Buildings 2.0 Library
Conversations on the future of the built environment
81 episodes of the Buildings 2.0 podcast, each bound as a short book: the ideas, the numbers and the lines worth keeping.
Season 1, Episode 15 /Jun 13, 2024
Why an Ennead principal thinks the neighborhood clinic is the new post office
David Tepper, Ennead Architects
Jun 13, 2024 /AI & Automation
Why an Ennead principal thinks the neighborhood clinic is the new post office
David Tepper is a principal at Ennead Architects, a New York firm known for healthcare, research, higher-education and civic buildings. He grew up in Champaign, Illinois, fell in love with public space, and has spent more than two decades at Ennead. He designs the buildings where care is changing fastest, which gives him a clear view of how hospitals, clinics and homes are trading roles.
David Tepper, Principal, Ennead Architects
In this conversation
The William H. Whyte films that taught David people say they want to be alone in public, then cluster together.
Why Ennead keeps both specialists and pollinators, and asks what a hospital can learn from a hotel, an airport or an Apple store.
How healthcare moved from the edge of the city to its center, while stable patients move back home.
The tension between bed forecasts that say hospitals have enough and nurses who have nowhere to put patients.
David's worry about AI: if it takes the grunt work, how does the next generation of architects learn to build?
With the demise of the mall, going to the doctor is maybe the most public thing we do.
David Tepper
Chapters
Learning from strangers
A kid from Champaign discovers the street and the secret language of public space.
Specialists and pollinators
Why a firm needs typology experts and people who carry ideas between building types.
The retrofit is the hard part
New all-electric buildings are solved; the old stock is building-by-building grunt work.
Healthcare leaves the shadows
Sicker patients in hospitals, advanced clinics in every neighborhood, and stable patients cared for at home.
By the numbers
Hospital expenses per adjusted inpatient day, 2024
David says it is cheaper to monitor a stable patient at home than to keep them in a hospital for days, and that insurers will eventually stop paying for the difference.
Source: KFF State Health Facts, Hospital Adjusted Expenses per Inpatient Day (2024) ↗When AI takes the grunt work
Senior architects will tell the machine what to do; the open question is how juniors learn.
Build the platform, not the program
The New York loft as proof that flexible structure outlasts every use.
We train our young employees by doing that grunt work. That's how you learn.
David Tepper
Takeaways
Care is splitting three ways: the very sick in hospitals, procedures in technically advanced outpatient buildings, and stable patients monitored at home. What insurers pay for will set the pace.
Under pressure on fees and schedule, standardize the familiar 80 percent of a project and spend the exploration on the 20 percent where the client wants something new.
Build in now what is hard to add later, like higher flood levels and wind speeds, and plan space for what can wait, like extra electrical capacity.
A good floor-to-floor, a robust structure, a core off to one side and the ability to put anything in it, that's never going to change.
David Tepper