WHY CHOOSE fractalfotos?

Chinook Fishing Harbor

Evidence-based design studies in healthcare art have overwhelmingly made the case for selecting representative nature art (see Art and Healing). However, not all nature art is created equal. There is a wide range of artwork available from the truly awful to the truly magnificent.  When it comes to artwork, no one-size-fits-all is ideal for every patient, under every circumstance.


The nature artwork most effective in relieving stress in patients has at least one or more of the following three characteristics; a) open prospect or depth of field, b) refuge or a place of shelter and safety, and c) lack of ambiguity or hazard (Vincent, 2011).  As helpful as these characteristics are, no set of guidelines exists for healthcare art that can be followed without ever having to ask additional questions and exercise judgment. To make the most appropriate and effective choices in healthcare art, first consider the context in which the art will be seen and who will see it. Then consider size, subject and composition.

Size Matters

Rhine II by Andreas Gursky

In 2011, German artist, Andreas Gursky, sold a photograph depicting the River Rhine for a record breaking $4.3 million dollars. “Those unfamiliar with Gursky may be wondering: What’s so special about a picture of a river and some grass? What elevates that photo above so many others?  And how did the price get so astronomically high?” asked Jakob Schiller (2011).


Schiller compared Gursky to a painter in the way he created scenes through stitching and digital manipulation, and by making very limited prints of each work. This explanation alone may not have been very convincing to people who only viewed the digital representation of Gursky’s work on a computer.  The actual art, or the “product”, is another experience altogether. Imagine walking up to a photograph about six feet tall by twelve feet wide, rich in subtle detail and saturated color, mounted onto acrylic glass. It isn’t until viewing the actual work that its value comes into focus. Whether or not you think it is worth $4.3 million dollars is not the point. The point is that size is a critical part of the artwork itself. The work is described by arts writer Florence Waters as "unforgettable."

Dungeness Spit Light House

Healthcare art seeks to press into service the power of nature. In large institutional environments especially, the benefits of nature photography are magnified by size.  However, making a photograph BIG does not necessarily make it better.  Many photographs that look good in small formats become fuzzygraphs when enlarged. We specialize in creating images that can be enlarged without losing color intensity and image detail.  Time and again customers are surprised by the depth of the change in appreciation they experience when viewing the finished large-scale art compared with the digital image from which the artwork was first selected.

Subject Matters

Bridge over Snake River

"I was going to have cosmetic surgery until I noticed that the doctor's office was full of portraits by Picasso," quipped Rita Rudner.  The subject of artwork should be determined by the function of each space and by attempting to maintain a sense of emotional congruency with the patient.  In Putting Patients First: Designing and Practicing Patient-Centered Care (Frampton, Gilpin, & Charmel, 2003), chapter seven is devoted to research findings related to subject matter and characteristics that studies show are most effective in healthcare art.  Roger Ulrich and Laura Gilprin describe research involving many different scenarios from nursing homes to psychiatric care facilities.   Ulrich and Gilprin state, “For groups suffering from boredom and under-arousal (such as many long-term patients in nursing homes), the capacity of visual images to be positively interesting and mildly stimulating over long time periods becomes a key therapeutic issue.”

Chelan Butte

Ulrich and Gilprin note that the art preferences of artists, environmental designers, serious art collectors and aficionados differ greatly from the preferences of patients.  In contrast to the general public, those within the art world prefer challenging and emotionally provocative artwork.  Art for the benefit of the patient, however, should have unambiguously positive subject matter, according to Ulrich and Gilprin.

Although this hop field in winter represents nature, it is hard to imagine a patient in pain would find it comforting.

A new orthopedic wing was recently constructed as part of a well-known metropolitan hospital. The award winning design includes many state-of-the-art features. The hospital’s webpage describes the new wing as a “stress-free environment,” and many stress-reducing design features have been incorporated. Much of the art, on the patient floors especially, is excellent in the context of patient recovery. However, the new facility features a mixed media work of art in the lobby that is definitely not patient-friendly.  Our friend, Luther, had hip replacement surgery in this facility shortly after it opened. He described being “horrified by the boney shoes!”  He was referring to two high-heeled shoes fashioned from bird vertebra, including a little bird scull on the toe.  Even the best and most well-intentioned environmental designers, or art selection committees, can find it hard to filter their own preferences when it comes to selecting healthcare art.

Mixed media art in the lobby of a new orthopedic surgery center.

Composition Matters

Foothills and Farmland

Healthcare art has the job of promoting healing. Pretty pictures that blend into the environment so much that they are nearly invisible are hardly going to make a significant difference. In my doctor’s reception area are a half dozen nicely sized impressionistic (blurry) views of nature in muted colors that perfectly match the decor.  Nice.  But ho-hum. Why not move from ho-hum to compelling?  An interesting composition provides a real positive distraction that benefits patients, visitors and staff. Staff efficiency and morale improves when patients are positively distracted and less stressed. One study found placing calming artwork in patient waiting areas resulted in a significant decrease in 1) front desk queries, 2) out-of-seat behavior such as talking, pacing and noise, and 3) people watching (Nanda, 2010).

Details Matter

We care about the details. Roy Williams refers to the details as the Magic of the ELBS: Exponential Little Bits– all the little things we do and the decisions we make everyday that create a sum greater than the individual parts (2002). If you are involved in environmental design, you understand the importance of all your decisions and how they can make a difference in the lives of others. Whether you are a designer, architect, healthcare professional, facilities manager, art curator, art committee member, or consultant, we know you care about the details.  When patients are able to “lose themselves” in a nature scene, the staff will notice. You will look like a hero for selecting art that does the work of distracting patients, even if momentarily, from their health concerns.


Our job is to make you look good.  We understand that healthcare art has a function. We understand the elements that make up a work of art appropriate for healthcare environments according to evidence-based design research. We also know many excellent artists whose work we will gladly recommend if our work is not a perfect fit for your needs. Talking is free. You will be talking to directly to Deborah or Tim. Please give us a call and let us know how we may help you.

fractalfotos LLC

Phone 425-485-3266  Email debgo@fractalfotos.com

Site content copyrighted © 2019, All rights reserved