11.06.2026

Gartenstadt Medical Center: Definition, History, and Examples

Building design

A red car is parked next to a green-and-white sign – Photo: mattseymour / Unsplash

A medical center in Gartenstadt is more than just a healthcare facility. It is a building block of urban planning that brings together two seemingly different worlds: the vision of the low-density, green residential city of the early 20th century and the modern demand for local, interdisciplinary health care. The Gartenstadt Medical Center represents a planning model that consistently embeds medical infrastructure within the context of settlement structure, the quality of open spaces, and user mobility—a model that has gained new relevance in times of demographic change and a shortage of primary care physicians.

What a “Gartenstadt” medical center is and how it differs from other forms of healthcare provision
What are the urban planning and architectural roots of the concept
How Gartenstadt neighborhoods function as a planning framework for medical infrastructure
What requirements exist regarding location, open space, and building typology
How the medical center is integrated into a settlement’s open space planning and green infrastructure
What examples from German-speaking countries illustrate the concept
What planning mistakes commonly occur and how they can be avoided
What role the Gartenstadt medical center plays in the context of healthcare and urban development

Definition: What is a “Gartenstadt” medical center?

The term “Gartenstadt medical center” refers to a building or complex of buildings that houses multiple medical practices and often other healthcare providers, and which is either located within a historic Gartenstadt neighborhood or was planned according to its urban planning principles. The term is not a protected technical term nor a type of building under construction law, but rather a combination of two distinct concepts: the medical center as an organizational form of outpatient care and the garden city as an urban planning model. In planning practice, it usually refers to one of two scenarios: either a medical center that has been retroactively integrated into an existing garden city development, or a new construction project being built in a development planned according to garden city principles and that incorporates its open-space qualities and sense of scale.

The medical center as such is a form of outpatient health care in which several practices from different specialties are brought together under one roof, without necessarily forming a legal entity. It differs from a medical care center (MVZ), which constitutes an independent legal entity under the Fifth Social Code and in which doctors may be employed. The medical center, on the other hand, is primarily a real estate and urban planning concept: a building designed for medical use through its location, floor plan, and amenities. The garden city context adds a specific spatial quality to this concept: low building density, generous green spaces, a small-scale building fabric, and an orientation toward pedestrians and cyclists rather than automobile traffic.

In planning terminology, the “Gartenstadt medical center” is occasionally described as a health center with a low-density layout or as a neighborhood healthcare facility within a green residential structure. These descriptions make it clear that this is a concept that integrates urban structure and healthcare infrastructure, rather than a purely medical or purely architectural category.

Historical Background: Garden Cities and Healthcare

The Garden City movement traces its origins to the British social reformer Ebenezer Howard, who, at the end of the 19th century, developed the concept of the Garden City as an alternative to the overcrowded, hygienically problematic industrial city. Howard’s idea was a planned settlement with a limited population, its own green belt, a mix of residential, commercial, and service functions, and cooperative land ownership. The first such projects were built in England, including Letchworth and Welwyn Garden City. In Germany, the German Garden City Society, founded at the beginning of the 20th century, took up these ideas and adapted them to the German context. This led to the creation of settlements such as Hellerau near Dresden, the Staaken Garden City in Berlin, and Margarethenhöhe in Essen, which are still regarded today as defining examples.

From the very beginning, a central concern of the garden city movement was the health of its residents. The low-density development, the incorporation of green spaces, the avoidance of backyards, and the orientation toward light and air were explicitly motivated by hygiene considerations. However, healthcare infrastructure was mostly rudimentary in early garden city plans: pharmacies, midwives, and general practitioners were typically housed on the ground floors of residential buildings or in small, purpose-built structures. A standalone medical center as a building type was not envisaged in the classic garden city, because the healthcare model of the time relied on private practices and house calls.

The development of the medical center as a distinct building type took place in Germany primarily in the second half of the 20th century, in parallel with the specialization of medicine and the emergence of larger housing developments in social housing. In the large housing estates of the 1960s and 1970s, healthcare centers emerged that brought together medical practices, pharmacies, physical therapy, and sometimes social counseling under one roof. These centers were functional but rarely integrated into the open-space structure of their surroundings. The combination of the medical center and the garden city principle is therefore a later synthesis, born of the realization that healthcare must be embedded not only functionally but also spatially and socially.

