Away from the maddening crowd

These four small towns provide the balance of life and work that physicians crave.

By Eileen Lockwood | Live & Practice | Spring 2014

 

Thanks to state-of-the-art technology and high-rated hospitals, many physicians have found that “isolation” is no longer a synonym for small-town living. Daily amenities are conveniently located, the internet offers access to the world, patients are friendly and grateful, there’s often surprising prosperity, and nature isn’t far from the front door. Here are four examples of these small-town gems: Gillette, Wyo.; Batesville, Ark.; Fishersville, Va., and Hanover, N.H.

Chris Steel, M.D.

Chris Steel, M.D., returned to his hometown three years ago and is now director of anesthesiology for White River Health System. He and his family enjoy camping, fishing, hiking and—a favorite activity of the 2-and-under set—throwing rocks into the river.

Where the White River flows Batesville, Ark.

In America’s earlier days, transportation spurred the founding of many cities. In Arkansas, Batesville’s raison d’etre was the White River, a perfect avenue for transporting people and products. As a key port on the river, the town would also be influential in the settling of the Ozark Mountains region.

Eventually, the area’s natural beauty and outdoor recreational possibilities would be became an irresistible lure, and services for tourists would thrive, too.

These days, the city’s mainstay tourism and agriculture businesses are sharing the profit spotlight with several other enterprises—especially, but not exclusively, the poultry industry, which has helped develop the area into a regional manufacturing and distribution center. The Batesville Motor Speedway has also become a huge business and tourist enterprise, attracting as many as 8,000 spectators for its largest races.

The successful business climate was a serendipity for Chris Steel, M.D., who returned to his birthplace three years ago after attending medical school at the American University of the Caribbean and clinical rotations in Baltimore, Brooklyn and Pennsylvania State Medical Center in Hershey, Pa. The return to Batesville has been a happy one. He’s now director of anesthesiology with White River Health System, he’s near his family again, and he can enjoy the small-town feel and nature almost at his doorstep.

“The position gave me a lot of leeway to do the critical care stuff that I enjoy, regular anesthesia and a lot of administrative tasks,” he says. “I wanted to do all these things instead of being in the OR all the time.”

So far, he’s capitalized on other professional opportunities, especially the chance to be involved with Lyon College, a small liberal arts institution, where he can have a direct impact on student career choices—and help them decide if a medical career path is the right one for them. “We like the collaboration and hope to do more projects in the future,” he says. On a personal level, he adds, “I love teaching and trying to figure out how to do things better. I find different ways to explain things and how to answer questions. It always makes me learn better, too.”

In keeping with this philosophy, and as a regional referral center for north central Arkansas with service locations in nine counties, White River Health has its own student program. Partly with an eye on future employee recruitment, the administration offers clinical rotations for students in nine area colleges and universities. It has also established the Community Health Worksite Wellness program, which takes health education programs to various companies. A soon-to-start “health coach” program, also in cooperation with the college, will train students to make home visits to patients at high risk for readmission, assuring medication compliance, setting up home care assistance and taking note of readmission risk factors.

Steel’s variety of interests seems compatible with hospital policies. Some other examples: “I like talking with other physicians, trying to help them when they’ve got issues with patients and illnesses. I like projects that improve efficiency. And (of course) keeping up with new developments in physiology and pharmacology.” In addition, he’s been making presentations to various church groups to promote a community care network. He finds added satisfaction in these activities because, he says, “The administration has been nothing but supportive.”

Steel’s heavy work and community activity schedule leaves him a bit short on recreation time, but “every weekend without exception” he spends time camping, fishing, hiking and “throwing rocks in the river,” the latter a favorite activity for his children, ages 2 and 1.

Possibilities, both outdoors and indoors, expand greatly for the non-toddler age group, including a car show, the putt putt tournament, chicken wing cook-off, lawn mower race, annual Winter Carnival and the White River Water Carnival.

There are parks on both sides of the river with a new walking/biking trail, plus fishing and flat-water paddling on a nearby bayou. A golf course overlooks the river, there’s a shooting sports complex, and two baseball parks for kids’ games organized by the county Youth Athletics Association. Coming soon: a community center and aquatic park, complete with a gym.

When it comes to fun time, it seems there’s no lack of originality in the upper reaches of Arkansas.

Dr. Mansell

After training and practice, then military service and time abroad, John Mansell, M.D., and wife Dona landed in Gillette, Wyo. They’ve taken to the area well—and even own a farm.

A tale of cowboys and coal Gillette, Wyo.

Like many other American cities, Gillette came into being as a railroad stop—and was named for Edward Gillette, who surveyed the territory for the Chicago, Burlington and Quincy Railroad. Not long after 1892, lured by open land, farmers and ranchers began arriving. Today, herds of cattle and sheep still roam huge ranches and are a major source of revenue in the area.

Cowboy and western traditions are also alive and thriving, as rodeos one weekend after another prove­—not to mention bid calling contests, trade shows and rodeo dances. “We have a great western bar and dance hall, the Boot Hill Legendary Steak House & Nightclub,” says Mary Silvernell, executive director of the Campbell County Convention & Visitors Bureau. “There’s live national-quality talent here every week, with line dancing and lessons as well.”

But the current stars of the economic show come from beneath the ground. The boom came gradually, first with a 1909 “traditional” underground coal mine, followed in 1924 by surface mining, which was well-established and lucrative by the 1970s, when two other energy sources—oil and natural gas—joined the group. Today surface mines abound in the area.

Operators of 13,470 producing wells ship 7.5 million barrels of oil a year, and the area’s natural gas yield is enough to rank second in the U.S. Little wonder that Gillette has assumed the title “Energy Capital of the Nation.”

The boom has increased population from 29,000 in 2012 to its current 32,000 in the city, with a countywide total of 47,000, and housing has kept pace with the resulting demand. Still some residents worry about losing their hometown flavor. Not so, responds Silvernell. “We’re still small, and we have the wonderful benefits of a small town. But we also have a lot of great amenities because of our energy income.” Wyoming itself, she points out, is a wealthy state with a surplus in state coffers. There’s a sales tax, but no state income tax, and property taxes, she says, are “low, low, low.”

The new Campbell County Recreation Center, she says, is “another outward sign of the energy bonanza.”

“As you walk in, there’s a climbing wall that’s a mini-replica of the Devil’s Tower (the state’s spectacular national monument). There are two swimming pools, two flume rides and (all in all) it’s a premier multi-use sports facility.”

For John Mansell, M.D., now affiliated with Northern Plains Anesthesia Associates and  Campbell County Memorial Hospital (CCMH), the wide-open plains and in-town convenience of work, stores and restaurants make for a haven of calmness after years of an often-frenetic lifestyle. A degree from the University of Southern Alabama College of Medicine and residency experience in New Orleans was followed by work in Texas and Illinois. Military service, both regular and National Guard, saw him posted in Iraq and Kosovo—and loaned for two years to the Emirati government. His eclectic education, which included a degree in electrical engineering, made him a good candidate to digitize thousands of military medical records.

