As one of my old architect buddies was fond of saying:-"There is no such thing as the prefect design".
And, do you know what? He was right!
Then there was the oft-repeated remark:- "Form follows function".
Also the idea of "The Hospital as a System"
(which, to my certain knowledge, has been bandied about since at least the 1980's ... and is a concept that I have always liked, and endeavoured to follow, myself).
What is perceived as "ideal" in one set of circumstances (and budget) can equally be found wanting in another. In the Real World, if the design pleases the client (that is, meets his aspirations, and does what he wants from the functional point of view) then that is usually enough to keep him happy (and have him pay the fees. LOL).
I still remember cases where well-developed (and entirely adequate) designs - and/or equipment proposals - were totally rejected out of hand after a change of personalities on the clients' side.
* Which we agreed should have been revised to read:- "form follows funding"!