Savannah, Georgia

By Liz Funk | Live & Practice | Winter 2016

 

Savannah combines historic Southern charm with an eclectic arts scene, plus everything from fishing to dolphin watching.

Dwayne Gard, M.D., D.C., was familiar with Savannah before he moved there. “This is where my wife’s parents are from,” he explains. “Even while I was going through medical school in Augusta and my residency in Charlotte, we were frequently coming down to Savannah to spend holidays and long weekends with her family.”

So when Gard and his wife looked for a place to raise two children of their own, Savannah was an easy choice. “I find Savannah to be an ideal-sized city for raising a family. It’s a place where you have extracurricular activities right at your fingertips, and it’s a very friendly town that’s easy to get around.”

Dwayne Gard

Dwayne Gard, M.D., D.C., was familiar with Savannah before he moved there—it’s where his in-laws are from. “I find Savannah to be an ideal-sized city for raising a family,” he says.

Gard began his career as a chiropractor in Georgia. After a few years of practice, he decided to go to medical school at the Medical College of Georgia in Augusta. He completed his residency at Carolinas Medical Center in Charlotte, North Carolina, and moved to Savannah in 2008 to become a hospitalist at Memorial Health.

A rapidly growing hospital, Memorial Health offers a wide range of specialties. “We don’t find ourselves referring out very often,” Gard says. “We have subspecialists all the way from neurosurgeons to interventional radiologists to interventional vascular surgeons. We have all the medical subspecialties that I call on.”

“You have to have a fantastic ER in order to take care of a Level I Trauma Center,” says Mark Kolbush, a physician recruitment and retention executive at Memorial Health. “We see all kinds of traumas here, and people get flown in by helicopter every day. We take care of the sickest of the sick. On top of that, the quality of our care is exceptional.”

The Leapfrog Group, which independently evaluates health care quality, gave Memorial Health a Grade A safety score.

“Our actual mortality is better than our expected mortality,” Kolbush says. “We have it graphed out so we can see the lives we save every year. It’s a great place to work.”

Erica Backus, director of public relations for Visit Savannah, says Savannah is economically healthy and that health care is the region’s second largest industry. “We have two major health systems: Memorial Health and St. Joseph’s/Candler,” she says. Memorial University Medical Center is an academic hospital with 604 beds. St. Joseph’s Hospital is an acute care facility with 330 beds. And Candler Hospital, which has 384 beds, is the oldest hospital in Georgia. It was founded in 1804.

Savannah’s natural beauty draws physicians to the area. “Savannah sells itself,” Kolbush says. “It’s a beautiful historic city, and it’s very charming with lots of squares filled with live oak trees. And the cost of living in Savannah is 6.5 percent lower than the average American city.”

He adds: “Savannah is a growing population. It’s a mixture of people who have been here generation after generation, as well as people new to the area. Savannah is home to Savannah College of Arts and Design [SCAD]. It’s a very good school, and that school has grown over the years and is a destination for students from all over the country.”

Savannah

At more than 20 city squares, Savannah has the nation’s largest National Historic Landmark District.

Another major draw to Savannah is Gulfstream Aerospace, a major area employer that designs and manufactures small aircraft. “They’ve done fantastic, and they are continuing to grow. So between SCAD, Gulfstream and tourism, we have a stable economic base, which makes it easier to grow the [Memorial Health] facility and add more jobs,” says Kolbush.

Backus agrees that SCAD has had a major influence on life and culture in Savannah. “We were once a sleepy Southern town that hung its hat on its terrific historic architecture. Now, it’s really been infused with a new vibrancy. We have four colleges, and we’re aptly described as a young, hip town,” says Backus.

Savannah’s coastal location influences its economy and culture. “We have 100 miles of coastline,” says Backus. “It’s great for boaters, kayakers and fishermen. People here tend to be pretty outdoorsy.”

The location has even affected the area’s cuisine. “It influences the way we eat—lots of seafood, especially shrimp,” Backus says. “We have a year-round growing season, so we cook with abundant in-season produce.” The coastline also makes for good family fun. Backus recommends day trips to nearby Tybee Island, where families can take dolphin-watching excursions.

Gard and his family like to take advantage of Savannah’s arts offerings as well as the entertainment provided by proximity to the water. “There are enough activities here that I felt like I didn’t miss the big cities. There are multiple restaurants in the historic part of Savannah and a real nice environment by River Street. We’re right here on the ocean with plenty of water sports and fishing. Savannah is definitely influenced by being a coastal town. We have a lot of good seafood. I grew up doing more freshwater fishing on lakes, so it took me a little while to adapt to saltwater life.”

With its seafood, dolphin watching and job opportunities, Savannah seems to be well worth the adjustment.

 

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Davenport, Iowa

Where rivers flow

By Eileen Lockwood | Live & Practice | Summer 2015

 

Skybridge

Davenport sits at the confluence of the Mississippi and Rock Rivers

A t the confluence of the Mississippi and Rock Rivers between Iowa and Illinois can be found not one city but five, each one an entity onto itself but altogether a formidable population of almost 400,000.

Davenport and Bettendorf, Iowa, and three Illinois locations—Moline, East Moline and Rock Island—are collectively known as the Quad Cities, probably for two simple reasons: tradition and euphony. “Quint Cities” came into being for a while, but it was soon abandoned because the words didn’t exactly roll off the tongue. Nicknames aside, Joe Taylor, the convention and visitors bureau CEO, summarizes, “We’re one destination that happens to be made up of multiple cities.”

iowa davenport skybridge anne jump

The floor-to-ceiling windows of the Davenport Skybridge offer sweeping views of the Mississippi.

Davenport was founded in 1836 and was the site of the first Mississippi River railroad bridge. Taylor notes: “We have everything a big city can offer but without the hassle of a big city.” That includes big-time employers. John Deere, the renowned producer of heavy agricultural and manufacturing vehicles, is headquartered in Moline but also employs about a thousand workers in Davenport. Alcoa, Inc., employs 2,000 in Riverdale, Iowa, a town surrounded on three sides by Bettendorf. Rock Island is home to the largest government-owned weapons manufacturing arsenal in the U.S.

Jason Hagemann, D.O., who practices family medicine with Genesis Health Group in Davenport, notes, “My patients all work at one place or the other (Deere or Alcoa).” Hagemann himself lives in Bettendorf, although he was raised in Davenport.

Genesis was one of the first community hospitals west of the Mississippi when it was founded in 1869 by the Sisters of Mercy. It now serves 10 area counties in Iowa and Illinois. It’s a “top performer” in endocrinology and diabetic care and also has “the best physical therapy care in the region,” notes media coordinator Craig Cooper. Its cardiology care includes advanced equipment and techniques, and it’s one of only three Iowa hospitals with staff and equipment to provide transcatheter aortic valve replacements for patients who would be endangered by open procedures. And also one of “very few hospitals nationwide” to offer Varian Trilogy image-guided, focused radiation that reduces treatment time and protects surrounding healthy tissue.

Fegge Museum Gary

Figge Art Museum

For all hospital employees, though, care expands beyond treatment and the building. From management to janitors, employees are praised for their compassion, and a book has been published chronicling many of their good deeds: Noting the 70th wedding anniversary of a dying patient, staff members bought a cake for a special celebration for him and his wife. Staff members gave shoes to a homeless patient, and then established a drive that brought in 206 pairs for others.

Another player in the Quad Cities health care scene is UnityPoint Health, the 13th largest nonprofit health system in the country. The system serves 88 communities in Iowa, Illinois and Wisconsin. Its Trinity Rock Island campus recently underwent a Heart Center and Emergency Department expansion. The new state-of-the-art Emergency Department features a dedicated trauma room, 22 general treatment stations and more. In 2015, UnityPoint Health-Trinity began offering the CardioMEMS HF heart failure monitoring system—the first in the area to do so.