In the meantime, his wife was leading an on-the-run professional life. Work assignments took her across the world. Mansell can’t forget “a couple of times when she’d get off a plane (inbound) and I’d get on the same plane (outbound).” He adds, “The day I moved here (September 2011) was the day I retired from the Army Guard. We’re just happy to be on the same continent most of the time now.”

To complete their transition, the Mansells now own a farm. “I do the plants,” he says, “and my wife does the animals.” When the getaway urge beckons, top-notch ski areas aren’t far away, including Vail, Aspen, Big Sky and Park City.

But the small-town ambience continues to entrance the new physician in town. “If I need to go to Walgreen’s, Walmart, Office Depot, Home Depot, the grocery store and the dry cleaner, they’re all within 150 yards of each other. I dare you to do that in suburban Chicago.” Even more refreshing: “There are two stop signs and one red light between me and my office—and another stop sign and red light between the office and the hospital.”

A third aspect of Gillette life has made its own indelible stamp on Mansell’s approval list is the positive work ethic. Colleagues tell him it’s not unusual for a patient to say, “C’mon, Doc, you’ve got to get me better. I need to work overtime.”

Those who need hospital services find a comprehensive care system approved by district voters in 1977, with a public board of trustees and partly funded by tax dollars. CCMH recently has undergone a $68 million expansion, which upgraded the surgical service department and especially the operating theater. “We went from three teeny ORs to four, plus two separate procedure rooms, and from eight outpatient beds with curtains to 14 (regular) rooms,” reports Karen Clarke, the community relations manager. The health system itself includes 14 specialty clinics and an ambulatory surgery center.

LivThanks to a 2003 partnership with an orthopedics and spine practice, Clarke adds, “We now have one of the most comprehensive orthopedic outpatient surgery and rehabilitation facilities in the state.”

Keeping up with prosperous times, the Campbell County Chamber of Commerce has signed on for seminars that can help professionals create businesses and established business leaders to develop a code of ethics.

Prosperous industry and civilization aside, those who yearn for a Wild West respite don’t have far to go.

Between the beautiful mountains Fishersville, Va.

Testimonials in a recruitment brochure published by Augusta Health in Fishersville make it hard to resist at least a visit to this town in the Shenandoah Valley between the Blue Ridge and Appalachian Mountains. One especially compelling comment: “I love waking up.” The reason: “The most beautiful view in the world from our family room window.” The home just happens to be located on 21 acres “backed up to the George Washington National Forest,” where the lucky owner can view deer, bears, foxes, coyotes, bluebirds and “a billion” hummingbirds.

But landscape alone does not a livelihood make, and though tourism is a big industry, Fishersville can claim a surprising number of thriving businesses. Not to mention the hospital itself, with 2,300 employees and a 230-acre campus.

As director of a new occupational health and lifetime fitness program started by the hospital in 2012, David Krieger, D.O., has familiarized himself with several of the large employers in the area. Krieger reports that several companies, large and small, have signed on to the Augusta program, which includes employment exams, wellness programs and help for drug and alcohol problems.

The combination of highly regarded health institution, location and natural beauty—with many streams amenable to his fly fishing hobby—helped to clinch Krieger’s decision to get on board. He was mustering out of the U.S. Army at Fort Belvoir in northeastern Virginia after serving as a physician for 27 years—and hoping to find meaningful work within a reasonable distance of the base. Among other considerations, his wife was reluctant to move very far away because of a tightly knit connection with the Korean community there.

Following a biochemistry degree from the University of Iowa, Krieger earned a medical degree from the Kirksville College of Osteopathic Medicine, followed eventually by master’s degrees in public health from Harvard and in business administration from Colorado State University. In his new job, he’s been putting all three pieces to good use. His military experience added to his capabilities. During an overseas assignment, he was commander of the military hospital in Heidelberg, Germany, and in the U.S. he served as chief of staff for a hospital at Fort Knox.

In his new life phase, he says, “I didn’t want to go where I would be just another doctor. I wanted a chance to mold a program into what I think a great occupational medicine program should be, meet industry leaders and tell them what we were expecting to do—and get their support. It’s been challenging, especially trying to put together a program under one roof where you have bits and pieces throughout the hospital’s framework. But it’s been really fun to do, and the people have been great.”

Augusta Health’s reach includes all of Augusta County and parts of two others, with two urgent care centers and three convenient care clinics, and it provides care in traditional areas, plus wound care, a sleep center and pain management center. A new Heart and Vascular Center opened last year, as did a joint center complete with the newest recovery practices.

As for leisure possibilities, Krieger says, “This is a real gem in the area, to tell the truth. There’s a lot to do.” The great outdoors awaits, with almost 2 million acres of trails (including the famed Appalachian Trail, which also meanders for a few blocks along Main Street in town) for hiking, biking and camping, plus trout streams and boating areas. There’s no shortage of golf resorts in the area, either. Not to mention spelunking possibilities in some of the U.S.’ best-known caves.

Nearby Staunton is also home to the American Shakespeare Center’s Blackfriars Playhouse, the world’s only recreation of London’s renowned Globe Theater. In addition, there are many performances of various kinds at Gypsy Hill Park. And architecture devotees can take in Staunton’s well-preserved historic buildings, plus the Woodrow Wilson Presidential Library. A little farther afield, but not too far away, over the mountain, lies the fascinating historic—and busy—city of Charlottesville, where the main historic attraction is none other than Thomas Jefferson’s Monticello.

A welcoming medical and intellectual center Hanover, N.H.

Some 40,000 people live in several clustered towns including Hanover, Lebanon (where the hospital is actually located) and Norwich, Vt. And the go-to place for in the entire upper Connecticut River valley for patients needing sophisticated care? Dartmouth-Hitchcock Medical Center, which provides conveniently located cardiovascular surgery for a wide population swath, as well as most other procedures usually associated with big-city institutions.

Dartmouth-Hitchcock was founded in 1893, but Hanover’s best-known establishment, Dartmouth College, preceded it by more than a century. In 1769 it would be one of the nine Colonial Colleges founded before the American Revolution. Today, the combination of the two institutions has made the area a center of intellectual and medical renown, with great interchange of services.

The hospital benefits from the college’s Audrey & Theodor Geisel School of Medicine, and the college benefits from having a convenient supply of practicing physicians as teachers, not to mention intern opportunities at the hospital. (Yes, Theodor Geisel is the given name of the internationally known Dr. Seuss.) And the community benefits from the many cultural events sponsored by the college, including concerts featuring world-famous musicians.

As the hospital’s media relations manager, Mike Barwell, says, “There’s a lot of flowback between the school and the hospital.” He adds: “One of our hallmarks is the incredible research that we do here, including an enormous amount of studies on patient outcomes. In fact, the whole idea for the Affordable Care Act came out of the research institute.”

The Dartmouth Institute for Health Policy and Clinical Practice, its full name, was founded in 1988. Its projects have included research on ways to improve health care methods and determining efficiencies that can make it possible for physicians to take on millions more patients per year.

The hospital itself operates both the state’s only Children’s Hospital Association-approved full service children’s hospital as well as its sole Level 1 trauma center.

