Chapter 13: The Master Plan Brings Special Challenges: Successes with the Faculty Center and the Mays Clinic (Ambulatory Clinic Building)

Chapter 13: The Master Plan Brings Special Challenges: Successes with the Faculty Center and the Mays Clinic (Ambulatory Clinic Building)

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Mr. Daigneau explains that the new Faculty Center is located on a site of a privately owned parking lot. Mr. Daigneau tells a story about threatening to use MD Anderson's power of eminent domain in order to bring the developer that owned the lot to come to the negotiating table. Mr. Daigneau next explains that he used the design-build system to construct the Faculty Center: this was the first time the system had been used by the UT system for any complex building. The Faculty Center was completed in record time, fourteen months for thirty-five million dollars. Moving the faculty offices out of the clinic buildings allowed them see more patients, earning enough money to renovate existing buildings.

Mr. Daigneau next talks about backfill and redevelopment projects totaling nearly 100 million dollars. He describes the changes required in the Alkek Hospital and LeMaistre Clinics. Speaking about the Faculty Center, Mr. Daigneau notes that he was able to get the administration to promise that if he would complete the building in the short time frame for the 35 million cost, if it was never used for clinical purposes. To construct the Faculty Center, he studied office tower buildings. At the same time, Mr. Daigneau explains, MD Anderson was looking to expand clinical services. He describes the Houston Main Building (also called The Prudential Building) the institution had acquired in the seventies, a twenty-acre property located at the corner of Fannin Street and Holcombe Boulevard. He and Kevin Wardell (to whom he reported) decided to locate the ambulatory clinic at this site: a 250,000 square foot clinic to be constructed in 36 months. Mr. Daigneau explains how the project was eventually expanded to 6000,000+ square feet, though there was no clear determination of who would occupy the building.

Mr. Daigneau next describes the hurdles overcome to insure a rapid building process for the Ambulatory Clinic: creation of the site master plan (to include 4 buildings); sorting out transportation and traffic circulation issues within and around the site 'a process that involved negotiations with the Texas Medical Center to construct new roadways. He notes that building went ahead though the occupants had not yet been determined, despite discussions that involved all section heads: Dr. David Callendar eventually decided who would occupy the building. Mr. Daigneau explains that the design-build process was used 'a controversial move on such a complex building and the largest ever constructed in the Texas Medical Center. Mr. Daigneau explains the construction approach used by adopting a mall-type strategy of determining anchors. He describes the unique features of the Mays Clinic, decisions made that were critical for the future, some political issues that had to be resolved. He describes the radiation oncology suites that had windows for the first time (instead of being sunk in the ground) and the way circulation was planned to help with wayfinding.



Next, Mr. Daigneau explains how Dr. Callendar found two volunteers to occupy the site and also outlines why the Mays Clinic is one of the best-planned, comprehensive facilities from the perspective of patient experiences.

Identifier

DaigneauW_01_20131003_C13

Publication Date

10-3-2013

Publisher

The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center

City

Houston, Texas

Topics Covered

The University of Texas MD Anderson Cancer Center Building the Institution; The Administrator; MD Anderson History; MD Anderson Past; Institutional Processes; Discovery and Success; Building/Transforming the Institution; Growth and/or Change; Obstacles, Challenges; Professional Practice; The Professional at Work

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Disciplines

History of Science, Technology, and Medicine | Oncology | Oral History

Transcript

William Daigneau, MBA

So immediately, we put into operation the plans for the Faculty Center, and there was a parking lot there. It was an interesting parking lot because it was not owned by Anderson; it was owned by a private developer from Canada. And Texas Medical Center basically had a lease to operate a parking lot on that site which most of our faculty parked in. A lot of people parked in there. But when they had built the first Rotary House, they built a bridge across the street, and when we built the LeMaistre Clinic, we basically extended that bridge that had already been built at Rotary House, which terminated on the other side of Holcombe. We extended it right into LeMaistre. I was never real happy with that bridge, mainly because of the slope on it. People coming across from Rotary to the main complex have a pretty significant slope to get to the third floor of LeMaistre. But again, that was one of those designs that had already been put into place, and basically I was executing that. But I was never really happy with that bridge for patients. But—but the only people that were really using the bridge were people staying at Rotary House, so it wasn’t too bad.

So when we were looking at all the sites for clinical expansion, we kind of ruled that out across the street for clinical purposes but ruled it in for office use—faculty office use. So we put into motion to build that and build it as fast as we could.

