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medical waiting rooms

Image by R O from Unsplash.

For the life of me, I can’t understand why doctors and dentists have added television sets to their waiting rooms. It’s become a popular practice. When I ask people casually, everyone I know says, “It’s horrible. Who wants to watch daytime television anytime, let alone as a captive?”

I know people who refuse to wait in a room with a blaring television. I complain to the receptionist, who invariably points to the one person who’s watching. It’s not clear why the presence of a few watchers should justify annoying the majority. Receptionists and office managers hold firm. They absolutely refuse to turn the **#*#&@!!! thing off.

I respond by refusing to allow them to take my blood pressure. I’m annoyed not just by the intrusive noise, but also because it adds insult to injury. Why risk a hypertension misdiagnosis due to an avoidable nuisance that’s deliberately created by the facility?

But as I think about this…I’m wondering why. Why is it so important to keep the television going? Television isn’t particularly healthy for our brains. If medical staff really cared about patients, wouldn’t they hire a consultant to reduce waiting times?

One clue comes when you google, “television in medical waiting rooms.”  Thousands of companies are after this potentially lucrative market. So I’m wondering…do they give rewards to the purchasing department? After all, articles have suggested doctors receive rewards for prescribing drugs, e.g., this one from ProPublica. 

Television does more harm than simple noise.

The noise itself can be annoying; television sounds have a unique quality that can be annoying if you’re trying to do something else. In a big waiting room, you may not hear your name called if the TV keeps blaring some soap opera.

In a largeish waiting room, the noise level must be turned up high so anyone seated in the back can hear it. Meanwhile, if you try to distance yourself from others (as big signs advise you to do), you might have trouble seeing the television set comfortably. You get all the noise and none of the benefits.

In a small room, you can’t escape. You can’t read. You can’t hear your own device through earphones (even if you’re allowed to use those devices, you risk missing your call if you use earphones or earplugs).

But that’s not the worst part of television.

Most people would say the worst part of dealing with doctors (and their nurses, techs, receptionists, and surgery coordinators) is being disrespected.

Many medical professionals show a complete disregard for their patients’ time and intelligence.  They don’t tell you they’re running late, let alone offer you the opportunity to leave and come back. They don’t hesitate to recommend tests that have little value.  Read Gilbert Welch’s book, Less Medicine More Health.

To take another example, many pre-op tests are required because “everybody does it.” For instance, the USPSTF specifically recommends against EKG screening for asymptomatic, low-risk patients, yet EKGs often are required before surgery – even surgery will be low-risk with a local anesthetic. Doctors won’t tell you that EKGs come with an 77-82% false positive rate.

Extra time wasted in a cardiologist’s office? Extra pain and possibly adverse reactions to tests due to false positives? Not their problem.

And now they decide how you should spend your waiting time. A loud television totally removes any opportunity to use your wait time to be productive. You can’t create an enjoyable experience by reading your own book, using your own electronic devices, or trying a relaxation technique like meditation.

Complaints usually lead to a rude, dismissive response. This article in the Washington Post represents the kind of experiences I’ve encountered,

And it’s not clear why anyone would want to jump into a program and get called before they see the ending. Wouldn’t that increase stress, even among people who like television?

Forcing us to watch television extends well-recognized medical discrimination against women, single people, “older” people, specific ethnic groups, and basically anyone who isn’t a 35-year-old white heterosexual married male who’s programmed to follow directions and see anyone medical (even the techs) as an authority.

The choice of content won’t just fail to please everyone. It creates a great deal of stress among a significant percentage of patients.

Today’s programs are based on narrowcasting. With vast choices of channels, programs are designed for very narrow segments of the market. The odds are, at least 50% of your patients will hate whatever you show…and it could be as high as 90%.

I once visited a primary care doctor whose office TV featured the Food Channel. While he counseled his patients to eat seafood and salad, the screens showed mouth-watering images of pies and cakes. What’s the point?

