Click here to read Part 1 of this interview.

A. Ray Pentecost III, DrPH, FAIA, FACHA, LEED AP

Vice President, Director of Healthcare Architecture, and Design Principal, Clark Nexsen Architecture and Engineering

A. Ray Pentecost has demonstrated throughout his career that when given the opportunity to lead and influence healthcare design, he will. He has done so and continues to do so with great passion from leadership positions that have national and international influence. His national leadership roles on the Board of Directors (and as president from 2009 to 2010) of the American Institute of Architects Academy of Architecture for Health (AIA AAH) and the Board of Regents of the American College of Healthcare Architects, his international leadership as president of the International Academy for Design and Health, and his role as co-chairman of the AIA’s America’s Design and Health Initiative demonstrate that Pentecost’s peers are inviting him to take positions of tremendous influence in the healthcare design industry.

Combining his training in the field of public health and research with his passion for architecture, Pentecost has been heavily focused on identifying linkages between design and health. Presentations made in the United States and internationally, as well as articles written on the subject, have served to help elevate this issue to prominence.

Pentecost has also been an outspoken advocate for the use of research in design, a practice that is changing the way healthcare facilities, and indeed other building types, are designed. His leadership and advocacy of healthy design as a national priority while serving as president of the AIA AAH was codified when the AIA AAH board approved revised bylaws including a mission statement that embraced not only healthcare design but the design of healthy communities. The result has been a broader perspective and scope of service for the leadership of the nation’s premier membership organization for healthcare architects.


Todd Hutlock: What sort of advice would you offer someone who is just starting a career in the healthcare design industry?

A. Ray Pentecost III, DrPH, FAIA, FACHA, LEED AP: I suppose I would offer two suggestions, the first a comment on who you become, and the second on what you learn to do.

The first suggestion would be to become an expert as soon as possible in your career. There are basically two paths to becoming an expert. One path is easily understood using the analogy of a children’s game. Many of us will remember the childhood game of “king of the hill”; picture the kid on top of the hill as the expert in his/ her field who fought hard against “look-alikes” trying to climb the same hill doing the same thing, and this illustrates one way to the “top” in your career. This is a path to expert status that is exhausting, time consuming, and part of a cycle of activity and challenge that is never ending. Of particular note is the harsh reality that not everyone even makes it to the top, for a host of reasons, including some who arguably even deserve to be there, and fewer still are able to stay there. At the end of the day, you look very little different from your peers, or for that matter, the next set of challengers.

The second path to achieving expert status is to define yourself, and your career path, so distinctly that you are confronted with very limited competition as you make your way to the top of the hill. You become an expert by definition, not from competition. This can be done in a number of ways, such as with niche in-depth understanding about a subject, or a combination of education and training experiences in different disciplines which, in their combination, equips you with a voice that is virtually without equal in the industry. You become an expert in the multidisciplinary voice for which you trained, and others, rather than try to duplicate it, will simply ask you to contribute your expertise. This path to expert status is faster, offers less competition, and offers more time to focus on maintaining and strengthening the status of expert. It allows you to establish your own value proposition, largely independent of what someone else is doing.

But I don’t believe that becoming an expert, no matter the number of disciplines or fields of study, will be enough to ensure career success in the future. The truth is that the world is not simple, relying on the voice of any single expert to solve a problem. Moving beyond the challenges of today and tomorrow will rely on solutions that are complex, multidimensional, multidisciplinary, and potentially dynamic.

Having said all of that about becoming an expert, my second suggestion is that those who would be successful in this field should also master the ability to integrate additional disciplines into one’s own area(s) of expertise. This should be a natural progression of the training for most architects who have chosen a career in which they likely will function as “integrators” to a greater degree than in any other role, including designer. They will first be asked to integrate a multitude of client priorities, wishes and interests, and then integrate with them the realities of codes, design guidelines, the specialties of sustainability, biomimicry, public health, local urban planning dynamics, finance, medicine, building research on materials, project delivery methods, building performance, a world of BIM capabilities, and facility management priorities, just to name a few. Integrating these different knowledge areas, each representing an opportunity for expertise in its own right, into a singular solution will be increasingly seen as the norm for the design community. Those who have built career competencies around their own expertise, ignoring the very special skill sets that would empower them to integrate additional knowledge bases into their own, will struggle.

Some would counter that this is what architects do anyway, and I do not disagree that some of this happens already. What I believe is different about tomorrow’s market is both the magnitude of integration that will be expected and the far greater number of disciplines that will bear on design solutions, and the potentially staggering volume of information available in these disciplines accruing from multiple kinds of research activity. I believe the successful “integrator” in healthcare design will not stumble casually onto that competence; rather, I believe it will be deliberately cultivated and refined, and by the way, particularly highly valued.

Hutlock: Obviously you influence and inspire many people in the healthcare design field. Who influences and inspires you in your work?

