is about those guesses: what they assume, what they leave out, what an empty room can and cannot tell us about whether it is any good, and what happens when the first person walks in and does something the room did not expect. It concerns no real patient, and when a person appears in it, he will be as imagined as the room.
Patient, Passive, Passion #
The Latin verb under patient has a large family, and the waiting room has adopted most of it. From pati and its participle passus English has patience, the virtue of enduring delay without complaint; passive, the condition of being acted upon; and passion, which began as suffering, as in the Passion of the Gospels, before it came to mean intense feeling. A patient, in the oldest sense, is a person to whom something is done, who endures it, and who is expected to bear the waiting with patience. The vocabulary has assigned the roles before anyone has arrived.
So, often, have the signs. The grammar of a waiting room is a grammar of the passive voice and the polite imperative. Please be seated. You will be called. Please wait to be called. Check in at the window. The person reading them is the object of most of the verbs: someone who will be called, seen, taken back, weighed. None of this is sinister. Clinics need order, and an imperative on a laminated card is a mild way to keep it. But the grammar matters because it shapes what feels permissible. A room that speaks to its visitors entirely in the passive is telling them that their part, until their name is said, is to wait well. Asking how long the wait will be, or why it is longer than promised, can then feel like a small breach of the room’s manners, though it is a perfectly reasonable question.
I do not want to overstate this. Grammar is not destiny, and a kindly person at the front desk can undo in one sentence whatever a sign implies. But the language of the room is one of its guesses, and its guess about the people in it is that they will be quiet and endure. Many will. The better rooms leave space for the ones who will not, and treat their questions as part of what the room was built for.
Punjabi names the occupant differently. The ordinary word for a patient is ਮਰੀਜ਼, marīz, which came through Persian from Arabic, where it means simply one who is ill; the more formal word is ਰੋਗੀ, rogī, from the Sanskrit for disease. Both name the person by the illness, not by the waiting. English calls its sick by what they must bear; Punjabi calls them by what they have. Neither name is quite kind and neither is the whole truth. Many of the people who will sit in this room are not ill at all. They have come for a vaccination, a form to be signed, a check that will find nothing, or for someone else’s sake, holding a coat and a bag while another person is seen. The names are guesses too, and like the furniture’s, they are guesses about kinds.
A Theory of Its Visitors #
Look at the chairs. Some of them have arms, and the arms are not there for decoration. They are what a person with weak thighs or a painful knee pushes against to stand when her name is called, and whoever chose those chairs was thinking, knowingly or not, about the people who would find rising difficult. A wider seat or two, without a divider in the middle, expects bodies of more than one size, and where such seats are placed, conspicuously or among the others, is a further guess about how people prefer to be treated. A gap in a row of chairs, where no chair has been put, expects a wheelchair or a walker or a pushchair. A rack of leaflets in several languages has already guessed which languages will come through the door. A low table in a corner with a basket of picture books assumes that someone will be bored at knee height. The pen on its chain at the front desk, the box of tissues placed where it can be reached without asking, the hand sanitiser by the door: each is somebody’s prediction about what the day will need.
Taken together they amount to a theory of the room’s visitors, a rough portrait of the people it expects, drawn before any of them has sat for it. Some of the theory is required by law. The federal accessibility standards in the United States measure such rooms in inches: a clear floor space of 30 by 48 inches in which a wheelchair can rest, a circle 60 inches across in which it can turn, a route at least 36 inches wide along which it can pass. These are good rules, and they exist because rooms built on unexamined guesses kept turning out to fit only the people who built them. But the measured requirements are mostly about space and passage. They say much less about whether a chair is so low and soft that it traps a frail person, whether the armrests are where a hand expects to find them, whether the one seat near the door is the one a person who cannot walk far will need. Those remain matters of judgement, which is to say of guessing, and the guesses are made by whoever buys the furniture.
What strikes me about the theory is that it is necessarily made of kinds. The room can expect the person who rises with difficulty, the person who reads Spanish, the bored child, the person in a wheelchair. It cannot expect anyone in particular. Its predictions are made in aggregate, and people arrive one at a time, each belonging to several kinds at once and fully described by none of them. The furniture has prepared for categories. Whatever happens in the rooms beyond it has to be prepared for a person, and that kind of preparation leaves nothing behind that could be photographed.
