Should Your Architecture Firm Hire a Clinician?

Andrew M. Ibrahim MD, MSc is the Maud T. Lane Research Professor of Surgery, Architecture and Urban Planning and Vice Chair of Surgery at the University of Michigan. He previously spent 6 years as the Chief Medical Officer and Senior Principal of the global design and architecture firm, HOK.

For decades, architects have in-sourced innovation by hiring clinicians into their firm. These clinicians – physicians, nurses, practitioners – have taken on various roles ranging from an arms-length consultant to a full c-suite leadership role.

The c-suite of a major architecture firm recently asked me, “If we were going to a hire a clinician, how could they best contribute to our firm?”

Of course the answer is tailored to the firm and the potential individual, but there are at least six domains worth considering. I present each with tempered enthusiasm recognizing both the potential advantages and over-reaches in each domain.

Thought Leadership. Everyone loves to talk about this one and for good reason. In the realm of design, thought leadership has a lot of value. It can attract clients to your firm and can also inspire colleagues within the firm to think anew and elevate their work. But I caution on doing this in isolation. The externally facing thought leadership only holds its value if the firm internalizes the concepts and uses it to inform their design. A disconnect between externally facing thought leadership and executed design will eventually be discovered by clients and ultimately lessen the value of both.

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Relevant Networks. Clinicians, particularly those with experience in research, tend to move in well-developed healthcare networks. It is likely that a clinician with 10 years of experience has contacts and exposures to a majority of major health systems and universities giving them tactic knowledge about their local culture. This can be incredibly helpful when firms try identify a client who shares their values and mission, as much of those intangibles are hard to detect without personally knowing the people involved. That said, a clinician who becomes a “networker” overly focused on business development can lose some of their creditability amongst their healthcare and research colleagues.

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Transferable Skills. While most clinicians do not have formal design training (with some notable exceptions), they do carry important skills that transfer well into the practice of architecture. Trauma surgeons and charge nurses immediately come to mind (and others) as being able to work with multi-disciplinary teams and manage unforeseen uncertainty. These traits can be a steady hand when a project inevitably hits a road block or when a really incredible, complex building opportunity arises that has a very broad range of stakeholders. ?That said, most clinicians will have a learning curve navigating the culture of a design firm.

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Appropriate Translation of Research-Evidence. More so than other professions, healthcare has a strong culture of research and evidence. More and more, research evidence is being directly translated into the way healthcare is delivered. As a result, healthcare training has increased the level of research training required. Even clinicians who are not active researchers will likely still be able to read a research paper, understand some basic limitation and help guide if that research should inform the firms design strategy. That said, architecture is also increasing its own evidence based, and each firm will likely need its own dedicated in-house research expertise to best interpret research and appropriately apply it into design practice.

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Clinical Validation of Design. From a technical and billable hours perspective, this might be the highest value of a clinician for an architecture firm. In my own work, I love to review design plans and simulate them through common clinical scenarios. For example, thinking through a patient who arrives in the trauma bay with a heart attack and identifying the flow and needed adjacencies to give them optimal care. I lost track of how many times I have caught a major design flaw by going through my care-simulation checklists. (A future post in the works for my top 10 common clinical scenarios that I simulate to identify design improvement opportunities.) Ideally, this work happens in studio alongside planners (as early as pre-planning) to get the most benefit. However, this not a “typical” billable service, and it requires firm buy-in to make it normative across projects with clients. ?

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Integrating Health into non-Healthcare Project. Since the COVID pandemic started in 2020, there has been a renewed energy focused on health and the built environment outside of hospitals. Some of my most impactful projects contributing as a physician and health policy researcher focused on the design of airports, office buildings, schools and public parks. I anticipate a continued growing demand for integrating health outside of hospitals, and firms will needed to adopt strategies to integrate that form of expertise into their designs.

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Certainly these six are not exhaustive, but are the most common I have seen in my own career and among my clinical colleagues who have been spending time in architecture firms. In looking at them, I (probably) have them listed in order of least to most-important (Thought leadership, networking->...-> clinical validation, non-healthcare projects).

Look forward to the discussion on how other firms have been able to utilize clinicians to elevate their design.

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