In case you have comfortable rapport with her and know where she would be at 4.
I would just show up to take her to the doctors place (dates dont always have to be dine n wine... it could be many more)
Otherwise, maybe send some flirtatious+cockyFunny text like :
"Well, last time i saw the doctor in [HER AREA] he advised me to go on a date immediately after the appointment... i think thats a prevalent advice among doctors in [HER AREA]
"
OR
"I read in an article that meeting high school friends after doctors appointment helps in speedy recovery.
"
OR something funny/cocky/persistance similar which does not decrease your value much but shows to her that you passed her shit test and are not just fooling around with her.
Persistance sometimes pays off well, i believe.
And make sure you respond her back after a little more than what she took to respond.
-- Jack
Patience and Calibration are the keys to a perfect seduction