Tacey Ann Rosolowski, PhD

How did you acquire the parking lot area?

William Daigneau, MBA

Well, that was my first—that was my foray into the administration with Texas Medical Center, which was led at the time—he’s retired in the last year—by Dr. [Richard] Wainerdi. First of all, we had to negotiate the release of the lease with them, and then we had to acquire the land. And the Canadian developer was not—did not want to sell. Now, at the time, since we’re part of the UT System—technically a part of state government—we have the power of eminent domain. The problem was nobody in the UT System administration wanted to use eminent domain because it was always public and created a lot of harsh feelings by people. But I was able to eventually convince the attorneys and the administration at UT that all we really wanted to do is threaten the use of eminent domain—go through the motions as though we were in the process of employing it to the point where we sent the developer a letter notifying him of our intentions to use eminent domain. To make a long story short—

The Mays [Ambulatory] Clinic and The Faculty Center

Tacey Ann Rosolowski, PhD

Can I ask you, what are the implications? Because some people who are listening might not have in mind what eminent domain is.

William Daigneau, MBA

Well, eminent domain is the use by government of acquiring private property for the public benefit. It’s most often used with highways. The interstate system was built extensively using eminent domain because you’d have to go across somebody’s farm in Kansas. Somebody owned that farm, but that was the route of the interstate system. The government would come in and basically the process is you pay fair market value for the property, and that is determined by independent appraisal. And there’s always some negotiation that occurs, but basically you’re paying that landowner for their land.

The reason it’s disliked by many people is—let’s take the farm example. That roadway is going right through the middle of the farm, so now what’s left for the landowner? Two pieces on each side of the highway. How are we going to get across? So it reached its peak of notoriety—the use of it—I think it was a city in Baltimore—I can’t remember exactly—used eminent domain to acquire people’s property in the city so that they could redevelop it for commercial uses. Now, the argument was that the city tax rolls would benefit if there was a higher and better use, but also, at the same time, a lot of people who had lived in those homes their whole life were displaced. There were lengthy court battles. It went to the Supreme Court. So eminent domain got a bad name. People could tolerate a farm, highway. We understand the benefits of putting the interstate system through, or improved road, but now you’re buying it so you can turn it over to a private developer? That doesn’t make sense.

So it got a bad name, so there was hesitancy to use it. And of course, in Texas—you know—very independent-minded folks, government intruding on their personal—so eminent domain, even though the power is used, was a last resort. Well, here comes MD Anderson wants to use it to acquire a parking lot to build an office building. It’s hard to explain to people the logic of why this makes sense from a mission standpoint. They’re just looking at you’re building an office building; you’re taking this poor person’s livelihood away from them.

Now, this particular developer offered to build us an office building on his land and then lease it to us, but obviously we didn’t want to do that. We wanted to be able to control the use and all of that. And it didn’t make economic sense. He wanted to charge us an arm and a leg for it.

So we threatened it. It was enough to bring it back to the table, and we settled. I think we settled in an amicable way, where he didn’t feel like he was getting deprived of things. Plus, he was very wealthy, so it’s not like he didn’t have a lot of resources. At one point in time, he came back to us—which we complied with—modified the terms of purchase so that the value that he could have achieved by self-development versus what we paid he could write off on his taxes as a donation to MD Anderson.

Tacey Ann Rosolowski, PhD

He got creative.

William Daigneau, MBA

He came out all right on that. So we had—but that took a little while to get control of the land. At the same time, we decided to use design-build. And as I said earlier, this was the first time design-build had been used other than for a very simple building such as a dormitory by the UT System. That project, from the point in time where we retained the architect to the time we occupied it, was fourteen months. One of the fastest—Dr. Mendelsohn remembered the amount we paid for it—thirty-five million dollars for this building—and always, from then on, asked me why things cost so much, because he remembered how much that building cost.

But we did it in record time, and so we were able to—with the completion of that building, we were able to mitigate the compression that was occurring and see more patients, which created another series of projects which were called the Backfill Projects and the Redevelopment Projects.

Tacey Ann Rosolowski, PhD

Is that the redevelopment of the Alkek?

William Daigneau, MBA

It’s going back into the Clark Clinic and the old hospital—Anderson—into Gimbel and renovating all of those older buildings to support more modern uses—expand the clinical operations, etc. So for example, the surgical suites in Alkek did not have a waiting room, so we used the Anderson—which was Anderson West. So the waiting room for the surgical suites on the fourth floor are actually in Anderson. So those kinds of things. So that led to a whole project to redevelop and what was called the Backfill and Redevelopment Projects—to go back into the older areas and expand them for clinical uses and support clinical uses. Laboratory medicine, all of that stuff occurred.

