First Impressions: What Your Clinic Exam Room Says to Your Patients

Sitting in my exam room with my patient, he asked me a question I get all the time now: “So, I’m guessing you’re from Texas?” 

I get asked that question more than almost any other question during my days in North Carolina-based clinic.  It’s not because I have particularly strong Texas accent, it’s because of the décor in my clinic exam room. 

When I was a GI fellow, I remember sitting in my clinic room one day and suddenly realized how depressing the décor was in the exam room.  There was a 10 year old notice on what to do in case of a bomb threat.  There were holes in the walls from prior physicians hanging diplomas and awards.  The room itself was painted a weird off-white color.  It was just sad. 

I got to work immediately to change all this. 

I put in a work request to have the holes patched and the room painted.  Then, I took down all the old posters, removed all the desk clutter, and brought in a new file organizing system.  Most importantly, I brought in some new décor pieces to hang on the wall. 

My goal was to bring a little taste of home to my clinic room.  Being from Texas, everything was naturally Texas-themed, with a cowboy rug, a stained glass picture of bluebonnets and cowboy boots, and a large colorful sign reading, “Howdy, y’all.”  I even brought in a fake cactus for some greenery. 

Did it really make a difference?

I was amazed at the outpouring of positive comments I got from patients.  At least 50% of the patients I saw would make some sort of comment about the décor or ask if I was from Texas.  It made for a really fun conversation starter, not least because I genuinely enjoy talking about my home state.  It even became common for other physicians to use my clinic room to see patients when I wasn’t using it, so they could have a nicer place to work.  Occasionally I would see those patients in a procedure or in a subsequent clinic visit, and they would ask, “Are you the doctor from Texas?” 

The other side benefit was that it offered an immediate opening to establish the physician-patient relationship.  Patients could see me as a person, not just a physician, and they would immediately open up to me.  Some of the questions I would get were actually pretty hilarious. 

• “Do you live on a ranch?” 
• “Why don’t you have an accent?” 
• “Do you have cowboy boots?” 

Ever since fellowship, one of the first things I do at each new job is to establish a specific exam room that I can set up with my décor, get the walls patched and painted, and put up the decorations.  It has been an invaluable tool in my clinical practice. 

My original goal was to just create a more pleasant work space, but I inadvertently solved a major problem I didn’t know I had:

Patients don’t like being in a doctor’s office. 

Think about the last time you went to a doctor.  The room probably had linoleum floors, brochures sponsored by the pharmaceutical industry, medical equipment galore, and uncomfortable chairs.  That’s the case for the majority of exam rooms I’ve visited. 

Having a well-decorated room provides a more relaxing, welcoming environment for my patients, putting them more quickly at ease and helping them forget for a minute about their health troubles.  Having a well-decorated room also implies a sense of intentionality.  Patients see that everything I do has purpose and meaning, which helps build more trust and boost their confidence in my medical opinions. 

If you want to leverage your clinic exam room as a part of your clinical practice , here are 10 things to consider as you decide how to decorate the room and what to put in it.

1. Clean out the clutter and throw away anything outdated.

You probably need to get rid of 90% of the items in the room, including in the drawers and cabinets. You no doubt have old, faded brochures that relate to clinical complaints of your patients. How often do you really use those? If the answer isn’t “all the time,” then get rid of them.

2. Patch and paint.

This is especially important if you work in an older building. Your paint may be faded, or you may have 20 year old wallpaper. Get rid of it! Spruce it up. Choose a simple color, like a soft white or light tan. Use your décor pieces to bring in color. Don’t paint the whole room bright green. It’s too much.

Also, make sure any hole in the walls or broken floor pieces get repaired or replaced. If there is missing or damaged hardware on your cabinets, replace them. Nothing undermines confidence faster than lack of attention to detail. Patients will think, “If he can’t fix his cabinets, how will he fix me?” Project confidence by taking pride in your room.

3. Where is your computer?

Let’s face it, you have to use your computer for each encounter. But, you don’t want to have the computer in a place where the patient has to talk to the back of your head. Be intentional about positioning your computer. Personally, I type my note as I talk to the patient, basically dictating their H&P in real time.

