Hack my waiting room!
April 27, 2015 4:45 PM   Subscribe

The medical practice where I work is showing some interest in revamping its waiting areas, especially as concerns patient educational resources. What have your doctors done that you like? What might you find useful?

I work in an adult primary care practice. It's actually a pretty well-run office, and patients don't typically wait long to be seen, but 5-10 minutes is pretty standard. Since it's also a teaching practice for residents, there's also frequently a short wait while the resident seeing the patient goes and has a discussion with the physician who is supervising them (another 5-10 minutes).

The practice recently achieved Patient Centered Medical Home certification and with that comes a lot of emphasis on patient education, collaboration in disease management, and so on. We also have a lot of support from our administration to try out innovations in medical care that support this model, and we have ambitions to be a bit of an incubator for high-quality care.

With that said, given that our patients are generally sitting around for 10-20 minutes over the course of a visit, initially in the waiting room and subsequently in an exam room, what can we do to make the experience more pleasant for them, and perhaps more educational? We used to have a TV showing a health education channel, but we weren't happy with the commercials ("ask your doctor about $Expensive_Med!") and canceled the service. We've been batting around the idea of having iPads or smart TVs to show informational videos on particular disease topics--obviously we couldn't do this in the waiting room as it would be a privacy violation, but we might be able to do it in the exam rooms. But I'd be interested in what other people would experience as useful/not useful or pleasant /a waste of time, during down time in the practices where they go.

Our patients: mostly over 50, about 50% Medicaid and a substantial portion of the rest are retirees living on Social Security. It's not unusual for a $10 or $20 copayment to be a real problem for them. Health literacy levels are not great, and the majority of our patients are not tremendously tech literate. A lot of them have smartphones, but one of the ongoing problems that we have is that patients run out of minutes on their phones toward the end of the month and we can't get hold of them for reminder or follow up calls.

(I know I'm going to get at least a few comments suggesting that we just try not to make people wait--unfortunately, a certain amount of that comes with a teaching practice. Unlike a lot of places, our docs are not overscheduled so waiting more than a few minutes usually means that the last patient's visit has become unexpectedly long/complicated or that the supervising physician has a lot to discuss with the resident for a particular patient. We are not interested in wasting anyone's time, including our own).
posted by The Elusive Architeuthis to Health & Fitness (38 answers total) 3 users marked this as a favorite
I'm always bummed when a practice tries to edu-tain me while I wait. Going to the doctor is stressful enough, I want to be rewarded with a few minutes of People magazine. I also always like the spa-vibe practices, like some dermatologists have.
posted by The Noble Goofy Elk at 4:57 PM on April 27, 2015 [22 favorites]

Something like Mental Floss magazine might be nice- it's light and easy to read, but at the same time it's a nice departure from the usual trashy magazines.
posted by Tamanna at 5:06 PM on April 27, 2015 [1 favorite]

Here's what I would like: a range of magazines (preferably current), a water bubbler, pleasant lighting, and an overall lack of loudness/unpleasant sounds. I had one doctor whose radio wasn't properly tuned and was scratchy - horrible.
posted by vunder at 5:08 PM on April 27, 2015 [3 favorites]

Guest WiFi network.
Water cooler.
Small desk area for filling out forms (some people (okay, me) have trouble juggling clipboards).
If you can afford it, COFFEE. My vet's office has a keurig machine; it doesn't get used often, but when you're there at an odd hour it's a lifesaver.
posted by phunniemee at 5:10 PM on April 27, 2015 [4 favorites]

My former gynecologist had the best waiting room ever. (I recognize that the patients at a gynecologist's practice have generally very different needs than those at a Primary Care office. Still, some of these could be worth consideration).

No TVs.
Adequate light, but still dim and well-filtered (nice blinds) in a way that kept the room relaxing.
Deep purple paint on the walls, also relaxing.
Minimal but well-selected art on the walls.
Attractive indoor plants (not sure if this is a potential issue for those with specific or rare allergies, but I wanted to point it out anyway).
High end magazines (not everyone's preference, but I found it a fun alternative to the more common tabloids).
A side cart with hot water, good tea and coffee.
The nurses and receptionist always spoke softly/quietly while conversing with people in the waiting room (again, not always a possibility if you are working with patients who are hearing impaired, but in general it aided a relaxed atmosphere).
She may have had some soft, spa-like music that played in the background.

She didn't have an aquarium, but I think an attractive, well-lit and well-arranged aquarium could be a great alternative to a TV. Nothing too bright or flashy. Watching the fish just bob and float is hypnotizing.