Tacey Ann Rosolowski, PhD

And about how much money did those backfill and redevelopment projects take at the time?

William Daigneau, MBA

Well, there were four of them. They were Backfill One, Two, Three, and then Redevelopment. When I left, we were talking about Redevelopment Two. But I think the total of those projects was near one hundred million dollars, just to go back in and do them. And they were named that way because of a couple of reasons. There were some things we knew we had to do when we opened Alkek and LeMaistre Clinic, and that was Backfill One. To make those buildings operational, we had to go back in and do things right away.

Tacey Ann Rosolowski, PhD

What were some of those?

William Daigneau, MBA

Well, like the waiting room, some projects for Laboratory Medicine on the second floor, connecting hallways, redoing the hallways.

Tacey Ann Rosolowski, PhD

Right, because these were the buildings that you had not overseen the design process, so they were ones that came out prior.

William Daigneau, MBA

Right. So they were fixes. We named them in the sequence they had to be done. Some right away—Backfill One. Some could wait a year, or because of dominoes we had to do this to be able to get to this space—move somebody. That required, for example, the opening of the Faculty Center, so that became Backfill Two projects. Then there were the Backfill Three projects related to the research areas. So they were named in the sequence that the work had to be done, and it was easier for us because we could put better numbers. Because one of the things that was my hallmark, and I never broke it except one project, was we never went back to the regents because we had a budget problem. So once we got approval by the regents of a project, we would never go back and say, “Oh, we missed it. We need a little more money approved.” Never did that. So by breaking the backfill projects, we went from projects we were pretty sure about and could estimate more accurately to projects that were more what-ifs. So the backfill went both in the sequence of execution as well as our ability to accurately estimate the cost of doing the work.

Tacey Ann Rosolowski, PhD

Let me ask you one other detail about the faculty tower. That was—you didn’t mention—you talked about the design-build, but the other piece of your kind of new system was also to anticipate technology by delaying decisions. I’m wondering—I mean, that was office space, but did you use the same logic in that space as you would in a clinical or patient care delivery space?

William Daigneau, MBA

There were two things that I was clear about with the president and the executives: That we would build this that fast and at this cost if it was forever used as an office building. It would be basically classified by building code as an office building. The way it was going to be built, it could never be used for any clinical activity. And going in, they had to understand that. And it was built for an office purpose. What we did was we looked at the most efficient office buildings constructed mostly by developers. The floor plates were between twenty-five and thirty-five thousand square foot, center core, and the most adaptable because of that design. For a developer who has an office building, they want different tenants, so they want maximum ability to change configuration on every floor to meet different tenants’ needs. So other than the restriction that it could never be used for clinical purposes—so the infrastructure, the mechanical, the electrical infrastructure could never be upgraded for a more heavy-duty use other than office use—we followed basically the same principles employed in commercial real estate of how to build an office building rectangular in shape—which the president was always very interested in architecture and the way things looked—but basically rectangular in shape with a center core of elevators—most efficient layout. So that allowed us to move forward. Architects across the state as well as Houston were very familiar with us because they’d built tons of these types of buildings. It was not rocket science—simple in design, straightforward. Builders had built a lot of this stuff in Houston. So we were following a template that was well understood, well known, and time tested for its adaptability for office-type use.

So the Faculty Center went forward. About the same time, of course, was the second piece of this, and that was to eventually expand clinical capacity—outpatient clinical capacity. So I mentioned earlier we had acquired HMB—Houston Main Building—in the seventies from Prudential. Houston Main Building, very advanced office building at the time in terms of amenities—big cafeteria, tenth floor was all executive suites, had tennis courts, swimming pool, a big parking area. It was basically on twenty-some acres of land. In the facilities context we called it the legacy site because that was the biggest piece of land we owned in proximity to the main complex that could be developed for the future.

The site had been studied as a future research building, and estimates had been made to expand research across the street. That was the previous master plan. I resisted that because, as I said earlier, to me it made more sense to capitalize on the infrastructure we had in place by developing research on the north side of the main complex and use that where the main vivariums were located.

Tacey Ann Rosolowski, PhD

Where was the Houston Main Building located—or the Prudential building located?

William Daigneau, MBA

It was on the corner of Fannin and Holcombe, and, at the time—you know—it was built in the fifties, and it was viewed as a state-of-the art office building at the time. It was a significant—it was one of the tallest buildings in Houston at the time. It was built on the Texas Medical Center campus, or across the street from it, and there was a significant—I mean, it occupied the skyline for many, many years.

