Interview with Garrett Ludwig
Name: Garrett B. Ludwig
Job Title: President, Diversified Design Technologies, Inc.
Hometown: Glastonbury, Connecticut
Businesses Profile: Garrett Ludwig currently provides professional healthcare office design planning and design services to all medical and dental specialty practices, and continues to lecture on the subject of dental office design to practitioners throughout the United States.
Journal: How have changes in the realm of managed care affected medical office planning?
Ludwig: Initially, those changes brought the industry to a screeching halt. Clearly the fear of the encroachment of outside controls on fees, and the imposition of new regulatory mandates, incited a panic throughout private practice health care. In an effort to consolidate and conserve, group practices began to flourish and the first things that were eliminated from the practice budget were facility expansion and capital improvements.
That was then, this is now. Ironically, the commercialization of health care that was provoked by managed care has inspired a mercantile method of thinking among health care professionals. Through this metamorphosis, most practitioners have become keenly aware of the benefits of image, efficiency, productivity, marketing and the retention of human resources. Consequently, they are now investing in the services of health care design specialists like myself in an effort to ensure that these elements are incorporated in their facilities design.
Journal: What are some of the special requests dentists and doctors are asking you to incorporate into their office structures that we weren’t seeing a few years ago?
Ludwig: Accommodations for advanced technological services and environmental accents- in a nutshell: computers and fountains. Although the computer has long been a staple component in health care administration, the technological developments that abound in clinical diagnostics, treatment and practice management have brought the computer out of the business office and into the treatment room. For example, diagnostic charting, scheduling, visual imaging and digital radiography are routinely performed in the dental treatment room along with some record-keeping. Each of these functions is dependent on a stand-alone PC or networked computer system. On the environmental forefront, there’s a growing awareness of the psychological and physiological benefits fostered by the integration of moving water in an interior environment. The visual and audible effects of a garden fountain or water wall can be both mesmerizing and calming. They can additionally serve as a soothing white noise barrier to the transmission of unsolicited sound, including the masking of private communications. They are also touted by many to remove airborne pollutants through the natural ionization process that is inherent in the flow of water. An interesting anecdote that endorses those theories took place with a client this year. I had purchased a table-model rock-garden fountain as a gift for the grand-opening of his office two years ago. He was so impressed with the fountains impact that, when we designed a satellite office for him this year, he insisted on installing a four-foot-high, seven-foot-long copper-clad water wall for his waiting room. Feedback from his patients has been incredibly positive.
Journal: Is it less risky to specialize in the medical office area because of its steady nature in terms of the economy?
Ludwig: Speaking exclusively to economic impact, one would assume that to be true; given the fact that health care is essentially recession-proof. However, because of its general stability, it has attracted design professionals whose primary client resources have been snuffed-out during an economic down-turn or who are seeking a more dependable client base. The fact remains that the health care market is very complex and is always in a state of flux. Without an inherent understanding of the basic needs and function of the medical and dental practice, combined with a keen interest in the research needed to embrace new technologies, few designers remain in the health care design market. Knowledge and desire notwithstanding, health care professionals tend to be extremely discriminating clients. It’s certainly not a market for the feint of heart.
Journal: How can a practices office design affect its success?
Ludwig: I’m convinced that there is a direct correlation between good design and the ultimate yield from the investment in those services. In fact, I adopted the slogan “Profit by Design” in an effort to bring clarity to my philosophy regarding professional design services. To wit, a practice can profit by the effect of design as well as profit by the purpose of design. The former is strictly one of image enhancement. Since the perceptions of a clinician’s quality of care begin as a patient enters a medical or dental suite, it goes without saying that a practitioner would want to make every effort to project an image which is representative of the quality of care that is provided within. Corporations and high-end retail outlets have long reaped the benefits of functionally designed and appropriately appointed environments. As managed care has spawned commercialism in health care, so has the “information age” created a market-savvy consumer. “As a result, patients are shopping for health care as they do every other service. A positive professional image is an indispensable and indisputably effective marketing tool in today’s medical or dental practice.
The latter is a more subtle orchestration of cost-management through the efficient use of space as well as the creation of a supportive work environment. If a design is executed responsibly, it should result in a measurable return on its investment. Conservation of time and motion by the strategic placement of support services not only optimizes efficiency and productivity, but creates harmony among vital staff members. As a result turnover in personnel is significantly reduced, and the expense of procurement and training of new personnel is profoundly diminished.”
Journal: Whats the thinking behind asking designers like you to separate clinical and administrative areas of a medical office?
Ludwig: The most profound benefit that I have witnessed is the patients appreciation for the practice’s respect of their privacy. Beyond the tactical use of white noise (fountains, music or synthetic sound devices) and acoustical contrivances the only effective means to assure patient privacy is to separate the areas where personal information is exchanged– be it medical or financial. The separation also serves as an effective means of traffic management, by eliminating the non essential convergence of patients and staff. I should note for the record that, as helpful as this concept is to privacy and comfort, it must be supplemented by full-height partitions that are constructed with sound-absorbing materials, in order to be truly effective in the development of a communications “safe” environment.
Journal: What issues exist in designing office space in the Northeast?
Ludwig: When calculating the amount of space that is needed for a health care facility, clients often overlook things like storage, wall thicknesses and corridor space. However, for those who consider a facility that has direct access to the building exterior, one of the least forgiving omissions when selecting a site in the Northeast is a weather barrier, or vestibule. With a little creativity and compromise, the oversight of internal accommodations can often be circumvented without significant sacrifice. However, the constant opening and closing of an entry door that exposes patients and staff to the harsh New England elements is an unavoidable necessity that must be addressed. As it stands, we are often forced to zone the heating in facilities that have a dominant exposure to morning or afternoon sun in the clinical area that may not be existent in the administrative space. The absence of a vestibule can compound those conditions exponentially. As a result, comfort is compromised, and energy consumption escalates. The solution, of course is to construct an internal or external vestibule. Although an external vestibule is fundamentally more complex and intrinsically more costly to construct, an internal vestibule will blatantly encroach on the available space. In either case, the enclosure must be large enough to meet ADA regulations. Clearly, consideration for this accommodation is part of long pre-planning check list that should be prepared prior to making a commitment for a long-term lease or purchase.