Dentist: “Bob, could you let out a blood curdling scream when I start drilling?”

Patient: “But why? It never hurts that much.”

Dentist: “The waiting room is so full that I’m afraid I’m going to miss the championship game this afternoon.”


The office environment is a reflection of the health-care provider much in the same manner as is dress and personal grooming. Since bedside manner is the perception patients have regarding your expertise, personality and very being, you can’t ignore your environment. Office design is vital to the patient experience. As a general rule, make sure your surroundings won’t offend anyone. While you may never please all of the people all of the time, try not to offend any of the people most of the time. Physical plant design techniques that enhance your image are often so subtle your patients may not notice, but they work.

The Private Entrance

If you are the type of practitioner who can’t get to the office on time, or if you have emergencies that require you to arrive late, a private entrance is essential. Nothing seems more inconsiderate than a doctor’s tardy entry met by a waiting room full of patients.

Treatment Room Privacy

Do whatever you can to keep your office a private enclave. You should isolate patients from each other. You don’t want patient A to hear your conversations with patient B. The last thing you want a patient to hear is another patient in pain. Separate patients as much as possible, by utilizing three treatment rooms. The middle room is used for simple procedures. The two end rooms are used for actual treatment. This way, approximately fifteen feet and two walls of insulation separate patients undergoing involved treatment. They are unlikely to hear confidential information about the other patient (HIPAA regulations), noise that may frighten them, complaints or financial discussions.


Patients like to go to the doctor with the best bedside manner and the best facility. No matter how kind and personable you may be, if there is another practitioner who is just as nice they will pick the one with the latest technological innovations. Patients want the latest and the greatest care from that great doctor. Never cut corners to save money when it comes to your equipment. Be willing to invest in new technologies and learn to master them. Use the best quality materials. There is usually a reason certain items cost more, and in the end, you save money and aggravation by avoiding failing parts and equipment that need to be replaced too often. When that failing part is an implant or device placed in the patient, the consequences of not using the best can be demonstrable.

Some very mediocre doctors have all the modern equipment, and their patients are duly impressed. While the equipment doesn’t make the doctor, it certainly helps the image. Don’t fool yourself into thinking you never have to embrace new technologies or the level of care you provide will not be at the highest level possible.

 Placement of the treatment table or chair should always be facing the entrance of the room. Many design consultants want the patient facing the window when there’s a nice view. This positioning puts the patient in a vulnerable state-of-mind. The patient should always see you enter so that you don’t startle them, and they should always see the exit. On a subliminal level, the apprehensive patient doesn’t want to feel trapped or enclosed.

The Accessible Doctor

Make sure you have phones in each treatment room so you can take calls if necessary. When a patient sees you answer a call to speak with another doctor or patient, they see that you are accessible, but never take personal calls in front of the patient. Excuse yourself if you must, and make it look like you have to take a call for professional reasons.

Make sure your staff has nonverbal or cryptic ways to communicate who is on the other line. “Your stockbroker needs to speak with you” is not an announcement that should be made for the patient to hear. Speaking to your stockbroker in front of patients is offensive. Taking personal calls from your spouse or children in front of the patient is another taboo, especially when the patients wait inordinate amounts of time to see you. They want your attention.

After-hours accessibility is a must in most practices. Either a highly efficient answering service or a good answering machine that calls your cell phone helps a patient reach you when in distress. Occasionally test your system to make sure it works.

A patient wanted to make an appointment with psychologist: “I called six offices. None of the offices answered the phone. One had an answering service that put me on hold for a too many minutes with static-filled music of an unprofessional genre. When the woman got back to me, she had to look up on a list to see if this was Dr. Smith’s office. She had no idea of his hours, his fees or where he was located. Can an answering service be any more impersonal? The answering machine offices were not much better. While I could leave my number for a call back, one machine noted that ‘you must speak loud or the device will hang up on you. Sorry for the inconvenience.’ Maybe that doctor should consider buying a machine that works! The others offered that I leave my name with no mention of hours, location, or anything about when I could expect a return call. They did all caution that if I was having an emergency I should go to the emergency room. I suppose that is to protect them when it takes days to return their calls.”


Many types of health-care providers, like the psychologists in the above examples, don’t have traditional offices or secretaries. The home office is often the venue and taking calls is not offered when they are not in or when they are seeing patients. It may be best to consider a full service answering service that has the ability to make appointments and provide any information that new or existing patients require. The first contact most new patients have before seeing you is whoever answers your phone. Make sure it is a pleasant experience or you may never see many patients.

The Distracted Patient

Some doctors like to keep the patient busy with headphone music because they want to do their work unimpeded by conversation. Some doctors have nothing to say and love to give the patient something to do to mask their lack of personality.

If you have the patient who asks to use headphones, let them. They need the distraction of the music more than they want to hear your witty monologue. If you have nothing to say, or if you make disturbing noises, like drilling, encourage the use of headphones. In either case, make sure the patients know that you are there for them, and if they need anything they should let you know. That thought is comforting.


Office décor should be tasteful and play to your patient base. Conservative choices are less likely to offend even if they may not be your personal taste. Avoiding excesses and extremes while employing good taste in decorating will most likely please just about everyone.

Utilizing rich furnishings and decorative accessories makes some patients feel that the provider overcharges them and they are paying for all the amenities. Some practitioners actually think the more costly the office looks the better their reputation. Utilizing a balanced approach to decorating will result in a happy medium that expresses good taste, success, and comfort while avoiding pretensions.

• Jennifer Schlesinger (2020/05/18 15:06)
Having an office look nice and modern will make pts comfortable and feel like they are in a place that provides good care. We all appreciate a clean and nice looking office/business. The answering service sounds interesting. I\\\'d be interested in discussing further during our webinars. What service are available and how to give another service access to your scheduling. Being put on hold is the worst and it happens so often to all of us.
• Shane Curtis (2020/05/17 19:09)
The positioning of the dental chair towards the entrance is a new idea for me, but it makes sense. In my clinic, the chairs are directed towards the wall and my section has very little space on both sides of the chair. I make an active effort to move into the patients\\\' vision before I start talking, but I still have had patients appear to jump or comment that they were surprised when I appear. Re-directing the chair towards the entrance could certainly alleviate this situation. However, I imagine the typical operatory layout would have to be adjusted so that patients are not staring at the hallway as patients are being brought in and out of the neighboring rooms. Being able to wave to every incoming/outgoing patient may create additional privacy concerns.
• Jane Shin (2020/05/17 12:19)
These are all good points to keep in mind for those setting up their own practice, and also for those deciding on what kind of practice they would like to join. A note about keeping the patient distracted: I once worked at an office with Netflix for patients in each room. Patients loved this, but some would take an unreasonable amount of time choosing something to watch, and at times we would run into difficulties connecting the headphones, adjusting the volume, or keeping the patient\'s head positioned correctly as they tried to watch the screen. Just as you wrote in this post, moderation is key. Having a patient bring their own headphones to listen to something on their phone should suffice. It is important to keep your office equipment up-to-date, but there is no need to install the best entertainment system. This is a medical facility, not a movie theater.
• Andrew Vo (2020/05/17 11:59)
This is a fantastic post that gets me thinking about setting up the ergonomics of an office to match the personality of the provider. Things like the private entrance and use of headphones are specific strategies to maintain a positive patient experience while not forcing providers to drastically change their habits. About having code words for personal phone calls. This was a major source of frustrations in offices I have worked. The staff spoke coarsely and bluntly that was off putting to many patients. It reinforces the importance of having scripts and purposefully creating the environment you want your patients to experience.

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