Alexa Fleckenstein M.D.

If I would decide how hospitals are governed (and I don’t), these would be important points for me: 1. Food: Thy food be thy medicine – and vice versa – Hippocrates said. What is served as “food” in hospitals these times, is mostly abysmal and just goes to show that conventional medicine is not interested in really finding out the root cause of disease. In many cases, it is nutrition, stupid! 2. Cafeteria: Same for the place where all the visitors come and eat. It could be an educational experience, instead just another gorging with inferior foodstuff, filled with chemicals, trans-fats, sugars and dairy. 3. Quiet: When I was a child in Germany, and my father was a doctor, he used to take me on his rounds. Hospitals then were very quiet places. The nurses (often nuns) would walk on their rubber soles like on cushions, and they spoke with low voices. The doors to patient rooms were double doors – the patient had privacy and quiet. 4. What hasn’t changed much: That the hospital routine is not geared toward patient recovery but to a ward schedule convenient for doctors and nurses: Then as now patients are pulled out of sleep to measure their temperature or draw blood tests at four am. I would like to see more concern for the patient’s wellbeing than for the organization’s. 5. No TV in patient rooms: My guess is that at least seventy percent of all illness is self-inflicted. It used to be that being in the hospital was a time for contemplation about what brought one there. Not any longer – as TV is squeaking and squealing day and night. 6. Conventional and complementary medicines are BOTH used. There should be no bias toward the one or the other – what has been proven to work should be applied: Hydrotherapy, movement therapy, food, herbal medicine and art, music, journaling, acupuncture, massage, and so on – they all should be used to make patients better. As they are in most European hospital. And paid for by national health insurance. And, no, they are NOT going to be broke … 7. More cleanliness in the facilities. More cleanliness of the patients. Used to be that hospital were spic-and-span places where you could eat from the floor; not any longer. Instead of on cleanliness we trust in antibiotics – to our detriment. Same with patients’ cleanliness: Used to be that nurses washed the patients daily; not any longer. Nurses have gone scientific (necessarily so – but who is now responsible for caring?); the paperwork has become overwhelming. Housekeeping has been out-sourced. And simple ideas like a washing and cleaning have become obsolete. But hospital infections are skyrocketing. 8. More friendliness and caring toward the patient. The patient has become a moneymaking device. 9. Less care and resources to be spent on very old, very sick people in their last days of life – more on pediatric and under-served populations. DNR (Do Not Resuscitate orders discussed with every patient and/or every family). It will lead to savings of money and will allow people to die with dignity. 10. In medical schools, only half of the students should be A+ nerds; the other half should be people who really want to become doctors and patient advocates from all walks of life. We need very brilliant students because they push medicine’s frontiers ahead. But we also need caring primary care physicians. And putting them together in medical school will hopefully lead to a dialogue between them. As I am thinking more about this, I might come up with more ideas. What would you wish to implement in the hospitals of the future?