I'm with The Noble Goofy Elk - edutainment in the doctor's waiting room can be really boring and may even exacerbate anxiety for some. Escapism can be nice.
posted by nightrecordings at 5:11 PM on April 27, 2015 [6 favorites]

I agree with The Noble Goofy Elk - the older people I know are pretty focused on their immediate concerns when they're going to see a doctor (and so am I).

For information on services and their own appointments, they like information in tangible form - paper (big print) and cards. Is mailing appointment reminders too labour- or cost-intensive? A second reminder mailed closer to the appointment time could work, in lieu of a phone call.

As far as making things pleasant for your patients, I really think old-school customer service can do a lot. Smiling, remembering people's names, asking about their grandkids or holidays - that goes a long way towards helping people feel at ease.

Also: reassuring patients that e.g. X-ray and lab results are exactly where they should be, so that they don't worry things have been dropped or forgotten, and taking care to set their expectations around timelines (and being very clear that they've understood you).

At one clinic I go to, I like using a kiosk to register myself, and I'll maybe glance at the TV, which flashes information on services the clinic offers. I usually have something to read with me, but I might flip through magazines (pretty much anything, if I'm doing that, it's to distract myself). Newspapers are appreciated by the older people I know.

(Also: clear signposting of waiting areas and bathrooms helps people out.)
posted by cotton dress sock at 5:14 PM on April 27, 2015 [1 favorite]

Best answer: I hate videos/TVs playing in the waiting room. The lab at my clinic has a TV turned to a news channel with sound off, closed caption on which I can barely tolerate.

An iPad preloaded with video on specific health topics for patients waiting in the exam room for the resident to come back. The doctor could offer it when he/she is ready to leave for consult and put it away when they come back (less likely to be stolen) This also lets the doctor ask "have you seen the video on [topic relating to patient's condition]?" and they can then start the video they want to patient to watch. Otherwise you could just offer it and let patient choose if they want any of the topics that are available. If the videos are also on youtube (or otherwise accessible) you could have a handout with the links so the patient could watch it again or ask a family member to watch it from home. Great way to make sure the patients gets exposed to 100% of the important information.
posted by metahawk at 5:16 PM on April 27, 2015

One additional thing outside of your question: call and listen to your office's hold music/recording. Does it make you want to claw your eyes out because it is atonal, scratchy, too loud, repeats the same aggressive recording over and over again?

No? Good start.
posted by vunder at 5:17 PM on April 27, 2015 [10 favorites]

meant to add - interesting health newsletter (your own or one of the university health newsletter that are already out there) in the waiting room gives them something more useful than People in a friendly accessible writing style. Be sure to include large type versions - many of your patients will appreciate that.
posted by metahawk at 5:18 PM on April 27, 2015 [2 favorites]

I cannot overstress how much a good magazine selection matters. It tells me so much about whether a doctor gives a damn, and it makes waiting far less awful. If there are nothing but dusty golf mags out there I know the doctor doesn't care about me and I already kind of hate him before I meet him. You'll be OK with a bunch of relatively recent Time, New Yorker and People mags, but those plus more varied and interesting choices will be even better. A clean waiting room matters a lot too. A big fishtank is a very nice touch.

A big SILENT TV showing relaxing nature images can be very nice. But a TV that plays movies or shows at full volume can be super annoying if it's showing stuff you don't care to see.
posted by Ursula Hitler at 5:19 PM on April 27, 2015 [2 favorites]

Absolutely no flatscreens. Real plants. Cushy seating, not hard chairs. No radio with commercials. Relaxing music if it's at a very low volume and there's no commercials. Paint the walls light blue or have paintings with soft colors and fluid motion (rather than hard angles or jarring colors like red or yellow). Oh, and I always find fishtanks relaxing too.
posted by Blitz at 5:20 PM on April 27, 2015 [1 favorite]

Wifi and water are all I want.
posted by wintersweet at 5:21 PM on April 27, 2015

A clean waiting room matters a lot too.

2nd - same for small things that need repair. Staring at huge dust bunnies peeking out of busted baseboards doesn't inspire confidence.
posted by cotton dress sock at 5:25 PM on April 27, 2015

I hate videos/TVs playing in the waiting room.

This. Being stuck in a waiting room when their appointment was half an hour ago is annoying. Being stuck in a waiting room with some @#$% television they can't control blaring @#$% sound will make patients find a new @#$% doctor.
posted by Blue Jello Elf at 5:34 PM on April 27, 2015 [3 favorites]

I'm agreeing with everyone above.