Hagemann followed a path that would extend around the world before he returned home and joined Genesis for his residency in 2010, becoming a permanent staff member in 2013. He stayed in-state as an undergraduate at Iowa State University in Ames, but then joined the Army National Guard, was trained as a combat medic and deployed to Iraq. He had worked with several DOs in the Army, which inspired him to follow the same career path when he came back home. He applied at the main campus of Lake Erie College of Osteopathic Medicine in Erie, Pennsylvania. “I interviewed there—in January,” he says, but learned of a campus in Bradenton, Florida, which he selected for a simple reason. “My wife. She said, ‘I don’t care what you say. We’re going to Florida!’” He now jokes, “All my medical books have sand in them.”

Still, the call to Davenport as a career location was too strong to resist. “It took us away from the beauty of Florida, but this is a better place to raise kids,” he says. The couple now has a 1-year-old and a 4-year-old. “The schools here are excellent and very family-centered,” he notes. Not to mention “lots of museums and dozens of parks.” The newest, and possibly most spectacular, museum is the 10-million-square-foot Science Center at Davenport’s Putnam Museum. The center opened in 2014 and features 45 hands-on stations for children to explore.

Hagemann is especially happy about the number of bike and walking trails, especially along the two rivers. Especially noteworthy are the Hennepin Canal Parkway linking the rivers and the 62-mile Great River Trail.

But the continuing city highlight is probably what Chamber of Commerce spokesman Jason Gordon considers “the amazing downtown renaissance” in the last five years.

In the last several years, more than 1,500 people have relocated to some nine or 10 blocks in the downtown area. The influx has sparked shopping areas, appealing restaurants and entertainment venues.

 

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Visalia, California

Gateway to the Sequoias

By Eileen Lockwood | Live & Practice | Summer 2015

 

Sequoia National Park

Sequoia National Park

When Thomas Fantes, M.D., joined the U.S. Navy, he had no particular thought about an after-service life in the coastal city with one of the nation’s biggest maritime installations. But that’s how it worked out. This is his story.

Fantes was born in Peru, but his family moved to northern New Jersey when he was 4. (At 6’4” and with light red hair, he jokes that he doesn’t look much like a Peruvian.) While studying economics at the then Rutgers College, he decided that medicine would be his life. The promise of government-financed tuition led him to join the Navy. After graduation from New Jersey Medical School, he went on active duty, incorporating internship and residency—and tours of duty in the Middle East and Japan.

Kern River

The Kern River runs through the Sequoia National Forest southeast of Visalia.

After four final years at Naval Station Newport, Fantes and his wife, who was following the same path and is also a physician, was ready for civilian practice. After private practice, followed by ER and community medicine, he decided to settle into a hospital-related environment. “We got out and looked around at a bunch of different places,” he says. “And we thought, ‘You know, (Newport) is pretty nice.’” For them, it still is.

He’s now the medical director of Newport Hospital’s Vanderbilt Wound Center, as well as of the Newport Health Care Corporation, a physician group affiliated with the hospital. The hospital itself is a member of Lifespan.

The city of Newport is probably best known for its huge luxury mansions, labeled vacation “cottages” by the super-wealthy industrialists, mining magnates and southern planters who built them during the Gilded Age of the late 1800s. But that crowd was preceded by a fledgling U.S Navy complex during the Revolutionary War. During the Civil War, it was briefly home to the U.S. Naval Academy, moved from Annapolis to save it from Confederate hands. In World War II, 80 percent of American torpedoes were manufactured in the area, the largest single industry ever operated in Rhode Island. Today, the site is best known for its Naval War College and officer training school, as well as its large Naval Undersea Warfare Center.

Dr Duncan with family

Orthopedic surgeon Ian Duncan, M.D., enjoys Visalia’s proximity to family, its central California location and nearby skiing opportunities.

A number of Newport’s magnificent “cottages” and early Colonial homes are now visitor attractions, in addition to other attention-worthy sites. Also on the water, excursion boats cruise past area lighthouses.

Today the words “sea” and “recreation” are almost synonymous, not to mention shipping and commercial fishing. The city is known as the sailing capital of the U.S. and is frequently the site of the America’s Cup race. At the seaside, the annual Newport Jazz Festival, a staple since 1954, may be the biggest lure of all. Everyday outdoor-lovers can be near the sea, too, thanks to the Newport Cliff Walk bordering the shoreline for more than three miles.

In its own way, Newport Hospital is forging the way into health care of the future. “It’s an exciting time,” says spokesperson Elena Falcone-Relvas, especially with the arrival of a new president, Crista Durand. Among other activities, Durand is “dedicated to making positive change and bringing on new doctors.”

For instance, several cardiovascular services are among recently introduced new and expanded techniques and equipment. It was the first hospital in the state to use a leadless implantable cardiac defibrillator, and its specialists now use the S-ICD System developed by Boston Scientific, the first subcutaneous implantable cardiac defibrillator for treatment of patients at risk for sudden cardiac arrest.

The wound care center itself is an example of, as Fantes reports, “the latest, most advanced treatments.”

In the meantime, Fantes reports that he, his wife and daughter “used to kayak a little, but we’re in the process of selling the boat,” possibly based on two factors. Their daughter, who was 6 when they settled in Newport, is now a college math major, so there’s one boater less in the family. And his physician wife recently became the chief medical officer at a Boston hospital, which, though only a half-hour drive away, is still a time-consuming post.

Work obligations aside, the Fantes adults continue to savor Newport for its surrounding “wonderful open space” where they enjoy walking their dog. Says Fantes: “It’s still a nice little city.”

Kaweah Oaks Preserve

The Kaweah Oaks Preserve offers a stunning view of the Sierra Nevada Mountains.

After crossing Narragansett Bay from Newport, it’s about a 10-mile drive south on mainland Rhode Island to Wakefield, a town where the population is small but the mood is lively. About a stone’s throw south is a protected harbor on the ocean, with many miles of coastline and beaches that attract thousands of summer tourists. “The area is known for its beauty,” says Martha Murphy of South County Hospital Healthcare System. “A lot of people have second homes here and retire here.” That includes professors from the University of Rhode Island in nearby Kingston.

Wakefield, with a population of about 8,500, is physically a part of South Kingston, population 30,600. However, it could be called the business beehive. “One of the biggest focuses is Main Street, with a lot of quaint shops and restaurants, plus two theaters,” notes Nick Pappadia, communications coordinator for the Southern Rhode Island Chamber of Commerce.

Of the hospital, with 100 beds (all in private rooms), Murphy says, “We like to say it provides everything from allergy to urology to everything in between.” Its strongest suit, she adds, is orthopedic surgery, especially joint replacement. “There are patients who choose to come here for surgery from across the state—and Connecticut.” She notes: “Our orthopedic surgeons have performed more MAKOplasty procedures than any other surgeons in the U.S. or the world—to date more than 3,000.”

The hospital has also received important awards and recognitions, including a LeapFrog “A” grade for patient safety, the only Rhode Island institution so cited for three consecutive years. Consumer Reports has given it the highest rating in both patient safety and post-surgery outcomes.

Coastal Medical is Rhode Island’s largest physician owned primary care group practice with 20 locations, including in Newport and Wakefield.

“The quality of life in Rhode Island is amazing,” says Kimberly McHale, director of marketing and communications for Coastal Medical. “The seasons and the ocean, beautiful communities, excellent school systems…. And we’re an hour from Boston if you want something bigger.”

“When your group is owned by doctors, the processes you put in place are patient-first,” McHale says. “We’re run by physicians that care about everything that’s important to patients, and everything that’s important to physicians.”

That means standard in every office is a pharmacist, a nurse care manager for the most chronic patients, and a team in the corporate office to help manage it all, which allows physicians to concentrate on their practice of medicine. nIn the San Joaquin Valley sits a variety of cities and towns, including 17 with notable populations. Visalia is one of the five largest cities. The total valley floor comprises about 6 percent of the state land, but produces almost 13 percent of all U.S. agricultural crops. It follows that the area is known as “the nation’s salad bowl,” but the area also has the third largest oil field in the U.S.