Signs That Presume a Reader #
Every sign in the room assumes a reader, and the assumption is usually more specific than its author noticed. Please have your insurance card and photo ID ready assumes a person who has both, who knows which card is meant, and who reads English well enough to parse a sentence in which several nouns are doing work. Check in here assumes that a person who sees the words will know what checking in involves, which is obvious to anyone who has done it many times and a mystery to anyone who has not. An arrow pointing to the restrooms assumes eyesight. A notice about a patient portal assumes a phone, an email address and the confidence to use both.
None of these assumptions is foolish, and some are unavoidable; a sign has to be written in something. The difficulty is subtler. A sign can be perfectly visible and still unusable, because it answers a question its reader is not asking and is silent on the one she is. A person carrying a referral letter she does not understand may stand in front of a well-designed board of instructions and find nothing on it about what to do with the letter. A person who reads Punjabi but not English may find a leaflet in Punjabi on the rack and still be unable to read the form she is handed at the window. Waiting rooms across California hear Spanish, Hmong, Punjabi and many other languages, and a room that has guessed this correctly in its leaflets has made a start. It has not yet made the conversation at the window possible, and the window is where the question will actually be asked.
There is a test I would apply to any sign, and it is not whether the sign can be seen from the door. It is whether a person who has never been in a clinic, who is anxious and slightly late and reading in her second language, would know from the sign what to do next. I suspect that very few signs pass. That is not a reason to write longer signs. It is a reason to put a person within reach of the sign, someone whose job includes noticing the look on a visitor’s face as she reads it for the third time.
Closed Like Confessionals #
The waiting room is the least private room in the clinic, and people bring to it some of the most private reasons in their lives. Everyone in it knows why everyone else is there, in the general sense, and nobody knows in the particular, and the room’s whole social contract depends on both conditions holding. The furniture is arranged so that strangers can see each other. Names are called aloud. At the check-in window, a question as ordinary as what brings you in today? can be heard by the first two rows.
What makes this bearable is a courtesy so habitual that it is rarely noticed. The sociologist Erving Goffman, in Behavior in Public Places (1963), called it civil inattention: the brief glance that acknowledges another person’s presence, followed at once by a withdrawal of the eyes that signals no special interest in them. Strangers in a waiting room practise it constantly. They look up when a name is called and look away when its owner stands; they notice a cough and decline to watch the person coughing. A waiting room’s privacy rests far more on that shared discipline than on its walls, and the discipline is fragile. It fails when the chairs face each other too closely, when the room is so quiet that every word at the window carries, or when someone is visibly distressed and the usual glance and withdrawal no longer seem enough.
Philip Larkin’s poem “Ambulances,” from The Whitsun Weddings (1964), opens on ambulances moving through the city “Closed like confessionals.” The poem is about the glimpse a passer-by gets of a stranger being carried in, and the sense of mortality the glimpse lets loose, and it depends on the closure: the ambulance hides the sick from the street, and the street, looking at the closed doors, imagines what it cannot see. The waiting room inverts the confessional. It asks people to sit in full view of one another while they wait to be seen in private, and to be named in public on their way to the room where the door will close.
The law in the United States has taken a practical view of this. Federal guidance under the HIPAA Privacy Rule has long said that calling a patient’s name in a waiting room, or using a sign-in sheet, can be a permissible incidental disclosure, provided reasonable safeguards are in place and no more is disclosed than necessary. That is sensible law; a rule that forbade any name to be spoken would make clinics unworkable. But it means that most of the room’s privacy is a matter of design and habit rather than prohibition: how far the window is from the nearest chair, whether there is a corner for a quieter word, whether the person at the desk asks the reason for the visit aloud or lets it be written down, whether a name is called in full or in part, whether a companion is assumed to be welcome or asked. None of these choices is obviously right in every setting. Some people want the companion at their side; others came alone precisely so that no one would know. A room can only guess, and the guess should be one that a person can decline without having to explain.
