I recently went to Jefferson to see my doctor. It was a doctor I don’t need to see very often, and I had not visited her for several years. When I spoke to the person to set up the appointment, she told me that the office had moved. When I arrived, I was immediately impressed with the new modern location. I was also a bit surprised at the design, which was clearly created to use automation. The staff was significantly reduced from the last time I had an appointment with this doctor.
When I arrived on the correct floor, instead of the chaos of the last office with numerous staff calling out to waiting patients and a bit of a maze, there was a single receptionist. The receptionist checked me in quickly and asked me to sit and wait. After a very short time, a nurse came to get me and took me to an exam room. In the room was a large monitor with a notice informing me that the camera was off and that it would be obvious if it was activated. The nurse took my vitals and left. My doctor came in quickly and we had the appointment. As always, this particular doctor was thorough, kind, and concerned. She listened to me, and we addressed the issue I had come to resolve. As she prepared to leave the room, the doctor explained that the monitor would turn on and someone would help me schedule the next appointment.
A Quieter, More Automated Experience
As my doctor promised, quickly after she left the room, the monitor turned on, and a friendly woman helped me arrange my next appointment. We discussed the new process because I am interested in such things. After we set the new appointment, the monitor turned off, and I left. I didn’t need to stop and talk to anyone on the way out.
I often have interesting conversations with my doctors, and this appointment was no different. The doctor and I discussed the new building. We both agreed that it was nice and impressive. We also agreed the elevator was confusing, an issue I will return to in a moment.
The Old Waiting Room vs. The New Reality
As noted, the waiting rooms in the old building were busy, loud, and often felt disorganized. You waited to check in. You waited to be called. You waited to check out. There was a lot of visible activity and a lot of visible inefficiency. The new space removes most of that.
When Efficiency Becomes Assumptive
One major change was the elevator system, which the doctor and I talked about. We both agreed it was a bit confusing. The doctor told me it took some time for her to get used to it. What was different about the elevator? First, there were no traditional buttons to press. Instead, there was a screen upon which you pressed the floor you wanted. The screen then told you which elevator would come for you.
Here is the only area where I had an issue. Not because the elevator is a bad idea, I am sure it is very efficient and helps when there are crowds. The problem was that there were no instructions. It took me a few moments to look around and figure out how the elevator worked.
I would hope, by this point, if you are a follower of my blog, you know that I am comfortable with technology. I work with tech and tend to notice systems. But I still had to pause and figure it out. Later, this caused me to stop and think about how this new elevator system works for people who are not comfortable with technology. I wondered about older people, stressed‑out patients who are already overwhelmed, and people who don’t see well.
Why This Was Not Theoretical for Me
At the time of the visit, I was in the third category. I underwent cataract surgery on one eye in December. I ended up with a longer gap between surgeries than normal due to the holidays. A longer period between surgeries can cause some temporary issues, such as blurry vision. In addition to blurry vision, my right eye, the one that was already operated on, was also starting to ache. This was starting to impact me. I even misread an email from someone who was coming to my house to do some work.
I mention my vision issues because I want you to know that, since I could not see very well, it impacted my ability to figure out the elevator. So my experience was not theoretical; it was something anyone could have experienced. Thinking about this later made me very aware of how the space set up for medical care assumed visual clarity and comfort with self‑directed technology.
The Building as the System
This entire building, which I suspect is how many buildings will be designed in the future, was created around the idea that patients can move through it with no assistance unless they bring someone with them. Instead, visitors need to rely on the screens.
Without getting into the issue of computers replacing people, I will say that the systems worked for the most part. Leaving the elevator aside, things were smoother, and everything was quieter and more efficient.
Adaptation Is Assumed
However, this modern design also shifted the burden. By removing human beings from the building, you remove the guidance they previously provided. This sort of system assumes that human beings are able to adapt. Despite my lack of visual acuity, I was able to adapt quickly. But what about other people? Without being specific about the type of doctor, I will say that she is for people who may have serious problems seeing and understanding technology due to age or health. Regardless of the type of doctor, medical facilities tend to be visited by people who are not at their best. They are in pain, are anxious, perhaps medicated. It is likely that they are cognitively overloaded due to the stress of visiting a specialist or any kind of doctor. White‑coat high blood pressure is a known phenomenon because people are stressed at the doctor, and it causes their blood pressure to rise.
Designing environments that require visual scanning, inference, and confidence is a choice. It is not a bad choice, but it has consequences. What struck me about this visit was not that it was creepy, at least not to me. I didn’t find the experience to be cold. But I did notice the lack of staff, and it made me wonder about how people feel about this type of experience.
What We Do Not Usually Talk About
I frequently talk about AI and how it is changing things. The first talk I did on AI included the impact on the medical profession, but I will admit I didn’t think about its impact on architecture. In the case of this new office, human beings are no longer central to the workflow.
How will these changes impact our future? What will this do to how people feel about going to the doctor? What will these changes mean for patients? Are those designing buildings looking beyond the systems into who the building is made for and making certain the patients will be comfortable?
I have to wonder about what all of this means for the future of medical buildings and architecture in general. After all, even I had a moment when I was confused.