Healthcare organizations spend millions—sometimes billions—on capital projects intended to improve care. Yet too often, those investments address symptoms rather than root causes. In this episode, Chase Miller sits down with Bill Hercules to explore how healthcare capital strategy, finance, and design intersect—and why architects must learn to think like executives if they want to influence real outcomes.
With decades of experience across healthcare architecture, executive leadership, and professional advocacy, Bill offers a rare systems-level perspective on how hospitals make decisions, how capital really flows, and why understanding finance is essential to designing environments that truly support care.
Key Topics Covered
· Why healthcare organizations frequently solve the wrong problem with expensive buildings
· The difference between capital strategy and capital reaction
· How CEOs and CFOs evaluate healthcare design investments
· Why "form follows finance" is often more accurate than architects want to admit
· The hidden risks of expanding emergency departments instead of fixing operations
· How functional programming reveals the real purpose of a project
· Translating evidence-based design into a business case executives understand
· The limits of codes and guidelines in delivering healing outcomes
· The ethical implications of ignoring design research
· How competition, deregulation, and data are reshaping healthcare planning
· Why healthcare buildings are tools—not the mission itself
Key Takeaways
· Capital strategy is diagnostic, not reactive. Expensive expansions often mask operational failures rather than fix them.
· Healthcare executives think in systems, not spaces. Architects who understand finance, operations, and incentives earn credibility.
· Evidence-based design only matters if it can be translated into value. Research without financial context rarely drives decisions.
· Functional programming is one of the most powerful—and underused—tools in healthcare design.
· Healthcare organizations are not in the building business—they're in the care business. Architecture succeeds only when it supports that mission.
· Solving the right problem matters more than designing the perfect solution.
Notable Quotes
· "Healthcare systems are not in the building business—they're in the care business."
· "If you don't understand the financial drivers, you'll lose the conversation every time."
· "Expanding the ED is often a symptom-based response to an operational disease."
Resources & Concepts Mentioned
About the Guest
Bill Hercules is a rare triple-Fellow of the AIA, ACHA, and the American College of Healthcare Executives. With more than three decades of experience, Bill helps healthcare organizations align capital investment, operational strategy, and design excellence to improve long-term outcomes.
Connect with Bill – https://www.linkedin.com/in/billhercules
WJH Health - https://www.wjh-health.com/
About the Podcast
The Architecture of Healing explores the intersection of healthcare strategy, design, operations, and experience—examining how environments, systems, and decisions shape care delivery and healing.
www.thearchitectureofhealing.com
Connect with Chase - https://www.linkedin.com/in/chase-h-miller/
