An article in a recent issue of the British Medical Journal traces the history of visiting patients in hospitals in England, from the 18th century to the present.

Sadia Ismail and Graham Mulley paint quite a picture in their opening lines:

From 2 pm they gather at the entrance to the ward, occasionally drifting through the doors, only to be reminded by sister that “visiting starts at 2.30 pm.” Doctors cower in the office, completing paperwork and dreading that journey to the bedside for a drug card, fearing they may pay the price with a long tirade from a patient’s relative.

It reminded me of what Tom Ferguson wrote in Chapter 4 of “e-patients” (see p. 57, under “Forgotten Heroes”):

[Family caregivers] outnumber all other types of health care workers combined by a factor of four to one, yet they often feel like the odd person out when dealing with hospitals and medical professionals. In the world of Health e-Communities, they are first-class, not second-class, citizens and frequently serve as the group’s mainstays, organizers, and hosts.

Ismail and Mulley conclude their article with a call for flexibility and mutual understanding:

We believe that a shift in culture is needed to ensure the best practice on visiting policies. Any visiting restrictions should be based on mutual respect and consideration. Health professionals should consider the rights, worries, and needs of patients and their families, and visitors need to understand the roles and pressure on staff and the needs of patients other than their own relative. Perhaps patients’ control of their visiting hours in the form of a contract may help, and this merits formal study.

We talk quite a bit about how most health care happens outside a clinical setting, but I think this article brings up important questions about how expectations are also changing in hospitals.