Urban Planning Context: Location, Scale, and Quality of Open Space

The choice of location is crucial for a garden city medical center. In a garden city neighborhood characterized by a fine-grained layout, low-rise buildings, and a distinct green structure, a medical center must be both functionally accessible and compatible in scale. Buildings that are too large, too much paved area for parking, and too little connection to green spaces destroy the very qualities that make the context valuable. Specialist planners therefore recommend positioning the medical center at transition points between residential areas and public spaces: at the intersection of the pedestrian network and the main street, close to public transit stops, but not directly within the quiet residential core.

The open-space planning around a garden-city-style medical center follows different rules than that of a shopping center or a hospital. Parking areas must be available but must not dominate the space. Accessibility is a mandatory requirement dictated by the user group: Older adults, people with mobility impairments, and those with chronic illnesses are disproportionately represented. At the same time, the outdoor space should offer a pleasant environment: shaded seating areas, landscaping with native trees and shrubs, clear pathways without detours, and sufficient bicycle parking spaces. These requirements align with the principles of good open-space planning and can be implemented particularly well in garden city developments because the settlement structure itself is already geared toward pedestrians and green spaces.

The building typology of a medical center in a garden city is modeled after the surrounding development. Structures ranging from two to three stories with sloped roofs, projections and recesses in the facade, and integration into the green structure through front yards or landscaped courtyards are typical of successful examples. Flat-roofed buildings that maximize floor area often appear out of place in this context and are perceived as a disruption by residents and planners alike. The building’s form is not merely an aesthetic detail but a tool for urban integration.

Planning Law Principles and Land Use Control

From a planning law perspective, a medical center in a garden city development is not always easily permitted. Garden city developments are generally designated as General Residential Areas (WA) or Pure Residential Areas (WR) under the German Land Use Ordinance (BauNVO). In a Pure Residential Zone, medical practices are permitted only in exceptional cases if they serve the area’s healthcare needs. A medical center with multiple specialties and a catchment area extending beyond the local community may exceed the threshold for use that is no longer compatible with the area, as it generates traffic, parking demands, and operating hours that may conflict with the character of a residential zone. In a general residential zone, medical practices are generally permitted as non-disruptive commercial enterprises, but here, too, the scale of the development is decisive.

Many municipalities resolve this conflict through targeted rezoning: A zoning plan can designate a specific lot in a garden city development as a “special area” under Section 11 of the Federal Building Code (BauNVO), thereby explicitly permitting medical use without rezoning the entire area. This solution allows for precise control over the type of use, building mass, number of parking spaces, and open space design. For planners and municipalities, this approach is more time-consuming than a simple building permit, but it offers the opportunity to preserve the “Gartenstadt Medical Center” as an urban planning concept with all its qualities.

Historic preservation plays a special role in historic garden city developments. Many of the classic German garden city developments are protected as architectural ensembles or are designated as historic sites in their entirety. A medical center that is newly constructed within such an ensemble or created through the renovation of an existing building is subject to the requirements of the historic preservation authority. This applies to façade design, roof shape, choice of materials, and the design of open spaces. These requirements are not an obstacle but rather a form of quality assurance: they compel planners to seriously integrate the building into its context.

Examples from German-speaking Countries

In German-speaking countries, there are a number of examples that illustrate the concept of the “Gartenstadt” medical center in various forms. In several German cities, medical centers explicitly bear the name “Ärztehaus Gartenstadt” because they are located in a neighborhood that is historically or in urban planning terms designated as a “Gartenstadt” (garden city). This naming convention is often topographically motivated: the neighborhood is called “Gartenstadt,” and the medical center serves as its healthcare hub. Well-known examples can be found, among other places, in Ludwigshafen am Rhein, where the Gartenstadt neighborhood houses a standalone medical center with several general practitioners and specialists, as well as in various other cities where neighborhoods bearing the suffix “Gartenstadt” have developed their own medical care structures.