Today, Visalia is home to some 125,000. Because of its proximity to the Sierra Nevada Mountains, the area attracts skiers from around the world. Other recreational prospects are almost unlimited, including snowshoeing, hiking, biking, rafting and horseback riding. Not to mention a multitude of natural wonders, from sky-high Sequoia trees and high waterfalls to some 270 underground caves in Sequoia and Kings Canyon National Parks. Also within easy driving distance is Yosemite National Park.

In the San Joaquin Valley sits a variety of cities and towns, including 17 with notable populations. Visalia is one of the five largest cities. The total valley floor comprises about 6 percent of the state land, but produces almost 13 percent of all U.S. agricultural crops. It follows that the area is known as “the nation’s salad bowl,” but the area also has the third largest oil field in the U.S.

Today, Visalia is home to some 125,000. Because of its proximity to the Sierra Nevada Mountains, the area attracts skiers from around the world. Other recreational prospects are almost unlimited, including snowshoeing, hiking, biking, rafting and horseback riding. Not to mention a multitude of natural wonders, from sky-high Sequoia trees and high waterfalls to some 270 underground caves in Sequoia and Kings Canyon National Parks. Also within easy driving distance is Yosemite National Park.

Ian Duncan, M.D., notes three major factors in his decision to join an orthopedic surgery group in Visalia: proximity to family; central location between San Francisco and Los Angeles; and skiing, a sport he now enjoys with his wife and three children, ages 13, 11 and 6. He performs surgery at the Kaweah Delta Medical Center.

Duncan knew from an early age that his life dream was to be a physician. He enrolled in a pre-med sequence first at Santa Rosa Junior College and then at the University of California, Davis. His choice of specialty came to him almost as a revelation, although a painful one for his girlfriend (now his wife). “She was changing a light bulb,” he says. “She pushed off a towel rack, it ripped out of the wall, and she fell backward onto her wrist and dislocated it, a pretty rare injury. We went to the ER. The doc popped her wrist back in, but he was struggling to do it for a while, so he looked at me and said, ‘Hey, help us out here and pull.’ I pulled down the elbow, and he was able to (finish the job). And from then on I knew that that work was for me.”

After being involved with sports teams in Santa Rosa, where he attended junior college, he concluded that “being in sports medicine and being a surgeon would be a good fit.” He reinforced his choice wherever he went by finding a way to work with at least 20 high school, college and even professional teams. He did so while at the Chicago Medical School (now known as Rosalind Franklin University), during internship and orthopedic residency at Temple University Hospital. He added a second residency at Thomas Jefferson University’s Rothman Institute of Orthopedics.

While at Temple, he worked with three different professional Philadelphia teams, including the Phillies.

In 2012, Duncan returned to Visalia. He had interviewed at several places in the state, but he soon realized that his hometown would be the best fit for him, especially since the need for his specialty was great. “I learned when I was interviewing that there were only six orthopedic surgeons here. (Statistically), that’s 80,000 people per surgeon (in my field).” Bottom line: “Before long, I was extremely busy. And I still do more surgery than just about anybody I trained with.”

And he still makes time to be on the field with football teams at a local high school and a college.

With eight campuses, the Kaweah Delta Health Care District provides state-of-the-art surgical techniques, services and equipment, such as endoscopic ultrasound, a large-opening MRI, brachiotherapy, a lymphedema center and a very new endourology suite for GreenLight laser surgery. Area residents can take advantage of the Lifestyle Center to keep in shape, and Kaweah Kids is a childcare service for employees and medical staff members.

The city itself is hardly lacking in cultural and unique dining experiences, especially in the downtown area. Performances of all kinds, including symphony, are held at the recently restored 85-year-old Fox Theatre, and Friday Nights Downtown attract crowds. A final touch is some 100 murals adorning downtown buildings. The Visalia Rawhide, an Arizona Diamondbacks baseball farm team, adds a sports ambience.

Visalia’s business scene is also alive and well. In line with its agricultural surroundings, the city is home to large food producers, distribution centers and various manufacturing operations such as International Paper, Voltage Multipliers (high-voltage diodes) and Alcoa.

City leaders are keeping busy, too. So far, a huge industrial park has attracted 18 varied businesses with another 27 probably on the way and ultimately room for as many as 150.

Visalia’s fifth new high school is one of several new facilities on the horizon, from a state-of-the-art animal control facility to a new city center consolidating currently scattered administration offices.

As a result, Visalia now exudes optimism for the future—and shows a smiling face.

 

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Newport, Rhode Island

History, water—and fun

By Eileen Lockwood | Live & Practice | Summer 2015

 

Ray Homoroc Cliffwalk Newport RI

The 3.5-mile Newport Cliff Walk showcases some of Newport’s “cottages”—impressive vacation homes, many of which came about in the 1800s.

When Thomas Fantes, M.D., joined the U.S. Navy, he had no particular thought about an after-service life in the coastal city with one of the nation’s biggest maritime installations. But that’s how it worked out. This is his story.

Fantes was born in Peru, but his family moved to northern New Jersey when he was 4. (At 6’4” and with light red hair, he jokes that he doesn’t look much like a Peruvian.) While studying economics at the then Rutgers College, he decided that medicine would be his life. The promise of government-financed tuition led him to join the Navy. After graduation from New Jersey Medical School, he went on active duty, incorporating internship and residency—and tours of duty in the Middle East and Japan.

After four final years at Naval Station Newport, Fantes and his wife, who was following the same path and is also a physician, was ready for civilian practice. After private practice, followed by ER and community medicine, he decided to settle into a hospital-related environment. “We got out and looked around at a bunch of different places,” he says. “And we thought, ‘You know, (Newport) is pretty nice.’” For them, it still is.

He’s now the medical director of Newport Hospital’s Vanderbilt Wound Center, as well as of the Newport Health Care Corporation, a physician group affiliated with the hospital. The hospital itself is a member of Lifespan.

The city of Newport is probably best known for its huge luxury mansions, labeled vacation “cottages” by the super-wealthy industrialists, mining magnates and southern planters who built them during the Gilded Age of the late 1800s. But that crowd was preceded by a fledgling U.S Navy complex during the Revolutionary War. During the Civil War, it was briefly home to the U.S. Naval Academy, moved from Annapolis to save it from Confederate hands. In World War II, 80 percent of American torpedoes were manufactured in the area, the largest single industry ever operated in Rhode Island. Today, the site is best known for its Naval War College and officer training school, as well as its large Naval Undersea Warfare Center.

A number of Newport’s magnificent “cottages” and early Colonial homes are now visitor attractions, in addition to other attention-worthy sites. Also on the water, excursion boats cruise past area lighthouses.

Today the words “sea” and “recreation” are almost synonymous, not to mention shipping and commercial fishing. The city is known as the sailing capital of the U.S. and is frequently the site of the America’s Cup race. At the seaside, the annual Newport Jazz Festival, a staple since 1954, may be the biggest lure of all. Everyday outdoor-lovers can be near the sea, too, thanks to the Newport Cliff Walk bordering the shoreline for more than three miles.

In its own way, Newport Hospital is forging the way into health care of the future. “It’s an exciting time,” says spokesperson Elena Falcone-Relvas, especially with the arrival of a new president, Crista Durand. Among other activities, Durand is “dedicated to making positive change and bringing on new doctors.”

For instance, several cardiovascular services are among recently introduced new and expanded techniques and equipment. It was the first hospital in the state to use a leadless implantable cardiac defibrillator, and its specialists now use the S-ICD System developed by Boston Scientific, the first subcutaneous implantable cardiac defibrillator for treatment of patients at risk for sudden cardiac arrest.

The wound care center itself is an example of, as Fantes reports, “the latest, most advanced treatments.”

In the meantime, Fantes reports that he, his wife and daughter “used to kayak a little, but we’re in the process of selling the boat,” possibly based on two factors. Their daughter, who was 6 when they settled in Newport, is now a college math major, so there’s one boater less in the family. And his physician wife recently became the chief medical officer at a Boston hospital, which, though only a half-hour drive away, is still a time-consuming post.

