“Reflections” is a new column featuring thoughts and commentary by former HEALTHCARE DESIGN Editor-in-Chief Richard L. Peck.

Not long ago the http://HCDMagazine.com blogosphere saw a somewhat heated exchange between a blogger and a couple of our editors over the concept of design/build. I am not about to say who was “right,” nor am I particularly qualified to judge. The only point I would note is the reformist tone struck by the architect/blogger.

He did not confine himself merely to defending the design/build model as systematically or operationally superior to the traditional design/bid/build or construction management model. He asserted, rather, that the conventional approach had become corrupted over the years so that architects, engineers, and contractors were each fighting to maximize their interests at the expense of the non-expert, all-too-trusting owner. Budgets and change orders are soaring out of control because of this, the indictment says. Design/build, on the other hand, would integrate these interests and be better able to offer focused cost-effectiveness and some sort of pricing guarantees.

In short, design/build would move the AEC process from the murk of shady dealings to the sunlit plains of transparent decision making and complete financial disclosure.

A more recent iteration of this is in an article, to be published soon, from a major design/build firm in the Midwest. The article is highly informative about the process of design/build but, again, reads somewhat like a reformist tract. It is edgy, critical, even condemnatory of undisciplined project management arising from the allegedly misaligned incentives of the major players. And yet, the authors note, the conventional process is sanctioned by today's architectural powers-that-be, including the AIA. This makes it almost “impossible” for a truly integrated design/build firm to function, they claim, although they note that they are doing very well, nevertheless. One can almost see the placard from the old silent movie: “Virtue Triumphs.”

This stance may be entirely justified. Conversely, as with all moral movements, some innocent (or trustworthy) parties may be smeared inadvertently, which is of course unfortunate. To me, the most striking aspect of this is to find that for an activity so seemingly mundane and rational as the conventional AEC process, serious moral overtones emerge. I don't know who's right, but I would say this: Owners, pay attention. You have nothing to lose but your shirts. HD

Healthcare Design 2009 July;9(7):80