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T O O U T P A T I E N T S U R G E R Y M A G A Z I N E • F E B R U A R Y 2 0 2 1
What prompted you to go architecture school after medical school?
I double-majored in biology and art history, with a fine arts minor, so I've always had an
interest in architecture. I just assumed it would remain an interest, not a career. But the
Cleveland Clinic, where I did my residency, played a critical role in my path. The Cleveland
Clinic encourages all its physicians to gain experience in non-clinical areas and, while
there, I was essentially mentored by campus architect Malcolm Cutting. He
believes in involving doctors and nurses in construction planning and asked if I
would help him with the planning of a large facility. That was the start.
How do you view healthcare design differently than your clinical peers?
I know what an architect does; I've been in the trenches. This understand-
ing is key. Because I understand square footage, I know why we can't just
make it smaller and cheaper. I grasp the relevance of mechanical and struc-
tural infrastructure needed for function. I see cost in a way you can't without
formal training. Next to nuclear power, healthcare is the most regulated industry
in the country. There are so many variables that factor into a project's cost, from
funding to current and future regulations. Those fancy finishes account for only
5% of a project's total cost, while HVAC expenses account for 45%.
How do you create a facility that's functional and aesthetically pleasing?
The key is "thoughtful design." When a patient arrives, they should instantly feel
that the facility was designed with their needs in mind. That's why the "Five-
Minute Space," the welcome area where patients spend those first five min-
utes, is so important. In surgery, there's so much patients don't see or
understand. They need to grasp onto something that lets them know they're
in a safe environment. Thoughtful designs can do that. For the final 20 years
of my mother's life, she served as my muse for every one of my projects. I
tried to see every angle from the patient's perspective. The patient I had in
mind when I made those decisions was always my mom.
How will COVID-19 alter healthcare design moving forward?
The pandemic is forcing us to reevaluate what's needed to stay
operational during emergencies. We need to future-proof facilities for any
emergency — whether it's a pandemic or a natural disaster — in ways
both clinically and economically appropriate. The pandemic highlighted
the need to overhaul structural and air-exchange systems in facilities,
but it's not feasible to redo all buildings and add negative pressure to
every space. The challenge post-pandemic will be striking a clinical and
economic balance as we prepare for whatever comes next.
OSM
Dr. Tingwald (gtingwald@stanfordhealthcare.org) is the administrative director
of medical planning at Stanford (Calif.) Health Care and one of only a handful of
individuals to hold the designation of both medical doctor and licensed architect.
Q & A
'Thoughtful Design' From the Patient's Perspective
Q&A with George Tingwald, MD, AIA, the surgeon-architect
who planned the new $2 billion Stanford Hospital.