Work obligations aside, the Fantes adults continue to savor Newport for its surrounding “wonderful open space” where they enjoy walking their dog. Says Fantes: “It’s still a nice little city.”

After crossing Narragansett Bay from Newport, it’s about a 10-mile drive south on mainland Rhode Island to Wakefield, a town where the population is small but the mood is lively. About a stone’s throw south is a protected harbor on the ocean, with many miles of coastline and beaches that attract thousands of summer tourists. “The area is known for its beauty,” says Martha Murphy of South County Hospital Healthcare System. “A lot of people have second homes here and retire here.” That includes professors from the University of Rhode Island in nearby Kingston.

Newport Quaint

Downtown Newport is quintessential New England, with the big city of Boston just 90 minutes away.

Wakefield, with a population of about 8,500, is physically a part of South Kingston, population 30,600. However, it could be called the business beehive. “One of the biggest focuses is Main Street, with a lot of quaint shops and restaurants, plus two theaters,” notes Nick Pappadia, communications coordinator for the Southern Rhode Island Chamber of Commerce.

Of the hospital, with 100 beds (all in private rooms), Murphy says, “We like to say it provides everything from allergy to urology to everything in between.” Its strongest suit, she adds, is orthopedic surgery, especially joint replacement. “There are patients who choose to come here for surgery from across the state—and Connecticut.” She notes: “Our orthopedic surgeons have performed more MAKOplasty procedures than any other surgeons in the U.S. or the world—to date more than 3,000.”

The hospital has also received important awards and recognitions, including a LeapFrog “A” grade for patient safety, the only Rhode Island institution so cited for three consecutive years. Consumer Reports has given it the highest rating in both patient safety and post-surgery outcomes.

Coastal Medical is Rhode Island’s largest physician owned primary care group practice with 20 locations, including in Newport and Wakefield.

“The quality of life in Rhode Island is amazing,” says Kimberly McHale, director of marketing and communications for Coastal Medical. “The seasons and the ocean, beautiful communities, excellent school systems…. And we’re an hour from Boston if you want something bigger.”

Coastal Medical is a progressive group—the first ACO in the state, and one of the first practices in the nation to have a successful shared savings plan that resulted in bonuses for the whole company.

“When your group is owned by doctors, the processes you put in place are patient-first,” McHale says. “We’re run by physicians that care about everything that’s important to patients, and everything that’s important to physicians.”

That means standard in every office is a pharmacist, a nurse care manager for the most chronic patients, and a team in the corporate office to help manage it all, which allows physicians to concentrate on their practice of medicine.

 

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Southern Delaware

Beaches, bikes and boats

By Eileen Lockwood | Live & Practice | Summer 2015

 

Rehoboth Beach

A mile-long boardwalk, bandstand and family-friendly fun beckon crowds to Rehoboth Beach.

Endocrinologist Francisco Padilla, M.D., considered himself a big-city guy, having lived in them all his life.

But as fellowship at UConn Health Center ended and he began his job search, he signed up for PracticeLink and received a call shortly after from an in-house recruiter from Nanticoke Health Services in Seaford, Delaware.

Shortly after the call—and now five years later—Padilla his wife, internist Sandra Palavecino, M.D., and their two children are ensconced in Southern Delaware.

“First, it’s safe,” Padilla says of the area. “It’s good to have my kids live in a place where they can play outside without having to worry. Everyone knows everybody. And working in a small hospital is nice. I know the hospital president and the network president, so we can interact. You can be more familiar and close with the administration.”

That close relationship is one benefit Padilla has found in making the move from big city to small—a move that gave him the ability to grow a department.

“If you go to a big hospital where there’s already an endocrine department established, you just have to get plugged in to the department,” he says. “But when you go to a small hospital, you get the opportunity to build something from the ground up.”

There are several examples of innovative services pioneered in Delaware and, in some cases, in the entire Mid-Atlantic region, by the hospital and its practitioners.

“We’re kind of a hidden gem here,” says Nanticoke Memorial marketing director Sharon Harrington. “We’re a smaller hospital, but we have a whole lot of things going on.”

The same can be said for Seaford itself. When Padilla’s not busy with his expanding department, he is an avid bicyclist. Water also plays a role in his family’s life: His wife enjoys paddleboarding and his kids like to kayak.

“Summer is very active here for the beaches,” he says.

On the other side of Sussex County, 35 miles east, Lewes, Delaware, sits on one of those beaches—a resort town where Delaware Bay meets the Atlantic Ocean.

“In summertime, it gets pretty crowded with vacationers from Maryland, Pennsylvania, Virginia, New Jersey and D.C. taking their one-week beach-rental vacations,” says Julie Holmon, M.D. “So we’ll often head out to do big-city things. We’re in this little oasis, but we’re not too far from major cities, even New York.”

She’s happy to be a permanent resident in “a safe, relaxed environment with farms and beaches influencing (our children’s) lives.” Not to mention the work satisfaction for Holmon, who is medical director of the hospitalist program, which started 10 years ago at Beebe Healthcare in Lewes and now has a staff of 20—and the search is on for more.

Holmon was recently named the Best Hospitalist for 2015 by the Delaware chapter of the American College of Physicians. After graduating from the University of California, Irvine, Holmon and her attorney husband, Chris, headed east, where she earned her medical degree at Johns Hopkins University, followed by residencies at Christiana Care Health System in Newark, Delaware, and Alfred I. duPont Hospital for Children in Wilmington.

Her plan was to practice internal medicine and pediatrics, and she soon signed on with a physician in nearby Milton.

She was already familiar with Beebe due to a residency rotation, and she loved the area. “I was also struck by how innocent the children were whom I was seeing (at the doctor’s office),” Holmon says. “Even girls as old as 12 and 13 were still climbing trees, in the 4-H Club and playing sports. They were not smoking and dating and things like that. I thought it was wonderful that they seemed to grow up slower down here than where I grew up in California and where I trained in Baltimore and Wilmington.”

Holmon has discovered bountiful outdoor activities available for her own children, a 10-year-old son and a 7-year-old daughter. She’s been especially pleased at the number of small-group beach nature camps with different nature themes.

In addition, Holmon notes, “My kids have been taking sailing lessons since they were 5.”

The great outdoors also caters to adults. Fishing, kayaking, windsurfing and hunting are very popular, but Holmon’s personal favorite is bicycling on a nature trail that extends from Lewes to Rehoboth. “It’s a great way to get to Rehoboth Beach without getting on any highways,” she says. Rehoboth is the area’s best-known and most popular of five public shore locations in the area. Adding to the oceanfront ambience are two nearby state parks, fine dining and a variety of specialty boutiques.

Not surprisingly, with its huge waterfront, the city is a popular boating center with a good number of docking slips.

Meanwhile, at Beebe Healthcare, action is going full speed ahead, not only with physicians and the newest equipment to provide high-quality care, but also with efforts to bring care closer to where patients live and programs to help them maintain good health, and of course provide top-notch care when needed. The mix includes a cancer center complete with state-of-the-art equipment.

In other areas, president and CEO Jeffrey Fried points out, “We’re targeting high-risk patients with chronic conditions, trying to set up a safety net so they can be treated quickly.” Outpatient walk-in care is also available in many county locations.

An electrophysiology capability has recently been introduced to correct heart arrhythmias. In line with that effort, the Dr. Dean Ornish Program for Reversing Heart Disease will soon begin at the Beebe Health Campus in Rehoboth.

Julie Holmon MD

Julie Holmon, M.D., has discovered plenty of outdoor opportunities for her family in southern Delaware. “My kids have been taking sailing lessons since they were 5,” she says.

As for patient self-care, Fried notes the Healthier Sussex County Initiative started in 2012. It’s designed to engage area residents to do more to take care of themselves. “The goal,” he says, “is to make Sussex County the healthiest county in the country.”

Also helping the area’s health needs is a new Bayhealth hospital slated for groundbreaking soon in Milford, known as the Gateway to Southern Delaware.