Pentecost: I am greatly impressed by those who know their limits. I am reminded of a conversation with my father and mother in my senior year in college, in which I was seeking their advice about choosing an internship for the following year. My father—a successful architect with his own practice, and whose approach to architecture (and life) I had come to greatly respect—made a statement that I can still remember as clearly today as the day he actually said it in the spring of 1975. After listening to my review of the internship opportunities from which I would choose one, he said, “Son, we love you, but you have reached the point where you have exceeded our knowledge of the subject, and consequently our ability to advise you. Just know that we will support you, whatever your choice.” Now, as a parent myself, I reflect on that conversation and marvel at
the personal strength and wisdom my parents possessed to say those words to me.

I also have to acknowledge those who have made me a project, my mentors, and I have had several over the years. I will mention, and thank, my first mentor, Dr. Robert Douglass, FAIA. Many readers will know and remember his expertise in healthcare facility programming and planning. He was a professor at my school of architecture and also at my school of public health. He loaned me his name as an advisor on my first serious research grant proposal, then known as the AHA-AIA Graduate Fellowship in Health Facilities Design, now known as the Tuttle Fellowship. It was awarded to me in 1977, and upon sharing that news with Bob he said something that has proven valuable throughout my career: “It is wonderful when you get the light to shine on you, but once it does, you really have to dance.” In a sense, that has been the message of each of my mentors through the years, as they prepared and equipped me for a broader and richer career experience. Indeed, their efforts continue to inspire me to always dance to the best of my ability.

I will mention the writing of Alan Ashley-Pitt. Early in my career I came across some of his writings and they resonated with me. They basically spoke to the message I gave earlier about becoming an expert. I shall do my best to include it accurately here, but will encourage readers to find it and embrace it for themselves.

The man who follows the crowd will usually get no further than the crowd. The man who walks alone is likely to find himself in places where no one has ever been before.

Creativity in living is not without its attendant difficulties, for particularity breeds contempt. And the unfortunate thing about being ahead of your time is that by the time others finally realize you were right they’ll say it was obvious all along.

You have two choices in life. You can dissolve into the mainstream or you can be distinct. To be distinct you must be different. To be different you must be what nobody else but you can be.

Over the years I have taken both inspiration, and comfort, in these words. If each of us could celebrate, and be celebrated for our individuality, what an amazing place this would be! 

Also, I am impressed with and influenced by those who can see patterns in the noise of daily commerce and communication, and then articulate those patterns with a clarity and simplicity that enables the hearer to comprehend, and then act upon them. Among those with this gift I think of Jim Bills, an executive with Novell when I heard him speak in the early 1990s. He mentioned that the electronics industry needed to acknowledge that it was no longer an industry of vendors, but was in fact an industry of integrators. By that he was noting that an electronics product bearing one brand name was rarely composed entirely of components developed by that brand. It was, more likely, a product made from components from multiple manufacturers that had been integrated into the one product. The truth of that, as it applies to what architects do as integrators of multiple kinds of information into singular solutions, crashed in on me in that moment, and I have not seen my profession the same since. I now have a clear sense of the integrator role that I play on every project team I am fortunate to join.

The work of a professor at the Dallas Theological Seminary, Dr. Howard Hendricks, has influenced much of my thinking. He tells the story of a student who walked to campus early every morning, passing one of his professor’s homes, and returned the same way late every evening after leaving the campus library. With rare exception, both early in the morning and late at night, the light was on in the study of that professor. One day the student asked the professor why he studied so much, pointing out the exceptional career that the professor had already achieved. The professor replied, “The answer is simple. I would rather have my students drink from a running brook than from a stagnant pond.” That perspective has profoundly shaped my daily walk. I now appreciate and value studying, learning and growing as being central to my effectiveness with clients, colleagues and students.

I have also been deeply touched over the years by leaders and persons of influence who were willing to take the time to acknowledge me when I was just beginning my career. There were times in those early years, as is often the case with young professionals, when finances were tight, and it was all I could do to just make it to a convention. Nice meals, social encounters, and business entertaining were things I understood and witnessed, but which were simply beyond my reach. Every now and then an established architect would remember me, gesture for me to join a conversation, and sometimes even ask me to join a dinner with other people I didn’t know or with whom I had little relationship. For me it was always a special moment when a highly successful professional noticed my situation, and with no fanfare and no big deal, respectfully included me in his circle, at his dinner table, as his friend. Many individuals could be mentioned here, and I dare not start for fear of missing one, but surely they know who they are, and I thank them.

Finally, I have to say that I have been deeply touched by the example of leaders who were just as effective in leadership, or even more so, when they no longer had the title of “leader” as when they had the title. This betrays a character strength and sense of purpose that are difficult to define, but unmistakable when they appear. A good leader inspires without contextual boundary, and without procedural or policy limitation, but with a universality that is empowering, confidence building, and forward-looking… forward-looking to a time when one no longer has the title of leader, but can, in fact, continue to lead.