Scott Rodi, M.D., MPH, now a 14-year area resident, is the emergency medicine section chief as well as medical director of the Center for Rural Emergency Services. He’s also an assistant professor of medicine at the Geisel School. He himself is a Dartmouth graduate, but his medical education took him literally from one end of the country to the other, first for a medical degree at Weill Cornell Medical College in New York City, then back to Dartmouth for a master’s in public health, followed by a surgical internship in Santa Barbara, Calif., and finally residencies at hospitals in Ithaca, N.Y., and Los Angeles.

Thanks to Dartmouth-Hitchcock’s air transport system—two helicopters and three ambulances—Rodi and his staff may treat patients from several states, and patients from local areas in need of specialty care can be flown quickly to or from rather far-flung areas. “We can cut a multi-hour transport time to minutes,” Barwell notes.

On the other side of the coin, adds Rodi, is the fact that area patients can now stay near home for intricate procedures like heart surgery instead of having to make the long trip to Burlington, Boston or Portland, Me.

After experiencing life in big cities during two of his post-degree tours, Rodi and his wife had “formulated the idea of raising a family in a rural location with access to an academic medical center and a good academic college. We’d have all the benefits that (they provide) to a community, but still a rural setting. It turns out that there are not a lot of places like that in the country.” They now have three daughters, ages 15, 13 and 10, and live in Lyme, a tiny community bordering Hanover. “In the town,” Rodi says, “there’s a lot of focus on children, they learn to appreciate the outdoors and there are excellent public schools.”

After eighth grade, students must choose out-of-town high schools. His two older daughters are now enrolled at Hanover High School. One downside, as Rodi puts it, since there’s no school bus, “Every day we have a circus of trying to figure out how to get them there.” Ditto for extracurricular activities such as swimming meets and basketball games.

But he and his wife are enjoying the ambience of “a really nice community,” not to mention the fact that “you can get to everything within 10 to 30 minutes.” Then he corrects himself: “Actually, most are within two minutes. When I trained in New York and Los Angeles, it took two or three hours to get errands all done.”

The nearness of off-duty activities also enhances life, such as a close drive to enjoy Rodi’s current favorite, cross-country skiing. “There are lots of places all over for downhill skiing, at least six that are within an hour’s drive. One is about 10 minutes from my house,” he says.

In other seasons, the outdoor possibilities include biking, hiking, fly fishing and golf. A warm-weather passion for Rodi’s family is kayaking. “I have a boat I keep on a pond near my house.” What could be more convenient?

Eileen Lockwood is a frequent contributor to PracticeLink Magazine.

 

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Howdy, neighbor!

Some states seem to have patents on hospitality and friendliness. Narrow the scope to cities, and you can expect to find extra-welcoming handshakes for new arrivals. And then some.

By By Eileen Lockwood | Live & Practice | Winter 2014

 

In once wide-open spaces such as Texas, friendship was a necessity for survival. Today it’s a well-honored tradition, including in Houston, currently the fourth largest city in the U.S.

Farther north, pioneers worked together to face off foreboding mountains and freezing winters and created a welcoming ambience in cities like Colorado Springs, Colo., for those who came afterward. The outgoing Midwestern reputation lives on in Wichita, Kan., and about a thousand miles to the east, Southern hospitality takes over in Greenville, S.C.

Put it all together with state-of-the-art medical facilities, and the key words are “Come and join us, friends!”

Resort Town to Full-fledged City
Colorado Springs

The Blum family’s move to Colorado Springs, Colo., was a bit of a homecoming—thoracic surgeon Matthew Blum, M.D.’s, father was a general surgeon there. Blum, with his wife, pediatrician Valerie Beck, and their daughter, Marissa, also own a ranch about 60 miles out of town.

In, 1871 Gen. William Palmer decided to build a city in a scenic Colorado mountain area. He was a Medal of Honor winner in the Civil War and a highly successful railroad builder who established a line to the new town, Colorado Springs. Little did he know that another entrepreneur, Stephen Penrose, would turn Colorado Springs into a prime resort area.

“We have a lot of things around here named for Penrose and Palmer,” reports Allison Scott, director of communications at the The Broadmoor resort.

Neither man could have imagined how his memory would live on, for instance in Penrose-St. Francis Health Services, one of two major Colorado Springs hospitals, and Palmer High School, with its statue of the founder in front.

Nor could they dream of today’s mega-community of some 400,000, which includes an Olympic complex where some 15,000 athletes train for the world’s biggest athletic competition, the United States Air Force Academy, three military bases, branches of several aerospace corporations and other defense industry projects. All of this within shouting distance of natural wonders such as the Garden of the Gods, Pikes Peak, Seven Falls and Cave of the Winds.

For Matthew Blum, M.D., moving to “The Springs” was a homecoming. “My dad was a general surgeon here in town also, so I run into a lot of people I know, or knew, or who knew my dad or had been operated on by him. It’s kind of fun,” he says. But it wasn’t a foregone conclusion. A general thoracic surgeon, Blum was educated at the University of Denver, then moved east to The Johns Hopkins University School of Medicine, with additional training at Vanderbilt University, where he conducted research on heart and lung transplants. Moving to Chicago, he spent eight years leading the general thoracic surgery program at Northwestern Memorial Hospital.

“I wanted to move back to a western mountain state someplace, and there are only a handful of places in the west that would support the kind of surgery that I do, until you get out to California or Oregon or Washington,” he says. “As for Colorado Springs, it wasn’t so much that I was coming home. It just happened to be a good place, and it WAS my home.” That was three years ago. “At the time, they were interested in trying to get a thoracic program going at Penrose-St. Francis, so I thought that was a good opportunity, although it meant I was stepping out of academics, which was where I had been.”

As it has turned out, Blum is one of only six board-certified, dedicated general thoracic surgeons in the state, with three at the University of Colorado in Aurora and three in The Springs. When the University of Colorado acquired Memorial Hospital, the city’s other health care provider, he took the back-to-academe road and moved there, where a second surgeon soon came on board. Meanwhile, Penrose hired a replacement for him. “It really has elevated the level of chest surgery in the whole southern part of the state,” he says. “Places like Chicago and on the East Coast have many, many thoracic surgeons. It’s not because there isn’t a need. It’s because it’s hard to keep a thoracic surgeon busy in a town of 100,000 people. Colorado Springs is kind of on the cusp of that.”

He also cites the need for someone to help build a thoracic program at Memorial and to integrate that system into the University of Colorado system. “This is kind of an exciting thing for me,” he adds, “because there really are not that many people with my background in our community. People don’t move to Colorado to do academic medicine.”

Robotic surgery, especially thoracic, at Penrose, as well as UC-Memorial, has taken a great leap forward in recent years. It’s been quite a step forward since the days when TB patients came to four or five big sanatoriums hoping to be cured with the help of clean, cool air. Today, robotic surgery in several areas has proliferated at Penrose, and, reports spokesman Christopher Valentine, “We have actually attracted a number of doctors, and we’re having people train here all the time.” Penrose is now part of the  Centura network, with 14 hospitals in the state and one in Kansas. Services at Penrose also include a hybrid suite. “If something goes wrong with a non-invasive procedure, such as heart surgery, the patient can go to a regular surgeon (on the premises),” Valentine says.

