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

Back in the pre-stimulus dark days, when most construction activity had all but fallen through the floor, the American General Contractors Association (AGC) held a press conference reviewing their business' shaky state of affairs. Noting that the healthcare sector seemed to be sustaining hard times better than all the other design and construction fields (in fact, it is still ranked #1 in consistent level of activity), I asked the panelists whether they thought healthcare might be viewed as a safe haven for contractors looking for work.

I received a surprisingly vehement response from one of the panelists, a highly experienced general contractor. He said, in so many words, there was no way this would happen. Healthcare was just too specialized and required special qualifications for the designers and builders involved, and it was highly unlikely that outsiders would try to step in. Of course, we have declaimed in this magazine for years on the special nature of healthcare design. Still, I was never sure that the design and construction field at large totally bought into that view.

Further evidence that it had, though, came from a poll we ran not long ago on our Web site, http://healthcaredesi.wpengine.com. Given a choice of statements ranging from “Healthcare design/construction will be a good area for underemployed designers/contractors in the commercial and residential fields to find work these days” to “Healthcare design/construction is for experienced specialists only, whatever the state of the economy,” fully 58% of respondents supported the latter view (and only 14% the former). As I've said before, we make no claims for the scientific accuracy of our online polls, which are really more in the nature of samplings. Still, the overall strength and thrust of the results indicate that the truth is lurking somewhere nearby.

All of which is to say, healthcare design can be considered a secondary market no longer. Its projects are too big, its demands and complexities too great, its liabilities for human welfare too risky. If you don't know what you're doing on a healthcare project, you can end up in trouble with a capital T.

This isn't to say healthcare design will go unscathed by the economic meltdown. Hospitals are struggling to maintain census and reimbursement, and are putting projects on hold or cancelling some outright. But in the overall scheme of things, activity remains significant based on continuing commitments and unflagging market demand.

A “greener pasture,” though, it isn't, and apparently never will be. HD

Healthcare Design 2009 April;9(4):56