When we redid the master plan, we looked at the legacy site for future expansion. For what, unsure, but—so at the time, I reported to Kevin Wardell, who was the chief operating officer. In devising this strategy of how to expand patient care, looking at all the options, we determined the clearest option was to expand across the street on the Houston Main Building site.

I talked about just the cultural issue of faculty now not being located next to their clinics and having to walk across a bridge. There was a much bigger step of convincing the faculty to actually move some clinics across the street. And the question was how fast could we do that? So the first question posed to me was, how fast can you build a 250,000 square foot ambulatory building, and do you have a site? And the answer was yes, we could use the HMB site for that, and it would take thirty-six months to build about 250,000 square foot clinical building. Great. So Kevin went back to the executives and said—this was occurring at the same time the Faculty Center was—these discussions—“We can have another 250,000 in thirty-six months. If the Faculty Center is done in eighteen months, that provides us some cushion. Then the new ambulatory comes online, and that allows us to meet projections for—”

So as it evolved, the 250,000 went up to 350,000 because Diagnostic Imaging said, “Well, if you’re going to move across the street, we don’t want people going back and forth, and we don’t have the capacity now. We don’t want to use the satellite facilities. So let’s add some diagnostic imaging space there.” So all right, 350,000. Then Radiation Oncology weighed in, and they said, “You know, we’re almost at capacity in our vaults. We’ve been looking at all these options. We’d really like to add some radiation oncology capacity over there.” Now, these are two heavy-duty uses. These are very specialized facilities. They’re not easy and fast to build. All right, 450,000. And I’ll talk more about this. Dr. Callender, who was at that time in charge of basically all the faculty, believed that the future would be more day surgery. Now, there was a lot of resistance within surgery about that. But he wanted to build another surgical suite across the street for in-and-out. Now, the argument against that was—from the faculty—from the surgeons—was that the type of surgery they were doing is not guaranteed day surgery, because once they get in there, something that was planned to be a two-hour surgery may be an 8-hour surgery. So there was no such thing in their mind as day surgery, like a hernia repair or cataract removal or whatever. There was nothing like that in the cancer business, so there was a lot of resistance to the thought of a surgical building, but Dr. Callender thought that increasingly there would be some types of surgery. That was his personal opinion about this and about the direction things were going in.

So to make a long story short, we went from 250,000 up to over 600,000 square foot within a period of months. That’s what, in my business, they call “piling on.” Now, the story about that is nobody remembered we started at 250,000 square foot. All they remembered was it would take thirty-six months to build. So all of a sudden comes back the news, “All right, we’re going to go ahead with the building—600,000 square foot, thirty-six months.” “Well, who’s going to occupy the building?” “We don’t know yet. All we know is we have Diagnostic Imaging, Radiation Oncology. We may have a surgical suite, and we definitely want outpatient exam rooms, but we don’t know who will occupy it.” “So other than those ones that you know of, we have no clients to work with?” “No, not yet, but get started.” (laughs)

So the first thing we did was we had a general master plan, but we didn’t have a specific site planned for Houston Main Building. So what we decided to do was, in order to shorten the time, we went out and retained an architectural firm for the design of the ambulatory clinic building. Part of the services that we requested of that firm was a site master plan. So that was the first task to be accomplished. So we eventually studied that site and got approval for basically four buildings of about two-and-a-half million square foot total.

Now, I got, over the years, many questions. Why only two-and-a-half million square foot? Can’t you build higher? Instead of nine stories up there, couldn’t you go up twenty stories? One of the studies we did was what was the capacity of the site in terms of transportation. So you could build an Empire State Building there if you wanted. The question is could you get people in and out based on the surrounding roadways to use that building. Office workers are one thing. They come in at 8:00 in the morning. They go home at 5:00. So it takes them thirty minutes to get out of the parking garage. Patients are a totally different thing. They want to be able to drive in in the morning, find a parking space, go to their appointment—or in the afternoon—and leave. They’re not going to come to a cancer center, no matter how famous it is—unlike Sloan-Kettering, we don’t have a subway system. We don’t have hordes of taxis to take you somewhere. In Houston, we’re dependent on private automobile. I mean, that’s ninety percent of how people get to and from MD Anderson Cancer Center. So the question became what would the surrounding street network support in terms of traffic volume in and out of that site? For patient care activities, that set the size of the complex—two-and-a-half million square foot. Now, you could fudge a little bit. You could go up to three million, but roughly it was in that range.