Just this year, according to Valentine, transaortic valve replacement (TAVR) has become part of the surgical regimen. Based on good outcomes for all surgeries, Penrose has been cited for six years in a row as one of the 50 best hospitals in the U.S.

Valentine says that the city “is totally family friendly,” with many opportunities for family activities, including “all sports.” Spectators can cheer at Air Force Academy football and Colorado College hockey games.

For dedicated pro-sports fans, Denver awaits just 45 miles away, the smallest city in America that has four major league teams: Broncos (football), Nuggets (basketball), Colorado Rockies (baseball) and Colorado Avalanche (hockey).

With the presence of the Olympic Training Center, plus the everyday outdoor activities of locals, it’s no surprise that sports medicine is a sizable part of the hospital scene. “With people out riding their bikes all over the place and running all over the place, training for triathlons and everything else, everybody’s breaking stuff and tearing stuff up and getting it fixed,” says Blum. That includes the medical community. He says with a chuckle, “The medical community isn’t wiped out by disease so much; they get wiped out by their own activities.”

In the meantime, his favorite relaxation opportunity awaits about 60 miles east on farmland he bought some time ago. “It was part of my escape-from-Chicago,” plan, he says. “If I spent my whole career in a big city, I could retire here and have a ranch. But then I figured I’d better learn something about ranching and farming. (Currently), friends of ours do all the crop planting and harvesting, but occasionally I’ll go out with them and drive a tractor around.”

With a job he enjoys and a farm for refuge, there’s not much likelihood that he’s developing an “escape-from-Colorado” plan any time soon.

Welcome to the new south
Greenville, S.C.

Proximity to the ocean, mountains and family in Pennsylvania motivated Thomas Sellner, D.O., and his family to look for a new practice in the east. They ended up finding a perfect match in Greenville, S.C., where Sellner and his wife, Sarita, and their children, Cali and Pearce, are enjoying the family-friendly environment—including their own backyard dock.

What does a medium-sized city in northwest South Carolina have in common with giant Houston? At least two things: It’s Forbes’ pick as number two in job opportunities. And a phenomenally energetic group of civic leaders has done a remake job in the last decade or so that seems almost magical.

“When we talk to people who have lived here 10 to 15 years, they say downtown was a place that you used to avoid,” reports Thomas Sellner, D.O., who arrived two years ago. “But now everyone flocks down here.”

It didn’t take long for him and his wife to join the enthusiastic crowd and add their own kudos. “Greenville is probably the first city where I’ve been where there was that growth, and it was amazing to see,” he says. “As soon as I finished the interview (with Carolina ENT, his current position), I called my parents, and I told them about the interview, but then I said, ‘I picked up the newspaper, and they’re hiring people down here.’ I just found that amazing. I’ve gotten to the point where I brag about Greenville constantly, because (the city is always) in Fortune magazine or some other magazine, saying, ‘This is an up-and-coming city.’ Or ‘This is the best of this or the best of that.’”

He also has some basis for comparison. He grew up in a town near Pittsburgh and spent several years in Erie, Pa., where he also graduated from college followed by the Lake Erie College of Osteopathic Medicine and a residency. Both cities were losing instead of gaining workers. While GE was moving a division to Greenville, it was cutting back in Erie. Today, Greenville hosts GE Power & Water, the world’s largest gas turbine manufacturer, as well as GE Aviation. And a supersized BMW manufacturing plant operates in the nearby town of Greer.

The Greenville “old-timers,” though, were recalling the early 1980s, when the face of downtown was empty storefronts, vacant lots and dying businesses, thanks in part to suburban development that had sapped the central city, but also because the factories that had made it the “textile capital of the world” had disappeared.

Today, downtown Greenville is a picture postcard of striking new buildings interspersed with green areas, fountains and even waterfalls descending over walls. A spectacular curved suspension bridge has replaced a feeble span over the Reedy River that divides the downtown area. Summarizing its progress from down-and-out to thriving is a statement from Visit Greenville SC, the city’s version of a convention and visitors bureau: “At a time when things were bad, and could have gotten worse, the community said, ‘Let’s do something remarkable!’” And they did that.

The “something remarkable” was almost a double reward for Sellner and his wife when he joined two other otolaryngology and facial plastic surgery specialists at Carolina ENT, affiliated with Bon Secours St. Francis Health System, which is one of two Greenville hospital systems. The other is Greenville Health System. There’s also a Shriners Hospital. St. Francis, now with three locations, dates to 1921 when it opened as America’s first Salvation Army hospital. It was acquired in 1932 by the Franciscan Sisters of the Poor and today is part of the Bon Secours Health System.

Besides adopting such state-of-the-art equipment as the “Absorb” heart stent, the hospital management recently initiated a reward program for employees who follow healthy diets, keep immunizations current and have physical exams. Those who do well, or even try, can receive as much as $900 in awards along the way. On the patient side, the hospital’s medical group introduced After Hours Care in 2011 to provide around-the-clock service.

Sellner is exhilarated by the city’s influx of younger, professional people. “You go downtown,” he says, “and all you see are young people and families—and everyone’s come from all over.” Not that he’s a stranger to large concentrations of contemporaries.

His last location in Surprise, Ariz., a Phoenix suburb, was anything but deserted. “We wanted to get away from cold weather,” he says. But there was a catch. “When we talked to our families, no one had any interest in moving out west whenever they retired.” But… “We also wanted to be close to the ocean and the mountains—and a major airport that will fly us back to Pittsburgh.” Greenville is at the foot of the Blue Ridge Mountains, and the ocean is three hours away. Then came the good news—a job opening in the perfect city. “We were just all smiles!”

Keeping pace with civic transformation is the school system, which actually covers 800 square miles to include the multi-county area. “Greenville is a very innovative place,” reports Oby Lyles, the system communications director. “Different people want certain things in schools.” To accommodate them, the mix includes several magnet schools, and about 15 percent of students attend schools of choice. In a construction binge, 70 new schools have been built recently, but—old or new—many in the system feature space-age equipment.

Road shows, symphony and ballet performances are held at the new downtown Peace Center. At least 50 artists have studios in various areas, including downtown.

Outdoor addicts can easily find activities, especially hiking or biking along a converted rail route, the 17.5-mile Swamp Rabbit Trail. Sellner goes in a different direction, to Fluor Field, to cheer on the Greenville Drive, a Boston Red Sox farm team. The field is a replica of Fenway Park.

The Sellners also plan to introduce their children to a truly full plate of special—and very diverse—activities.
As for special events, there’s something for everyone—and often. Taryn Scher of Visit Greenville SC, the visitors bureau, offers yet more proof of the city’s rejuvenation. “The biggest problem that Greenville has,” she says, “is that it’s hard to schedule a new event, because so many days are already booked.”

Deep in the Heart of…
Houston

Everything about America’s fourth largest city seems to come in Brobdingnagian proportions. The metro population is over 6 million—in a land area of 600 square miles.

