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Why are hospitals so ugly?

I used to believe, quite naively, that hospitals were depressing places simply because no one had noted the connection between environment and recovery. It seemed that white walls, antiseptic scents, and cork boards were somehow required of hospitals – and no one had bothered to imagine anything different.

I thought that the solution was fairly simple – get some creative minds to come in and make recommendations for change. So one day I called the chair of the department of interior design at Parsons School of Design and asked whether she might send her students to my hospital to consider how to improve our situation. She was intrigued with the idea – and we soon had an entire team of bright young designers measuring the floors and windows, considering the limitations of our square footage, and getting to work on some dramatic proposals for exciting change.

Several months later the Parsons students made a presentation to our hospital’s executive team, and this was met with great enthusiasm. We all thought that we were on the verge of an exciting breakthrough for patient wellness. But alas, in the end not a single design suggestion was implemented as our administrators told us that there was no money available for environmental improvements.

I found out much later that our acting CEO was making about ½ million dollars per year in salary at the time. All the while the poor patients had to recover in a grim void of sensory stimulation.

There is ugliness in hospitals – and it runs deeper than the white walls. As with many sectors, money is the deciding factor regarding whether or not something gets done. I think that hospitals should take a hard look at their white walls, and the white linings of their executive pockets and ask themselves whom they were built to serve.

This post originally appeared on Dr. Val’s blog at

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5 Responses to “Why are hospitals so ugly?”

  1. Hashslingingslasher says:

    Wow, Happy Juice…and to think I left hospital adminstration!

    Great write, Val! You should go to Children’s Hospital of Phiadelphia or one of the “for profit” hospitals built in the last 10 years. These hospitals are professionally designed.

    I was a team lead in a joint venture with a for profit chain where we went out of our way to break the very mold you write about. We used lazer printed wood laminate for the floors (so the microbes didn’t permate the wood or carpet and it was easy to clean and disinfect). You would be hard pressed to tell this from a real wood floor.

    We went out of our way to pick fluid resistant fabrics in colors and treatments that let the patient know they weren’t in just any old hospital. We spent a ton on art, window treatments, music. We even went as far as to put seperate heating and cooling controls for each and every patient space (inpatient and outpatient exam room) so the patient could set the comfort level without asking. We encoraged them to play with thermostats so they would feel comfortable. We put in full cable TV…at no extra charge. Before I left, we were putting in wireless Internet access for patient and family use.

    We even went to using sheets for the table vs. the old cold white paper. Each and every exam table could articulate so the patient didn’t have to “hop up”. The tables were heated for patient comfort. I wish that you were writing about the hospital of the past…despite me knowing you’re not. I’ve seen the promise land of how good it really can be.

    As far as salaries go…I think the world would be a better place if everyone is on the same side of the ball…all in a pay for performance model… where the patient is placed in the center of a unified experience aimed at a good outcome. The problem is this…the patient isn’t paying for the care. Hospitals and physicians talk a great deal about quality…but still mostly in the past tense. Quality…all of it…needs to be part of the discussion while care is being delivered. Not after it.


  2. LadyVol says:

    Your words speak volumes.
    When we were in Sorrento, Italy 3 years ago, our hotel room looked out on the back of the local public hospital. EVERY room had a deck (well, maybe a veranda) where patients actually sat in the sun, visited with family, ate lunch. Imagine that….

  3. kaykay says:

    Dr Jones I understand your frustration.The appearance of our hospital will not changed until the board of directors change their attitude. It is this group that accepts or declines a proposal. They each need to be required to spends-a week every year in the hospital, as a qualification for position,”take a walk in my shoes”. I’m sure their attitude would change concerning hospital asthetics. Also equally important is the community and hospital personnel support of monetary expenditures for projects other than increase in services and salary.

  4. ValJonesMD says:

    Thanks, kaykay… priorities in medicine are so backwards. I love your idea of mandatory hospital stays for executives. I’d advocate the same for docs, but they already live there.

  5. Meg says:

    I agree.

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