Tacey Ann Rosolowski, PhD

Let me ask you a quick question so I’m clear in my mind. So this four-building master plan that the architect developed, they took the total footprint of what Houston Main—

William Daigneau, MBA

Twenty acres.

Tacey Ann Rosolowski, PhD

Okay. And then they divided—all right. So I just wanted to make sure I’d understood that. So we’re still working with the footprint of the old Prudential Building?

William Daigneau, MBA

Right, of the old Prudential site, so twenty acres of land. How much can you build there? And for people to be able to get in and out—you know—get into a parking garage and then leave without being dumped into gridlock—constant gridlock. So that determined—we did the traffic studies of Fannin. We looked at other people’s plans for expansion. We did projections on the street capacity then started testing—because we had these statistics—how many visits per day, how many hours per visit. We did all those calculations and said you could support two-and-a-half million square foot with X number of parking spaces on that site. So the master plan was now done. We now knew the exact site of the Ambulatory Clinic Building.

Tacey Ann Rosolowski, PhD

And what year was this when you figured this part out?

William Daigneau, MBA

This was all occurring in the early 2000s, because we’d opened Alkek, and we were—Dr. Mendelsohn arrived. So around the beginning of 1999 and working through the early 2000s, all this was going on simultaneously.

So we had that in place now. That allowed us then to move ahead with plans for the Ambulatory Clinic Building. Dr. von Eschenbach, he had now left, convincing the faculty that they would be happier moving across the street. Now it fell into Dr. Callender’s hands. He was integral to the master planning process, because we involved the section heads in that. It was a very inclusive process of looking at different options, which, frankly, Dr. Mendelsohn demanded. He demanded that people that were going to be running these programs have a very key role in making decisions, so a very inclusive process. We had a strategic planning group composed of all the section heads. Dr. [Helmuth] Goepfert was part of it. Dr. [Raphael] Pollock was involved—Dr. Murphy. There was a whole cast of characters involved in all of this. Dr. Callender chaired it, led the discussions. One thing that came out of it, while we could agree on the development of the site, there was no agreement on who would go over there—who would make the jump across the street. So that laid on Dr. Callender’s shoulders, to eventually be able to tell us who would move across the street. Secondly, was there going to be a surgical suite over there?

Tacey Ann Rosolowski, PhD

Now, just so I am clear, is this all operating according to that project core team model that you were talking about earlier?

William Daigneau, MBA

Yes.

Tacey Ann Rosolowski, PhD

Okay, so Dr. Callender was the executive who had to make the final decision if there was gridlock.

William Daigneau, MBA

Right. He was key part in all of that. I mean, literally, when the building was done, he had left Anderson at that point. I actually had a picture of the original concept of the ambulatory and the finished product. Here was the sketch, and here was the finished product side by side. I dedicated that to him, because, really, he played such a critical part in dealing with the section heads and the faculty and planning that facility. Without him, we would have never finished it at the speed that we—because we had to make decisions. They had to be made, and you couldn’t say, “Well, give me twelve months to think about it.” Unlike the gridlock you see in DC, “Well, let’s just go ahead and shut things down.” No, if we want to occupy this, we need to have this decision by such-and-such a date. So he was critical in playing that part of getting those decisions.

Tacey Ann Rosolowski, PhD

So what was his logic in terms of deciding who would cross the street to the new clinic?

William Daigneau, MBA

Well, it’s interesting. Of course, I was not part of—I mean, I’d make presentations for him. I’d go with him sometimes to meet with the heads of some of these departments, where we’d have just kind of these generic—but there were a lot of behind-the-scenes meetings that I was not part of. He knew what he had to do and the time that he had to do it. And almost everyone that I worked with at Anderson, they were good to their word. That’s the nice thing, working in the medical environment; they understand the importance of time. Time is important in patient care. It’s critical in research. So there’s an understanding of that, that you don’t have all the time in the world. You’ve got to do something now. So there’s an urgency in medical environments that doesn’t exist in the strictly academic university. So that was good. Dr. Callender stepped up to the plate; otherwise we wouldn’t have been able to complete that building in the time we did it.

The second major issue for us was we had, again, negotiations with Texas Medical Center because we were building that roadway that goes behind the Ambulatory Clinic Building. That was all going to be a new roadway, and it would connect to existing roadways, so we had negotiations going on with the Texas Medical Center about the design of that roadway, its capacity, the future, how it would connect into the various other roadways, traffic generation, all of these things. Those were all going on at the same time. And then we had to build this building in, of course, thirty-six months. Not going to happen.

