Why is healthcare design so painful?
Is the problem in the systems, the doctors, or the patients?
“Just relax.” Those were the words I heard as I sat on the examination table, and the confident, older German doctor exited my exam room. I looked down at my bare foot, confused. Was that it? Was my appointment over? Was “just relax” this physician’s professional recommendation to treat my hurting foot?
Still not sure what was happening, I put my sock, shoe, and jacket back on, exited the room, and went home feeling disappointed and frustrated.
This wasn’t my first doctor’s appointment ever, of course. In fact, in my 30-something years, I’ve had interactions with multiple types of physicians, and healthcare systems, around the world. I’ve lived in Sweden, the U.S., and Germany — three countries with different structures and cultural expectations. The Swedish system is mostly public, the U.S. is mostly private, and Germany is a mix of both. My personal belief is that healthcare is a human right and should be provided to all citizens. However, this is not an article about universal vs. Private healthcare — that’s a whole other story. Rather, it’s a series of questions and reflections on why healthcare design is so painful, no matter where in the world you’re experiencing it.
As a designer, I’m passionate about human-centered design and creation experiences that uplift, empower, and help people. So I can’t help but wonder: when it comes to healthcare, where does it all break down?
Is it the system?
Most people would agree that healthcare systems, no matter where you live, are incredibly complex. The number of stakeholders, the pressure, the money involved, the government regulations…they’re often so tangled and interdependent that many physicians don’t even fully understand the inner workings.
Having experienced three different healthcare systems in my life, I can confidently tell you that none of them seem to favor human-centered design. In the U.S., people who are already in pain are handed more stress and anxiety by having to navigate referrals, bills, copays, and other insurance black holes. In Sweden, you might spend months waiting for an MRI (albeit a free one), all the while knowing that after the MRI, it may be several more months until you’re able to receive surgery or treatment. A similarly broken system most likely played a role in my two-minute interaction with Dr. “Just Relax” in Germany, leaving me staring blankly at my foot as he rushed off to his next patient.
Humans have solved many challenges in our modern world. So why haven’t we figured out a way to implement large-scale human-centered design solutions within any of these systems?
I’ve seen many inspiring experiments in bringing restorative, human-centered design to healthcare. Most recently, I went to an exhibition about “spaces that heal’’ at a local museum here in Munich.
The exhibition Das Kranke(n)haus features 13 international case studies that demonstrate how the use of evidence-based design tools can lead to creating more “healing” hospital environments and architecture, and after visiting, I felt a sense of hope for health care and humanity. I had a similar feeling the first time I watched Mass Design Group founder Michael Murphy’s Ted talk Architecture that’s built to heal.
These are only two examples, of course. And I’m sure there are many more out there. But why are these the exceptions, not the norm? Is it that the health care system is too complex, and everyone who tries to implement these kinds of changes at a mass scale fails because of the size, complexity, and seemingly purposeful confusion of the system? Or is curing patients simply not a sustainable business model…and everyone knows it, except the patients?
Is it the doctors?
My recent interaction with the German foot specialist was frustrating, but not unusual. Like many other physicians, it didn’t seem like he was interested in taking the time to listen to my concerns or understand my situation. At one point, he even mentioned how “his wife overreacted about foot pain once, too,” which both seemed like a very gender-biased comment, and also, wasn’t helpful to me in any way. It was the opposite of empathetic, which is what we all hope for from our physicians. Maybe his medical advice was actually right for my situation. Maybe there was nothing clinically wrong with my foot, and I did just need to rest it. But I, the patient, left the room more frustrated and confused than when I came in. The problem wasn’t so much the advice itself but rather the way he spoke, or rather didn’t speak, to me. I felt like a box on a piece of paper that he needed to check-off in order to move onto the next one, rather than a person who needed to be heard, acknowledged, and cared for.
I recently saw an Instagram reel comparing doctors on TV to doctors in real life. The skit is meant to contrast the lack of engagement and questionable advice we get from our own doctors, to the way fake MDs on TV go above and beyond to help their patients with everything. The clip is unquestionably funny, but also incredibly truthful — which makes the comments even harder to read.
I’ve never worked in the medical field, so I can only imagine what it’s like to be a doctor in our current landscape. You’re asked to be a scientific expert and a walking textbook, while also having great social skills, a sense of humor, and a calming bedside manner. You’re given five minutes to see each patient because insurance carriers are only interested in maximizing their profits — and you have a three-month waiting list for appointments — and any time you’re not spending with patients is dedicated to finishing and filing paperwork. Honestly, it sounds like it might be just as frustrating being a doctor as it is being a patient sometimes.
But where does the responsibility actually lie? And where can the challenges be solved? Is the pressure from the system so great that it genuinely prevents doctors from more thoroughly investigating patient problems, or taking an extra minute to ask how someone is really doing? Or does the issue go back even further in the chain — where medical schools, teaching hospitals, and professional mentors need to be providing doctors with different training, skill sets, and compassion practices in order to interact in a more human-centered way?
Are we, the patients, the problem?
When I go to the doctor, I expect to be met with curiosity and compassion. I expect to be seen by a physician who asks me questions, who pays attention to my answers, and who tries to understand my unique circumstances. I expect to leave…feeling better. But more often than not, I’m disappointed. The advice I receive is often shallow, and the time I get to spend sharing my concerns is typically limited. This is all without taking into account the cold, physical space of most doctors’ offices — it’s hard to “just relax” in a room that doesn’t center care and well-being. With my designer hat on, I am constantly noticing the lack of warmth in many of these environments. Maybe it’s naive, but I believe that healthcare spaces, and experiences, should be designed SO well that even the most vulnerable are seen, treated, and regarded with respect, care, and love.
I often ask myself if these expectations are too high, or too idealistic.. Many of my closest friends would say that I overanalyze many things when it comes to design in the world around me. Writing about it here probably proves them right. And yet… in an industry that touches literally every human being, oftentimes in incredibly vulnerable states, I believe that bringing a critical eye is necessary if we’re ever going to create change.
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This post asks a lot of questions, and I know that the answers are varied and complex. BUT… they are questions that we need to keep bringing up.
Does healthcare have to be this painful? Is there a better way, or should I “just relax”?
Resources:
- Health Design Thinking (book)
- Architecture that’s meant to heal (TED talk)
- Das Kranke(n)haus (exhibit)