Hopper’s Empty Rooms #
Edward Hopper painted empty rooms better than anyone, and his empty rooms are useful here precisely because they are not waiting rooms. In Rooms by the Sea (1951), now at Yale, an open door gives directly onto the sea with no visible step, porch or shore between the threshold and the water, and a block of sunlight lies across the bare wall and floor. Through a doorway to the left another room is furnished, with a sofa, a chest and a picture on the wall, and no one in it. In Early Sunday Morning (1930), at the Whitney Museum, a row of two-storey shopfronts stands in a long, low light with nobody on the street; a barber’s pole and a fire hydrant throw shadows across the pavement, and the windows above the shops show blinds drawn to different heights. Much later, in 1963, he painted Sun in an Empty Room, which is exactly what its title says.
What these paintings show is that an empty room is never neutral. Hopper’s emptiness is charged with anticipation or aftermath: the street before the shops open, a room just before or just after somebody, a door through which something has gone or will come. The viewer supplies the absent person and becomes, for the time of looking, the occupant the room is waiting for. That is the source of the paintings’ power and of their peculiar loneliness. A Hopper room is beautiful partly because nobody has to use it. Its light falls on a floor no one will cross.
Hopper did once paint something close to a waiting room with people in it. In Hotel Lobby (1943) an older couple wait, the man standing in his overcoat and the woman seated near him, while across the room a younger woman reads and a clerk is half hidden behind the desk. Nobody looks at anybody. The lobby is occupied and still feels empty, because the people in it have agreed, as people in such places do, not to see one another. It is Goffman’s civil inattention painted twenty years before he named it, and it shows how close that courtesy lies to loneliness.
A waiting room photographed at seven in the morning has some of the beauty of Hopper’s empty rooms, and the photograph is a temptation. Clinics are photographed empty for their brochures and websites, and they look their best that way: the chairs in straight rows, the magazines squared on their table, the floor clear, the light falling cleanly. That tidiness is itself somebody’s work. Someone cleaned the floor after the last visitor left the evening before, wiped the armrests, emptied the bins, straightened the rows and turned on the lights that are now burning for no one. The empty room at seven is the product of labour done when nobody was there to see it, and the day will undo it by noon. The photograph shows the result and hides the work, which is what photographs of rooms generally do.
But an empty room cannot tell us whether it is easy to use. It can show an unobstructed path, but not whether the person arriving understands where the path is meant to lead. It can show a sign, but not whether the words answer the question someone is carrying. It can show a chair, but not whether choosing it means crossing a conversation the chooser would rather avoid. It cannot show the noise of a full room, the television nobody chose, the child who has finished the picture books, the person standing because every chair with arms is taken. Use supplies information that an arrangement alone cannot contain.
That is why I would be cautious about calling a room welcoming before anyone has been welcomed in it. The adjective describes more than furniture. It includes what happens when someone is uncertain, arrives with an unexpected need, or does not follow the sequence the space seems to request. A room can look generous in a photograph while the answer to a simple question at its window makes a person feel in the way. Hopper’s rooms are allowed to stay empty forever. A waiting room is judged by what happens when it is full.
Your Turn #
Punjabi has a plain word for what everyone in the room is waiting for. ਵਾਰੀ, vārī, is a turn: a turn at the well, a turn to speak, a turn at the window. ਤੁਹਾਡੀ ਵਾਰੀ ਆ ਗਈ, tuhāḍī vārī ā gaī, your turn has come, is a sentence that ends a wait, and the same word, used of time, gives ਇਸ ਵਾਰੀ, is vārī, this time. A waiting room is a machine for distributing turns, and like most machines it works better when the people inside it can see how it works.
The clinic’s machine is usually invisible to them. In a shop queue the rule is first come, first served, and everyone can check it with their own eyes. In a clinic the order is set by appointment times, by which clinician a person is seeing, by whether someone came for a scheduled visit or was fitted in, by a blood test that has to be drawn before a visit can begin, and sometimes by urgency. The sequence can be perfectly fair and look, from a chair, entirely arbitrary. A woman who arrived at 8:40 is called before a man who arrived at 8:15, and the man, who knows nothing of her 8:30 appointment or of his own clinician’s late start, concludes that the room does not care about him. He may be wrong about the fairness. He is right that it was hidden from him.
