Medical Malls

doctorMedical Malls can provide better healthcare. Take a few minutes to read these ideas, and let me know in the comments below whether or not you agree. This is the first in a series of articles detailing how I believe the healthcare system can and should be improved.

Medical settings must be transformed in order to best serve those who need them

  1. House calls should be routine for basic services, a team of doctor or PA and nurse or MA should have a regular schedule of home visits. These home visits can assess more than health itself, including the (living) conditions which affect the patient’s health. In my opinion, it is also essential that all interactions between doctor and patient be recorded – if not on video, then at least audio. A copy of this recording should be immediately available to the patient and kept in a well-organized archive where medical staff can routinely review and ascertain that nothing was missed in passing. (People often do not listen thoroughly, this goes for patients and medical staff alike.)
  1. Visiting Facilities: Sending patients to varied locations which may be far from home is time-consuming, inefficient and a waste of fossil fuels – which generates unnecessary pollution. In addition to this, patients who are unwell may have more difficulty attending such appointments, especially when transportation is either unavailable or unreliable.
  2. All in one convenient place: Patients will be better served in a mall-style setting, in which all of the doctors they need to see are under one roof, and appointments can be coordinated to occur on the same day. This facility should also include a lab and pharmacy as well as any and all diagnostic equipment that any of the participating doctors may need for the patient to utilize, as well as a canteen (café) for the use of both patients and medical staff.
  3. Restrooms, including a shower, would be fantastic (with a handheld wand and large enough for a wheelchair & attendant) for homeless patients or those who soil themselves while awaiting their appointment or transportation home. Ideally, multiple showers (minimum of three) in different locations throughout the facility would be best. One with access from the outside in case of accidents during transport as well as one near the canteen… and a third full-service bathroom placed elsewhere so that the three represent a triangle within the building and none of them is ever far.
  4. For the dignity of all, it might also be a good idea to maintain a closet of donated clothing and other things (socks, menstrual products, etc.) commonly needed by homeless and wheelchair-bound patients – and a private room in which to dress, also large enough for a wheelchair and attendant if need be.
  5. Transportation for patients should be accomplished largely through an app, more like Uber and Lyft does it, with their POOL and Shared Ride aspects of the application: BUT in vehicles equipped for wheelchair transport. This is much more efficient and can alleviate the long waits many patients currently experience: Long waits can erode self-worth and damage mental stability, especially if there is no comfortable waiting area.
  6. Comfort, which reduces anxiety. If the above recommendations are followed, waiting areas for transport can be connected to the canteen, offering wifi and even a few computer terminals for those who can’t afford one to use at home, as well as TV monitors with various programming ranging from informative to entertaining. This area can be separate from the waiting room(s) for seeing a doctor – and those can be segregated into “sick” and “well”** waiting rooms so that cross-contamination is minimized.In a “mall” type setting, “well” patients could choose the option to receive a text on their cell phone when the doctor is ready to see them, so they could wander around, view the art* and get a little physical therapy and/or just exercise in a climate-controlled environment. **sick patients could have their own outer access to the building and window to the pharmacy, and precautions should be taken when taking them for diagnostic testing. Let’s face it, when we’re sick, we don’t WANT to wander around much, we are more likely to just sit still and hope we’ll get the help we need to get better soon.

Other ideas to improve the aesthetic of healthcare facilities

  1. Art: In many facilities, art adorns the walls. Yet I have noticed that it is largely corporate-bought “art mill” work that does not support the community. Instead, I propose that the walls of the “medical malls” I’m suggesting should be covered with *the works of local artists as well as information on their work including website URL etc. and also announcements of upcoming exhibits elsewhere. Sculptures, strategically located throughout the building, could allow blind patients to enjoy art as well – and could have sanitary wipes nearby for hygiene after touching the pieces. Local musicians may also be interested in performing at such a facility.
  2. Nature: Outdoor (or greenhouse-enclosed) gardens attached to the facility, whether they surround it or exist within a protected courtyard, offer more oxygen-rich air as well as enhancing the beauty of the experience. However, these should be kept separate in such a way that those with uncontrolled allergies won’t be affected when they first come to be treated. (New patients should not have to walk through allergens in order to see a doctor)
  3. SMOKING: People are going to smoke. Giving them a place to do it where they won’t choke others is ideal. Right outside the door of a given facility is the WORST place for smokers to light up. In my opinion, smoking areas should be on rooftops, with a shelter up there to protect them from the weather, and strong exhaust fans sucking the polluted air into filters before releasing it into the atmosphere. Signage everywhere should direct smokers to this area, and it should be accessible via elevator as well as stairwells.
  4. Safety/security: All areas should be routinely patrolled by security personnel, as well as monitored with cameras from a central security location. This will help to prevent assaults, vandalism and other petty crimes as well as to assist patients if need be. Ensuring that smokers do not light up outside of the designated and filtered area would be one of their primary functions.

 Travel-related improvements

Insurance as it currently exists is primarily “state bound” and therefore not really portable across state lines. For the majority of people, who live in a fixed domicile, this is not a problem.

However, a growing number of individuals choose to travel by various means and live on the road. While they are en route one of their biggest issues is the continuity of medical care for both physical and mental conditions. Obtaining medications can be difficult, particularly for those drugs which require additional doctor’s visits in order to monitor effects and adjust dosages.

This is the 21st Century. There is no reason why our medical system should still be stuck in the past, and so ineffectual.

Patients need to be able to use Facetime or Skype for psychological doctor “visits” and for those which require further scrutiny such as blood tests etc. it should be a simple matter for them to stop by a medical facility, receive the test, and obtain a prescription renewal. If the test takes a few days for results to be ready, and the patient is no longer local, it should not be a problem for them to fill it wherever they happen to be when the test results have been received and a/the doctor knows whether dosage should be adjusted.

Thank you for reading my ideas, and please comment below – especially if you have some more great ideas to add!