By Healthcare Facilities Today

In the past 20 years, Native American tribal healthcare centers have evolved from small, boxy, cookie-cutter clinics to large, airy buildings that reflect the unique culture of the tribe they serve. James Childers, a member of the Cherokee Nation, has designed seven such clinics, and talked about his experiences in the July issue of Healthcare Design. 

Childers said that he initially had to work around federal Indian Health Services requirements that typically did not allow space for a waiting room – a significant lack in a culture where going to the doctor is often a family event. By choosing smaller mechanical systems and putting them on the roof instead of the floor, he was able to create a waiting room – the kind of basic amenity that the private sector took for granted. 

When the IHS began to do joint ventures with tribes, Childers said, the clinics began to get bigger and offer more flexible designs. 

Every facility Childers has designed tries to incorporate the tribe’s history and culture – such as making sure that the door of a Cherokee clinic faces east, or including display areas for tribal art and artifacts.  

A Choctaw clinic featured a two-story glass atrium flooded with sunlight; a Muscogee facility featured brick in shades of the natural clay of Oklahoma. The newer clinics also feature bilingual signage, because it’s both easier for older patients and exposes younger ones to their ancestral tongue. 

The most satisfying part of his career, Childers said, is that growing tribal revenues can fund not only bigger, more aesthetic buildings but also more varied and better quality health programs inside the buildings. 

Read the article and view the photo gallery.