Houstonians can claim the world’s largest concentration of health care and research institutions. So many, in fact, that no one seems able to cite the total number. According to the American Hospital Directory, the sum, including those in the suburbs, is 67.

Overshadowing all of the above is the city-sized complex cited by former First Lady Barbara Bush as Houston’s gift to the world, the Texas Medical Center. Started in 1945, TMC is indeed the world’s largest medical-related concentration: 290 buildings on 1,300 acres encompassing 21 “renowned” hospitals (seven acute care), plus schools of medicine, pharmacy, dentistry and nursing and eight research institutions.

It’s now spreading its services throughout the area and other parts of Texas and the world. (And, by the way, it hosts the largest air ambulance service.)
With that background, it’s no surprise to learn that more heart surgeries are performed at the various hospitals than anywhere else in the world.

Houston is the top U.S. market for exports, number-one port in international waterborne tonnage handled and has the greatest total area of parks and green space. The Houston Livestock Show and Rodeo is the world’s largest event of its kind.

Some local futurists hint that all of the above is part of a “conspiracy” to take over Chicago’s place as the  third largest city in the U.S.

Chris Langan, M.D., is hardly intimidated by the gigantic surroundings. His pre-Houston experience was in the New York City area. Before moving southwest in 2009, he earned a medical degree at New York University, plus a business degree at Columbia University. His other training and work experience was in nearby New Jersey. As an ER specialist and regional medical director for TeamHealth in the Memorial Hermann Healthcare System, he supervises facilities in eight locations.

He, his psychiatrist wife and four children now live in Katy, an up-and-coming western suburb. But, he says, “I lived 25 minutes out of Manhattan, and now 25 minutes out of Houston, (and) it’s a little easier commuting here—without bridges.”

“Katy itself has really grown a lot,” he adds, joking, “When we bought our home we were pretty much the last home before San Antonio. Since then, thousands of homes have been built, and Katy itself has been expanding. We don’t really have to go into Houston to get to a good restaurant and so on.” However, he does mention “a lot of great restaurants downtown.”

Another example of Katy’s expansion is the school system. “The buildings are all brand new,” Langan reports. “When (our children) started, we were (practically) the first people to ever walk into their school. Down the road, they’re building high schools and junior highs.” But he was surprised at the size of school populations in other parts of the metro area. “Sometimes there are a thousand kids per grade,” he notes.

However, even in the newly expanding suburbs, there are many activities for the students. Langan’s three sons are all involved in sports, including the 7-year-old, who plays football. The other two have opted for gymnastics and tennis. His 12-year-old daughter’s main interest is art, but track and field is on her to-do list for next fall.

All in all, he’s concluded that Houston is indeed a very family-friendly city. Its prices are friendly, too. “The value of our home is so much greater out here—and much more affordable,” he reports, adding that the cost of living in general is lower.

Langan has developed his own theory on the number of hospitals in the city and metro area. There’s actually a lot of competition because there are so many, “but here there are smaller hospitals that feed into the bigger tertiary care centers downtown,” where more sophisticated care is available. “When I’m at a community hospital, I have a backup of a tertiary care center, so if someone is really sick or needs a specialized procedure, we have that transfer ability. And the same thing is true if you have a sick child. If I have to incubate a child for respiratory distress, I know a helicopter is coming to pick them up within 20 minutes to take them to the pediatric unit at (a well-equipped place).”

Besides overseeing ERs in the hospital group, his job includes doing regular shifts in various facilities and/or taking over whenever there’s a need in one of them. As a serendipity, he says, “One of my favorite places to work is Memorial Hermann NE, near the airport. We get all the patients who are sick from the airport, and I meet people from all over the country and the world. It’s really interesting.”

In a recent survey by Forbes, Houston was named number one in the U.S. for jobs. Bob Harvey, president and CEO of the Greater Houston Partnership, a chamber of commerce organization, picked up on the theme—and then some. “Houston is becoming synonymous with jobs,” he says, “not to mention quality of life and renowned educational institutions.” In fact, the city has made a 201.9 percent recovery from job losses during the recent recession.

Not surprisingly, six oil companies are among the major employers, although the aerospace industry accounts for a good number as well as technology corporations, shipping and, of course, health care. “There is a scramble for highly educated and skilled employees” says Jeannie Bollinger of the Houston West Chamber, one of a mind-boggling number of the area business organizations. There’s also a major reason for the corporate proliferation: “business-friendly climate and solid infrastructure.” For Texans, that’s elementary.

Still, in spite of the population and the bustling activity, Bollinger adds, “This is not a pretentious city; it’s the biggest small town you will ever live in.”

From Cattle Town to Air Capital
Wichita, Kan.

‘‘Expect the unexpected” is the catch phrase of Wichita’s Convention & Visitors Bureau. It’s hardly an exaggeration.
Who would expect even a big city deep in the Midwestern prairies to support so many aircraft manufacturers that it’s known as The Air Capital of the World? Or to be headquarters of two of America’s largest privately held companies? Or be home to what became the world’s largest pizza chain (Pizza Hut)? Or encompass at least 33 museums, one of them in a century-old former factory now showcasing worldwide exhibits donated by 140 different nationwide collectors? Not to mention 1,000-plus restaurants and 117 parks and greenways.

City promoters say that tourists—and residents—can leap 125 years in a single day by visiting museums chronicling Wichita’s progress from its years as the northern terminus of the celebrated Chisholm Trail to the amazing progress of science in its 21-century glory at the ultra-modern Exploration Place, one of six diverse museums along the Arkansas River, which borders the city.

Still, there was a different surprise for Kyle Vincent, M.D., who relocated from Orlando almost three years ago. It was what his patients consider heavy traffic. “I didn’t appreciate this until I started practicing and I had patients tell me they couldn’t come at certain times (for appointments) because it would be rush hour in the big city.” A robotics surgeon who specializes in gallbladders, hernias, upper GI work and the esophagus, Vincent was less surprised by other aspects of the city because he grew up in Ponca City, Okla., about 75 miles from Wichita, and had been to Wichita on shopping trips with his parents.

With his general surgery residency completed at Orlando Health, he began a job search. “We liked living in the Midwest and decided we’d like to come home,” he says. With a new child, proximity to grandparents was also an enticement. “I interviewed at several small towns around Oklahoma, and interviewed here. This was definitely the best fit for what we were looking for. My wife is Jewish, and her absolute requirement was that we had to live in a town big enough that they had a synagogue.”

Besides many activities with his family, plus attending an occasional Wichita State Shockers basketball game, Vincent has become a frequent user of area YMCA facilities, which he calls “amazing.” “A lot of people in other towns are looking to redo their facilities. They come to look at the facilities here,” he says.

“Coming from Orlando, everybody thought this was going to be a huge transition for us,” he says. “But it has the pace that we wanted to keep. We like the convenience of being able to get around easily. And we like that our kids can go to public schools.” With good reason. Besides traditional neighborhood schools, the city encompasses 28 magnet and 35 private and parochial schools.

The public schools have been keeping up with recent practices, too, and were among the first to incorporate workplace skill standards into curriculum and graduation requirements. Within an eight-year period, starting in 2000, voters approved two huge bond issues ($284 million, followed by $370 million) that resulted first in new buildings and enhanced computer facilities, then in 275 new classrooms, six more new schools and 60 storm shelters. (Kansas, after all, is the most tornado-prone state.)