Research on queues says a good deal about this, most of it common sense written down. In an essay of 1985 that has become a standard reference in the study of service, David Maister set out a series of propositions about the psychology of waiting: that occupied time feels shorter than unoccupied time, that uncertain waits feel longer than known and finite ones, that unexplained waits feel longer than explained ones, that unfair waits feel longer than equitable ones, that anxiety makes waits seem longer, and that waiting alone feels longer than waiting in company. Every one of them applies to a clinic. The fourth applies with special force, because the room’s order is hidden, and the fifth because the person waiting is often anxious about the very thing she is waiting to discuss.
Maister made one further observation that fits the waiting room more exactly than any other room in a clinic: a wait before a service has begun feels longer than a wait once it is under way. The person sitting in an examination room for the clinician to come in has at least been taken in; something has started, and her name has been said. The person in the waiting room has not yet been admitted to anything. The waiting room is where the wait before the beginning lives. It is, by its nature, the room in which nothing has started, and that is why its minutes are the longest in the building.
The lesson is not that a waiting room should be made more entertaining. It is that the most useful thing in it is information. A room can have comfortable chairs, a pleasant view and a fish tank, and the person in it will still feel the wait as endless if she does not know how long it will be or why. A clock on the wall is an odd object in such a room: it measures the wait precisely and explains nothing about it, so that a person can count minutes she cannot interpret. A sentence from the desk, the clinician is running about forty minutes behind, and you are third, does more for the experience of waiting than any amount of furniture, because it turns an uncertain wait into a known one, an unexplained delay into an explained one, and a hidden order into a visible one.
Here the room’s limits are plain. No design gives anyone back the time. A person paid by the hour who has lost a morning’s wages to a delay has lost them whether the chairs were comfortable or not, and someone who arranged care for a child until eleven is in difficulty at half past, whatever the lighting. A pleasant room can make a wait easier to bear. It cannot make it cost less, and it should not be offered as though it did. The honest answer to waiting is partly a room and mostly a schedule, a staffing plan and a habit of telling people the truth about delay, and those live outside the furniture entirely.
One of Them #
There is one great poem set in a waiting room, and it is about what a waiting room can do to a self. Elizabeth Bishop’s “In the Waiting Room,” published in Geography III in 1976, takes place in Worcester, Massachusetts, on the fifth of February, 1918, in a dentist’s waiting room where the child Elizabeth, three days short of her seventh birthday, waits while her aunt is seen inside. The room is full of grown-up people in winter coats and overshoes, with lamps and magazines. She reads the National Geographic: a volcano, explorers in pith helmets, a dead man slung on a pole, women whose necks are wound round with wire. From inside the dentist’s room comes a cry of pain, and she hears it, with a shock, as her own voice; the room seems to tilt, and she feels herself falling off the turning world. To steady herself she tells herself what she is: “you are an I, / you are an Elizabeth, / you are one of them.”
The poem is about many things: the strangeness of having a body, the arbitrary fact of being this person and not another, the war that is on outside in the slush. But it seems to me the most accurate account in literature of what a waiting room does. It puts a person among strangers who are, for the duration, of the same kind as she is, people waiting, people with bodies that hurt or might, people whose turn has not come, and it does this in a setting so bland that the recognition arrives with the force of vertigo. The child discovers that she is both an I and one of them, singular and a member of a category, and she cannot see how both can be true at once.
That is precisely the design problem of the room. Its furniture is a theory of them, the kinds of people expected, sorted by mobility and language and age. Each person who enters is an I, fully particular, with a reason and a history and a preference about where to sit that the theory did not predict. A room built only for them treats every I as a specimen of a category. A room built for no category at all excludes the people the categories were invented to include. The good room holds both, and the people who work in it have to hold both too: the general preparation that makes a space usable by many, and the attention that notices which one of the many has just come in.
From the Other Door #
There is an asymmetry built into every waiting room, and it explains, I think, many of its failures. The people who design it, furnish it and work beside it almost never wait in it. They enter by another door, from a corridor behind the desk, and their view of the room is the view from the threshold of the inner rooms: a glance across the chairs when a name is called. A clinician can work for years beside a waiting room and know it chiefly as a murmur through a wall and a field of faces turning up at the sound of a name. The room is experienced in full only by the people who have no say in it.
This is not a peculiarity of clinics. Most public rooms are designed by people who will not use them the way their users will, and the difference shows in small things only a user notices: the glare on the one seat by the window, the draught from the door in winter, the chair with a wobble, the sign that can be read only by standing up. Such faults are trivial to fix and nearly impossible to see from the other door. They are found by sitting.
