I think "because they treat sick people there," is a good reason to hold back on the criticism. The best building for patient services is the building we should get, even if it offends certain aesthetic considerations. And yes, I defer to the hospitals to make those decisions.
What you say is true in an ideal world, but again, the uncritical acceptance of anything healthcare institutions do, which includes, prominently, expansion projects, is what I find concerning on here. Simply because a hospital treats patients does not mean that everything that hospital does is good nor does it mean that all of the care provided is good. Patients suffer and want treatment but what is the right treatment as measured by longer term outcomes and overall value of the care provided are the ways real healthcare is measured and these rarely align with patient preferences (which, like it or not, tend to be highly distorted by a number of non medical factors). ChatGPT can give a better concise summary of the problematic ways in which American healthcare institutions operate than I can, if you care to educate yourself about these issues. But none of this is black and white. Hospitals aren’t evil, but when healthcare is a commodity, and when the mechanism for approving medical devices and drugs flows through a highly corporate and capitalist system, there are many different interests at play and this has direct bearings on the finances and priorities of hospitals, particularly and especially of the biggest and most academic healthcare institutions. And none of this is completely irrelevant to the question here, which pertains not only to design and architecture but also the broader question of how is this institution being a good neighbor and a good player in the local environment and city? I certainly agree that when push comes to shove, if we are talking about absolutely indispensable, high value care that benefits all and not the few, or that otherwise has proven its value in public health analyses, of course that should take precedent over design if it must be one or the other. But the reality is far more complicated. A major driving force for this new building and the finances behind it is the desire, which fundamentally was driven by financial interests, for the new, hyper-corporate MGB to have its own cancer center, which is why DFCI bounced. Was this really necessary? Does the city
need a second cancer center of this magnitude, especially from an institution in which there is almost zero primary care available—the type of care that the people of the region actually need, far more than any specialists—at any of its hospitals or clinics? Does it not bother you that beneath all the good intentions and smiling patients who are helped, there are vast sums of money and competition for patients as customers and insurance reimbursements, and that unlike in any social-democratic system, where cost controls rein in this tendency, in our healthcare system, the sicker the patients, the better it is for the hospitals?
In any case, in this particular instance, we’re talking about a $2 billion dollar project. I’m sure there are an army of finance advisors and managers who can justify this cost, but I don’t think anyone is being unreasonable by wondering whether or not more concern for the imprint these buildings will have in an incredibly prominent location is something that the hospital should have been pressed a little harder on.