Beyond the mere naming convention, there are examples that particularly well embody the conceptual ideal of a medical center embedded within a green residential structure. In Margarethenhöhe in Essen, one of Germany’s best-known garden city developments, medical care has been organized for decades in small-scale structures that correspond to the scale of the neighborhood. In the garden city of Hellerau near Dresden, which is now a designated historic site, healthcare facilities are housed in historic buildings that reflect the architectural style of early 20th-century reform architecture. These examples show that the “Gartenstadt” medical center is not a uniform type, but rather encompasses a range of solutions that all share the same basic principle: healthcare as part of a high-quality, green residential structure.

In Switzerland and Austria, comparable concepts can be found under different names. Health centers in residential areas planned according to the model of the Garden City movement exist in the Zurich metropolitan area as well as in the outskirts of Vienna. The conceptual similarity is evident, even though the term “Gartenstadt medical center” is less commonly used in these countries than in German-speaking regions.

Open-Space Planning and Greening: Quality Characteristics of a Successful Concept

Open-space planning is not a secondary consideration for a “Gartenstadt medical center,” but rather a fundamental element. The outdoor space of such a building fulfills several functions simultaneously: It serves as an access area for patients and staff, a waiting area for those waiting and their companions, a buffer zone to the adjacent residential area, and a component of the community-wide green infrastructure. This multifunctionality requires careful planning that goes beyond simply planting flower beds and installing benches.

Trees are the most important design element in the outdoor space of a Gartenstadt medical center. Broad-crowned deciduous trees provide shade over waiting areas and parking spaces in the summer, reduce the heating of paved surfaces, and integrate the building into the canopy of the neighborhood. The selection of climate-resilient, native, or near-native trees and shrubs meets the requirements of contemporary open-space planning and is particularly appropriate in Gartenstadt neighborhoods, which are already characterized by existing tree populations. Planners should integrate tree locations into building design at an early stage to ensure sufficient root space and canopy development.

Accessibility and quality of stay are not mutually exclusive. Wide, level paths made of non-slip material, adequately sized entrance areas with weather protection, high-contrast markings for visually impaired users, and easily accessible seating in both sun and shade can be combined with sophisticated landscaping and a clear open-space concept. Especially in garden city developments, where the tradition of open space emphasizes both quality and usability, this combination is not only possible but desirable.

Common Planning Mistakes and How to Avoid Them

The most common mistake when planning a medical center in a garden city neighborhood is underestimating parking needs while overestimating the available space. Medical centers generate significant parking demand because many patients—especially older adults and those with limited mobility—arrive by car. If this need is not determined early on and realistically, the result is either oversized parking areas that destroy the neighborhood’s green character, or a chronic shortage of parking spaces that puts a strain on residential streets. The solution lies in a combined strategy: parking spaces in underground garages or structured parking decks, supplemented by good connections to public transit and attractive bicycle parking facilities.

Another common mistake is the lack of coordination between building design and open-space planning. If the open-space planner is not consulted until after the building design is complete, the only space left for trees, green areas, and recreational spaces is often the leftover space remaining after the buildings, access roads, and parking spaces have been allocated. These leftover areas are usually too small, have an unfavorable layout, or are too heavily shaded to develop the qualities that should characterize a Gartenstadt medical center. Open-space planning must be an integral part of the planning process from the very beginning.

Finally, the importance of the user’s perspective is often underestimated. Patients visiting a medical center are often in a vulnerable situation: they are sick, anxious, exhausted, or accompanied by children or relatives in need of care. An outdoor space that provides orientation, exudes tranquility, allows for short distances, and creates a calming atmosphere through its greenery contributes to the quality of care, even if this connection is rarely made explicit in planning practice. The Garden City as a model offers a valuable framework here because it views the quality of open spaces as a natural part of community life.

The “Gartenstadt” Medical Center as a Model for Contemporary Healthcare Planning

The concept of the “Gartenstadt” medical center is gaining significance against the backdrop of two parallel developments: the increasing shortage of primary care physicians in many urban and rural areas, on the one hand, and the growing interest in high-quality, sustainable urban development, on the other. When municipalities seek to establish new healthcare structures or strengthen existing ones, the medical center—set within a green, walkable residential structure—offers a solution that combines medical efficiency with high-quality urban design.

The Garden City principles, formulated by Ebenezer Howard more than a century ago, have lost none of their relevance. Low-density development, green spaces, pedestrian-oriented design, and a mix of residential and service functions align with the guiding principles of climate-adapted, resilient urban development. In this context, the “Gartenstadt” medical center is not a nostalgic reference but a functional model that harnesses the strengths of both concepts: the organizational efficiency of the medical center and the spatial quality of the garden city.

