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Doctor/Patient communication is important!

March 05, 2015

A lot is being written recently regarding groundbreaking “studies” that show that doctor/patient communication is actually more important than the environment in determining patient satisfaction.


Why is this surprising to anyone?

Some of my fellow architects have been known to drink a little too much of their own Kool-Aid and convince themselves that their buildings can actually heal patients. 

Some hospital administrators get carried away and think that if they can just get that fancy new building, all of their errant policies and practices that “have always been done that way” can be continued and will not need to be replaced.

Maybe it is time for a reality check.  Those who have read my ramblings in this and other forums may remember one of my favorite themes is that buildings cannot cure people.

Does all of this mean that the built environment does not matter? 

No, it does not mean that. 

With regard to behavioral health facilities in particular, buildings can make people more ill and harder to treat.  I am not a clinician, but I believe this to be true for several reasons, eventhough I do not have any “scientific evidence” that “proves” these are actually true.

True But Unsubstantiated Reason #1 – If people who are suffering from severe depression or low self-esteem are placed in a facility that makes them feel like they are being punished for being ill, their depression may actually deepen and make then more resistant to the treatment that the staff will offer them.

True But Unsubstantiated Reason #2 – If people who are suffering from manic attacks are brought to a typical general hospital emergency department with its bright lights, overhead paging, overcrowding and people rushing everywhere, this may heighten their already highly agitated state.

True But Unsubstantiated Reason #3 – If staff members are going to work every day to an environment where they are legitimately concerned for their personal well-being and at risk of physical harm, this anxiety may transfer to the patients and be counterproductive to patients recovery (not to mention difficulties with staff recruitment and retention).

What all of this does mean is that the built environment plays a very active role in the well-being and recovery of the people who come to our facilities to receive help. The building can play a very important part by being a calming influence that helps relax everyone, make them feel like they are respected individuals and are being welcomed into a place that is comfortable and non-threatening.  This applies equally to those that come to be treated as well as those who will be providing the treatment.

In summary: The building cannot treat people, but it can make them worse. 

This reminds me of the famous saying (not originally part of the Hippocratic Oath): first do no harm.

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