I'm not especially in the anti-Rand brigade. But the thing that especially annoyed me about The Fountainhead was that it put on a pedestal all the annoying features of egotistical architects. Guess what, it's not actually about your vision. There's a client paying the bills.
Now, if you persuade a client to come along for the ride with your vision, good for you. But the idea that a building is all about the architect's vision and no other consideration is egomaniac territory.