Over the years nature photographer Henry Domke, MD has become synonymous with healthcare art. His hundreds of photographs encompassing woodlands, streams, the seashore, and flora and fauna, some of it extremely close up, grace the walls of physicians' offices and hospitals throughout the country. (The offices of HEALTHCARE DESIGN and The Center for Health Design have been beneficiaries of Domke photo collections and proudly display them.)
Henry Domke, MD

Henry Domke, MD

A couple of years ago, though, Domke-a family physician turned photographer-decided that this wasn't enough. He had developed an intense interest in the uses of art in the therapeutic environment and wanted to learn more: Who was doing what? How was it working? What sort of evidence was emerging on this in the growing field of evidence-based design? His approach, so obvious now but less so then, was to start his own blog.

The 600-700 people who regularly visit http://www.henrydomke.com recognize that Henry's blog has developed in the direction of becoming a virtual magazine. The sheer variety of topics addressed and responders has grown so markedly in such a brief period of time that Domke recently published a hardcover book based exclusively on his blog (http://www.Health CareFineArt.com), called Picture of Health: Handbook for Healthcare Art. Recently Domke elaborated on this unusual publishing venture and its implications in an interview with Richard L. Peck.

Richard L. Peck: How did you put together a blog so encyclopedic, in a sense, that it ended up as a 200-plus-page hardcover book?

Henry Domke, MD: The blog certainly does meander! Seriously, my intention was complete coverage of the subject of healthcare art. When I started it almost three years ago, though, I didn't know what a blog was. My basic motivation was to learn more about art in healthcare because I was finding it difficult getting information. There were snippets here and there but no one had put it together in any substantial way. So I thought going online and experimenting with an interactive format would be informative for me, and hopefully for other people as well.

Peck: What helped you to get the ball rolling?

Domke: I know a lot of people in the healthcare design field, and most of the experts on healthcare art. Also, I'm persistent. I like to ask a lot of questions-“What about abstract art?,” for example, or to take a more provocative stance on it, “Why isn't abstract art any good in the healthcare setting?” I welcome people who disagree with me-and you get some very passionate responses! I'm no journalist and a mediocre writer at best, but I'm not afraid to ask questions like this.

Peck: There's been a lot of dialogue in the blog on evidence-based design-what it means, and how it applies to healthcare art. With your medical training and background, what is your take on evidence-based design?

Courtesy of Karlsberger

Domke: I've been surprised at how misinterpreted it is. I think it's valid to say that evidence-based design is a critical part of any healthcare design tool kit these days, but we do have to acknowledge how little we really know. I've done polls asking people what percentage of their work do they think is based on solid evidence, and you get practitioners who say 50% and researchers who say 2%, so there's a pretty big gap in perception. As a physician, I view evidence-based as meaning peer-reviewed studies and studies that publish negative as well as positive results, because negative results are instructive too. Much of what designers do, though, is reacting to what they see and experience, so that's why evidence is only a part of it. Another concern I have is that good studies, of the type I alluded to earlier, are very expensive to do. Who is going to pay for a good study-the client? Project budgets are tough enough already for designers, so building in those costs wouldn't help them be very competitive.

Peck: Your views sound like the blogosphere to me! Any other current topics that are especially “hot”-sustainability, for example?

Domke: I haven't seen a whole lot on that so far in the blog. But then again, everybody is green these days-if you're not, you're nobody. In a sense, “green” has almost lost its meaning. Saying things like that, though, can offend people, one of the problems with blogging. Still, I can bring it to a personal level and say that my field, photography, has become quite green in recent years-all digital, no more chemicals and so forth. Our techniques are incredibly green now.

Peck: So what is the future of your blog? Another book, maybe?

Domke: I'm not sure. I do know that blogging is a lot of work. I've probably spent one hour per day per post, on average. Once I got involved in putting together the book I backed off from the blog a bit and started recycling some of the more timeless items and discussions. But we'll continue to develop new content, including interviews with people throughout the field. I feel incredibly lucky to have gotten good comments from so many knowledgeable and articulate people. Another great thing is that, even with a topic as narrow and “nichy” as art in healthcare, I still keep learning new things and finding new areas to explore. It's like photographing a large “backyard” for 40 years, as I have-there is always something new. HD

© Feinknopf Photography/Jason Meyer

Henry Domke's Picture of Health: Handbook for Healthcare Art is available as a free download from http://henrydomke.com. Hardcovers can be purchased from Henry Domke Fine Art, 3914 Foxdale Road, New Bloomfield, MO 65063.
Healthcare Design 2009 December;9(12):52-53