The Perfect Exam Room

BY WENDY EASTMAN, M.D.

Have you taken a critical look at your clinical exam room?  Is it the most functional and accessible for you and your patients?  

Have you thought about:

  1. The positioning of the patients and family members (so you can see everyone's’ face)
  2. Ease of moving around (is your chair on wheels?)
  3. The position of interpreters and scribes (so you can see them and they are not in the way)
  4. Activities for kids (to keep them occupied while you talk with parents?)
  5. Ease of using the computer (is the computer movable so you can show results and images to patients?)
  6. Color and wall hangings in the room (calming or distracting?)
  7. Printer in the room (so you are not running up and down the hall to get the AVS)

As a deaf doctor, I need to be able to see and lipread the patients well and have control over the room.  When I started my first job as a newly minted Child Neurologist, I was given two exam rooms that were designated as "Dr. Eastman's rooms."  Over the course of time and with experience, I have modified the rooms, rearranged the furniture, made requests for specific equipment, and perfected the rooms.  My exam rooms are small which I like since it is easier to control the space and I am not bobbing my head back and forth to lipread everyone.

Get in there and move the furniture around!  Think about the seating arrangement.  Get good flexible equipment.  Make sure you have a good work surface. 

Here are some pictures of my perfect room:

Wendy_1.png

I am sitting at my computer in my chair on wheels.  To my right, you see my medical scribe standing with his laptop computer typing as I talk with the patient.  The scribe summarizes the important parts of the interview, I talk out loud through my physical exam for the scribe to document,  and the scribe outlines the plan in the After Visit Summary (AVS) as I discuss it with the patient.  Then I go to my computer to enter orders and prescriptions then print the AVS to give to the patient. The person on the exam table is one of my super MAs who is modeling as my well-behaved patient!

Wendy_2.png

I like sitting in the corner with the door to my back. I can back up to the corner and observe the child playing.  If the child is trying to escape, I can block the door. I am able to access my computer while facing the patient and family members.

Wendy_3.png

I love having my computer on a flexible swing arm so I can move it around so patients and parents can see the screen as I review the brain MRIs and the labs.  I am showing the brain MRI of a 3 yo patient with Neurofibromatosis Type 1 with a small brain tumor, can you see it?  (Look in the left cerebellum.  It is a small 1cm diameter low-grade neoplasm.)