The Bayhealth team is actively recruiting new providers in preparation for the forthcoming, totally new 150-bed facility. That means all new equipment and technology, too—“they’re not bringing anything over,” says senior physician recruiter Marc Powell, who is based in Bayhealth’s Dover facility, Kent General Hospital, about 20 miles north.

At the top of the state is Wilmington, the state’s largest city. The Christiana Care Health System is headquartered there, a major teaching facility that includes two full-service hospitals with a total of 1,100 beds. It’s the largest private employer in the state. It also hosts a number of forward-looking agendas to build its reputation as a center of innovation, both in medical advances and care regimens. It’s recognized as a regional center for excellence in cardiology, cancer and women’s services.

Among its more “humanistic” programs are the Value Institute and Lean Six Sigma Training, the first striving to develop care improvements at affordable costs, and the second to increase quality of care by upgrading employee knowledge and skills. On the lighter side, Musicians on Call is a Wednesday-afternoon program in which instrumental and vocal artists go to patient rooms, using their skills as a way of cheering patients.

 

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Grand Rapids, Michigan

Hardcore hockey and craft beer

By Liz Funk | Fall 2015 | Live & Practice

 

Karen Kennedy

Karen Kennedy, M.D., moved to Grand Rapids from New York City. “As much as I love New York, I think the size of Grand Rapids has helped me progress faster,” she says.

Out of the 8 million people in New York City, I found a Michigan man to fall in love with,” marvels Karen Kennedy, M.D. So the native Brooklynite moved to Grand Rapids, Michigan. She not only fell in love with the city but also found professional opportunities there. She says the Grand Rapids medical community accelerated her career in a way New York City could not have.

“As much as I love New York, I think the size of Grand Rapids has helped me progress faster,” she explains. “New opportunities are easier to access. In New York, if you want something, there may be 20 people with similar experience and the same idea up against you. I had eight years of experience under my belt when I moved to Grand Rapids. I was a board-certified physician, and I became lead physician within one year.”

Kennedy is the medical director of Mercy Health St. Mary’s Hospital Browning Claytor Health Center, a family practice clinic that provides care to underserved community members. She says helping these patients requires understanding and motivational interviewing.

“As doctors, we can all have this high level of information, but it’s not helpful if you can’t get to the core of the issue,” Kennedy explains. “When you treat a patient with diabetes, you can take some extra time to connect with them, and then you can get them on the right path. For example, do they feel that this is a family curse and that there isn’t anything they can do about it? Then that’s a new conversation, and you try to have them walk away with an attitude of, ‘You do as much as you can do anyway.’”

James Lebolt, D.O.

As medical director of sports medicine at Spectrum Health Medical Group, James Lebolt, D.O., appreciates how motivated athletes can be to get back to their sports. In Grand Rapids, that includes a fair share of hockey-related accidents.

Although Kennedy loves working with patients, she decided she also wanted a voice in hospital administration. “There is a beauty to the trenches, but I was also interested in how we orchestrated and managed patient care,” she says. Being in Grand Rapids instead of New York helped her make the shift quickly. “All I had to do was voice an interest, and here I am.”

Like Kennedy, James Lebolt, D.O., came to Grand Rapids for love. His wife grew up there, and Lebolt had lived in Michigan during his residency at Sparrow Hospital-Michigan State University. So when his wife wanted to move to Grand Rapids to be closer to her family, he says, “It didn’t take much convincing.” He is now medical director of sports medicine at Spectrum Health Medical Group in Grand Rapids.

A lifelong athlete, Lebolt played on his high school and college baseball teams. In college, he realized that although sports were his passion, he probably wouldn’t make it to the MLB. “I wanted to be in a sports environment and be active with great teams and also make a living. I realized that the way to make that transition was to become an orthopedic surgeon.”

Lebolt completed his fellowship at the American Sports Medicine Institute in Birmingham, Alabama. “I didn’t realize how motivated people could be to get back to their sport. Some people had had devastating injuries, but they had this drive to get better.”

That’s Lebolt’s favorite part of his job: “People get better,” he says. “In other specialties, you’re dealing with chronic illnesses, and you’re helping people live with their illness and deal with it. It’s very gratifying for me to see my patients recovered, such as when I see a high school sports player on the news, back on the court, or I read in the paper that a former patient was recruited to play at a college.”

Practicing in Grand Rapids means Lebolt sees his fair share of hockey accidents. He treats a lot of junior players, including high school students and adult league players. Raised mostly in the South, Lebolt didn’t have much exposure to hockey as a young athlete, but he says, “I’ve learned to appreciate the sport through my patients, and I’m growing to love it because of my patients’ passion for it.”

The town’s love of hockey is great not only for sports medicine but also for sports fans. “We have a more active community of younger residents than people realize,” says Janet Korn, senior vice president of Experience Grand Rapids. “If you are a hockey fan, watching a hockey game is one of the go-to activities.”

“The Grand Rapids Griffins have a real connection to the NHL,” she adds. “Frequently, the players will trade to the Red Wings or go back and forth. There are some times when a weekend player for the Red Wings will come play with the Griffins. The Griffins games offer a fun family atmosphere. But they also market the games as a fun thing to do on a Friday night, with college student night or Friday night specials like $2 for a beer and a hot dog.”

“Hockey is really special to our community,” says Beth Brackenridge, FASPR, a physician recruiter with Spectrum Health. The city has a traveling youth hockey team, and most schools partner with the Grand Rapids Griffins. Brackenridge adds, “There are a lot of ways people can participate in the local hockey community as a spectator, as a participant or parent of a participant,” she says.

Spectrum Health System, which operates 14 centers and employs 1,300 providers in Grand Rapids, is a sponsor of the Grand Rapids Griffins. They give away tickets and offer special ticket prices to support the Griffins while raising awareness of their facilities and their city wellness initiatives.

Another major health care player in the area is Metro Health. Its 208-bed general acute care teaching hospital has been named one of the country’s Top 20 Most Beautiful Hospitals five times. Metro Health Village combines restaurants, retail and Metro Health Hospital on one unique 170-acre campus.

Also in town is Michigan State University College of Human Medicine.

“Michigan State University Medical School opened a campus in downtown Grand Rapids just a few years ago. It is a wonderful addition for physicians who are interested in teaching,” Korn says. Korn explains that Grand Rapids is making a great effort to intertwine its economic development with its health care systems. “We are trying to build the city as an anchor for the health sciences,” she says.

The city’s other anchor is its breweries, which have earned the city the affectionate nickname “Beer City, USA.” Korn says, “There are over two dozen craft breweries in the area. The community is very engaged with the craft brewing culture, and people usually have a favorite brewery. They get to know the brewer, and many of the breweries have a Cheers-like feeling.”

There’s plenty to eat as well as drink. The Grand Rapids restaurant scene is eclectic enough to entertain any palate. A self-described foodie, Lebolt raves, “The restaurants here, just fantastic food. Grand Rapids’ restaurant scene has a big-city feel. There is a plethora of choices.” Lebolt’s recommendation for the best meal around? Fish tacos from Donkey Taqueria, a trendy Mexican restaurant.

But the metropolitan flavors don’t come at the cost of small-town friendliness. Brackenridge says, “Grand Rapids is the second-largest city in the state, but it has a small-town feel. You get a little of both. We’re near Lake Michigan, so we have beautiful beaches. We’re rated number one in Forbes to raise a family.”

Jenna Thayer, a physician recruiter for Mercy Health, agrees. “People live in Grand Rapids for the exceptional quality of life,” she says. This includes not only the city’s offerings but also its people. “Grand Rapids fosters a dynamic environment with increasing diversity and a growing population. …People notice the sincere kindness and generosity that radiates throughout the city.”

No wonder they call it grand.

 

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Portland, Oregon

The dream of the Winterhawks is alive

By Liz Funk | Fall 2015 | Live & Practice

 

Matt Snodgrass, M.D.

Matt Snodgrass, M.D., hung up his white coat a few months into residency. “The patient population (in Portland) doesn’t think you need to have a white coat in clinic,” he says.

