In the web.config file, change umbracoHideTopLevelNodeFromPath setting to false and your top level nodes (home, patients, etc.) will be included in the url. There is nothing wrong with your xslt.
<add key="umbracoHideTopLevelNodeFromPath" value="true" />
becomes...
<add key="umbracoHideTopLevelNodeFromPath" value="false" />
cheers,
doug.
MVP 2007-2009 - Official Umbraco Trainer for North America -
Percipient Studios