Observations Body/Building

What doctors have in common with architects—part 2: The common good

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h1823 (Published 09 April 2015) Cite this as: BMJ 2015;350:h1823
  1. David Loxterkamp, medical director, Seaport Community Health Center, Belfast, Maine,
  2. Bruce Snider, architect and writer on US residential architecture
  1. david.loxterkamp{at}gmail.com

In the first part of a two part dialogue on medicine and architecture (doi:10.1136/bmj.h1810), David Loxterkamp and Bruce Snider reflected on the effects of technological change on each profession. In this second part they discuss the social obligations of each

Who do we work for?

DL: My father was a rural family doctor who trained during the second world war and began practice in the post-antibiotic era. When he was paid it was often in cash or barter. I followed in his footsteps, but my income is now tied to insurance programs, including the government’s. Increasingly I answer to credentialing agencies, licensing boards, and professional review. Do my patients’ needs speak as loudly, especially when what they need most is a fair wage, a caring partner, a decent break, or some small show of kindness? Sadly, no.

Yet, fundamentally, we work for our patients, save when they break the law or endanger others. I am not owned by them but strive to do what is right by them, however demanding, disguised, or burdensome it may be. My goals do not depend on who pays, appreciates, rewards, or recognizes me. This gives me the right to be called a professional.

BS: In architecture the matter seems simpler, at least on the face of it. The architect works for the client, the person paying the …

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