The Smiling Hospital

Entering Boston's Beth Israel Hospital for surgery, Carol Wein, 22, of Brookline, Mass., wondered at first if she had come to the wrong place. Instead of the usual sterile hospital lobby, she found a large, warmly decorated room with brightly colored window hangings and a garden of potted palms and dra-caenas off to the side. In the second-floor admissions area, she was interviewed, not at a crowded public desk but in a small, tastefully decorated private office. Corridors were carpeted and traditional hospital smells and white walls were conspicuously absent. After Wein settled into her stylishly furnished, pastel-colored private room ($180 a day), the head nurse entered and cheerfully announced: "Carol, you have rights in this hospital and I want to explain them to you."

Carol's pleasant welcome reminded her of an episode from TV's Medical Center. But Beth Israel, a major teaching facility of Harvard Medical School, is a real-life institution. Opened only a few weeks ago at a cost of $16 million, Beth Israel's posh 176-bed Feldberg Building has already won a reputation among patients as the hotel with nurses and operating rooms. It is far more than that. More than a decade in the planning, the wing caps a long campaign by Beth Israel's innovative director, Dr. Mitchell Rabkin, 45, to ensure patients a "full bill of rights," which he feels is long overdue. As the Harvard-educated endocrinologist puts it: "We have reached the point where doctors and hospitals can really tyrannize patients."

Full Explanation. That tyranny has been ended at Beth Israel. Soon after patients enter the hospital, they are given a little blue and white brochure. It tells them, among other things, what they are guaranteed: the best possible care regardless of the form of payment; a full explanation of their illness and treatment; knowledge of who is in charge of their care; and the privilege of leaving the hospital at any time, even over a doctor's objections.

One of Rabkin's favorite innovations is what he calls "a telephone hot line for patients," which enables them to call direct from their rooms to the hospital service manager if a bulb burns out or the kitchen is late in delivering dinners ordered from one of the seven different room-service menus. Says Rabkin: "I have seen a lumpy mattress replaced within 20 minutes of the hotline call."

The director periodically reviews the log of calls--and the responses to them --to keep the staff on its toes. He may also take other action; even his fellow doctors are not spared Rabkin's criticism. After he discovered that a patient had been left unattended in a corridor, he rebuked the physician responsible (without naming him) in his weekly "Dear Doctor" memo to the staff. Explains Rabkin: "A patient's rights brochure is not worth the paper it is printed on if it does not reflect an institutional commitment." At Beth Israel, whose bright new wing is attracting many patients, the commitment is apparently real. As Trustee Eliot Snider explains: "We want this to be a smiling hospital."

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