Now I Know: The Best Medicine is... A Room With A View?

Please, please, please do not take this as medical advice. In fact, never take medical advice from some random source on the Internet, including my newsletter. Thanks! -- Dan

The Best Medicine is... A Room With A View?

Hopefully, you're not reading this from a hospital. (If you are, I hope you or whomever you are visiting has a quick recovery!)  Childbirth aside, hospitals are places that we'd rather not be, and that requires no explanation. So if you're there, your goal is pretty simple: recover quickly so you can leave. But that said, while you're there, you want your stay to be as pleasant as possible -- friendly staff, edible food, and maybe, a room with a view.

But if you had to pick just one of those three, you may want to go with that last one -- a window that looks into a park or something like that -- because it may actually make you recover more quickly.

That's what a study led by Robert S. Ulrich determined in 1984. Ulrich, a Ph.D. researcher who focuses on the impact of design in health care, wanted to see if factors outside of our normal scope have an impact on patient outcomes. His study on windows, available here, observed the recovery of 46 patients who underwent a cholecystectomy -- they had their gallbladders removed -- from a suburban Pennsylvanian hospital from 1972 to 1981. Ulrich focused solely on the rooms in which these patients recovered; per the study, "in these rooms, patients either had an unobstructed view of [a] small stand of trees or a brown brick wall when lying in bed. Other than window views, the rooms were nearly identical in size, arrangement of beds, furniture, and other major physical characteristics." To control for other factors as much as possible, Ulrich directed the hospital to pair off each of the patients with someone with a similar health history, creating a total of 23 pairs, with one person per pair seeing the bricks and the other seeing the trees.

Ulrich's results suggested that seeing the trees mattered. Patients in the tree-seeing rooms spent almost a full day less in the hospital recovering, 8.7 days to 7.96. Their nurses also noticed fewer complaints, at about 1.1 per patient in their rooms compared to nearly four complaints from the patients looking at bricks. The tree-viewing patients also took fewer pain medications and weaker versions thereof -- they were more likely to take aspirin or Tylenol while the patients without a view were more likely to need narcotics. Across the board, those with a view of nature were better off.

Subsequent studies on hospital architecture have found similar results. In October of 2022, a team of researchers published their findings from a three-year study of patients at the University of Michigan to see if windows still mattered, and it turns out, they probably do. As Fierce Healthcare summarizes, "the study included 3,964 patients who underwent 13 high-risk surgical procedures, such as colectomy or kidney transplant, who were admitted between 2016 and 2019. Researchers characterized their rooms based on features including window, occupancy, nursing station distance, and clinician line of sight." Once again, the windows had an impact: "patients in rooms without a window recorded 20% higher mortality and 10% higher 30-day mortality rates compared to those with windows after adjustment for comorbidities and procedure complexity."

There are, certainly, more important factors to one's health and recovery when in a hospital. But all else equal, if you're in need of care, there's lots of evidence that says you should insist on a room with a view.

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Bonus fact: If you're going to the doctor, you may want to ask the receptionist to turn off the TV in the waiting room, and maybe even take the art off the wall. That's probably what Ulrich would recommend, at least. In a 2010 interview, he explained some of his newer research on the impact of design on health outcomes, and it turns out that daytime TV and abstract art may not be great for you: "one was a study of the effect of different kinds of art on patients who had just undergone coronary bypass surgery. To our surprise, we found that abstract art made people sicker than if they had no art at all. Another interesting one was when Robert Simons at the University of Delaware and I studied the effects daytime television played in waiting areas on stress for blood donors. The research showed that the widespread practice of playing daytime television continuously and uncontrollably in waiting areas increases blood pressure and heart rate and can worsen stress."

From the Archives: The Isolated Tree: It was a tree all by itself. Someone probably saw it and couldn't look away -- until it was too late.
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