Come in the Front Door: What Your Waiting Room Says About Your Practice

Sometimes the best way to understand the patient experience is simply to experience it yourself.

Leslie Edmondson | Founder & Principal Consultant

Years ago, while working as a physician liaison, I regularly visited a urology practice as part of my outreach route.

One day, when I walked through the front door, something struck me almost immediately.

There was a very light, pleasant aroma in the air—nothing overpowering, just clean and welcoming. The waiting area was spotless. Plenty of seating meant enough room that patients didn't have to sit shoulder-to-shoulder with strangers.

It felt comfortable.

The aroma reminded me of something I had learned about Disney years earlier: Disney is intentional about engaging the senses to help create an experience for its guests. Many Disney resorts use signature scents as part of their environments and storytelling.

I had remembered hearing about chamomile being used, although I haven't been able to substantiate that particular scent. What stayed with me wasn't the fragrance itself. It was the strategy behind it.

Disney understood that an experience isn't created by what guests see alone.

What do they see? What do they hear? What do they smell? How does the environment make them feel?

Genius.

A physician practice certainly isn't a theme park or resort—and fragrance itself may not be appropriate in healthcare environments because of allergies and sensitivities—but the lesson about intentionality translates beautifully.

We are setting a stage for our patients, too.

When the Environment Becomes Part of the Experience

Think about why someone might be visiting a urologist.

A patient may be experiencing the excruciating pain of a kidney stone. A man may be arriving for a vasectomy consultation. Someone else may be seeking treatment for erectile dysfunction, urinary problems or another condition they consider deeply personal.

These aren't necessarily conversations patients want the entire waiting room to hear.

Privacy matters. Space matters. Comfort matters.

And sometimes seemingly small details communicate something much larger:

We thought about you before you arrived.

Research supports the importance of the healthcare environment. Studies have identified cleanliness, adequate seating, reduced crowding, good signage and privacy as characteristics patients value. Other outpatient research has found an association between more attractive physical environments and higher perceptions of quality and satisfaction, better perceptions of staff interaction, and lower patient anxiety.

None of those things replaces excellent clinical care. But they become part of how patients experience that care.

The Door the Physician Never Used

During one of my visits, I mentioned to the lead urologist how impressed I was with the practice's waiting area—how clean it was, how pleasant it smelled, and how welcoming it felt.

He looked at me a little strangely.

Then he told me something that made me stop:

He never came through the front door.

The physicians and staff entered through a separate employee entrance. They arrived, went directly into the clinical and administrative areas, and started their workday.

Think about that for a moment. The physician responsible for the practice rarely experienced his own office the way his patients did.

So I encouraged him to try something simple.

Come in the front door.

Walk through the parking lot. Look for the signage. Open the same door your patients open. Stand where they stand to check in. Sit where they sit. Listen to what they hear. Look at what they see.

Experience the practice for a few minutes—not as the physician, administrator or employee, but as the patient.

The Formal Living Room

The experience reminded me of homes built in the 1970s and 1980s with a formal front entrance and formal living room.

The family rarely used either. We came through the garage, basement or side door. The formal living room was reserved for company. But when guests arrived, they came through the front door.

Healthcare practices can operate much the same way.

Physicians and employees often become accustomed to entering through the “family entrance.” We know where to park, which door to use, whom to ask for and where everything is located. Our patients don't.

And yet the “formal living room”—our reception and waiting area—is where we welcome them.

If that space is dusty, crowded, noisy, confusing or uncomfortable, patients notice.

Patients may not be able to evaluate the sophistication of the clinical equipment or independently judge a physician's clinical expertise. But they can evaluate what they see, hear and experience. And those impressions become part of their perception of the organization.

Take a Closer Look at the Front Desk

As you come through the front door, stop and really look at the check-in area. What does your patient see?

Over time, front desks can become crowded with signs: PAYMENT IS DUE AT TIME OF SERVICE. PLEASE HAVE YOUR INSURANCE CARD AND PHOTO ID READY. NO FOOD OR DRINKS. PLEASE SILENCE YOUR CELL PHONE. MISSED APPOINTMENTS MAY RESULT IN A FEE. PLEASE SIGN IN.

Then there may be notices about privacy, insurance, payment policies, patient portals and other information the practice needs—or may be required—to communicate.

Each sign may have been added for a perfectly good reason. But has anyone stopped to look at all of them together from the patient's point of view?

One laminated sign becomes two. Two become five. A handwritten reminder gets taped to the counter. Another notice appears on the glass.

Before long, the first thing patients encounter isn't a welcoming reception area. It's a wall of instructions.

Some notices may be legally or regulatory required and should remain displayed as appropriate. But that doesn't mean every message needs its own sheet of paper, font, color, and location.

Conduct a simple front-desk communication audit. Which notices are required? Which are outdated? Which are duplicates? Could several messages be consolidated into one professionally designed communication? Could you provide information before the appointment, through registration materials or digitally instead? Are temporary handwritten signs becoming permanent fixtures?

