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What Happens When Noise Gets Normalized in Health Care.
When I was a child, medical offices had old, dog-eared magazines. We read them or brought our own reading material.
I did not visit a doctor for most of my adult life. When I finally returned at the age to receive Medicare, I was shocked at what had changed. The magazines were gone, replaced by large, blaring television sets.
Some offices feature gourmet food channels, so we can watch all the gooey, sugary foods we are not supposed to eat. Others show Fox News, which feels little different from placing political material in the waiting room.
“But it helps people…”
“We think it helps people relax.” That explanation rings hollow when patients are then sent into exam rooms to wait again, this time in a literally sterile and silent environment surrounded by intimidating equipment. Somehow, the same people who supposedly need television to relax manage without it.
Sometimes receptionists say, “We need it for HIPAA.” That justification seems thin. It results in sound that is too low to follow yet loud enough to irritate. It leads to televisions positioned where many patients cannot even see the screen. Anyone who believes television meaningfully protects patient privacy is settling for a cheap and superficial solution.
It gets worse. People who bring companions simply talk over the television. Patients feel about as relaxed as they would in an airport when a technician suddenly appears to check blood pressure. The logic escapes me, and I often refuse, which earns me pointed notes in my patient portal. Then doctors seem surprised when I hesitate to return.
At times, I wonder if there is a grand scheme.
Add the television. Raise blood pressure. Prescribe drugs with serious side effects. Then declare a national crisis of hypertension.
In at least one hospital, Pennsylvania Hospital, rooms have two televisions without headsets, both in inpatient and emergency settings. It is hard to imagine how two people can listen to two different programs in the same space.
Medical staff often do not understand a patient’s wish for silence. Two doctors I know socially shrugged and said, “Can’t you just bring earplugs?”
Ordinary earplugs do not block a noisy television. Effective noise-canceling headphones are expensive, and they block all sound. You lose awareness of your surroundings and may not hear your name called. Receptionists typically respond, “That is your problem.”
They assume TV-watching is as natural as breathing.
Many nurses, technicians, and doctors seem unable to imagine that someone would choose not to watch television. I once spent a night in a blissfully silent recovery room. The nurses kept asking if I wanted the television turned on. They seemed genuinely surprised when I said no.
In one outpatient setting, when I objected to Fox News, I was invited to wait outside in the cold, in an area without seating. An emergency room receptionist at Pennsylvania Hospital told me I was free to leave if I did not like the television.
I once read a comment by a physician who described a patient, a retired professor, asking for the television to be turned off in a treatment area. When the doctor complied, the nurses complained. I believe it. I have seen the same disbelief when silence is preferred.
Another physician wrote online that she had tried to introduce quiet, calming alternatives in her waiting room. As she put it, “the money men” insisted on a television.
What really surprises me
Doctors publish extensive research on stress and blood pressure. They analyze treatment effects across populations. Yet they remain largely oblivious to the impact of an avoidable stressor: the television.
In a rare academic discussion of this issue, David A. Fryburg identifies several stress effects of television. He suggests that nature imagery and “kindness media” can help. He even mentions Oprah as an example, though many people find her programming stressful rather than soothing.
Fryburg also pushes back against replacing entertainment with medical education. Such material, he argues, can be boring or even frightening, triggering anxiety about potential diagnoses.
My own experience supports this. “Educational” content is often poorly produced and irrelevant. At one eye doctor’s office, repeated segments on cataract surgery frustrated me. I had already undergone the procedure, and the material reminded me of questions I wished I had asked earlier.
As Fryburg notes, media can have a rapid and profound impact. News programming can provoke stress, anxiety, and fear. Even neutral content such as home and garden shows can create boredom, which is itself a stressor.
I go to one clinic with no television and clear signs asking patients to take phone calls outside. It is blissfully quiet. The staff are calmer, and so are the patients. The contrast with high-stress specialties like cardiology could not be sharper.
This gap in understanding affects a growing segment of the population. More people live alone than ever before. In my city, nearly one third of housing units are occupied by a single person.
Some people need quiet to recharge. A reader from the UK once told me she was sent to a special waiting room to lower her blood pressure. The room was beautifully designed, but a large television dominated the space. She did not relax and ultimately required medication for the test. The assumption that relaxation equals television had direct consequences for her care.
What is needed
I will never understand why medical settings rely on a one-size-fits-all approach to sound. We now have affordable personal devices with headphones. Television programming is already tailored to narrow audiences. It is unrealistic to expect one show to soothe an entire waiting room.
As more people live alone and shape their own media habits, this issue will only grow. Many have abandoned traditional television altogether. There is no clear evidence that background noise, especially unwanted noise, improves health or lowers blood pressure. As Bella DePaulo has argued, people who thrive in solitude are not abnormal. They want silence.
The greatest resistance likely comes from what one physician called “the money men.” Writing a comment to an article, she wrote that she wanted to replace the television with a simple, comforting alternative. She was overruled.
It is hard not to wonder who benefits from all these screens. Are purchasing departments receiving incentives? Are administrators responding to unseen pressures? Is this another misplaced efficiency imposed from above?
These are questions worth asking.
In the meantime, I would welcome the return of those worn, outdated magazines. They were silent. They assumed patients could read. And they allowed something rare in modern medicine: a moment of calm.c
