What Matters to Patients?


The other day I was talking with a friend about the kind of welcome patients get when they enter a medical setting or interact with caregivers ( I am struggling here with language because I don’t want to use the term “providers” and so am going to go for caregivers, to refer to anyone who gives care to patients). How welcoming are the spaces patients enter? How are they greeted by people who are often their first contact with a system – say a receptionist or nurse, or dental hygienist, or well anyone? My friend and I were talking about the arrangement of office space – do you want, for example, some sort of glassed in setting or semi-walled off space where the office staff are perched and where they greet patients from behind a kind of medical office moat? Does space matter? I think it does and it doesn’t.

Yes, having some chest high wall between you and the office staff can suggest distance. But what is much more important is the affect of the staff who greet the patient. Space plays a factor here but I think what is … Continue reading

Where Has All the Time Gone



This blogpost is an excerpt of a chapter I wrote in Collaborative Caring: Stories and Reflections on Teamwork in Health Care. a book I co-edited with David L. Feldman and Michael Leonard.

The other day, I had an amazing experience. I went to see my primary care provider, a physician named Jane Himmelvo, whom I have talked about in an earlier post, to discuss the pesky issue of my elevating blood pressure. As I age, it has gone from lower to higher – like 155/90 sometimes. Problem is, given what I know about healthcare, and a terrible experience I had with a complication following surgery (one that my surgeon tried to blame on me and for which I received no apology, which would have been much appreciated), I have developed white coat hypertension. So whenever anyone takes my blood pressure in a healthcare facility, zoom, it goes way up. Jane and I have been trying to figure out how to get an accurate BP reading and so I have been doing the readings at home.

So I was in Jane’s office to report on the data I had collected. … Continue reading

On Needing More Nurses

staffiingOn May 28, Alexandra R0bbins wrote an Oped for the New York Times entitled “We Need More Nurses.”  Robbins has written a book exploring and promoting the work that nurses do entitled The Nurses: A Year of Secrets, Drama, and Miracles With the Heroes of the Hospital.  Her welcome plea for better/safer nurse staffing comes after a long line of researchers, journalists, and, of course, tens of thousands of nurses have begged local, regional, and national politicians to enact safe staffing laws.  As I have written in my book Safety in Numbers: Nurse-to-Patient Ratios and the Future of Healthcare, every single study of nurse staffing and patient safety documents the fact that more nurses equals safer patients.  That a nurse would be assigned to care for seven to nince patients or 20 who were deemed to have non-life-threatening conditions is — albeit astounding to some — not surprising to those of us who have followed this issue for decades.  Nurses have been begging for help for almost three decades now.  As a recent survey by the Massachusetts Nurses Association once again documents, nurses are terrified by  With the … Continue reading