Some offices show “educational material.”  You’re forced to watch commercials for procedures you’ve already had and won’t have again (such as certain types of eye surgery). You might not be a candidate for the products and services they sell (and yes, they’re aggressively selling). You might already know the material well and you get irritated with inaccurate information, presented in a style more appropriate to third-graders than to educated adults.

Long wait? These programs run on a loop and you’re forced to endure them over and over again. It’s the same principle water torture in a POW camp.

Many offices choose news stations.  Now you’ve got the battle between Fox News and CNN. After being forced to listen to Fox News, a columnist in the Tampa Bay Times wrote

I believe that if a medical office wants to make its waiting room into a satellite headquarters for a particular political party or candidate, it should offer brochures, lapel buttons, and bumper stickers that don’t make a sound. That way, people can either pick up the campaign material or ignore it…

But to subject patients who are often already nervous about an upcoming diagnosis or procedure to a braying voice that only increases stress is cruel and unusual punishment and has no place in a facility that is supposed to be for healing. [Emphasis added.]

Even worse, an anonymous author in the Health Care Design blog found herself listening to a news report about dangerously unsafe conditions in hospitals! She points out that television in waiting rooms can be “a gamble,” as certain programs effectively increase stress.

Why do we need television at all? 

Richard C. Senelick is a neurologist and author. Writing in Huffington Post, he was horrified to find television sets in the waiting room of his own clinic:

But who decided that we would be better off watching a television? Did the transformation of the television from a large, clunky box to a shiny, sleek, attractive flat screen promote its invasion into our quiet zones?…I can’t find a single study that shows any legitimate health benefit to support their presence in a doctor’s office, but I can think of 100 reasons to take them out.”

Anecdotal evidence shows the controversy. In one forum, the original question was posed by someone who worked for a group of allergists. One patient complained about the television. With typical medical arrogance, the doctor’s office felt they should ignore her.

The responses were pretty consistent. A few people said they liked to have a television for long waits but nobody spoke enthusiastically about the televisions. Nobody said they’d go out of their way to choose a practice with a television set…but several people said they’d change doctors to avoid a television experience.

One response in that forum made the point clearly: :

I would not go to a doctor’s office that had a tv on in the waiting room, with or without sound. I am more than capable of entertaining myself while waiting. I think having a tv in the waiting room, especially when someone else chooses what I and the rest of the people waiting have to watch, is insulting. So far I’ve been able to find doctor’s offices that don’t stoop to having tvs in the waiting rooms.

My favorite comment was from someone who appears to be a medical professional, as he or she refers to “our practice:”

I despise TVs in waiting rooms. We intentionally avoided them when we opened our practice. I know it’s modern medicine, but needing TVs is a symptom of bigger things that make patients wait far too long. No one wants to address the elephant in the room, but people wait too long when we see too many patients.

I haven’t seen any studies of television in waiting rooms. However, a British study of HIV patients found that people want to use their time constructively. When people expected to wait, they brought laptops, iPads, and reading materials. This study was qualitative so we couldn’t get percentages of who preferred one intervention or another.

As I say in my book, if you complain,  you have to be willing to be seen as uppity, difficult, or worse. But it’s the only way to make change happen.

Beyond complaining, let’s ask why they’re so adamant to have those televisions in the waiting room. Is someone getting kickbacks from the companies? I haven’t seen the slightest evidence that this happens…but frankly I can’t think of another reason why televisions are so ubiquitous, let alone why receptionists are trained to be so aggressive about protecting them.

If more people would speak up, we would see a change. Let them know. Receptionists refuse to help? Ask for the name of the hospital president and send an email. (It’s usually easy to google them.) Post strong negative reviews on social media.

And if you switch doctors because of the waiting room, make sure they know why. If you work for a medical service and you have answers, please post them below. Frankly, given the many arguments against television, I can only imagine a bizarre reason for keeping them on.