For landscape architects, urban planners, and architects working on such projects, the challenge lies in productively navigating the tension between functional requirements and contextual qualities. A medical center that respects its context, creates open space rather than destroying it, combines accessibility with a high quality of life, and is carefully integrated within the framework of planning regulations can become an anchor for neighborhood life. It not only provides medical care but also strengthens the identity and quality of life of the neighborhood in which it is located. This is a task that goes beyond the building program and draws on the best of the long tradition of garden city planning.

22.01.2025

Project

Co-creation instead of participation

Building design

Management

Participation versus co-creation: Would the Superkilen work better today if citizens had been integrated into the process from the outset?

Superkilen in Copenhagen has failed. The citizens as a whole use the square more as a place to pass through than to linger, even though they were integrated into the planning process through participation – according to a long-term analysis by students at the Danish Institute for Study Abroad. During the design and development process, the Superkilen planners asked citizens to suggest artifacts from their countries of origin for the new city square. Holistic planning with co-creation and prototypes would have been one way of increasing acceptance of the square.

Co-creation

Co-creation originally comes from the business world, which began to involve consumers in the product development process in the 1990s. The Leading Cities research group defines co-creation in urban development as “the active flow of ideas and information between five sectors: government, business, academia, non-profit organizations and citizens that promotes participation, engagement and development.”

What is the difference to citizen participation? Public participation is a means for planners to learn more about the attitudes and opinions of local residents and to develop new ideas. They increase acceptance for a project. Co-creation, on the other hand, involves the most important sectors of society on an equal footing from the outset.

It therefore offers citizens and citizens’ organizations a better opportunity to be truly heard and gain more influence in planning processes. Co-creation views users as proactive citizens rather than consumers, and focuses on long-term cultural change and the whole community rather than individual user groups. Where citizen participation seeks to integrate citizens’ opinions into an already prescribed program, co-creation helps future users to shape and enforce their own decisions. Co-creation is an endless process in the best sense of the word, with regular exchanges taking place between those involved.

Co-creation has a number of advantages. The public provides input and feels equal, citizens feel they are taken seriously. They become much more aware of their living environment. In return, the government has to be much more responsive and responsive to citizens and other sectors. In return, however, it saves costs because only what is actually needed and used is implemented and the risk of a new project is correspondingly low.

Prototypes

In large design projects such as Superkilen, it is extremely important to test ideas in advance before they become a permanent part of the landscape or city. It is a long way from the abstract idea, analysis and public participation to the concrete installation. The prototype should be seen as a learning tool that can be optimized and changed in the next step. Prototypes are a democratic way of dealing with public space, they also reduce the risk of a failed project and unnecessary expenditure.

The holistic approach

Combining co-creation with the prototyping approach makes it easier to explore the potential of a space. This holistic approach leads to more sustainable and vibrant places in the city. However, the Superkilen started with an assumption that co-creation and prototyping would have led to a different design. Users would accept the space better and make it more their own. Perhaps a more critical examination of the initial idea would also have been achieved.

You can read Bianca Hermannsen’s current analysis of the square here.
Robert Schäfer visited Superkilen in 2012, directly after the opening. You can read his review of the new city square in Copenhagen here.
Watch the video here to see how BIG travels with local residents to their countries of origin to select artifacts for Superkilen.

19.12.2024

Design

Heavyweight with a message

Building design

The Globo Uovo sculpture is an impressive work by stone sculptor Marc Reist and is currently on display at the Dürrenmatt Center in Neuchâtel, Switzerland. The artist made the 6.5-ton “global egg” out of white marble. In an interview with STEIN, the Swiss artist explains what message he wants to convey with his sculpture, why he only uses white marble and […]

The Globo Uovo sculpture is an impressive work bystone sculptorMarc Reist and is currently on display at the Dürrenmatt Center in Neuchâtel, Switzerland. The artist made the 6.5-ton “global egg” out of white marble. In an interview with STEIN, the Swiss artist explains the message hewants to conveywith hissculpture, why he only works with white stone and why he launched an appeal to collect eggshells before the opening.