My patients sit in chairs on the same wall as the computer, so I can glance at the computer screen but spend most of the time looking directly at them. Don’t sacrifice the ability to maintain eye contact with your patients!

4. Minimize the equipment sitting out.

Medical equipment is cold, lifeless, and mechanical. You want your exam room to be warm and inviting. The less medical equipment you have sitting out, the better. Instead of the otoscope/ophthalmoscope mounted on the wall, consider investing in a stand-up unit that can sit on a counter, or better yet in a closed cabinet. Keep as many medical items as possible out of direct sight.

Now, you don’t need to do this to the point of making your clinic flow inefficiently, but consider removing at least half of the clinical equipment from sight and just see how that goes. You’ll be surprised at how much more open and comfortable the room feels.

5. What’s your theme?

I think pediatricians tend to do this better than most physicians. I love pediatricians’ rooms because they’re usually full of fun themes like trains or a jungle safari. Even the exam table may be a fire engine or safari jeep. Consider what your own theme will be. The more cohesive/coordinated the theme, the better you project intentionality. As I said, I chose a Texas/cowboy/western theme, which is part of my personality, but you can do whatever you want. Consider your audience carefully. Decorations should be appropriate to your clinical practice.

6. Avoid things that could be culturally offensive.

This should be pretty obvious, but you’d be surprised at the kinds of things that people put in their offices and exam rooms. Keep décor simple, universal, and fun. Don’t use your room to make a political statement, or really a statement of any kind. Just keep it fun and inviting.

7. Brochures and handouts.

We love giving information out to patients. Go through all of your clinic’s patient literature annually and throw away items that are outdated. These are also items that should go in a cabinet or drawer instead of sitting out on the counter. It’s pretty infrequent that patients are coming to your office and specifically looking at all of the brochures on your counters to figure out which ones to grab. They’re there to talk to YOU.

I give stuff out to my patients all day long, but I pull it from a file drawer from under my desk as needed. Also, don’t have brochures or handouts that aren’t directly applicable to patients. Keep your drawers free of unnecessary clutter. Make your files organized so it’s easy to get what you need. Be mindful of industry-sponsored literature. A lot of it is good, but you need to carefully vet each item before you ever give it to a patient.

8. Don’t put your diploma on the wall.

Patients don’t care where you went to school.  Your competence is assumed. Patients don’t need to see your diploma to believe you’re a physician. Remember, the clinic visit is about them, not you.

9. What about my awards?

Putting awards on a wall is a two-edged sword. On one hand, it can promote your competence and be a fun conversation starter. On the other hand, it can pull you into the trap of making the encounter about you instead of your patient. In general, I recommend not putting awards up in your clinic room. Save those for your office.

The exceptions to consider would be if you have an award for teaching or community service, as those could be good conversation starters and a way to talk about your passion for your students and community. If you have a “Top doctors of (insert state/city)” or a “Who’s Who of Medicine?” kind of award, don’t put it up anywhere. Those are not useful other than as ego-boosters.

10. Take these tips and apply them to the rest of your clinic.

When patients walk into the clinic, what magazines are on the table? Are they crumpled relics of the 1990s or are they recent issues? Does the flow of your clinic feel natural? What is the décor in the room where patients get vital signs? Is your scale where you weigh patients out in the hallway where anyone walking by can hear you tell them their weight? What decorations are in the hallway?

Like it or not, we are often judged by patients’ first impressions. Remember, they may be waiting in your exam room for 10-20 minutes before they see you. They’ll have a lot of time to study the contents of the room and form a first impression of you. Be intentional about setting up your room, and make sure you’re putting forward the best impression you can!

Leave a comment below and tell us something you or your patients really love about your exam rooms.

Further Reading

• Coding and Billing Basics
• How to Get the Most out of Attending a Conference Part 1 – Planning for the Conference
• How to Get the Most out of Attending a Conference Part 2 – During and After the Conference
• A Primer on Moonlighting
• The Three People Who Can Make or Break Your Clinical Practice
• Nurses Are Entitled to Respect from Physicians
• How to Maximize Your Patients’ Experience in Your Practice

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