Born and raised in suburban Portland, Oregon, Matt Snodgrass, M.D., credits the Oregon wilderness with sparking his interest in medicine. He went to college at Willamette University in nearby Salem, where he originally planned to study psychology. “I thought I might even want to be a Ph.D. or Psy.D. therapist,” he says.

But before his junior year, Snodgrass led a week-long wilderness program for incoming freshman. To prepare, he and the other leaders took a training course that changed his career path. “We basically had to train to become first responders,” he says. “I took the course, and I was really impressed and thought, ‘Man, maybe medicine…is what I want to do.’”

Snodgrass has traveled extensively, but he’s found nothing compares to his lush native city of Portland. Now a family medicine physician, he is putting down roots and plans to stay. He recently began a new job, and he bought a house close to his work. Snodgrass embodies the city’s cultured, laid-back vibe—one of the reasons it’s growing so rapidly—and he believes this down-to-earth attitude makes him a better physician. He listens to patients, makes himself approachable and provides thorough care.

While job hunting, Snodgrass looked for a group practice and an established health system, one that could support a patient-centered medical home. “The residency where I trained was a patient-centered medical home,” he says. “Practically speaking, it meant I had a lot of backup. It allowed patients to have a lot more points of contact. My numbers were much better. Clinical pharmacists can help, we have on-site behavioral health, and it’s all the same co-pay to see me.”

He considered Providence Health & Services, Kaiser Permanente and Legacy Health, and found his fit at Providence Medical Group-Tanasbourne, a small primary care practice within a large health care system. He says he likes the teamwork he sees there. “I am such a team fan. Maybe it’s because I’m a team-oriented thinker that I’m drawn to the way these practices are organized.”

But although Snodgrass loves teamwork and athletic activity, he doesn’t follow Portland hockey and can’t play himself: “I can’t skate worth a darn, and my son knows it. I’ve tried to skate with him, and it’s embarrassing.”

Portland sign

Local flavor in Portland

In this, Snodgrass differs from the rest of Portland. “Portland is serious about their sports, hockey included,” says Megan Conway, vice president of communications and public relations for Travel Portland, the city’s tourism and visitors bureau. “The Winterhawks have sent more than 100 players to the NHL, including hall-of-famers like Mark Messier and Cam Neely.” The Winterhawks also won the 2013 WHL Championship.

Lucky for Snodgrass, Portland has something for everyone, not just sports fanatics. “Portland is a great community,” says Josh Erde-Wollheim, physician recruiter for Providence Physician Services & Development. “You have a lot of open-minded, intelligent, driven people. Portland has a small medical community for a city closing in on 2 million people. It’s really not hard to get established and get your name out there quickly.”

The area has four major hospital systems: Legacy, Providence, Kaiser and Oregon Health & Science University. Erde-Wollheim sees an overlap between Portland’s health-consciousness and the state’s health care system. “Oregon as a whole has been really aggressive on accountable care organizations. …Health insurance companies are really pushing wellness metrics across the board. I think having the right primary care doctors and right specialists in the area that can help and promote that is important.”

At The Portland Clinic, a multispecialty group with seven locations and a 94-year history, 100 providers are committed to the medical home model.

“We have behaviorists, specialists and primary care in our locations,” says provider recruiter Jan Reid. “Doctors get to know their MAs, and they get to know their team members. Each site has its own personality, but we’re all a part of The Portland Clinic.”

The Portland Clinic is a unique partnership of independent physicians who are self-governed. “Our administrative staff works for the physicians,” Reid says. “That’s very different from the other major health systems. We tend to attract physicians who have that independent mind and want to someday have a role in the ownership structure and a voice in how the group is led.”

Potential new team members ask a lot of questions about the Clinic’s structure, especially in light of the current climate of smaller groups being acquired by larger systems.

Assures Reid: “Our physicians aren’t just independent—they’re fiercely independent. Together with the administrative team, they’ve implemented measures to assure our longevity over the long term.”

When it comes to recruitment and hiring, however, their process take a high-touch, concierge approach.

“From the first time they make contact with our group, they are going to be walked through the process of interviewing, contracting, onboarding, to their first day of practice and beyond,” Reid says. “We’re not just looking for clinical skills, but a personality match. They’re not going to be lost here; they’re going to be known here.”

Same could be said for Portland as a city.

“I think in Portland, a physician will have the opportunity for a very healthy balance of life,” Reid says.

“It’s a very healthy place,” seconds Erde-Wollheim. “We lead the country in terms of miles of bike lines. When the weather is nice, you see everyone outside, and it inspires you to go outside and be active. It’s really easy to go shopping at a local farmer’s market or get produce delivered from your CSA [community supported agriculture] farm.”

Conway agrees. “We’re also pretty enthusiastic about our amazing food and drink options. …Both a cultural and health trend, Portland is big on the farm-to-fork movement of eating local, sustainable food.” Conway also adds that Portland doesn’t have sales tax.

Conway says that some people “think the indie music and arts scenes define our particular brand of cool,” while others point to Portland’s trees, fresh air and outdoorsy lifestyle. No matter how you define the city’s brand of cool, Portland’s free-spirited atmosphere even extends to doctor-patient interactions.

“I have not worn my white coat since the first few months of my residency [at Providence Milwaukie Hospital],” Snodgrass says. “As an intern, we’d have a month in ICU and a month at a larger hospital near Providence Milwaukie. The month we spent on wards, I was white-coated out. I even had a pocket that was big enough for my iPad. I wanted one specifically designed for my iPad, and let me tell you, I never put my iPad in my white coat ever.”

Snodgrass eagerly returned to using his computer on wheels and abandoned his white coat. “Once I had no reason to rock my iPad white coat, I had no reason to wear my white coat at all.” He adds, “The patient population here doesn’t think you need to have a white coat in clinic.”

How very Portland of them.

 

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Charlotte, North Carolina

Four seasons, all pretty nice

By Liz Funk | Fall 2015 | Live & Practice

 

Freedom Lake Park

Freedom Lake Park in Charlotte

Professional admiration attracted James Rachal, M.D., to Charlotte, North Carolina. Rachal had heard of John Santopietro, M.D., FAPA, chief clinical officer at Carolinas HealthCare System, and admired his work. “He was changing psychiatry and telepsychiatry,” Rachal says.

Santopietro practices telepsychiatry, in which psychological professionals treat patients via teleconferencing. This allows them to treat more patients and reach underserved populations in remote areas. And in Rachal’s new role as the medical director of Behavioral Health Center Charlotte for Carolinas HealthCare System, he reports to Santopietro.

But Rachal’s interest in Charlotte wasn’t just professional. The city was also appealing. “The draw was multifactorial,” he says. “It was a beautiful city,”

In this, Rachal is like many who move to Charlotte for work, according to Ryan Knox, a recruiter for Carolinas HealthCare System and a 17-year Charlotte resident. Knox says, “Once they come to interview, it’s usually a done deal. I’m lucky Charlotte is such an easy place to sell.”

Before moving to Charlotte, Rachal spent time in Ohio and near D.C. and served in the Air Force. He attended Ohio’s Miami University for undergrad and graduated from medical school at the University of Cincinnati.

Rachal then did his residency in Bethesda, Maryland, at the National Capital Consortium at Walter Reed National Military Medical Center. While working in the psychiatry and family residency program, he worked with the center’s large number of trauma patients. “I saw several hundred returning veterans that had been traumatized by the war,” he says. “I was also involved in the trauma services provided to Pentagon workers the day of and the day after September 11th.”

This was good training because as Rachal explains, “A large percentage of behavioral health patients have experienced trauma.” He finds psychiatry rewarding because he can help these patients and others. “You’re making an impact, working with someone who was going to harm themselves.”

Rachal believes other physicians can do the same. “A lot of mental health is performed in primary care with psychiatry in consultation,” he explains. “I always felt a fusion of the two was important.” And when it comes to physical and mental health, Rachal teaches his patients to be proactive, not reactive.

