What’s your Mountain?

How is being an architect like scaling Mount Everest?  I always read accounts of climbers with a sort of sick fascination, part of me wondering what would ever possess anyone to take on this task.  You can’t even see very far from that high up, and your body is so ravaged by the lack of oxygen and extreme cold that you can’t hang out up there and enjoy it.  As someone who is not athletic and is proud of myself that I attend yoga class three times a week, I don’t have a refined appreciation for the physical.  Especially an extreme sport like mountain climbing. I didn’t see the appeal of putting your life on hold for nearly a year to train, then scale this mountain.  Why, why, I thought would anyone risk their life like this?  Why would they make themselves so uncomfortable, put their bodies through such a grueling experience?  I recently read Mark Inglis’s story of how he scaled Mt. Everest as a double amputee. Mark’s account helped me to see that it was about more than just the ego. 

It’s easy to take the concept of scaling Everest as a totally literal pursuit.  The man vs. nature plot at its finest.  But that would be getting it wrong.  You don’t climb the mountain to conquer the mountain.  You climb to conquer yourself. It’s about setting a challenge and devoting yourself single-mindedly to meeting that challenge with every resource of your physical, mental and spiritual being.  If you are going to climb Everest, you cannot let anything stand in your way, especially not yourself.  You clear out your life to train and then make the climb.  And then you let go, you work with, not against the mountain.  You respect its seasons, weather patterns and above all the advice of your guides.  Depending on the year, you may not make it up and the fact that by waiting, you live to make the attempt another time has to be enough.

So back to life as an architect.  What’s your Everest?  What big goal do you have that you would devote yourself to achieve?  What matters so much to who you are that you will make the time and the space to realize it?  If you don’t know, or came up with some wimpy goal like “get a promotion,” you are not alone.  Maybe just thinking along these lines made you feel slightly depressed because your career is so NOT going the way you hoped it would.  You may even be rolling your eyes right now and thinking that having a goal as big as yourself is as ridiculous as it is unattainable.

I’m here to tell you that it’s not.  You can have a career that is life-affirming because it reinforces your sense of purpose in this world.  But first, you have to be deeply in touch with what that purpose is.  You have to have a personal mission statement and a plan that includes steps you can do today that align you with that purpose.  You have to clear away all the fears and all of the rationalizations that are holding you back.  Like the mountain climber, you have to eliminate all the waster activities in your professional life that are not directly moving you towards your goals. 
As a reader of this blog, you aren’t content to have just an average career.  You want to make a difference.  You want to operate as an inspiration to the world.  And I want to help you get there.  In addition to my blog posts, I offer career coaching services that allow you to work with me one on one on your individual career quest.  I’m also so excited to announce that I will very shortly be publishing my first book, Career Crisis.  This book contains many of the strategies I use with my coaching clients, but it let’s you use my techniques and act as your own coach.  It’s not very long on purpose because it’s not meant to dictate, but to guide you.  You have to do the work, but if you do, I promise you’ll be amazed at the transformation you see in your career and in your life.

Find your career mountain and know that you can get to the top.  Get ready to challenge yourself to your greatest potential, to concentrate your efforts to a single purpose, to push through hardships, and finally, to stand up on that summit and say, “Yes, yes, I did it!”

Remedies for Healthcare Design: Major industry directions you need to address

Sometimes as architects, we get so myopically focused on what we do, in the process of design and project delivery, we fail to see the biggest picture. Our clients and colleagues often suffer this same malady, leaving us in need of a new place to go to seek perspective, and get out of the healthcare design echo chamber. One of my sources of choice is MedCity News. Founded in 2008 by Chris Seper, MedCity is a clearinghouse for information on all things related to healthcare and life sciences (which I often find includes many other aspects of design as well). Precisely because of his vantage point as a journalist, not a designer, with his finger on the pulse of macro issues impacting healthcare world, Chris has some amazing insights into what we’re missing:

There’s been a lot of focus lately on the patient experience. How do you see these trends impacting healthcare spaces themselves?
Patient engagement is emerging as a big issue, as healthcare consumerism rises. This will include a bigger emphasis on wayfinding, guiding patients around the hospital, as well as designing hospitals to provide more information through integration of data and organization of the space. It is also important to make the hospital feel less institutional and more welcome. Hospitals are the least inviting of any buildings, but now they are the largest buildings being constructed in most cities. For example, when you compare past architecture and current major building projects here in Cleveland, you are comparing structures like Symphony Hall and Playhouse Square to the University Hospital’s Seidman Cancer Center and Cleveland Clinic’s Sydell and Arnold Miller Pavilion or the Medical Mart. Healthcare will sculpt the face of many of the metropolitan areas of the country, it’s where the jobs are and the donors. There is an external aesthetic, and a legacy that will be written by hospital designers, something that was not even thought of seven to ten years ago. City planners will wake up too late to understand how to integrate them into the urban context. In 50 years, these hospitals will be the historic buildings we will be looking at. It’s an unknowing legacy.

How important do you think employee satisfaction will become in healthcare? What are some ways that amenities offered in the work environment will affect this?
You hear about shortages of high quality talent, but the indicators are that this is a buyer’s market. Many physicians are running to be acquired by health systems. Nurses have suffered notoriously poor treatment and are being laid off. Unless you are a rock star clinician, most systems will treat you like a widget. Any changes to your environment will be based on how it will extract value to patients because of the emerging reimbursement model and business model. The answers for shortages are to leverage technology and increase productivity, i.e. telemedicine.

How can design work to support the technological change taking place in the way healthcare is delivered?
There’s a lot of product fulfillment going on, leveraging RFID, sensors, wireless networks, better inventory management. There needs to be a level of consideration of how you manage and supply these systems. How patients flow matters, but so does inventory management to avoid over or understocking of supplies and correct delivery of drugs. Security will also be a bigger issue. How do you design a hospital where these are no visiting hours and people come and go all day?
I was at the Digital Health Summit this year and came away realizing that there were three major issues impacting healthcare; changes to government policy on reimbursement of sick care vs. management of wellness, the food people consume or are forced to consume (i.e low income residents of food deserts), and unlocking the desire of human beings to be healthy. Most people who need health and wellness don’t seek it or can’t do it. Most people who do seek healthcare are the worried well. Therefore, hospitals are dealing with managing the seriously ill or crisis conditions, while at the same time trying to pivot their focus on wellness.

We are a third of the way at most to achieving optimal healthcare delivery. Despite the resources out there for people to manage their own health, no physician is going to trust information gathered by a patient. Technology is still in the background. Mobile apps are useless when it comes to the clinical diagnosis of your problems because the rules and regulations and ability to quickly scan or tag information is still not there. There is also still a tendency to look to a clinical solution instead of a lifestyle one. For example, they are inventing all of these high priced ways to deal with sleep apnea when the number one way to deal with it is weight loss.

As architects, we often have to place design in the context of a hospital’s value vs. cost propositions. How many of these emerging value scenarios will actually improve quality through innovation in delivery of care or process?
Innovation is the biggest challenge. If there’s one thing healthcare is panicking over, it’s how to change their innovation and interface. Motivations have changed. How do you leverage data, and keep it accurate and of high quality, much less tap into big data potential? Everything has been structured for silos. Healthcare over the past ten years has moved into a real overall ROI through cross pollination of ideas. A hospital will spin off and partner with early stage companies in ways they never would have in the past and pharmacy companies will pursue a mobile app as aggressively as they would have a molecule. The whole ecosystem is changing, but the structures have not changed with it. An triumvirate of healthcare has emerged; patients/customers, clinicians, and the B to B side. One of the things we have been able to accomplish with Med City is to provide a forum for all sectors to interact, especially the underserved B to B side of healthcare.

Chris Seper (chris @ medcitynews.com) is the CEO of MedCity Media, which publishes MedCityNews.com. Chris drives the culture, oversees business and editorial directions, and manages the governance of the company (he also writes periodically for MedCityNews.com). Chris is a former journalist turned media entrepreneur who launched MedCity Media in December 2008. He sits on the board of directors of The Civic Commons and the advisory boards of Spoke Software and Your Teen Magazine.