Long before magnet schools, the soon-to-be-famous Jesse Chisholm set up a trading post in a prairie location destined to be Wichita. His half-Cherokee heritage eased his passage through Indian Territory. Cattle drovers began to follow his route, eventually named the Chisholm Trail, and by 1874, Wichita had become one of the major destinations for drovers who could use the railroad to transport some 5 million cattle to stockyards in Chicago. The city in Kansas became known as “Cowtown.”

Half a century later, Clyde Cessna built the city’s first airplane. By 1929, there were nine aircraft manufacturers. During World War II, about a fourth of the population (30,000) was employed in the industry. According to one city history buff, “Almost every pilot at some time during the war was in a Wichita-made plane.” And the city’s new unofficial title was “Air Capital of the World.” Today there are a few less industries, but the work force still edges around 25,000. There are also 6,000 military and civilian personnel at nearby McConnell Air Force Base.

With three hospitals and four specialty facilities on its roster, one of the other top employers is Via Christi Health, Vincent’s employer. Wichita’s largest and sole inpatient provider of behavioral health services, Via Christi also operates the state’s sole round-the-clock interventional primary stroke center outside the Kansas City metro area. A long-term goal is to provide an integrated system of care from cradle to grave.

The city’s other large health care group is Wesley Medical Center, with an acute care hospital and a heart hospital. Founded by a Methodist Church organization in 1912, it became an HCA facility in 1985 and was recently awarded the “Blue Distinction” for its spine surgery program by Blue Cross and Blue Shield of Kansas. In 2011, Wesley added the new O-Arm® surgical imaging technology, which provides three-dimensional images during spinal surgery. It has the area’s only Gamma Knife that non-invasively destroys brain tumors in one treatment. Another new acquisition is Trilogy, which can even treat inoperable tumors non-invasively, in any part of the body.

Medical technology is not the only field in which upgrading and modernization is part of the mix. Wichita itself has taken on a new ambience, from the rehabbed Old Town area to its downtown and riverfront. Today, the 44-foot high Keeper of the Plains, mounted on a 33-foot rock, keeps watch at the confluence of the Arkansas and Little Arkansas Rivers (pronounced Ar-KAN-sas), surrounded by the Ring of Fire, a set of flames rising from stone receptacles. A second spectacle is the Fountains at WaterWalk, a 150-foot-long choreographed display of music, lights and fountains.

Downtown has developed a revitalized face, too. Shops, restaurants and a farm and art market, plus a generous serving of outdoor art, keep company with the traditional symphony, ballet and theater mainstays. Not to be left out is the Old Town area, which has come alive with more shops and restaurants in revitalized warehouses.

For Vincent, the Wichita relocation couldn’t have been more rewarding. He summarizes, “It’s a good location for us.”

Eileen Lockwood is a frequent contributor to PracticeLink Magazine.

 

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Happiness without Babe Ruth

These four cities are major hot spots when it comes to physician opportunities and livability—even if their sports teams happen to make only the Minor League.

By Eileen Lockwood | Fall 2013 | Live & Practice

 

In many cities, it doesn’t take big sports names for the calendar to be busy and the stadiums kept full. The calendars are so packed with other athletic events that LeBron James, Peyton Manning and Derek Jeter are hardly missed. We scanned the map in search of happy Minor League havens and selected four good examples: Spokane, Wash.; Norfolk, Va.; Providence, R.I.; and Montgomery, Ala.

360 DEGREES OF HISTORY
Montgomery, Ala.

There’s a special street corner in Montgomery where all the major aspects of city history come into view.

Standing at the venerable Court Square Fountain, built atop an artesian basin in 1885, a history buff can view the important buildings involved in the city’s most notable upheavals. As Meg Lewis at the Convention & Visitor Bureau puts it, “There’s no other place in the world where you can stand on one street and see 360 degrees of (Civil War and) civil rights history.”

Straight ahead at the end of Bainbridge Street sits the state capitol where Jefferson Davis stood in February 1861 to take the oath of office as the Confederacy’s first president. (Montgomery was the capital for a short time before Richmond took its place.) South of the fountain is the Winter Building, where the telegram proclaiming the start of the war was sent. A block south is the first White House of the Confederacy.

Just a block before the capitol building is the now-named Dexter Avenue King Memorial Baptist Church, the first pastoral assignment of Martin Luther King and the starting point for many civil rights activities. One block south of the church, though out of sight from the fountain, two “newcomers” enhance the scene: the flat black marble Civil Rights Memorial fountain and, behind it, the new Civil Rights Memorial Center. Exhibits there include the stories of 40 activists who lost their lives between 1955 and 1968. Two blocks south on Court Street is the Greyhound station where Freedom Riders got off the bus on May 20, 1961.

And—somewhat visible on the street behind the fountain—is the Rosa L. Parks Library and Museum, built at the spot where Parks got off the bus after her defiant ride.

Though these monuments can conjure painful memories for them, capital city residents recognize their significance. But they’ve also moved on to create an atmosphere that’s brought the city into modern times.

Downtown Montgomery’s Riverfront Park includes an ampitheater, splash pad, riverboat and the Riverfront Stadium, home to the Tampa Bay Rays’ AA team, the Montgomery Biscuits.

Mobile native Brian Richardson, M.D., accepted a urology position in 2011 with the Jackson Clinic, affiliated with Jackson Hospital, following a University of Florida internship at Shands Hospital in Gainesville and surgical training as chief resident at Tulane University in New Orleans. He specializes in minimally invasive urologic surgery using state-of-the-art robotic, laparoscopic, percutaneous and endourologic techniques. “One of the best things about working here,” he says, “is the very close community of urologists. They provide top-notch care, and there’s a nice collegial atmosphere. We share information and get along very well, even when we have no financial ties.”

At Jackson, “state-of-the-art” isn’t confined to urology. Founded by a group of local physicians in 1946, it’s been steadfast in adopting new methods and technology. Most recently, it became the region’s sole provider of scarless robotic gallbladder surgery. This followed the installation of the STERIS Corporation integrated operating room and the new daVinci SiTM system. Five years ago, the hospital took the local lead with this center for robotic and minimally invasive procedures and now has the most comprehensive area program. The STERIS partnership has been fruitful for both parties. With a large manufacturing facility in Montgomery, the company has been able to show Jackson’s equipment to sales prospects from other cities.

The hospital has added another neurosurgeon to its staff for state-of-the-art minimally invasive spine procedures in two I-suites complete with new equipment. Thanks to these and other upgrades, spokesman Peter Frohmader notes the hospital “has all the services that would be found in a medium-sized community. The only things you need to leave Montgomery for are transplants and experimental procedures.”

In the meantime, the city’s two Baptist Medical Centers—East and South—have been preparing for the future by incorporating new methods to shorten treatment and recuperating times as well as introducing a wide range of wellness programs—and working to help patients reduce risks of illness and disease by teaching them to live healthier lives.