Is the information written for the patient—or for the organization's convenience?

Good communication isn't simply giving people more information. It's giving people the right information, at the right time, in a way they can easily understand.

What Does Your Front Desk Say?

Think about the difference between entering an office that seems to say WELCOME. HOW CAN WE HELP YOU? and one dominated by DO NOT. MUST. REQUIRED. NO. PAYMENT DUE.

Policies are necessary. Presentation matters. A clean, professionally designed check-in area can communicate expectations without making the first interaction feel like a list of rules.

And while you're reviewing what the front desk says, consider adding one message that healthcare organizations sometimes forget:

Thank you for choosing us!

Patients Have Choices. Say Thank You.

Healthcare organizations can become so focused on operations, schedules, and clinical demands that we sometimes overlook a simple truth: patients often have choices.

Insurance networks, geography, physician availability, and clinical needs certainly influence those choices. But when a patient chooses our organization and entrusts us with their care, we shouldn't take that for granted.

So, say thank you. Not because a customer-service manual says you should. Because you're genuinely grateful for the opportunity to care for them.

A simple “Thank you for choosing us. We appreciate the opportunity to care for you.” can make a very different impression than “You're all set.”

It takes only a few additional seconds. But those few seconds can help turn a transaction into a relationship.

Gratitude doesn't need to become another laminated sign cluttering the counter, either. Incorporate it into your culture. Say it at checkout. Include it appropriately in patient communications. Thank patients when they provide feedback. Let patients know their trust matters.

The exact words don't have to be scripted so tightly that employees sound robotic. The goal is to establish communication standards that make warmth, courtesy, and gratitude part of the organization's culture.

Patients aren't interruptions to the work. They are the reason for the work.

Take the Front-Door Test

Every so often, I encourage healthcare leaders to experience their organization from the patient's point of view. Come through the front door and ask:

• Is the parking area clean and easy to navigate?

• Is the entrance obvious?

• Is signage clear?

• Is the reception area clean and uncluttered?

• Is there adequate seating and personal space?

• Can conversations at check-in be overheard?

• Are there too many signs competing for attention?

• Are handwritten or outdated notices displayed?

• Is the television too loud?

• Is the temperature comfortable?

• Are restrooms clean?

• Is there trash on the floor?

• Does the front-desk greeting feel welcoming?

• And most importantly, how does this environment make me feel?

Then sit down. Don't look at it as the CEO, physician, practice administrator or employee. Look at it as someone who is worried about a diagnosis, hurting, embarrassed, unsure where to go, or simply having a difficult day.

What does your environment communicate to that person?

Sometimes You Need a Fresh Set of Eyes

One problem with evaluating a place you see every day is that eventually, you stop seeing it.

The faded sign. The confusing directions. The cluttered front desk. The conversation patients can overhear. The long wait without communication. The employee who no longer looks up when someone approaches the desk.

Familiarity can make these details almost invisible. That's one reason an outside perspective can be valuable.

LMR Healthcare Mystery Shopping & Patient Experience Assessment

LMR Healthcare Advisors offers healthcare-focused mystery shopping and patient-experience assessments designed to help organizations see their operations through the eyes of the people they serve.

An assessment can evaluate key patient touchpoints, including the exterior and parking experience, signage and wayfinding, arrival, reception and check-in, waiting-room environment, cleanliness, privacy, staff interactions, communication, checkout, and follow-up.

The purpose isn't to “catch” employees doing something wrong. It's to understand what patients actually experience.

The findings can help identify what's working well, uncover opportunities for improvement, support service recovery, recognize employees creating exceptional experiences, and give leadership practical recommendations for strengthening the patient journey.

Because sometimes the people closest to an organization simply need someone else to come through the front door.

LMR Insight

The Agency for Healthcare Research and Quality describes patient experience as encompassing the interactions patients have throughout the healthcare system and considers it an integral component of healthcare quality.

Patient experience doesn't begin when the physician enters the exam room. It begins much earlier.

The parking lot matters. The front door matters. The waiting room matters. Privacy matters. Cleanliness matters. The greeting matters. And gratitude matters.

None of these replaces excellent clinical care. They help shape the experience surrounding it.

So every once in a while, don't come through the employee entrance.

Come in the front door. You might be surprised by what you see.

Further Reading & Resources

Agency for Healthcare Research and Quality (AHRQ) — What Is Patient Experience?
AHRQ’s overview of patient experience and its relationship to healthcare quality.
View resource

LaVela et al. — Patient Perceptions of the Environment of Care in Which Their Healthcare Is Delivered
Research on environmental features patients value, including cleanliness, signage, seating, crowding and privacy.
View resource

Becker & Douglass — The Ecology of the Patient Visit
Research on outpatient physical environments and patients’ perceptions of care.
View resource

planDisney — Disney Resort Signature Scents
A guest discussion of how scents contribute to the atmosphere at Disney resorts.
View resource