You may not mind long waits for the doctor if this is what the waiting room looks like.

Think: library-coffeehouse.

That reception area could be turned into a place where health information is free-flowing along with a few healthy libations.

None of this exists, yet. But as Obamacare puts a greater emphasis on the primary care physician, design innovation is just waiting to happen.

2013-12-11

The Doctor's Office Of The Future: Coffeeshop, Apple Store, And Fitness Center

As health care reform starts to reshape how we think about wellness, we're going to need new medical spaces that help encourage more healthy behavior. See where the doctor will see you.

As Americans try to figure out what changes the Affordable Care Act will bring to their lives and pocketbooks (and politicians continue wrangling over the rollout), here's one that probably missed everyone's radar: the new experience that could be waiting for people in their primary care doctor's waiting room.

Think: library-coffeehouse. That reception area could be redesigned and turned into a place where elite health information is free-flowing along with a few choice and, of course, healthy libations.

Intelligentsia Coffee, Chicago, IL. Image courtesy Gensler, photographer: Joe Liesky

Or the space might be used to host live, in-person "chat rooms" for people with the same chronic disease or lunch hour "work the kinks out" exercise sessions for office workers with lower back pain.

None of this exists, yet. It's a vision of the future from the architects and designers in the health care sector at Gensler, where we've been thinking holistically about the doctor's office and how it might be used to transform both the patient's experience and the business of doctoring.

We suspect doctors are doing the same—and especially primary care physicians. Once the unsung generalists in a world of increasing specialization, primary care physicians (a.k.a. internists and general practitioners) have been recast by the health care law as the front line in a new war to keep Americans healthy and out of the hospital. We're moving from a health care system that pays providers a fee for service (encouraging volume of services) to one that rewards good outcomes and value. Those (doctors, hospitals, health care systems) that keep patients well and motivate them to stay healthy are the Affordable Care Act's winners.

And there's a special asterisk on those primary care physicians. Winning for them means running lots faster. Doctors will have to see many more patients during the course of a day, given a slew of new cost pressures and increasing competition from retail clinics, drugstores, and even the big box stores, all of which are already chipping away at the general practitioner's profits by turning basic health care services into a consumer good.

Willowbrook MLK Wellness Community, Los Angeles, LA. Image courtesy Gensler.

Put all those facts together and what primary care physicians have is a mandate to reinvent themselves. They must get into the business of managing people's health, not their disease. They have to work at the "top of their license" (face time with patients reserved for services that only a doctor can provide). And they have to figure out how to "see" patients in new and different ways.

To do all that, their physical space has to change. Doctors will need to start thinking like merchants and in terms of squeezing profitability out of every square foot. As architects and designers who view "space" as a tool to solve problems and make life better and more interesting, we reimagined the doctor's office as a cross between a vibrant retail space and serious medical office building. What if:

Doctors' waiting rooms looked and functioned more like coffeehouses

People who may not have anything in common could come together for the experience of partaking health care information. Gone are the rows of chairs and old issues of Golf Digest and Self. Instead, patients hunker down at tables and have easy access (either electronically or via printed materials) to the latest research on cholesterol-lowering medications or on Celiac disease or to home safeguarding techniques that help prevent the elderly from falling, etc.

Doctors' offices were more like an REI or Apple store

People with the same agenda would meet to share information or talk to someone at the (doctor's version of Apple's) "Genius Bar"? Perhaps the office hosts (in-person) "chat rooms" for people who suffer from Crohn's disease or diabetes or obesity and makes a nurse or other clinician available to answer questions and facilitate the discussion.

Doctors' offices were fitness/well-being centers

30-minute "unplug" sessions are held during the lunch hour (or after work or after moms drop the kids off at school) and devoted to stress management techniques, deep breathing exercises, posture improvement, gut redux, etc.—and all of them led by a health care professional other than the doctor.

Doctors had small branch offices

These could be located throughout a metropolitan area or in rural areas so patients didn't have to travel so far. And perhaps, they "see" the doctor via high technology: a video screen and monitors that feed the patient's current health metrics/readings directly to the doctor.

The point is the doctor's office no longer can just sit there as a container for people waiting to be diagnosed. As the new health care law gains traction with its mantra of value, doctors are likely to see the value in their office space and transform it into a dynamic place where patients come not only for a doctor's exam but for access to high-quality health care information and experiences that they can't get anywhere else. That's the value of a primary care physician in America's new health care order.

Horizon Blue Cross Blue Shield of New Jersey, Mount Laurel, NJ. Image courtesy Gensler, photographer: Chris Leonard.

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8 Comments

  • Amanda Rohkohl

    These ideas are well and good, but really? I think "health-care" needs to be re-evaluated. "Diet," "Health," "Wellness." The focus should be teaching people how to better take care of their bodies, but in a cost-effective and realistic way. How much will this actually cost in tax dollars. How will insurance be adjusted to cover "wellness" (which most don't cover as of now!). Where exactly would a location like this be put? L.A., Scottsdale, Seattle and NY? What about Fresno, California or Show Low, Arizona?

  • Ian Pereira

    Interesting article and even more interesting commentary. If we can take healthcare into our own hands, the waiting room of the future, may not be waiting at all.

  • johnnosta

    I found this a bit "lite" and too design driven. In fact, I think it's wrong.

    I'm voting for a much more decentralized medical engagement driven by consumer empowerment, technology and the likes of IBM Watson and TeleMedicine.

  • John Sharp

    What about no waiting rooms? Use technology to stay on schedule, get a text if the doc is running late, check in, walk in. Everything else will be virtual

  • Rebecca Ryan

    This article makes me wince. Dressing up a doctor's waiting room as a Stabucks or REI simply veils the tortuous and time-wasting activity of visiting the doc's office and does little to improve patient outcomes. Doctors that want to be future-ready should skip better furnishings and invest in smart technology like UP bands or FitBits, that give patients real-time feedback on their wellbeing goals. Docs could pool their patients' data together and help them form "teams" so that patients could connect with each other and support each other in reaching their goals. The doctors office of the future may not be an office at all; it will be a relationship between doctor and patient based on goals and outcomes. Smart technology and behavioral science, not coffee and climbing walls, will be the killer apps of the next generation of medicine.

  • monirom

    Ugh. Looks like my original comment went into moderation for having a link.

    Anyways to paraphrase, regardless of amenities, it still comes down to the level of care and the responsiveness of the staff.

  • monirom

    It has to be more than window dressing and my doctors for the last few years have been the folks at One Medical. You can google them. They're just in a few cities right now, SF, NYC and DC.

    What makes them different is SERVICE. So despite the modern surroundings and amenities -- at the core, what matters most is my doctor knows my name, my ailments and he's accessible. Whether via phone, text or email he's accessible. OneMedical also uses technology to its advantage with mobile apps and a web presence that allows you to schedule appointments, reschedule appointments, read up on maladies and request basic functions like prescription refills etc. All at my convenience.

    Just last year, they were able to see me, arrange for all my vaccinations for travel and recommend specialists who could all juggle their schedules to get me the vital care/surgery I needed. (This of course based on the finding and diagnosis of a malady that had been dogging me for years prior to changing doctors.) All this juggling allowed me to have the recovery time needed before I spent a month in the rural parts of South East Asia. When was the last time your doctor did something like that for you?

  • oderb

    My PCP's office recently added three ipads with dedicated seating, and an exercise bike. I love it...Looks like the first image above is of a blue cross office, not a doctor's office...?