My favorite doctor always had a range of magazines like National Geographic and Vanity Fair and Smithsonian and Men's Health, in addition to the usual People and New Yorker, and they had those in the waiting room and in the exam rooms (I hate hate hate waiting in an exam room with only brochures on high blood pressure and the like to read while I wait).

In addition to the recommendations above related to comfort in the waiting room (wifi and water are high on my list also, along with an easily accessible bathroom), my doctor always had a box or two of tissues and a bottle or two of hand sanitizer in the waiting room. One of the best things also was that he had small portable heaters in the exam rooms, which, depending on how I was feeling, I could ask to be turned on if I was feeling cold while wearing a gown.

Finally, another doctor made sure to have 2 sizes of gowns (with different cloth patterns so they were easy to tell apart), so larger men and overweight people did not have to wear the same tiny gowns as petite women.
posted by gudrun at 5:35 PM on April 27, 2015

Yes to good magazines, yes to fish tank, if you can. Wifi too. I find myself staring at the screen saver of amazon's firetv way longer than I should - nice high def photos of faraway places. There are so many that repeats are rare, and it's soothing and interesting at the same time. So if you did want a tv, this could be a nice touch. It could even maybe replace the fish tank...
posted by umwhat at 5:59 PM on April 27, 2015

nthing no TV. Glad I'm not the only one who hates them, now puzzled why they are everywhere. But if you have one already and don't want to ditch it, I like umwhat's suggestion of photos of faraway places on repeat.

I like quiet (soft background music is fine if no ads and it's not elevator musak). Clean and seats not too close together, no one wants to be elbow to elbow with obviously ill people. Also while padding is nice in seats, arm chairs/sofas that make you sink to the ground are not good, people will avoid them for fear of never getting out again (looking at you, local path lab sofa of doom).

I like readers digest magazines, they have a good mix of short and longer articles to read. Whatever the magazines are, replace them if they look grotty. The health centre near my work has a stack of magazines that are so gross looking, I'm convinced I'll catch some horrible disease just touching them and I'm not particularly germ phobic.

Fish tank would be lovely if someone can care for the fish - otherwise just plants in it would be relaxing too.
posted by kitten magic at 6:19 PM on April 27, 2015 [1 favorite]

WiFi and relative quiet, please.

Also, as far as educational pamphlets and posters and that kind of thing go, I find a lot of places I've been the past 5 years or so (college clinic, my employer's clinic, private practices...) they just seem kind of outdated and/or ugly. Nothing says "I'm keeping up with the times and continuing my education!" like pamphlets about recreational drugs or managing stress levels from 1994. (Though to be honest, it does make them kind of funny sometimes...)
posted by Donuts at 6:21 PM on April 27, 2015 [1 favorite]

I just want to disagree -- I like when waiting rooms have a TV. It gives people something to focus on instead of having awkward loud conversations or staring at strangers. Young people are going to be on their smart phones anyway, so it's for the older folks who are otherwise just going to sit there. I will say, I don't like when they show the news, for instance, because it will just be showing a live feed of the worst thing that happened in the world that day, but something like HGTV is fine and neutral. I don't mind health related programming too -- sometimes you can actually learn something interesting, but yes, I don't enjoy being sold to.

For me, the most important thing is adequate seating, and it positioned in a way to make sure there is a enough seating for everyone without personal space being violated. As long as the room is clean and not smelly or stuffy, and there is room to sit comfortably, it will be fine. Run down furniture with scratches and marks plus a stained carpet will do more to make the wait unpleasant than a TV ever could.
posted by AppleTurnover at 6:31 PM on April 27, 2015 [1 favorite]

Best answer: A thing my pediatrician does that I love is that along with all the other blahblah forms is a piece of largely blank paper that asks "What are the three most important things you'd like to discuss with the doctor today?" Spending my waiting time considering what exactly I want to talk about and putting it down on paper helps me a lot -- I'm a blurter and a babbler and a crier, so having a chance to get my story together is really helpful.
posted by purpleclover at 6:41 PM on April 27, 2015 [11 favorites]

If there are ever patients who arrive with a child in tow, some kiddie thing somewhere. These wall-mount toys mean nobody has to pick it up. A tiny stack of kids' books in the sea of People and New Yorkers are nice to find.
posted by kmennie at 6:41 PM on April 27, 2015

Best doctor's waiting room had two big black leather recliners on both sides of the room, and comfortable seating along the other walls. Those were worth the trip.

I also appreciated that they had cold water, as well as hot water for coffee/tea. They also had good magazines.

I agree with others - no TVs. I hate TVs in waiting rooms.

