Keenan: Healing and hawking in the waiting room

The COVID-19 pandemic taught us a lot about telemedicine and virtual visits with the doctor. Still, there are times when an office visit is necessary. Recently, I had the annoying feeling that an eyelash was poking into my eyeball. I figured it would go away, and when it didn’t, I made an appointment with my eye doctor. I normally see him once a year, mainly for reassurance that my eyes are healthy and to get a renewed prescription for reading glasses.

I got there early and watched some of the videos that were running on the waiting room monitors. One video described my symptoms exactly, from the scratchy feeling of a foreign body in the eye to redness and blurry vision first thing in the morning. The video explained that these could be symptoms of an often underdiagnosed condition called meibomian gland dysfunction (MGD). It then morphed into a lowkey sales pitch for a procedure called BlephEx?, which is an exfoliation treatment for your eyelids and eyelashes.

Convinced that I had MGD and needed BlephEx?, I sat down in front of the eye doctor’s equipment. “You have an eyelash poking into your eyeball,” he said. “Would you like me to pluck it out?” To make me feel better, he did call this condition trichiasis, which means “misdirected eyelash.” So, no MGD, no special procedures or medicated eyedrops, just instant relief as he pulled the thing out and proudly displayed it for me to examine.

In an article called “The waiting room ‘wait’ – From annoyance to opportunity,” Toronto family physician Dr. Heather Sherwin and colleagues argue that time in the waiting room is a golden opportunity for patients to learn about things that might get missed in their brief session with a busy doctor. They suggest that patients could be given questionnaires specific to their conditions and also that videos can be helpful. They write that “patients who watched an educational video on glaucoma and who interacted with a staff nurse while waiting for the doctor were more satisfied with the education they received during their clinical encounters than patients who had routine care.”

An ambitious project called Tonic Direct aimed to raise $4 million in 2014 to put free TVs in the offices of Australian family physicians, showing health information peppered with ads. It was backed by the Australian Broadcasting Corporation’s program host Dr. Norman Swan, who describes himself on Twitter as “Australia’s most trusted doctor.” A report evaluating Tonic Direct claimed that “patients overwhelming(sic) responded positively to the introduction of Tonic Direct” but also noted that most of them had “divided attention as they simultaneously undertake other activities such as check Smartphones and observe activity at the reception desk.” I can report from personal observation in Australian waiting rooms that this service has not taken that country by storm.

So, what’s actually running in Canadian waiting rooms?

Being a men’s health kind of guy, I dropped by the Southern Alberta Institute of Urology at the Rockyview General Hospital and observed that they had sports running on their waiting room TV. The receptionist said that sometimes they play the news instead. CEO Jeff Davison tells me that “we are undertaking a major expansion and renovation,” and it will probably include educational content playing on those screens in the future.

Dr. Joe Vipond, an emergency room physician at Rockyview Hospital, has been very outspoken on issues ranging from climate action to COVID-19 prevention. Asked about waiting room videos, he starts with “what I don’t want to see, which would be anything advertising something targeted at the susceptible patients in the room. Ideally, it would be some great public health messaging, done well.”

The non-video aspects of the waiting room are important, too. Singapore’s Khoo Teck Puat hospital was redesigned in 2010. They gave their design firm, CPG Consultants, a tall order – create a hospital where your blood pressure goes down when you enter the building. The designers took a biophilic design approach, creating a structure with an abundance of natural light and lush gardens with 200 species of plants. The building’s architect, Stephen Kieran, says this biophilic design approach is not only beautiful, but it is also “part of the healing process.”

Maybe those fish tanks weren’t such a bad idea after all!

Dr. Tom Keenan is an award-winning journalist, public speaker, professor in the School of Architecture, Planning and Landscape at the University of Calgary, and author of the best-selling book, Technocreep: The Surrender of Privacy and the Capitalization of Intimacy.