The Doctor’s Office

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The doctor’s office is a stark, concrete room with a single desk framed under large windows and a tall vaulted ceiling.  Two chairs sit on a carpet in front of the desk for patients.  A couple pieces of art and personal photos line the room, but they are overwhelmed by the industrial-ness of the rest of the space.

When the doctor enters, he carries a large folder with the patient’s health information and background on paper.  He then talks with the patient directly, without help from notes or his patient’s folder.

There is no visible computer in the room.

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While not a traditional interface, this office is interesting because it lacks any traditional interactive features of a futuristic doctor’s office; things like holograms, giant computer screen walls, and robots are completely absent.

It is also the patient’s interface to the medical industry and its news for her. And it can use some improvement.

Authority Figure

In this situation, the Doctor is acting as an authority figure to tell Laura what her diagnosis is and how likely she is to recover.  The office is setup to put all the focus on the doctor, and his method of entry adds to the power focused on him.

Even the lack of computer indicates that the doctor is alone in the final call of what the diagnosis is.  There is no intermediary between caregiver and patient.

This sets up a psychological condition where the patient is not in a position to question the doctor’s advice or diagnosis.  The doctor tells the patient what they have, and the patient has to deal with it.

Medical Goals

Here, the doctor’s goal should be to help the patient through the situation and give them the best chance possible to recover.  Generally, this means making sure:

  • The patient understands their situation
  • Knows what their options are
  • and follows through on the best plan of treatment.

From the transcript:

(In a large room, looking up through a glass ceiling. Ships are flying past overhead. Camera pans down to Laura Roslin, sitting in a chair in front of a desk. She’s looking out the window, and jumps at the sound of the door. A doctor in a white coat walks in.)

Doctor: I’m afraid the tests are positive. The mass is malignant. It’s advanced well beyond our…

(Noises drown him out [Laura no longer paying attention]—we see a ship taking off and then moving through space.)

As we are shown by Laura’s reaction to the doctor’s first words, she completely fails to understand the second two points.  The doctor’s emphasis on power has scared Laura so badly that she can only focus on the fact that she has cancer.  She leaves without being confident in her plan of care or her chances of survival.

That means that she is unlikely to follow through on the plan of care (which is exactly what we see later on), and she is unlikely to continue trusting that doctor (which we don’t see, only because the doctor’s office is violently removed from the planet along with pretty much everything else shortly after the visit).

Help the Patient

Research is now showing (a white-paper by Samira Pasha in 2013 (http://www.ncbi.nlm.nih.gov/pubmed/24089182) does a good job of collecting previous research and showing the importance of good design in the garden) that patients do better when surrounded by greenspace and people who are willing to talk to them in ways they can understand.  Doctors who explain a patient’s options well are shown to improve the rates at which patients follow through on their treatments.

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Ulfelder Healing Garden, Massachusetts General Hospital, Boston, MA.  Photo by Naomi Sachs

Immediate improvements could include the following:

  • Add plants and trees
  • Take more care with the patient’s state of mind
  • Lower the ceiling to create more personal space
  • Refrain from invoking authoritarian criticism

Adding in more plants and trees to the office would have an immediate benefit for both the patient (Laura) and the doctor.  Explaining the options more confidently and with a greater care towards the patient’s emotional state would give Laura a better chance to actually take the doctor’s advice.
Additionally, that giant binder of Laura’s medical history is impossible for a reasonable patient to read through and understand.  A basic overview and history could remind Laura of the procedures she’s been through and the encounters she’s had with various doctors.  This could be followed by a summary sheet with the doctor’s recommendations and links to relevant treatment information.

Don’t Intimidate

A doctor’s job should not be to intimidate their patient with the doctor’s skill and experience.  Instead, they should be focused on helping their patient through a very tough time in their life.  Various tools can help both the patient and doctor in this situation.  By restructuring the office to be more inviting and creating effective summaries of patient encounters, both the patient and doctor can create positive outcomes for the patient’s health.

4 thoughts on “The Doctor’s Office

  1. Greenery and plants are nice, but they’re also expensive in requiring space, maintenance, ventilation and drainage. Has anyone tested if artificial plants, or for Galactica levels of technology wall screen or hologram images, would work?

    • I’m pretty sure that it’s in the article I linked, but they’ve shown that sufficiently complex imagery can provide some benefit but not too the same level as live plants.

      If I had to guess, the depth and visual levels provided by all the leaves is calming.

    • Agreed: it definitely takes cues from medicine during the 50s and 60s. I wish we had more insight into how the physician arrived at his decisions, and other patients that had gone through the process.

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