FOREWORD
Having grown up in Nashville,
Tennessee, I would, no doubt, have been aware of the work of Earl
Swensson and Dick Miller even if I had not been a heart-lung
transplant surgeon, or my father a physician with one of the largest
medical practices in the state, or my father and brother, Tommy,
founders of the largest investor-owned healthcare network in the
country. That’s because few Nashvillians these days could
imagine what their city would look like without, for example, the
Opryland Hotel or the BellSouth Office Building, two landmark
projects of Earl Swensson Associates.
But, as it happens, my father was
indeed a doctor with patients and friends everywhere in Nashville and
around the state; my brother, with Dad’s help, did found the
Hospital Corporation of America which has had a longstanding
relationship with ESa; and for many years, I headed up Vanderbilt
University’s Multi-Organ Transplant Center. So my familiarity
with ESa design is truly firsthand, and a bit more intimate than most
of the city’s other residents.
In fact, when my father, Thomas
Frist, Sr., set up his first office in the house he bought on West
End Avenue, it was to a young architect named Earl Swensson that he
turned in the hope of transforming the place into a state-of-the-art
facility. So, it’s not surprising that when I first read this
book, I heard echoes of Dad in the concepts Earl and Dick expound as
principles of good hospital and healthcare design.
An old-fashioned family
practitioner in many ways, Dad retained the same set of compassionate
beliefs as head of a multibillion-dollar corporation that he held
when he visited his patients at home with his black bag in hand. He
believed in providing quality care, which he thought depended on
finding and hiring good people. He believed in always putting the
welfare of the patient first. He believed in cutting-edge yet “homey”
(that is, comfortable and relaxed) services. And he insisted all this
should be carefully designed into the facilities one used.
Let me rush to say that I’m
not claiming that Dad was the inspiration behind the stunning success
ESa has made of its work in the healthcare sector. I’m simply
saying that—from the beginning—ESa listened to its clients.
That was one of the reasons Dad was attracted to Earl as an architect
in the first place. It is certainly the reason that, nearly forty
years later, ESa worked with him and with my brother Tommy on what
proved to be Dad’s last hospital.
The Centennial Medical Center in
Nashville is a jewel of a facility, encompassing everything they had
learned from decades of experience in practicing medicine, running
healthcare corporations, and designing and building complex
structures that both treat patients like valued guests and provide
the finest possible care in the most comfortable surroundings
available.
This book is a distillation of
that knowledge, of where it has taken us, and why. But it is also
something much more. It is a spotlight on the direction healthcare
facility design will take in the future.
When the first edition of this
book appeared, I was in the process of transition myself—from a
heart-lung transplant surgeon to a United States Senator. As part of
the preparation for that transition, I did an extensive study of
healthcare reform, an issue that was at the top of the nation’s
agenda at the time. The basic thrust of the debate was whether
Americans should have a system of universal healthcare insurance
mandated and controlled by the government or a system more responsive
to the marketplace.
As it turns out in the several
years since, the market has prevailed, and the consequences for
healthcare design and facilities are fully documented in this book.
They include, among other things, a move from inpatient to outpatient
care; a concentration on primary care, prevention, and wellness; and
the development of integrated, regional networks that not only
attract more customers but work with large managed-care groups.
Today we are moving into an era
filled with new hope but also new challenges. Rather than an overly
prescriptive government solution, or a micromanaging private sector,
this new era offers a third way, an approach centered on physician
involvement, local decision-making, and unprecedented patient
empowerment. Dramatic change will take place as the market responds
to new advances in diagnostics, noninvasive surgery, drug treatments,
and other therapies promised by the revolutions in telemetry,
biotechnology, and genetics. Already ESa, and several other savvy
firms, are designing facilities to accommodate these changes. We all
need to work harder to make American healthcare more responsive to
individual needs, to ensure that the patient remains the focus of the
practice of medicine.
If we do that, American
healthcare will continue to be the kind of care of which my father
was so proud, and the kind of care for which architects like Earl
Swensson and Richard Miller are—even now—showing us how to
build.
—William H. Frist, M.D.
United States Senator