I also like having information about the doctor on the wall somewhere - a bio, or something is sufficient - helps me see him/her as a real person and not a soulless instrument of torture.
posted by guster4lovers at 6:43 PM on April 27, 2015

Oh, purpleclover's suggestion is excellent! All doctors should do that (I get flustered and cry - gah!).

Puzzle toys for nervous people to fiddle with!
posted by jrobin276 at 7:10 PM on April 27, 2015 [1 favorite]

Honestly the best thing you can do is to have staff that is super friendly and provides exceptional customer service. Oh, and comfortable chairs.
posted by radioamy at 8:08 PM on April 27, 2015

Please have a space for a wheelchair user to comfortably park in, facing or next to other seats (Near an outlet is best, on the off chance someone will need to plug in an old motorized wheelchair that barely holds a charge, or other medical device.) You may already have a lowered counter, but if not, make sure you can see/hear any wheelchair user who approaches.

When you're feeling sick or expecting bad news, harsh lighting and a sterile-looking environment will only increase your anxiety.
posted by Soliloquy at 8:26 PM on April 27, 2015 [4 favorites]

If I have to lie on an examining table (or dentist's chair), I like to be able to focus on an interesting complicated poster on the ceiling (not educational) so I can ignore what else is happening.

In the waiting room, I like more than enough (comfortable) chairs so I don't have to sit next to someone sick (noisy, smelly, chatty).

If there are magazines, I want to be able to toss mine as I'm called in, not have to take it right back across the room (because I feel rude leaving it in my chair, and I feel rude not following the doctor straight away).

Enough standing space near the counter so that I'm not eavesdropping on the person in front of me, or standing right in front of someone who's sitting.

I get frustrated every time someone asks me for my current address and phone number loud enough for other patients to hear, because some of these people are weird and stare at my breasts and I don't want to get obscene phone calls, not that I ever have, but can't you ask me more discreetly?

If there are multiple doctors and several pathways to doctor's offices, please make it clear with signage which side of waiting room I should sit on. I'm afraid that I will become absorbed in my magazine/phone and miss my name being called out if I'm on the wrong side.

If you have a long form for me to fill out (some of the mental health ones, for example) can't you make a computer available so that we cut down on transcription errors (also, I type faster than I write, and much neater). In fact, if I'm a new patient, and you want loads of information (that's good, I'm happy with that), can you send me a PDF form by email before my first visit, and then harvest the data?
posted by b33j at 8:35 PM on April 27, 2015

Oh, in terms of education - I have a tiny handbag from choice. Your pamphlets (while potentially useful) don't fit and get mangled and lost. If you send me the information by email, I can save it and refer to it when I have questions, and the links are live. You could also use email to remind me to set up yearly check ups and follow ups. This won't work for everyone, I know. Most of my health care providers now text me too, when results come in and I need to make a new appointment, or to confirm I'm going to attend the current one. I don't mind that.
posted by b33j at 8:38 PM on April 27, 2015

Toys for adults like a Perplexus.
posted by HMSSM at 10:39 PM on April 27, 2015

Desk Area with an iPad bolted down on a stand..

Space between individual seats
posted by Mac-Expert at 10:52 PM on April 27, 2015

old-school customer service can do a lot - I forgot to say "for what". What I've heard from the people I know (who may be similar in ways to a chunk of your practice) is that they feel invisible, ignored, forgotten, unimportant. They might be lonely. That visit might be the only thing they do that day. Receiving friendly, focused, personalized attention (from all staff) can make a difference in how much they trust they put in the clinic, how much faith they have that their problem will be adequately dealt with, and even how much they understand the information that was given to them. (My dad, for example, complained that a doctor at a particular walk-in clinic [which also lost some bloodwork] wouldn't look at him, at all. Another doctor there rushed through the visit, and didn't slow down or repeat himself when my hard-of-hearing dad said he couldn't understand him. He doesn't like to go to that clinic unless there's no other option. He likes seeing his cardiologist, though, because the receptionist is "very pleasant!".)
posted by cotton dress sock at 11:18 PM on April 27, 2015 [2 favorites]

Brochures and posters which acknowledge that patients may be of diverse sexualities and genders. Talk to your local LGBTIQ health organisation, they'll have loads of resources for you. I'm always happy to see a poster like this in doctors' waiting rooms.
posted by embrangled at 1:34 AM on April 28, 2015

Putting in a plug for calling your local Medicaid office or Medicaid MCO's provider rep line! Any Medicaid MCO will be happy to provide you with educational sheets and pamphlets about some of the major concerns your patient population faces - CAD, blood pressure, blood sugar, diet, COPD, etc. they may even have some nifty tools your patients can use like reminder sheets for important well visits and screenings for the 50+ age group. These will be low lit enough to be useful (at or below 6th grade reading level usually - it's a requirement in most areas).