The city itself surprised Richardson. “We used to drive through Montgomery but never (spent time) here,” he remembers. “When I actually got here, I really was impressed with the growth of the city and the kind of direction (it was going in), as well as the vision of city leaders. It’s a much different city than it used to be.”

He soon discovered that fact when hospital representatives took him on a pre-arrival tour. “They showed me around several places and the nice neighborhoods. But when they showed me the downtown, I said, ‘Well, my decision’s already made. I’m moving downtown when I get here.’” He lives in a top-floor loft apartment with a balcony.

The downtown trend is likely to continue, he says, citing plans circulating for about 200 to 300 new condos in the next three years. “Now people are actually staying and enjoying the things that are going on down here.” Besides “all the good restaurants, there’s a performing arts center with concerts almost every weekend—and not by groups you’ve never heard of.” Adding to the congenial ambience, “There’s live music downtown literally seven days a week, both inside and outside, including bands in bars.”

Downtown is even a convenient location for some of the city’s sports events. The Tampa Bay Rays’ AA baseball team, the Montgomery Biscuits, plays at Riverwalk Stadium, once the site of a Confederate prison. If only those old prisoners could have known that the new land occupant would be rated among the top five best food arenas.

The stadium is only one of several recreational facilities in the park along the Alabama River. Among them are an amphitheater, the River Skate Park for skateboarders and bikers, and even a new Bark Park for canine recreation.

In fact, the city is inundated with sports events and opportunities, played at a large variety of arenas and outdoor complexes. There are kickball and softball leagues, as well as high school and college basketball games. A new YMCA soccer complex boasts eight fields. Tennis courts abound, and an annual highlight is the Blue Gray Tennis Tournament for college athletes.

Plus private and public golf courses. In fact, even a Robert Trent Jones course is a mere 10-minute drive away for Richardson.

Besides sports, new efforts are in progress to encourage healthier eating and to spark inquisitive minds. E.A.T South is a program in which participants establish urban gardens and learn how to prepare southern foods in much healthier ways. That includes starting school gardens and lobbying with school cafeteria managers to serve meals prepared from the crops.

Soon to come is Questplex, a dramatic new hub for learning, as promoters describe it. In the “all-purpose learning center,” people of all ages will explore nature, learn new career skills and participate in brainstorming exercises, complete with interactive technology “to customize the experience for each visitor.” The guiding force: “Children can be inspired for a lifetime of learning.” It’s hard to think of a more important goal.

The Creative Capital
Providence, R.I.

Strictly speaking, Providence is bereft of Class A renowned sports teams. But for residents, that’s a mere matter of opinion. “We’re closer to Gillette Stadium than Boston,” says Kristen Adamo at the Providence Warwick Convention & Visitors Bureau. “So we like to think of the Patriots as our team, too.”

Not only that. “New England” is an unwittingly apt title for the Patriots, because they help add greatly to the coffers in Rhode Island. Adds Adamo, “Their opponents—and the media—stay in the Providence area because it’s cheaper. And it’s wonderful when the Patriots make the playoffs. The economic benefits are terrific!”

“There are lots of Patriots fans around here, and sometimes they offer to take me to a game,” says Louis Rice, M.D. “But the games are usually in December, and it’s too cold.” Having moved to Providence from Cleveland three years ago, Rice also says, “I’m still a suffering Cleveland Browns fan.” As for baseball? “I was a Red Sox fan when I was in college (Harvard), but I was so disappointed the year that the Yankees beat them in the playoff game.” In Cleveland, the Indians became his baseball team of choice.

Now once again he’s caught in a love-hate situation. “I played football in college. My oldest son is a 2010 Yale graduate. He was a catcher on the baseball team, but now he coaches linebackers on the Yale football team. Bottom line: “It’s always difficult rooting for Yale.”

Nevertheless, for true Patriots fans, transportation is super-convenient, Adamo points out. “The Massachusetts Bay Transit Authority runs trains from the airport in nearby Warwick to the stadium, and there’s also a Massachusetts subway system.” And: “The Pawtucket Red Sox are five minutes away.”

For Adamo, this accessibility is a great asset. “That’s the beauty of Rhode Island,” she says. “It’s such a compact state that it’s easy to get from place to place.”

Providence, R.I., attracted Louis Rice, M.D., with a great job opportunity­—and the added bonus of being close to the ocean in a beautiful location. As for sports? “I’m still a suffering Cleveland Browns fan,” Rice says.

Rice couldn’t agree more. “Cleveland was a great place to live,” he says, “but there weren’t a whole lot of beautiful places nearby,” a contrast underscored when he and his wife decided to explore their new home area. “Going over that beautiful bridge to Newport, we couldn’t believe it was only 40 minutes away from Providence.” Even more important for Rice is the “real privilege” of being close to the ocean after 20 years in Cleveland, Lake Erie notwithstanding. In a way it was a homecoming because of his childhood years between New York and Boston, followed by college in Cambridge, medical education at Columbia University and a series of fellowships in Boston.

Closeness is a key word for those whose sports interests go beyond the Patriots. Cheering fans flock to the newly refurbished Dunkin’ Donuts Center to watch the Providence Bruins of the American Hockey League and the Providence College Friars as they take on Division I basketball opponents. “The Dunk” is also a concert and large-event venue. In the great outdoors, Brown University football and Bryant University lacrosse can also boast big attendances.

There’s also an impressive lineup of other sports, spectator and participatory, and some more exotic than others, including the Rhode Island Rebellion (rugby), the Roller Derby (roller skating) and bocce ball, with teams sponsored by local businesses. There’s a Rock ‘n Roll Providence half marathon, plus road races and ice skating at the Bank of America Center. And sailing along a seemingly endless coastline.

Rice was chief of the medical service at the VA Medical Center in Cleveland when he was offered “new challenges” in Providence—positions as physician-in-chief with Rhode Island and Miriam Hospitals, as well as executive physician-in-chief at three other hospitals. He’s also a professor of medicine at Brown University’s Warren Alpert Medical School. Rhode Island Hospital is the school’s principal teaching hospital and is one of three acute care Providence facilities of Lifespan, the state’s largest health care system. One is Hasbro Children’s Hospital, which is incorporated within Rhode Island Hospital, and The Miriam Hospital is the third. There are three other acute care institutions in the city.

Lifespan’s two “adult” hospitals are working hard to cut costs by merging key programs such as cardiac services, orthopedics and bariatric surgery. For instance, all open-heart surgery is now performed at Rhode Island. A newly created Total Joint Center is located at The Miriam. To ensure that more patients keep up with medications, Lifespan has opened an on-site pharmacy at RIH to dispense prescriptions and, for the general public, to provide adult vaccinations. Ambulatory care centers have been set up around the state and include lab testing, checks on implantable devices and, coming soon, infusion facilities for cancer patients. The impetus for the centers, as spokesperson Ellen Slingsby explains it: “We’re going from a hospital system to a health care system with a focus on making care more convenient for our patients.”