Rachal’s happy to be helping patients become more active and informed, and he’s happy doing it in Charlotte. He explains, “I was attracted to the commitment to excellence and innovation that seems to be across the entire hospital system [at Carolinas HealthCare System].”

It’s no wonder Rachal enjoys Charlotte. As Laura White, director of communications at Charlotte Regional Visitors Authority, explains, “Charlotte is the perfect blend of big city with small-town charm and Southern hospitality.” But don’t let that small-town charm fool you. Residents still shout and scream for their favorite teams. “Charlotte is a huge sports town,” White affirms. “We calculated that in a year [on] 200 days or nights, there was a major sporting event.”

Hockey is especially popular. “Our AHL team is the Charlotte Checkers,” White says. “The community around the Checkers is so enthusiastic that there was recently a big effort to move them to a renovated historic coliseum, the Bojangles Coliseum. This was a major renovation to bring the Checkers home.” Charlotte’s other sports venues include the Bank of America Stadium and the Time Warner Cable Arena.

Charlotte is experiencing huge growth. Forbes magazine ranked it the fifth fastest-growing city in the U.S., citing 32.8 percent population growth since 2000. This rapid growth makes getting connected easy. “People who are new here have the opportunity to get involved in and be embraced by the community,” says White. “Right now, we’re seeing new people moving into new neighborhoods and a lot of growth and change in these neighborhoods. When you’re living there, you feel invested in the growth of these places.”

According to White, popular and up-and-coming neighborhoods include South End, Plaza Midwood, Dilworth, SouthPark and “NoDa” (short for North Davidson). And in Charlotte, downtown and uptown are reversed. Uptown has the city’s highest point of elevation, so the city planners centered city attractions there instead of downtown.

“Uptown is where there are a lot of new buildings and high-rise condos,” says Knox. “They are good for doctors who are younger and right out of residency to rent or buy, if that’s their goal. Downtown is where there are older homes, historic ones that have been updated and remodeled.”

Many physicians buy homes in the Myers Park neighborhood, an area that Knox says is “cozy, chic and very livable,” and it’s close to a cluster of hospitals. These include Carolinas Medical Center’s F.H. “Sammy” Ross, Jr. Center and Carolinas Medical Center-Mercy. Thanks to its livability, Knox says Charlotte attracts many young families. “Sometimes doctors will do their first few years in a bigger city and come here once their kids are ready to start kindergarten,” she explains. “They move for the school system and all the family options.”

White agrees: “Charlotte is a desirable place to live and settle down.” In addition to its family friendliness, Charlotte has excellent weather. Even in fall, it’s warm enough for outdoor activities, and golfers can play year-round.

Rachal has lived in Charlotte since May. He and his wife bought a house for themselves and their three children, and they are enjoying exploring nearby neighborhoods. “Right now, finding restaurants and cultural activities is important,” he says.

Chances are that won’t be much of a struggle in Charlotte.

 

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Hershey, Pennsylvania

Come for the chocolate and stay for the game

By Liz Funk | Fall 2015 | Live & Practice

 

Hershey's Chocolate World

Photo by Bill Cress

When Lilia Reyes, M.D., left New York City last year to move to Hershey, Pennsylvania, she didn’t anticipate the cultural and linguistic diversity she would encounter. Now as she nears her first full year as a pediatric emergency medical specialist at Penn State Hershey Emergency Medicine, Reyes describes herself as “happy” and “grateful.” She says Penn State Hershey has given her a valuable and well-rounded experience. “It’s been amazingly busy,” she says. “It really benefits my clinical acumen.”

Reyes focused on general pediatrics in medical school and then trained at the Jacobi Medical Center at the Albert Einstein College of Medicine in the Bronx. There she treated trauma patients, including many with stab wounds and gun shots, and felt a call to treat children with traumatic injuries. She honed her expertise during a fellowship at Yale University and then returned to New York City to practice.

Reyes doesn’t see many stab wounds in Hershey, but she does treat patients who have had major ATV accidents, farming accidents, car accidents and severe bicycle falls. “When I interviewed, they told me I’d have some interesting cases.”

They were right. Reyes deals with a diverse patient base, including many children from the large Amish population in nearby Lancaster County. “They come in with either major injuries or chronic illnesses. We want to provide the best quality of care for them while also doing the minimum number of tests. The families are paying out of pocket because they don’t have health insurance.” Reyes enjoys working with them. “They are so grateful and humble,” she says. The children speak Pennsylvania Dutch to their parents, and their parents translate into English for Reyes.

Penn State Hershey’s diverse patient base also includes many Spanish-speaking migrant farm workers. As a second generation Colombian-American, Reyes is able to serve these patients in their native Spanish. Her Colombian-born parents raised their daughter in suburban central New Jersey, and Reyes went on to attend Rutgers University.

Now Reyes is thrilled to have landed at Penn State Hershey. “We have all the resources of a major hospital,” she says. “I have every specialty to consult with.” What she appreciates most is her colleagues’ commitment to teamwork. For example, once as she was sedating one patient so the EMT could do stitches, she was called away to resuscitate a second patient. Another physician quickly stepped in to help. “It’s so great to have that collaborative help between the nurses, the techs and the EMTs. Hospitals strive for that level of collaboration. It should be the norm, but that’s not always the case. So I feel very grateful to be here.”

Others who move to Hershey have their own reasons to be grateful. Mary Smith, president and CEO of Hershey Harrisburg Regional Visitors Bureau, sees more and more young professionals coming to the area and finding their niches. “Hershey-Harrisburg has intrigue for the Millennial group,” she explains. “We always say, ‘You may be familiar with Hersheypark, and you may have even visited as a child. But there are more areas to discover.’”

Smith explains that the Hershey-Harrisburg region is a good fit for people in several different stages of life. She describes the area as having three pillars: “There’s family fun, there is life for couples without kids, and there is the outdoor component. If you come here for the eclectic urban life, you can stay here and grow into a family.”

Also important is Hershey’s sports scene. “There is an awesome following of hockey in the area. The Bears are our team, and they are the affiliate of the Washington Capitals,” says Smith. “The people here really follow sports and the minor league teams, whether it’s the Bears [hockey], the Senators [baseball] or the Islanders [soccer]. We are definitely known as a minor league sports destination. In 2009 and 2011, we were rated the number-one minor league sports city by Street and Smith’s SportsBusiness Journal.”

People come to Hershey for its hiking trails, its farm-to-table restaurants (enabled by Lancaster County farms), and of course its chocolate. But for physicians, Hershey’s draw is professional. It provides an opportunity for a high-level medical career at a large-scale hospital without the intense competition, stress and expense of a major metropolis.

“Residents and fellows are generally only accustomed to working in large state-of-the-art hospitals in major metropolitan cities,” says Jessica Mullany, MHA, associate director of physician recruitment at Penn State Milton S. Hershey Medical Center. “But patients who otherwise would need to go to Philadelphia or Pittsburgh for care can come here.”

Penn State Hershey not only offers varied and exciting cases, but also the opportunity to learn about all areas of treatment. “We’re an academic medical center,” Mullany says. She echoes Reyes’ experience in the ER. “Physicians want to teach the clinical passions they pursued. The hospital takes a very collaboration-oriented approach between the doctors, the nursing staff and the technicians. We try to be on the cutting edge in terms of cross-collaborations in our institute.”

“People like the work/life balance that our system and our community provide,” says Mullany. “It’s very rewarding work, and we operate like most of the facilities in a major metro area would. But we have this nice work/life balance. This makes us unique and desirable as an employer.”

“It’s a great place to raise a family. Our location is very central to getting to the bigger cities, but the cost of living is lower,” notes Linda Campbell, manager of physician recruitment for PinnacleHealth in nearby Harrisburg, Pennsylvania’s capital city.

PinnacleHealth’s CardioVascular Institute, Cancer Institute, and Weight Loss Center are among the system’s most well-known offerings.

“For our women and children’s services, in addition to deliveries, we have maternal fetal medicine and reproductive services,” Campbell adds.

