The first thing people see is an ugly great barrier

For effective engagement with their quarry, the service provider has to be open. When the first point of contact with that person is a tall desk it sends the wrong message. The reception counter says:

  • You are on that side, we are on this side.
  • We are hiding things from you back here.
  • You are here to ‘get something’ from us, we’re not sure we want you here just now.
  • We are very busy and your needs are one of many things we have to cope with today.

There are many aspects to designing the ‘ideal’ reception counter but first, consider the reason for having one in the first place:

What kind of impression should it make? Should it be warm and inviting, or bold and austere? What kind of reaction do you want to create in the visitor? Is it purely functional or a real ‘statement piece’ aimed at dominating the whole area? Jo Blood

For many practices, it seems that the counter is designed to process a queue much the same as the counter at an airport check-in or a vehicle licensing office. It speaks to what we think of our visitor:

Who will be using it from the visitor side? Will it be treated with respect by all who come into contact with it, or must it be able to withstand some abuse? Maybe a tough, metallic finish plinth would help to prolong the counter’s working life. Jo Blood

When you arrive you must:

  • Check in.
  • Prove that you are entitled to be there ( i.e. you have an appointment)
  • Prove that you can pay or that someone will pay or make a payment.
  • State your business clearly and briefly.

The counter hides PCs, printers, fax machines, security equipment. It’s there to keep people from abusing staff and to keep people out. To complete the ‘look’ the walls may be covered in mismatching posters and the counter stocked with leaflets dispenser full to the brim. Who reads this stuff? There is limited evidence that such communication has any impact. There are suggestions from the retail industry that less is more.

As for the counter, it is generally as tall as it can be.

An able-bodied visitor with a typical minimum height of 1540mm approaching a raised counter tall enough to hide a large monitor on a desktop height of 740mm, would clearly struggle to make eye contact with a seated receptionist. As a rough guide, a counter height of over 1200mm will create a potential ‘blind spot’ resulting in the visitor remaining almost unseen and making the counter simply too high to be practical for signing in.

But what if the reception counter were removed altogether? It’s not unthinkable if hotel chains are beginning to consider it:

Two bloggers walk into a hotel …No, that’s not the opening line to a joke. We’re talking about two travelers who picked the same hotel chain — Andaz, a boutique Hyatt property. One stayed at a Los Angeles Andaz, the other at a New York City Andaz. Neither lobby contained a front desk — a budding hospitality-industry trend that’s equal parts chic and shrewd. Bill Briggs

But of course, doctors clinics are not hotels or airport terminals. But that’s not to say that clinics should not be welcoming, comfortable and inspiring places to be. This issue received some attention in the medical literature last year- with the authors of the paper were cited as concluding:

96 percent of patient complaints are related to customer service, while only 4 percent are about the quality of clinical care or misdiagnoses. Kelly Gooch

There are umpteen ‘reasons’ why it is so. Primarily the process of dealing with payments. However such administrative tasks are also a part of many other industries and they are striving for better solutions rather than risk their customers take their business elsewhere.

The critique of the paper quoted above included an insightful comment from a ‘front of house’ staff member:

Our role has developed from “just scheduling staff” to a more complex, and crucial, role for any healthcare organization. We are the start and end of every patient visit and also the start of the revenue cycle. In order for “customer service” to improve, an organization first recognize the importance of their Patient Access department and understand that their processes are directly related to the culture of the organization. Kelly Gooch

Is it possible that people who perceive that their visits are welcomed are more likely to take the advice on offer? Isn’t that what healthcare is about? We have had evidence for this for decades. This quote from the literature says it all:

…the feeling in the practice when you arrive, busy…exhausted receptionists, people fed up, waiting , a feeling of delapidation and stress…You can hear people being put off on the phone and you can hear ‘no no I can’t put you through to the doctor now’, ‘no no you’ll have to call back’ and that makes you feel worse because you don’t want to call back at an inappropriate time. Gavin  J Andrews

The reception area engenders the circumstances in which the outcomes of care are compromised. There is a better way and at least one Australian practice has redesigned the experience.

Picture by Barnacles budget accommodation

3 thoughts on “The first thing people see is an ugly great barrier”

  1. I guess I’m not for NO barrier. I think general practice teams want to feel safe when taking care of people who are fragile and unpredictable. Not all barriers are desks or imposing. Let’s think about the transactional elements, I’m expecting to ‘arrive’ electronically soon.

    1. I think some Banks do it better than anyone else. To me they have taken the “Concierge” model from hospitality and somewhat ignored the reception desk that is commonly paired with it. A person, not a desk greets you and then streams you to the appropriate area. I can see this being adopted for larger general practice. It would free up what is almost always valuable space as you do not need to corral all staff behind a large reception barrier, counter and area.
      I too think we will arrive electronically as I would happily do. I think the “ipad armed” concierge idea would catch those less inclined to pre book electronically etc . This would make the front end of the doctors visit a non counter one. The counter then covers the transactional items at the back end. At this stage I can’t see those elements not happening without a person’s assistance.

Leave a Reply

Your email address will not be published. Required fields are marked *