A Meeting of Minds: When Architects Talk to Healthcare Providers

Architecture, as a profession, is a kind of paradox; it inherently attracts individuals who are good at solving problems and creating an ordered canvas out of an endless list of activities and needs that will be housed by a structure. But on the other hand, an architect also needs to be able to have the ability to communicate their ideas to people, be it in visual communications or even in public speaking and meetings.

What makes it a paradox? Architects are in general, quite melancholic people, who often have traits in the creative fields. You can even go further and say quite a number of us architects are introverts, as observed by others, since we architects are quite comfortable in contemplating alone (and for hours) on the design solutions of the works that we do. Then, on the other side of the coin, architects also need to be extroverts! A successful architect is the one that can effectively communicate and speak about their designs to their clients. This is a skill, that on my part, was a learned trait—I even wryly mention this to my wife that I have to “activate” being an extrovert when it is time to talk about my architectural works to clients.

And thus, my introverted tendencies faced one of the most challenging aspects of my job—talking to actual extroverted clients. I mentioned before in a previous blog post the types of people you encounter when designing healthcare architecture, as well as there being a communication gap between architects and clients. In my experience of working for over 15 years in the architecture field, I find that individuals who work to make hospitals operate and be a profitable endeavor all have dominant personalities. Regardless of if they are doctors, CEOs, head nurses, or finance officers, the people I have interacted with over the years from this line of work are mostly extroverted, direct in their needs, and have very strong opinions. When one faces such personalities during meetings and presentations, all I can think of is that I have a tough audience to convince.

I generally expect what I call “verbal warfare” during these meetings; with the client scrutinizing every detail of the floor plan, all the concepts, the list of comments from a previous meeting. Everything and anything will be discussed in a meeting that will last for hours on end.

Many architects will attest that these types of meetings are exhausting and very discouraging to one’s morale and motivation to work in the architecture field. I distinctly remember a meeting many years back. I had to present the proposed design of the principal architect of the office I worked for at the time. Since I was a Consultant Project Coordinator, I could only present the approved designs to the client and take note of the changes that the client wanted to adjust in the design; I was not allowed to provide final solutions during the meeting—I was not the design architect of the project. One particular doctor was practically scolding me, saying something in the line of: “You architects have no idea about the activities of the hospital; you are only pencils that are drawing what is on my mind.”

Too harsh? But the funny thing is… that doctor was not wrong! Architects are the translators of what our clients are thinking. We design their ideas and make it possible to turn them into physical reality. That doctor could have voiced his annoyance in a more civil manner (as his angst was coming from my being unable to commit to any final design solutions during the meeting) but as many architects would have experienced working in this field, this is par for the course.

With all that in mind, I always take note of three principles for talking to clients in the medical field. Remembering them helps me to keep my peace of mind and also respect the difference between the architecture and healthcare fields.

1. Patience is a virtue. A design project is a large investment in resources, especially healthcare facilities. The clients, knowing this at the back of their minds, will of course be not as objective to the design process as the architect may want them to be. Some clients will insist on a specific layout for reasons beyond the architect’s control—and in these cases the architect must be patient. Keep calm, listen to the concerns of the client (no matter how heated the discussion is getting), and try to cool the temperature of the meeting. Try to avoid words in the meeting that can incite negative emotions and do your best to be in a peaceful state of mind.

2. The doctor knows best. This one will be hard to accept for architects. Healthcare Facility design is a complicated building type to work on as an architect; all the information that you can get should be welcomed and analyzed on how it can affect the design. The doctor who runs the hospital, department, or clinic that you are designing is literally the best person to ask for information on how you should design the healthcare space. Generally, what will happen is that the architect brings the empirical design principles of healthcare architecture for the space, while the doctor client will bring the specific operational preferences that they need for the healthcare space. The goal for the architect and the doctor in this case is to find a “happy middle” in which both the architect and the doctor can be satisfied and happy with the design of the healthcare space.

3. Insist on your design principles… gently. Not all meetings will go smoothly, and the hardest ones are when the client will insist on specific design alterations that are not allowed by the architectural design principles that an architect follows. When this happens, the architect must rely on his or her knowledge to insist on why these specific changes cannot be done to the healthcare space—be it National Construction Laws, basic impractically, or negative effects on the overall floor plan among other things. When meetings go this way, stay composed, be calm, gain leverage using your professional knowledge, and be not afraid to refuse the changes of the client if there is an actual liability or reason that will affect your career. Losing a project is painful, but losing your license to work is worse.

Hopefully, when talking to clients, we keep in mind that both architect and client do want to complete the project. Meetings should not be battleground but a collaborative space in which everyone’s ideas and concerns should be considered so that the final design is one that provides the best solution for the healthcare space.

"Not all meetings will go smoothly, and the hardest ones are when the client will insist on specific design alterations that are not allowed by the architectural design principles that an architect follows. When this happens, the architect must rely on his or her knowledge to insist on why these specific changes cannot be done to the healthcare space."