It seems to me that one of the most useful things anyone responsible for such a room could do is occasionally use it as its visitors do: arrive by the front door, read the signs without already knowing the answers, sit in the chair nearest the window for forty minutes, and listen to what carries from the desk. It is a modest discipline and not an original one; designers and administrators have long been told to walk the route their users walk. But it makes a specific correction. It replaces the theory of the visitors with an hour of being one, and a theory that has never been sat in is only half a theory.
The moment at which the two doors meet deserves attention too. When a name is called across the room, a person is lifted out of the category the furniture prepared for and becomes, at once, the particular person who is expected inside. Bishop’s child felt herself turn into one of them; the called name does the reverse, and makes one of them an I again. How it is done matters more than its brevity suggests: whether the name is pronounced with care, or at least with a willingness to be corrected; whether the person calling waits while someone with a stick gets to her feet, or turns away and leaves her to follow; whether the call sounds like a summons or a greeting. Where names come from Punjabi, Spanish, Hmong, Armenian, Portuguese and English, the willingness to be corrected about a name is itself a form of welcome. A waiting room’s last act, and its most human one, takes place in the few seconds between a name and a door, and it is performed not by the furniture but by whoever stands in the doorway.
What the Empty Room Also Holds #
There is a strong objection to everything I have said, and it deserves its full force. An essay that dwells lovingly on armrests and signage can turn accessibility into decorative empathy, a matter of thoughtful objects, and imply that unequal care is a problem a better chair could solve. It is not. The people who most need a clinic are often the people least able to reach it: those without a car or a bus that runs at the right hour, those whose work does not allow a morning off, those without insurance or with the wrong insurance, those who were told the next appointment is six weeks away. None of them is in the waiting room at seven, or at any hour, and nothing in the room’s design will bring them.
Seen that way, the empty room at seven is empty in two senses. It is empty of the people who will arrive at eight, and it is empty, permanently, of the people who will not arrive at all. The furniture’s guesses concern only the ones who make it through the door. A room can be perfectly arranged for its visitors and say nothing about the people the rest of the system has filtered out before they reach it.
I accept the objection, and I do not think it makes the room unimportant. It puts the room in its place. The waiting room is the last few yards of a long road, and most of what makes care fair or unfair happens on the road: in scheduling, transport, cost, language access, staffing and the time each visit is allowed. A good room cannot make up for a bad road. But the last few yards still matter to the person walking them, and a room that is hard to use adds its own small cost to all the others. The honest claim for design is modest. It cannot do the work of justice. It can avoid making that work harder, and it can make the arrival of the people who do get there a little less hard than it needs to be.
The First Arrival #
At a little before eight, in this imagined morning, the door is unlocked. The first person to come in, a figure as invented as the room and with no history that I will give him, looks around and does not do what the room expects. He does not go to the window. He takes the chair nearest the door, though there are better ones, moves it a few inches so that its back is against the wall, and lays his coat across the seat beside it. Then he waits.
It would be easy to read this. The chair by the door is the chair of someone who may want to leave; the back to the wall is the posture of someone who wants to see the room; the coat is a small territory claimed. All of these readings may be wrong, and the room has no right to any of them. He may simply have been here before and know that the window does not open until eight. He may like that chair. A preference does not have to explain itself to the furniture, and a person who has come to a clinic should not have to account for where he sits in order to be welcome there.
But the moved chair is also information. The arrangement did not quite fit this person’s use of it. The useful response is neither to restore the old position at once nor to declare the new one correct. It is to stay interested in what the adjustment reveals: perhaps that one chair near the door should face the room; perhaps that people would like to know, from the door, whether the window is open yet; perhaps nothing at all. The room began as a set of guesses. Its work improves when the people responsible for it allow those guesses to be corrected by ordinary use, and notice, at the end of a day, which chairs have migrated and which signs were read three times.
For a moment the room is still. The light is a little stronger at the windows. One row is no longer straight, one small territory has been claimed, and the room, less tidy than it was a minute ago, has started doing the work it was arranged for. Its guesses are being tested now, one person at a time, which is the only way they ever are.
