December 2000 Bulletin

Reception room should be ‘patient friendly’

Grime, burned-out bulbs, old magazines give a bad impression to patients

By Carolyn Rogers

When was the last time you spent a little "quality time" in your reception room? The reception room provides patients with their first impression of the doctor–neglecting it can be costly.

"It should be mandatory for surgeons to walk through their own waiting rooms once a month," says Jain Malkin, president of Jain Malkin Inc, a San Diego-based medical space planning firm, and author of the book, Medical and Dental Space Planning for the 1990s. "Doctors need to be aware of the condition of this room. For instance, are the baseboards caked with dust? Is the carpeting stained? Are the plants dusty? Are light bulbs burned-out? These things erode the patient’s confidence in the physician. Patients see these as tell-tale signs that, in terms of clinical practice, the physician is just slipping by, and is not proactively managing the practice."

Contemplating surgery is frightening enough, says Suzanne Boswell, a Raleigh, N.C.-based consultant and author of the book, The Mystery Patient’s Guide to Gaining and Retaining Patients. "But, if you’re sitting in a waiting room with harsh overhead lights, people coming and going, linoleum floors and magazines that are four months old, your fears will increase. As you sit there, you’re making judgments about the providers…am I just going to be seen as a number? Will this doctor care about me as a person? It’s not fair that we make judgments like that, but we do. And the reception area is kind of the kickoff place for that."

Beyond obvious signs of neglect, other features of the reception room can serve to reflect the physician’s level of consideration and respect for his or her patients.

"Frequently, there is a divide between the patient and the practice, and that divide is often represented physically by having a ‘window in the wall’, or a counter with a window that closes," Boswell says. "It leaves patients feeling like the staff is unapproachable and off-limits. Patients are very bothered by that."

The typical 42-inch high counter, although practical for standing up, is not ‘patient-friendly’ according to Malkin, "It’s a barrier between the patient and the front desk staff," she says. "You need to have a section of the reception desk that is lower–30 inches–which will open things up and accommodate people in wheelchairs. The 42-inch portion of the counter can hide the backs of computers, etc."

Another important front-desk issue is patient privacy, Malkin says. Patients should be able to communicate sensitive information without other patients hearing it, so make sure that seating areas are not too close to the reception desk.

In terms of seating choice, Malkin and Boswell agree that a variety of chairs are needed, especially in an orthopaedic office.

"No one chair will be comfortable to more than handful of people–you need variety," Malkin says. "You’ll want to accommodate people of different heights, patients with back problems, etc. It’s important to have a number of chairs with a high seat for people with hip problems, and none of the chairs should be armless. Not only do people often use the arms to raise themselves, they don’t want to touch the stranger next to them. Also, wood frames on the furniture are much preferable to metal –the cold touch of metal is not desirable. But the most critical thing about seating is that it not be too low–seat height should be no lower than 18 and 19 inches."

Orthopaedic practices require a wider than normal area of circulation in the waiting room, Malkin points out, due to the number of people arriving in wheelchairs and on crutches. "You might want to provide an ottoman or hassock, as well, for a patient who needs to elevate his leg," Malkin says.

"If the room has a medicinal smell, the patient’s anxiety level will increase," Boswell adds. "Noisy reception areas are distressing as well. Soft music and a pleasant smelling room can help to reduce anxiety. Lighting also makes a difference. In large clinics, you often find overhead lighting that produces a bright, clean feeling, but in smaller practices, subdued, indirect lighting with lamps will help to make patients feel like they’re in someone’s living room."

Offices should be painted in an uplifting color, too. "Don’t be afraid of using color–drab browns and grays should really be avoided," Malkin suggests. "Also, there’s a lot of research that shows you can greatly reduce patient stress by providing pleasant diversions such as a small water fountain [not a drinking fountain], or perhaps a built-in salt water aquarium," Malkin adds. "These really appeal to people."

Providing up-to-date magazines shows respect for patients, as well. And, "providing a carrel or kiosk, with a computer is another nice idea," Malkin adds.

The waiting room should always accommodate and reflect the patient population the practice serves. "Older people often need three times the amount of lighting to see the same as a 35-year-old," says Malkin. "Providing large print magazines shows respect for older individuals."

Many reception area "failings" will be forgiven, however, if the staff are warm and welcoming, and if waiting time is kept to a minimum. "We do focus groups with patients, and I can tell you that the office does not have to be physically beautiful, Boswell says. The most important thing, patients tell us, is the staff who works there. If the staff is highly skilled personally, it can compensate for the décor."

Nonetheless, Malkin stresses that today’s patients, and baby boomers in particular, are "very concerned about comfort and convenience and they want to be treated with dignity as patients."


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