We Heal Differently

Posted on March 24, 2012

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A few weeks ago at the 2012 PDC Summit, I was sitting in a session which examined if and how private rooms paid for themself versus more economical (from a construction financing standpoint) semi-private rooms. The presentation was pretty thorough and I found the evidence compelling in support of private rooms.

Toward the end, the presenters took questions from the audience. Eventually I asked the presenters whether any of their research compared length of stay of semi-private rooms (which may have outperformed private rooms)? My premise was that semi-private rooms offer at least one benefit over private rooms, a social component, and that might contribute to better outcomes over private rooms in some cases.  I posited in conclusion, “some patients might prefer semi-private rooms.”

A man behind me snickered condescendingly, as if such a notion could be anything but preposterous.

I am not oblivious to market changes; I know nearly every hospital with semi-privates is trying to convert or banish them in favor of all private rooms. I get that. But my point is that maybe this is too much a given. The business case might win out, on average, but there may be value in having a semi-private option available.

The idea is not academic. Americans love their privacy, but we tend to think in a self-centered way:  what I like is what everyone likes (or should like), when it is not.

All-private room design is no fait accompli, nor should it be. There is plenty of anecdotal, if not scientific, evidence to support multi- as well as all-private room facilities. First, other countries do it. Last year a Dutch national told me how his father and his five or seven other ‘ward mates’ in a Netherlands hospital helped each other heal and gain mental strength during their collective hospital stays. They played cards and games together, watched tv, and told stories. This person said friendships were forged and that the group was like a platoon, becoming friends and meeting frequently long after their discharges.

Similarly, when my grandmother was recovering from a hip replacement after a broken hip, she was going crazy in a room by herself. My Gram was a very social person and likely would have given her good hip for a roomie to talk to and share her rehab adventures. It is no stretch to say a semi-private room would have greatly improved her spirits and thus her healing capabilities.

The most obvious support for the belief that we heal differently is research in other fields that has shed light on misconceptions about other human behavior. For instance, a great deal of personality type work has been done in the past thirty or forty years clarifying the importance of matching jobs, mates, neighborhood type, and lifestyles with our personality types. It only makes sense then that our healing ways have some correlation to our personality types. An introvert will likely want a private room but an extrovert might feel better in a semi-private with another extrovert.

Also, we work differently. It is more than corporate culture that supports how our work environments facilitate our work. The foosball tables at the ad firms and napping stations at the tech start-ups are not generational accidents; they reinforce and enhance performance because people work differently and achieve results differently. Why not malleable environments in healthcare?

Perhaps most influential is how individuals learn and think. I love reading books for content and watching how something is done first in order to learn; a good friend of mine would rather jump right in and feel his way through trial and error—technique and theory be damned. The differences in the way people think and process information describes why some people can listen to music while cranking out a white paper, and others need peace and quiet, or why some people like directions written out and others need graphics or they will never arrive. Why not a similar sensitivity in healthcare?

I believe it will take a long time to maximize the healing environment. Clinically in 2012, we recognize a lot, and science is, luckily, standard in the treatment realm for humans. However, there is an emotional and psychological component to treatment that has direct bearing on our physiological well-being. There are more receptive ways to achieve results with some patients than with others, and in 2012, I think we know very little about how to customize, let alone maximize, healthcare for individuals based on their personality and psychological make-up.

This is a major component of care delivery, and one that deserves far more serious scholarship and research than giggles if healthcare is to become as effective as it can be.

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