At an event this week I had the opportunity to talk with leaders in the healthcare facilities community about the state of the industry and the challenges they are facing. It should not be a surprise that the biggest concerns organizations are dealing with right now are all related to the drastic changes that have occurred in our economy over the past month. New project starts are uncertain and many people are taking a wait-and-see attitude due to the upcoming presidential election.

So I started to wonder: Have we really moved so quickly from an industry-wide attitude of optimism about the future and planning for new projects, to an absence of confidence in our economic foundations? Is my perception really an accurate reflection of the way we viewed our situation merely one year ago?

In a review of news stories and blogs from October 2007, it becomes apparent that we have been through a lot of changes in the past year and, if anything, the economy and election have refocused our collective attention:

· Hillary Clinton, Mitt Romney, Rudy Giuliani, Mike Huckabee, and Ron Paul were still holding onto their presidential hopes.

· A gallon of gas averaged $2.82.

· Congress was fighting over immigration reform legislation.

· The Dow Jones Industrials Average reached an all-time high of 14,164 on October 9, 2007. DuPont, Apple, UPS, and Amazon were reporting significant increases in earnings.

· The growing effort to fight global warming was a consistent headline as a national sustainable movement continued to gain momentum.

· Airlines were beginning to show signs of resurgence as flights filled up and demand for business class seating increased.

There was very little to suggest that we might be heading towards the destabilized situation of today, so how can anyone be blamed for holding onto an optimistic outlook well into 2008? None of us wanted to believe there would be an end to the very good times we were experiencing. We may have forecasted a slowdown, but few of us saw the drastic downturn.

Fortunately, healthcare is an industry that cannot stop growing or innovating for very long. Facility infrastructures continue to age, technology continues to improve, and people continue to need quality care.

So I am looking forward to October 2009, when I can reflect on the state of our industry, relieved that another year has passed and forward progress has once again become an expectation.

Mark Patterson, AIA, ACHA, LEED AP, is vice-president and practice leader at SmithGroup, a leading healthcare architecture and engineering firm with 10 offices across the United States.