Good luck, and thanks for being so thoughtful about your patients' needs!!
posted by kythuen at 6:29 AM on April 28, 2015 [1 favorite]

I'm with the No TV crowd. Every doctor/dentist I've been to in the past year has HGTV blaring in the waiting room. I think I've seen an entire season of those two brothers who try to compete to sell houses. I hate that show.

One thing my dentist does instead of magazines is coffee table books. Some cookbooks, some trivia, some jokes, some sports, some history, some travel, etc, most of them with big gorgeous photos or lots of tiny bites of text that can be picked up and put down many times over the course of the years. This might not work in a doctor's office with germy people.

I realize that most of the answers in this thread are very much NOT educational, which is what you asked for, and I think that's something to consider about what people want. You could have a rack of pamphlets or video-tablets available, but most people don't really want to look at that in the doctor's office. We want relaxed mid-range luxury.
posted by CathyG at 7:57 AM on April 28, 2015 [1 favorite]

Some adult-ish puzzle-type game toys that are not noisy. This kind of thing.
posted by beagle at 8:33 AM on April 28, 2015

I like some of the comments above about a sort of "spa-like" experience, as opposed to a harshly lit, take-a-number experience.

I really just jumped in to say please pay attention to the smell of the office. Of course it shouldn't smell like disinfectant, but it also shouldn't reek of cloying air freshener either. My dentist's reception area sets off my allergies every time I go in from the overpowering jasmine scent. Thank goodness their wait time is similarly short as yours is.
posted by vignettist at 11:09 AM on April 28, 2015

No tv. No radio. If I am trying to read (and nervous about the appointment) I can't do it with blinky or noisy stuff going on. People have given you good advice about the waiting room which I'd generally agree with, especially tissues and sanitizer because my feelings are always "This is a shared space with a lot of potentially sick people in it and it only gets cleaned maybe once a day..." and things you could do to mitigate that. In the doctor's exam room I'd also like magazines to read and I'd really like knowing about how long I'll be waiting. When the doc says "Oh I'll give you a few minutes to change" and I know they're going to vanish for 20 minutes I want to be like "Don't bullshit me, how long will you be gone for, more or less...?" and whatever the answer is, it's better than the polite fiction that the doc is leaving for my convenience.

Places to hang my coat and bag in the waiting room and the doctors office and a bag hook in the restroom.

Also a thing that rarely gets paid attention to at the doctor: restrooms. They are often large (so they are accessible) and very very sterile or possibly dirty. Having a good clean bathroom with some visual interest (poster, plant, who knows) and some decent smelling soaps (do not have to be fancy, just not antibacterial smells-like-bandaids stuff) would be good. A door that is easy to lock and easy to tell when it's locked from the inside and outside. If people need to provide/leave urine samples there, have a way to do that which is clear and doesn't involve someone carrying their pee around in a public place.

Last: HOW TO GET OUT. I followed a nurse to get to the waiting room and I do not know how to get back on my own, often. Clear signs that just say "exit" or, better, "Exit to waiting room" would be useful and pleasant.

Also if you are dealing with low income adults who might need to take their kids to the appointment with them, a small kid-friendly place in the waiting room (good for them, out of other people's immediate foot traffic) is a kindness.
posted by jessamyn at 3:20 PM on April 28, 2015

What I think would be pretty great for a waiting room would be to have a few clipboards with a variety of simple paper games for your patients to work on while they're waiting.

Photocopies of sudoku games, word searches, Monday-level NYTimes crosswords, word jumbles, that sort of thing. If each clipboard had about 10-20 sheets of varying games and a pen tied on, they could while away their time doing something that engaged them and kept them occupied. Invite them to take the clipboards along into the exam rooms.

I guess it's not very educational, but maybe you could insert a little health info tidbit on each sheet.
posted by that girl at 7:58 PM on April 28, 2015

Response by poster: Interesting feedback! Ironically, since we took the TV out our front desk staff have been telling us that the patients keep asking where the TV is and when it's coming back!

Lots of good ideas, thanks everybody! I think we'll take it to heart that people don't want to be edutained on general topics in the main waiting room, but that having the ability to watch videos specifically relevant to their conditions in the exam rooms might be OK.

I also like the idea of letting the patients set an agenda ahead of time.
posted by The Elusive Architeuthis at 2:17 PM on May 28, 2015

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