Tag Archives: medicine

The Town Planning Medical Metaphor

By Dom Nozzi

March 20, 2018

It has been said that town planners are doctors for cities. The job of the town planner, according to this metaphor, is to prescribe medicine (zoning and transportation recommendations) that will improve or maintain the health of a city.

To borrow an analogy from Donald Shoup, let us say that the town planning “doctor” lives in the 18th Century in Colonial America. It has been claimed by historians that George Washington’s doctors hastened the death of our ailing former president by administering blood-letting, which was a widely accepted medical treatment at the time. Indeed, had the American Medical Association been in existence in those days, they would have strongly recommended blood-letting due to the guidelines established by medical science and books of medicine of that age.bl

Let us say that you were a doctor in Colonial America, yet you had come to learn that blood-letting was detrimental to the health of patients. But the AMA, your medical books, and nearly all of your patients were strongly demanding that you administer blood-letting. If you agree to administer blood-letting, you will keep your patients (patients that are otherwise threatening to use another doctor who favors blood-letting) and will therefore keep your job as a doctor.

But if you abide by your Hippocratic Oath to do no harm, you will not administer blood-letting. You recognize that doing so would be a form of medical malpractice. However, you will therefore lose your occupation as a doctor.

What do you do?

Similarly, let us say you are a town planner in contemporary America, and you had come to learn that requesting developers to provide the “free” off-street parking was toxic to the health of your town – particularly your town center. But your land development code, your elected officials, your planning supervisor, and nearly all of the citizens in your community were strongly demanding that you request abundant off-street parking from developers. If you agree to demand that required off-street parking, you will keep your job as a town planner (your office is otherwise threatening to replace you with another planner who will follow parking guidelines and the orders of your supervisor and citizens).

But if you go along with requesting off-street parking, you will do so knowing that you are violating your duty as a town planner to promote the health of your town.

What do you do?

To borrow from Victor Brandon Dover, this analogy works even better if we look upon off-street parking as an addictive drug (Donald Shoup calls off-street parking a fertility drug for cars). As a town planner, your citizens (and the banks that finance development loans) are addicted to the off-street parking fix. As an addict, they must get their fix, yet they can never get enough of it. Giving them their fix is a downward spiral, as it pulls them more strongly into their addiction. The same is true with providing wider roads and larger parking lots, as doing so makes citizens increasingly wedded to their cars because other forms of travel become less safe or feasible when roads and parking are enlarged.

Do you, as a town planner, keep administering a (off-street parking) fix to your addicted patients (citizens)? Is it not true, though, that doing so would be a form of malpractice?

315-0722092524-NSA-building-and-parking-lotIn sum, given the state of affairs I outline above, is it not true that the very heavy contemporary town planning emphasis on enabling car travel (particularly via the demand for providing off-street parking – which is so much of what American town planners now do in their jobs) exemplifies the premise that town planning has become an outdated, failing profession? That it is trapped in the role of administering medicine (or a drug) that is clearly toxic to its “patients” (the town)?

It is time for us to reform town planning so that it returns to the timeless tradition of planning for people, not cars. To return to restoring city health, rather than pushing papers (issuing permits) for cars.

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Filed under Politics, Sprawl, Suburbia, Transportation, Urban Design

Town Planners as Doctors

By Dom Nozzi

December 29, 2007

I sometimes explain to someone who does not know what a town planner does by stating that town planners are like towns which have a team of doctors.images

One problem with the planner-as-physician analogy, is that the “medicine” we’ve been given by conventional American Planning Association planners over the past several decades has been mostly poisonous, and resulted in counterproductively ruining the health of a great many Americans.

In theory at least, planners have been trained in their schooling to diagnosis a community ailment brought to them, and to recommend a “cure” that will make the community more healthy. An unhealthy downtown, for example, can become more healthy if the “therapy” of the removal of excessive surface parking downtown occurs. A “sick” street experiencing excessive car crashes and vacant shops can be restored to “health” by removing excessive traffic lanes or installing on-street parking.

However, it seems to me that the analogy can be useful for planners who “get it.” I am convinced, for example, that new urbanist “doctoring” is needed to cure the hideous diseases that are killing so many American communities.

Andres Duany has made a similar analogy in the past. He noted that America is starting to see a phenomenon in which destroyed communities (either by natural disaster or car-happy design) must “call in the Marines” to win a battle and save the day (his reference was to the many new urbanists who were called in to help design destroyed communities post-Katrina in the South).

Sure, it is a bit corny. But I think both the “Marines” and “doctor” analogies can be a helpful educational tool when in the proper hands.


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Filed under Urban Design