Evidence and Editorial Note #
Documented findings. The essay relies on the author’s public biography as a family physician practising in California, with Fresno, in the Central Valley, as home. Sunrise in the Fresno area a little after 7 a.m. Pacific Standard Time for several weeks around the winter solstice and new year, and well before 6 a.m. Pacific Daylight Time in June: standard astronomical calculation for the region’s latitude and longitude. Patient from Latin patientem, from pati, to suffer or endure, and patience, passive and passion from the same verb and its participle passus: Online Etymology Dictionary and standard etymological reference. Clear floor space of 30 by 48 inches, a 60-inch turning circle and a 36-inch minimum route width: the 2010 ADA Standards for Accessible Design, sections 305.3, 304.3.1 and 403.5.1, as standard reference knowledge. Federal guidance under the HIPAA Privacy Rule that calling names in waiting rooms and using sign-in sheets may be permissible incidental disclosures with reasonable safeguards and minimum necessary information: U.S. Department of Health and Human Services guidance on incidental uses and disclosures, stated in general terms. Philip Larkin, “Ambulances,” The Whitsun Weddings (1964): one phrase of three words quoted, the rest described. Edward Hopper, Rooms by the Sea (1951, Yale University Art Gallery), Early Sunday Morning (1930, Whitney Museum of American Art) and Sun in an Empty Room (1963): standard reference knowledge, described from the paintings’ well-known compositions. David H. Maister, “The Psychology of Waiting Lines” (1985), and its propositions, including the observation that waits before a service begins feel longer than waits during it: standard reference knowledge, paraphrased. Erving Goffman, Behavior in Public Places (1963), and the concept of civil inattention: standard reference knowledge, paraphrased. Edward Hopper, Hotel Lobby (1943): described from its well-known composition. The Punjabi words ਮਰੀਜ਼ (from Persian, from Arabic, “one who is ill”), ਰੋਗੀ (from Sanskrit, “disease”), ਵਾਰੀ, ਤੁਹਾਡੀ ਵਾਰੀ ਆ ਗਈ and ਇਸ ਵਾਰੀ: standard Punjabi usage and etymological reference. Elizabeth Bishop, “In the Waiting Room,” Geography III (1976): setting, date, the magazine and the cry described, and one passage of thirteen words quoted. California’s linguistic diversity, including Spanish, Hmong and Punjabi speakers: general public knowledge. Chairs with arms as an aid to rising: general clinical and ergonomic knowledge. Vendor representations. None.
Recollection and tradition. The waiting room, the morning and the first arrival are hypothetical and illustrative throughout, and the essay says so at the start. They do not describe any particular clinic, employer, building, schedule or staff, and no patient is described; the first arrival is an imagined figure without a history. The time in the title is not a statement of the author’s working hours. No remembered scene is described.
Analysis and forecast. The reading of the room’s vocabulary and grammar, of the furniture as a theory of its visitors, the test for signs, the contrast between the Punjabi and English names for the patient, the inversion of Larkin’s confessional, the readings of Hopper, Goffman and Bishop, the account of the clinic’s hidden order of turns, the asymmetry between those who wait in the room and those who work beside it, the reading of the called name, the argument that information matters more than furnishing in the experience of delay, the acknowledgement that design cannot repair unequal access, and the view that a room’s guesses should be corrected by use are the author’s personal interpretation as of November 7, 2026. Nothing here is a statement of what any law requires of a particular setting. Independence. This essay is not sponsored by any institution, company, health system or technology developer.
About the Author #
Kanwar Partap Singh Gill, MD, traces his family roots to Khadur Sahib in Punjab’s Majha region and grew up in Amritsar. He attended Spring Dale School and completed pre-medical studies at Khalsa College in 1994–1996. He earned his MBBS from Sri Guru Ram Das Institute of Medical Sciences and Research in Amritsar in 2002.
He completed PGY-1 at the University of Arkansas for Medical Sciences in Little Rock in 2007–2008, and PGY-2 and PGY-3 with UCSF Fresno at Community Regional Medical Center from 2008 through 2010. He has practiced medicine in California since 2010.
His career has crossed four distinct information eras: predominantly paper-based medicine, early and fragmented electronic records, the integrated-EHR era, and the emerging age of generative and agentic artificial intelligence.