BehindTheMedspeak: 'Must good medicine come with bad design?'

Virginia Postrel, in the April 2008 issue of the Atlantic magazine, asks that question in an excellent piece which begins as follows:

"I'm sitting in a mauve vinyl recliner facing a mauve laminate counter and cabinets. On the countertop are a couple of candy jars, five peacock feathers leaning around a black wall phone, a small plant that may or may not be real, three boxes of medical-exam gloves, and a radio tuned to smooth jazz. A curling five-by-seven-inch photo of the participants in a 2000 fund-raising walk hangs below a sign warning guests not to use cell phones. Someone has pinned three teddy bears to a small strip of cork on the grayish-white wall. 'I’m gonna be Okay,' says the slogan on the orange bear's chest. The yellow bear wears a blue scrub outfit with an 800 number and the slogan for a cancer organization. On the white bear, hot-pink embroidery declares, 'Cancer sucks.'"

Enough to make anyone jump out the window in despair.

I must say that the decor in every doctor's office or clinic or hospital waiting room I've ever been in comes from that same playbook.

It's the ultimate poke in the eye to the patient, who's told in no uncertain terms, "you have no power, you are a victim and must now play your part."

I beg to differ, as does Postrel.

Here are more excerpts from her essay.

The Art of Healing

Over the past decade, most public places have gotten noticeably better looking.... Unless, that is, your establishment is a doctor’s office, medical clinic, or hospital. Mounting clinical evidence suggests that better design can improve patients’ health—not to mention their morale. But the one-sixth of the American economy devoted to health care hasn’t kept up with the rest of the economy’s aesthetic imperative, leaving patients to wonder, as a diabetes blogger puts it, “why hospital clinic interiors have to feel so much like a Motel 6 from the ’70s.”


Consider diagnostic imaging departments. MRIs and CT scans can frighten many patients, and research shows that simple elements such as nature photos can ease their stress... One of the bleakest rooms at the UCLA Medical Plaza, where I spend my time, is a waiting room in the imaging center. Small and beige, it epitomizes aesthetic neglect, with stained chairs, mismatched tiles, and tattered copies of U.S. News & World Report. The only wall art is a drug-company poster on myocardial perfusion imaging—just the thing to comfort anxious patients.


... why assume good medicine must come with bad design? Most hotel guests care more about reliable reservations than about crisp duvet covers. That doesn’t mean they want ugly rooms, though. Given the choice, they’ll go for the hotel that offers the best of both. When Starwood Hotels, which owns the Westin, Sheraton, and W brands, upgraded its rooms in the late 1990s, the rest of the hotel industry followed.


Under similar competitive pressure, medical facilities react the same way. When Baby Boomer women started choosing hotel-like birthing centers over hospital delivery rooms, hospitals quickly wised up. Now even rural hospitals offer well-designed labor-delivery-recovery suites. “People do shop, and they will actually sometimes change an obstetrician because they want a certain hospital experience,” says Malkin.


Much of the time, however, patients don’t know they can do better. Take semiprivate rooms. Like hotel guests, sick people aren’t eager to share their rooms with strangers. But most patients assume they don’t have a choice. “You grow up thinking that is how hospitals are, that there’s always two people in a room,” says Malkin. As of 2006, however, the American Institute of Architects’ guidelines, which many states use for their regulatory codes, specify single rooms in new medical- surgical and postpartum units. Medical centers may not care what makes patients happy—such a subjective, unscientific concept!—but they can no longer ignore the research demonstrating that single rooms lead to better outcomes: lower infection rates, shorter stays, less noise and hence better sleep, fewer expensive patient transfers and subsequent medical errors, and much less stress for patients.


Of course, Starbucks and Starwood didn’t wait for decades of peer-reviewed research to prove that customers would respond to better aesthetics. Their CEOs were willing to bet that subjective quality improvements would translate into higher sales. Patients like the diabetes blogger who are tired of “dreary, dull and dare I say, a bit depressing” medical environments need similar visionaries.

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Ever the perspicacious observer, Postrel is spot-on with her identification of "tattered copies of U.S. News & World Report" as the default periodical of choice in health care setting waiting rooms, at least in the U.S.

I wonder if interior designers and office managers order them special rather than spend the money on a subscription that might actually result in this year's issues being present.