Dr. James is a founding editor of
; lecturer at Johns Hopkins University School of Medicine ; Chair
Emeritus at Vanderbilt University; and a clinical professor at
the University of North Carolina.
In this era of managed care, physicians, regulators, and
patients have become concerned about the total quality of medical
delivery. Any determination of quality entails certain assumptions,
and I believe that an assessment of the healthcare environment
should be an important part of this evaluation.
Healthcare facilities are often our most impressive,
contemporary architectural structures. Massive healthcare edifices
of bricks and mortar are often characterized as austere and
foreboding, rather than pleasant and comforting. Inside these
walls, healthcare is often provided by a nameless and impersonal
"team" who may be almost totally absorbed with the technology and
science of medicine, rather than its humanity. Patients and their
families may be awed and bewildered by this environment. Our
attempts to nurture as physicians can be compromised by the
impersonal place in which we dispense our healing.
Visual stimuli are very important to this analysis and much of
our assessment of an environment is based upon perception. Patients
decide upon their level of satisfaction with their medical care
based upon their opinion of their physician's caring attitude,
their assessment of the health delivery "team," and the ambiance of
the environment. An art collection in a medical facility can make a
significant contribution to the perception of the humanity of the
Most hospital walls are lined with nondescript art and
decorations. This often reflects the inclinations and tastes of a
non-physician decorator or committee that has created something
sterile in an attempt to "color coordinate." The use of fine art
can contribute to the nurturing of the healing process. Medicine is
in an era of declining financial resources and heightened
complexity, yet we must not neglect the ministry of care. Art
collections in hospitals can be an important part of this
humanitarian effort and have a financial or commercial value as
There may be initial objections to, and rejection of, an arts
program for your hospital, since fine art is viewed by some as
elitist. Fine art is also of monetary value and somewhat fragile,
thus it must be insured and some measure of security may be
necessary in its display. However, these objections should not be
insurmountable if one has endured the rigors of medical training,
intricacies of practice, or complexity of medical administration.
The challenges will prove much less formidable if one is committed
to the project and seeks advice from the experienced.
There are a number of methods that have been employed
successfully to acquire and place painting collections in
hospitals. For example, many hospitals have cultural enrichment
programs, often including the performing and decorative arts. The
hospital budgets for these programs can be supplemented by private
and corporate donations, but the monies to initiate a collection
should come from designated institutional funds. In fact, it is
much easier to secure outside "gifts in kind" or monetary donations
if there is tangible evidence of the facilities' support. Often the
director of cultural affairs is the most logical and effective
chairperson for the funding effort, but someone from the hospital
development office should also be involved.
The gathering of the art collection should be a continuous
process, and an acquisition committee or an art committee is
essential for solicitation and quality assurance. The committee
will serve several important functions. It will allow discussion
between relevant parties regarding the type and purpose of the
hospital's painting collection. A committee will also provide a
balance of personal tastes. Just as our patient populations are
diverse, the group accepting paintings should have diverse
representation. The committee will also be helpful in the
acquisition process and in refusing the offer of a potential donor.
Rejections of inappropriate offerings should be depersonalized as
much as practical. You should never accept a painting unless you
intend to display it in a public place in the hospital. Donors,
just like patients, have expectations and they anticipate that
donated art will be displayed.
Another method of painting acquisition is to have a painting
given to honor someone (eg, a physician, founder, or benefactor),
or given by the relatives of a former patient in appreciation for
the care provided by the hospital. A hospital may be offered an
entire collection of paintings, which provides an excellent
opportunity to acquire a tangible asset. The gift will enhance the
hospital's image as an environment where patients and their
families can be healed and can increase employee pride. The
donation of a collection of works may represent the opportunity to
create an expression of gratitude. Designated spaces in the medical
facility for the collection and the use of plaques to identify the
donor and honoree are effective in increasing patient awareness,
acceptance by the medical staff, and donor satisfaction.
Memberships in named institutional societies are increasingly
common as a method of recognizing hospital benefactors and the use
of paintings as "gifts in kind" can be encouraged to obtain
membership in these organizations. Since these groups have value
thresholds of giving for entry, monetary value can be used as one
parameter to assure the quality of the paintings accepted. For
donors, this might be an opportunity to donate a painting that has
increased in value and obtain tax advantages. Hospital development
offices can assist donors in realizing the full benefits of their
Decorating hospitals with fine paintings will assist in
personalizing the medical experience for patients and their
families. A patient's hospital experience may be inherently
traumatic, but an appropriate environment can create the perception
that the institution cares. As providers, we are very aware of the
rapid and dramatic changes in the delivery of healthcare. Despite
these changes, the perception of caring must remain. Visual
evidence of this humanity can be demonstrated by pleasant images
provided by paintings in our health institutions.
1. Getlein F:
A generous gift of art. Cosmos Bulletin, October, 1991.
2. James AE:
One physician's opportunity to contribute to the arts. PHAROS
3. James AE:
The James Collection at Vanderbilt University Hospital. Nashville,
Vanderbilt Press, 1989.
4. James AE:
Knight K: Art patronage: More rewarding than collecting. Art
5. James AE:
Palmer J, Collotin J: Painting collections in hospitals. IJAM,
6. James AE:
James Collection for the Roentgen Centennial Celebration. Eastern
Carolina Press, Rocky Mount, NC,1995.
7. James AE:
Thoughts of a Collector. St. Louis, Warren H. Green, January
8. James AE:
The Radiography of Paintings, Rochester, NY, Eastman Kodak,
9. James AE:
Paintings in Hospitals. J Roy Soc Health (London) 118:227-230,
10. James AE:
Proper paintings appraisals. Southern Antiques, December 1999.
11. James AE:
Donation of Paintings. In: Paintings: Process, Pain, Pleasure.
Baltimore, Literary Press, 2000.