Marc Reist: It’s a logical consequence of my artistic work and how I reflect on my surroundings by observing them. I notice how certain rules and mechanisms are similar on both a small and large scale. I never consciously came up with the topic, it just developed. I think it started in 2005.

The Globo Uovo symbolizes the world and the origin of life. Was there a specific reason for this idea?

Yes, that was in 2011. I was invited by a newspaper in Switzerland to write a few columns. I started to write about resources and food in these texts and about what bothers me: the way we deal with food, the way we deal with our environment. And during this phase, I designed the globe and then the egg. The eggs actually always resonate with me. Regularly for my wife – I only mention this in passing – for her birthday, for Mother’s Day, there are always drawings of chicken and egg. I either start with the chicken or the egg, but the egg always resonates.

Do the many openings in the sculpture also have a meaning?

The openings were created by the lines of longitude and latitude. And I found them very special as soon as I was able to work in the egg. There is a feeling of protection when you are in your human egg and you can see the outside world through these openings. At the same time, it could also be a prison. These feelings arose in me when I was working in the egg.

From a professional point of view – I trained as a stone sculptor and also took the master craftsman’s examination – I know almost all the materials. But even so, I used to only work with black stone for my shapes. And now, for years, I’ve only been working in white. For the small sculptures I make, I use a bright white marble. There is no other solution for me and for my forms. I have never used any materials with textures. They are beautiful, but not for my shapes.

But the marble for the egg has a certain texture. Was a block of 55 tons in pure white not available?

For the Globo Uovo, the stone is a little more marbled. Because this size in pure white – that would have been almost impossible and would have meant such a long wait. And the egg in this size in pure white would almost be a little too beautiful(laughs), almost baroque. That’s impossible. Visually too, it’s almost not rock anymore.

So the egg also looks much more “alive”.

Exactly, that’s what I mean. This methamorphosis of the rock, this mountain, that has to resonate.

How did the change from black to white rock come about?

That’s an interesting question. I have to go back to that. I wanted to make a really big sculpture in the 1990s. I chose a large block in Carrara without knowing what I was going to do with it. I wanted to be inspired by the material, by the block. I normally proceed differently. I have a drawing or a model and then work on the stone. But now I wanted to be influenced by the block. At the time, it was 20 tons in size. And that put an enormous strain on me(laughs). I suddenly realized that the further north the block was transported from Italy, the greater the strain in my head became. I was very blocked! And suddenly I found the solution. I then worked out a light cloth from this block. That was probably my solution, to release this heaviness in me in relation to the block. And since then I’ve only worked with white stone.

Are there purely visual reasons why you like to work with marble a lot, or is it also because of its properties?

Both, actually. My sculptures are also a matter of light. Not only with the large egg, but also with the other sculptures. The way the light passes through the opening and the edges is what makes it so good. And the properties for working are a pleasant side effect. It is easy to work with because it is so even, so homogeneous. But I mainly use marble because light and shadow are important for my sculptures.

You also want to send out a message with your art objects.

Yes, absolutely. I think that’s the greatest task of an artist. That his work is seen and heard, as the case may be. Communication is important. It makes no sense at all if I make an egg like this just to have another beautiful sculpture in a park somewhere. That wouldn’t be enough. It needs a message.

What message is that?

We have great difficulties with resources in general. This is most sensitive when it comes to food. And I really want to draw attention to the fact that people need to deal with the issue of food and resources. That a small train of thought changes.

Your sculpture is currently on display at the Dürrenmatt Center in Neuchâtel, Switzerland. Before the exhibition began, you launched an appeal to collect eggshells. What was the reason?

We had planned a performance with a dancer for the vernissage. I needed a lot of eggshells for that. Over the course of a year, people collected around 35,000 eggshells, washed them and brought them to me. Something you would normally throw away. For the exhibition opening, we laid them out on the floor of the museum and cleared paths, like a labyrinth. The dancer danced her way through it. But every now and then she made missteps on the eggshells, causing them to crack. And at the same time, with every misstep, a part of her body died. Because the shells represent our resources and if they are destroyed, the person dies too. And so she danced through the labyrinth and gradually died a dramatic death after three or four missteps.

Find out more about the project and the natural stone work in the February issue of STEIN. You can also find more information at www.stein-magazin.de/skulptur-des-monats-globo-uovo.