PinnacleHealth was recently named among the top 10 Pennsylvania Hospitals by U.S. News & World Report, and is ranked in the top 5 percent of the state for major joint replacements, open heart and spine/back surgery and heart catheterization and stenting. The 636-bed system has more than 6,000 employees.

Chris Scheid, D.O., is one of PinnacleHealth’s newer employees, having moved to Harrisburg in July after finishing medical school at the Philadelphia College of Osteopathic Medicine and residency at UPMC Altoona, about two hours away.

“I would say that there’s a little bit greater patient diversity,” he says of his new location. “And as far as living here, a little bit more convenience to getting to things.”

He picked PinnacleHealth thanks in part to the hospitality toward physicians he witnessed during the interview, compensation levels for the region—and location to family.

“The best part’s been the way that they treat physicians,” he says.

For Reyes, Hershey is a place where she can “enjoy her work, enjoy her life and have a leadership position at the medical school.” She marvels at her progress. “In one short year, I was able to get there. This is really a place where you can advance.”

She and her husband are also first-time homeowners. In New York, they had to rent, but after just one year in Hershey, they saved enough to buy a house. Reyes believes that would not have been the case had they stayed in New York. “We could have eventually bought an apartment, but it would have taken much longer.”

Like so many others, Reyes has found life in Hershey as sweet as the chocolate.

 

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Lexington, Ky.

Horse capital of the world

Live & Practice | Winter 2015

 

Bratton Family

A day at the Kentucky Horse Park is one way Robert Bratton, M.D., and his family enjoy life in the Bluegrass State.

There may be only one American city that can credit its growth and prosperity to the color of its grass.

In fact, the Lexington area has a “triple threat” of benefits, as University of Kentucky animal and food sciences professor Laurie Lawrence explains. “A limestone-based soil [produces] pasture grasses high in a balance of calcium and phosphorus that provides an almost perfect amount of [nutrition] for growing horses,” she says. “The climate is very amenable to grasses that do well, and we have a long growing season. Horses can live outside for a longer period of the year. The terrain is very rolling, so they can get a lot of good exercise running up and down the hills.”

Horses at fence

Lexington’s home to more than 150 horse farms.

Currently there are 450 dedicated farms in the region, including 150 in Lexington/Fayette County. (The two governmental entities were consolidated in 1974.) Their offspring join the world’s best race competitors and become preferred stallions in many another setting.

Today, Lexington’s Keeneland Association track is where some of the world’s best Thoroughbreds run for the money. “We also get the best jockeys,” says communications associate Amy Owens. She cites the biggest fall race, the million-dollar Shadwell Turf Mile, won in 2014 by Wise Dan, whose prize accumulation of $7.5 million made him the USA Horse of the Year. Many millions of dollars also change hands four times a year when Keeneland hosts the world’s leading Thoroughbred auction, attracting buyers from all 50 states and 50 countries.

Horse-related events crowd the local calendar and visitors are welcome to tour several horse farms, including one for retired champions and their brethren. But the year-round champion of equine attractions has to be the Kentucky Horse Park, a 1,224-acre horse “theme park” that’s home to 42 breeds.

Keeneland Race Track

Keeneland Race Track is where thoroughbreds come to both race and go to auction.

For Robert Bratton, M.D., a top-of-the-list family activity starts at the horse park on a Sunday afternoon. “You get a big bucket of chicken and a blanket, and you go out and watch them play polo,” he says. For the park itself, that’s only the beginning. Among visitor attractions are daily presentations of several breeds, horse-drawn tours and carriage rides, horseback and pony rides, three museums, an art gallery, the Hall of Champions Barn, steeplechase events, cross-country competitions and specialized breed shows.

Bratton, who practices urgent care and family medicine, is chief medical officer at the Lexington Clinic, Central Kentucky’s oldest and largest group practice, with more than 30 area locations and some 225 primary and specialty care providers. A Lexington native, Bratton earned his medical degree at the University of Kentucky College of Medicine, then moved on to Rochester, Minnesota, for his Mayo Clinic residency, then to Jacksonville, Florida, for 14 years.

The Paddock at Keeneland

Sales at Keeneland have included 83 Breeders’ Cup World Championship and 19 Kentucky Derby winners.

Then the Mayo leadership tapped him to chair the family medicine department at its Scottsdale, Arizona, location. He’s been back on “home ground” since 2008. “As you grow older,” he says, “you appreciate your family and your hometown. So when this job became available, I applied for the position, and from there I was coming back to Lexington.”

“It has been a good move for my family,” he adds. “I have two teenage kids who are finishing up in school, and they thoroughly enjoy it.” Although his daughter and son are in private schools, “mostly because it was more or less a cultural thing for them,” Bratton notes that his years in public schools were very happy, and that Lexington is fortunate to have some outstanding schools.

The city itself did not stand still during his absence. He has been especially gratified at “a lot of changes downtown.” Vintage buildings are undergoing renovations, especially the centrally located Victorian Square (aka The Square), and new restaurants are springing up.

Among new crowd-attracting events is Thursday Night Live, when restaurants bring tables outdoors and the area blossoms with music by local talent. A neighborhood restaurant boom started in 2012 with the renovation of an old factory. The city now boasts several new eateries, including Country Club, cited one of the best 15 new U.S. restaurants. Bratton’s continuing favorite, though, is a vintage-house-turned-restaurant, the Merrick Inn.

More than a hundred city parks, with six golf courses and a 12,000-square-foot skateboarding park, await those in search of healthy outdoor pursuits. With 11 miles of hiking trails, the Raven Run Nature Sanctuary combines recreational possibilities with scenic beauty. It runs along the Kentucky River Palisades.

The city’s history is also alive and well. Four vintage homes are open to visitors, including Ashland, the estate of Henry Clay, the city’s most famous citizen and long-time 1800s U.S. Senate leader.

Culture lovers enjoy the Lexington Philharmonic, the Kentucky Ballet Theater, Broadway road shows, traditional opera—and the Troubadour Concert Series featuring blues, jazz and folk music.

Some events take place at the University of Kentucky, not to mention the ever-popular games of the Wildcats, “the winningest program in college basketball history.” “Everybody lives for basketball around here,” says Bratton, but he adds, “We finally have a football team we can be proud of, too.”

Not to be forgotten is the state’s unique brand of spirits, which has spawned a Bourbon Trail incorporating several Lexington-area facilities. The hugely profitable distilling operations are part of a state economy that has grown by the proverbial leaps and bounds, including the Lexington-area mix that includes divisions of Xerox, Toyota and Lockheed Martin. A Jif Peanut Butter plant churns out more of its yummy product than any other factory in the world, and Lexmark International, a 1991 IBM spinoff, manufactures printers and related equipment. Its worldwide headquarters are in Lexington.

Not least in the mix is UK with 14,000 employees, plus some 7,000 at UK HealthCare, its medical complex, which includes a trio of sectors covering research, education and clinical care and includes UK Chandler Medical Center, Good Samaritan Hospital and Kentucky Children’s Hospital. Among Good Samaritan’s notable services is the state’s second largest orthopaedic and joint replacement program.

Baptist Health Lexington provides some of the region’s most advanced facilities, technology and capabilities, including in heart disease and cancer care. Physicians also help companies set up educational programs matching specific company needs.

KentuckyOne Health has more than 200 health care facilities in Kentucky and southern Indiana, including two Lexington hospitals, Saint Joseph Hospital and Saint Joseph East. Their cardiology, orthopedics and stroke care programs have received national recognition. Three major hospitals in Louisville are among the mix, and leaders are proud of the fact that Catholic, Jewish and academic heritages are part of the mix.

Meanwhile, back in equine territory, Bratton says he’s probably as enthusiastic about the magnificent breeds as any of his fellow Lexingtonians, but he’s also well aware of the outlandish expense of owning one. Instead, he and his wife are proud owners of ponies and a mule. He says: “They’re a lot cheaper than a Thoroughbred.”

 

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