Let's stop the architectural imprisonment of doctors
Dr Benjamin Rusholme
I have noticed a worrying new trend emerging. Across the country new, larger health centres are being built, ones that supposedly better meet patients’ needs while isolating their doctors.
The design of your surgery defines the physical limitations on how you work. New builds frequently wrap the consulting rooms around the waiting room, giving more immediacy to your waiting patients while removing a layer of discretion.
How now am I to ask a colleague to take a look, or go for a short break without a weary row staring at me? Every thought of a second opinion or a cup of tea now paused to consider what the waiting room might infer from this action.
It seems the new designs have been put together around the patient’s journey in and out of the building with little regard to how services will be delivered. I think the future of primary care deserves better, with designs that encourage team working and keep up morale with a more pleasant environment.
I advocate for including a space beyond the consulting rooms – the traditional back office placed behind them and transformed by immediate access to each consulting room, a space that frees the doctors from their rooms to discuss cases and explore more flexible working.
Here the consultation rooms would not wrap around the waiting room or back office, but occupy the interface between them. It seems apt that where we meet with patients should sit between these two spaces, symbolic that we work as a practice team and not alone in isolated offices.
With the increasing use of nurse practitioners this set-up would enable a GP to supervise several consultation rooms at once. Also, access to rest areas and back office services may improve efficiency – in my experience it’s often at the kitchen table that practices make their most important decisions.
With greater physician engagement in new plans, I believe we could design clinics adaptable to future healthcare and put our mark on the places to which we want to recruit the next generation of GPs. I hope you will join me in doing so.
Dr Benjamin Rusholme is a GP ST1 in Winchester