So a couple key decisions, again, were made there. Number one decision was we were going to use design-build. Well, we just finished getting approval for Faculty Center, which was now moving ahead with construction under design-build. Now we wanted to do the total square footage of the Ambulatory Clinic Building, the Mays Clinic now. The total square foot is over a million square foot because it includes the underground parking garage. The actual occupiable area is more than the 600,000, but the total building came in roughly a million square foot. One of the biggest projects in the UT System ever—bigger than the original Major Building Program, just for this one single building—all to be built in a timeline half of what the Major Building projects were. So we chose design-build because there was no way we could ever meet those time requirements under a more traditional process. And we had to convince, at the time, UT System and OFPC to allow us to—because it’d never been used on a complex building on this. Office building—that was a stretch. Now you want to build an ambulatory clinical building with specialized facilities using design-build? How are you going to do this? It was a hard—I mean, we even went to—of course, we have the Board of Visitors, which the president would brief. Even some of them raised questions about using design-build on this. Is that going to work? There were a lot of questions.

To all of the credits, from the president on down—by then I’d been there long enough that trust had now been earned, and there was a big leap of faith. The president, even though he got questions from Board of Visitors, a lot of second guessing going on at System, who knows what he heard? He came back and said, “Is this going to work?” And I kept on telling him, “That’s the only way we’re going to do this. I can use other methods, but if you want it this fast, that’s the only way I can have any hope of doing it.” So they supported it, and it turned out well. (laughs) But at the time, it was a real leap of faith. Big project—biggest project ever in the system and you’re using an untested method. So that was one key thing. Got support for that and backing for that.

The second critical issue was how to build this building, and I mentioned earlier the anchor approach. We knew we had some anchors. We had Radiation Oncology going in. We knew we had Diagnostic Imaging in. We weren’t sure if we were going to have any surgical suites, and we didn’t know the occupants for the outpatient clinics. So that’s where maximum flexibility starts to play. So how can we build this building?

Mays Clinic is unique in that it’s actually two buildings. There’s the north end of the building and the south end of the building. The north end of the building is basically all Radiation Oncology and Diagnostic Imaging. Heavy floor loading in it, vibration proof, built to very tough standards to accommodate specialized equipment. The south side of the building was designed in a more generic, clinical fashion. Work with the architects—because of the master plan, there was circulation of the whole site was planned, where the parking garages would all be in the future, all of that had been planned out—how the four buildings would be interconnected. Remember I told you about the ramp that goes? We wouldn’t have those kinds of ramps ever. How would we move materials around the site? The loading material delivery, all of that worked out. Emergency power generation—where would that be placed? We ended up putting it in the garage across the street. That has the emergency power for the whole building, expandable to provide it for the whole complex someday. All those things had been worked out, so we knew where everything was going to go, how it all fit together, both now and in the future.

We divided the building into two halves—one that we knew who the occupants would be. We could plan that, build it. The second half—well, we didn’t know who was going to be there, but it would be used for clinical purposes—for outpatient purposes. That allowed us to move ahead with design. Knowing who the anchors were, by subdividing the building, allowed us to—and we made a lot of decisions that were critical for the future. For example, all the heavy mechanical equipment is at the two ends of the building, because I didn’t ever want to be trapped where I was trying to fix things on the interior that I couldn’t get to. So it’s a pretty unique building in terms of its design.

Several political issues had to be solved. One was with Dr. Murphy. This was the first time that Diagnostic Imaging was on multiple floors of a building, so the question is, can your faculty go up a flight of stairs, down a flight of stairs? And your technicians, can they move vertically through the building instead of just on a floor? Because if you look at the main complex, all the diagnostic imaging is on the third floor. So Dr. Murphy sold that to his faculty. “Yeah, we can do that.” See, that allowed us to basically break the building into two halves. If he would have said, “I want an entire floor like I do in the main complex,” we couldn’t have moved ahead with design. So a critical decision was made there. It allowed us to move forward.

Radiation Oncology had to make some decisions, especially about—they’re always buried in the ground. That’s the first ever radiation oncology suite that actually has some windows in it. (laughs) Bring light in instead of being sunk in the ground. So all these decisions were going on, critical to our moving forward.

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Chapter 13: The Master Plan Brings Special Challenges: Successes with the Faculty Center and the Mays Clinic (Ambulatory Clinic Building)

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