People older than 50 might remember a comedian named Jimmy Durante, a balding, wizened little guy with an immense nose and a habit of ripping off his beat-up hat in exasperation, slapping it against his thigh, and rasping “Everybody’s gettin’ inta da act!”

There just might be some healthcare designers out there who are feeling this way, too, and would (privately, at least) slap their hats, too (if they wore them), given today’s talk about not only clients, but staffers, patients, families, and even kids getting involved in facility design. Is this a good thing?

I had to laugh recently when I read this quote from a famous person: “I have carefully studied hospital design and, frankly, I am fed up with the type the Government has been building during these past twenty years. Therefore, I personally designed a new Naval Hospital with a large central tower of sufficient square footage and height to make it an integral and interesting part of the hospital itself, and at the same time present something new—getting away from colonial brick or ultramodernistic limestone. All of the doctors who have seen the design are tremendously keen about it as a practical and useful building for the needs it will serve.”

Of course, President Franklin D. Roosevelt no doubt got the building he wanted in Bethesda Naval Hospital, with his sketched-in tower. He also got his way in supporting the design of the Jefferson Memorial against fierce criticism, thus honoring another presidential architect, although one wag said Roosevelt’s architectural “taste was Jeffersonian without Jefferson’s inventiveness.” (My appreciation to author Steve Vogel’s wonderful book The Pentagon [Random House, New York, 2007] for these anecdotes.)

It’s pretty tough to say no to a President. These days, designers are becoming increasingly loath to say no to others, as well. Again, is that a good thing? One of the revelations for me in editing HEALTHCARE DESIGN has been the number of times our designer and planner authors have referred to design sessions with staff, patients, families, and children as being extremely helpful and gratifying. From the designer’s standpoint, it goes to the idea of being of direct service to all who come in contact with one’s work. For designers who create environments where people live and work providing and receiving healthcare, this seems to be the responsible thing to do.

Perhaps it is odd to bring this up in our September Architectural Showcase issue, where the full firepower of the healthcare design profession is on display. Again, nearly 180 projects were peer-reviewed and accepted for publication. You will find architectural ingenuity displayed in many forms—no doubt quite a bit of it inspired and even shaped by involved “outsiders.”

Architecture, like pop singing and stand-up comedy, has a strong amateur allure. In the serious business of healthcare design, though, it’s up to the pros to make it work. Enjoy seeing in these pages how this interplay expresses itself in this unique field. HD