Roger Williams Medical Center, named for the revered founder of the state, is one of two member hospitals of CharterCARE Health Partners. The two institutions have been promoting collaboration, especially in efforts to reduce costs, strengthen core services, add new ones and increase patient access. Among most recent initiatives has been geriatric-specific training for all staff members, with special emphasis on safer and more agreeable surroundings for patients, such as non-skid floors, portable hearing aids, magnifying devices and soft music.

The presence of Brown University and four other higher learning institutions is bound to influence local culture, which Rice suspects has something to do with “the terrific theater here for reasonable prices.”

With all the culture to experience in Providence, there’s still a sports-related goal on Rice’s “to do” list: “My hope is to turn a not-very-good golf game into a reasonable game.”

With the city’s considerable number of courses, that seems like a reasonable plan.

Dynamo of the Inland Northwest
Spokane, Wash.

‘‘Sports don’t just entertain. They improve communities. They drive economies.” Thus sayeth the sages from the Spokane Sports Commission, a dedicated organization that recruits and often manages athletic tournaments, nurtures a mind-boggling array of local sports activities and lobbies for more sports venues. “And it’s not all about (Major League) baseball,basketball and football,” says Eric Sawyer, the commission’s CEO.

Think sellouts like NCAA tournaments and figure skating events. Consider 100,000 players in Hoopfest, the world’s largest three-on-three basketball tournament; Bloomsday, the U.S.’ largest timed road race; a dual lane roller derby, and—one of Sawyer’s favorites—the National Blind Bowlers Championship. “We encourage any ‘adaptive sports,’ such as wheelchair events and almost any competition with opportunities for the handicapped,” he says.

Other options include the Spokane Indians (baseball), Shock (arena football), Shine (soccer) and Chiefs (junior ice hockey). The Indians, a short-season single-A affiliate of the Texas Rangers, consistently fill their 6,800-seat stadium. The list of spectator and participatory sports goes on and on: volleyball, gymnastics, wrestling, boxing, figure skating, polo, table tennis, Ultimate Frisbee, chess…. Then add college sports at Gonzaga University, Washington State University Spokane and Whitworth University.

Not enough? Try the volleyball Border Smackdown for U.S. and Canadian boys; the eight bike races in the Lilac City Twilight Criterium; the Citizens Ragtag Rally, welcoming “every kind of bike”; and the Dirty Dash, a mud course obstacle race.

Little wonder that Outside magazine has cited Spokane as “one of the most active cities in the U.S.”

Less publicized is the economic advantage of sports tournaments. In Spokane, the related hotel income alone is $30 to $40 million a year.

After moving to the city two years ago, Anna Barber, M.D., quickly became immersed in the Bloomsday race and was definitely impressed by the number of participants—50,000. She and her perinatologist husband couldn’t resist watching the horde of young participants at Hoopfest, either. “They shut down downtown and turn it all into 3-on-3 basketball courts,” she says. They’ve also taken in baseball games, and have cheered on the Gonzaga hoopsters at least once even though, she says, “It’s ridiculously hard to get tickets.”

The original goal for the Doctors Barber was to locate to a big city—but not too big—conveniently located near where they grew up: She in Seattle and he in Great Falls, Mont. She had graduated from the University of Washington School of Medicine and finished her residency at the University of California–Davis, then hired on for four years as a general pediatrician with Kaiser Permanente.

But for more permanent job placements, Spokane became the obvious solution. Two years ago, she signed on as a pediatrician working out of Providence Holy Family Hospital, one of four vicinity facilities in the Providence Health & Services group.

Though the sports lineup is massively impressive, it’s hardly the only act in town. According to chamber of commerce Greater Spokane Inc., the city has been “the state’s primary inland distribution center and transportation hub since 1881.” It also holds its own as a center of medical care, shopping and entertainment. Today’s corporate mix includes health-related companies such as Signature Genomics Laboratories, Jubilant HollisterStier and Applied Science Laboratories.

There’s another less-noted plus, according to Wendy Smith at Greater Spokane, Inc. The city has been ranked America’s sixth geographically safest city by the data analyst Sperling’s Best Places. There are no tornados, nor hurricanes, earthquakes, flooding, drought or hailstorms.

Health care is no small part of the mix. Providence Health Care is now the major medical presence and a top employer in Spokane. A second large medical presence is the Rockwood Health System, with its Deaconess and Valley Hospitals. Spokane is also one of 22 U.S. locations of the Shriners Hospitals for Children.

Founded with 29 beds in 1896, Deaconess has grown to 388 beds and offers exclusive care as a bariatric surgery center, certified chest pain center and accredited stroke pain center. Valley Hospital, founded more recently (1969) by 14 physicians and located in the nearby city of Spokane Valley, was the first area facility to be accredited for joint, hip and knee surgery. Recently, the hospital was the sole recipient in northwest Washington of an “A” grade for quality and safety from the Leapfrog Group.

Most recently, the Providence group has made strong efforts to collaborate with “like-minded organizations to advance health care access, affordability and excellence.” In May it signed a memorandum of understanding with two other groups to form a regional cancer alliance that can coordinate services and information, resulting in the most modern care available. A Surgical Plus program has added to its minimally invasive capabilities, enabling better and safer results from neurological procedures. Other recent and projected services include an emergency department expansion, upgraded maternity services and a pain management clinic.

However, the current local medical highlight is the August consolidation of Washington State University’s School of Medicine on its Spokane campus. Now medical students can complete all four years there. WSU Spokane plans to create a comprehensive health sciences curriculum that will include colleges of pharmacy and nursing, public health and health policy and a collaborative dental program. “This is all part of our attempt to create an urban research campus using medicine as a jumping-off point,” says spokesman Doug Nadvornick. Equally important: “There are currently 70 medical residency slots in Spokane. One of our (other) big issues is the need to create new opportunities. We’d like to keep (those doctors) here.”

Those who do stay get 260 days of sunshine­­—conducive to any outdoor sports they’d like to try on their own.

Nautical—And Then Some
Norfolk, Va.

With the U.S.’ largest Naval base—not to mention shipbuilding, shipping and cruise businesses—water-related breadwinners create an impressive percentage of residents. The five-city Coastal Virginia region (including Norfolk) is also one of the top five U.S. retirement havens for veterans.

The story of Coastal Virginia is “the story of water,” says Sarah Martin Lampert, development vice president at the area Chamber of Commerce. It’s hard to deny.

The Virginia Port Authority continues to move toward its goal to handle the greatest shipping tonnage on the East Coast, especially promoting its ability to handle deep-draft containers.

Water proximity also played a role in the decision by Aaron Bleznak, M.D., to relocate to the Coastal Virginia region, although the job was his main lure. A specialist in breast surgery and surgical oncology, he’s now vice president and senior medical director with the Sentara Medical Group, a division of Sentara Healthcare. His responsibility covers all seven Sentara hospitals in the Coastal Virginia area, but he’s headquartered in Norfolk, where Sentara Norfolk General Hospital is located. The job enticement was the opportunity to combine an administrative role over hospital-based physicians with a clinical role. Previously, in Lehigh, Pa., his administrative role as vice chair of surgery was confined to supervising surgeons only.

The water-related consideration in his relocation choice was his calculation that a shore ambience would be a more enticing place for his four children, as adults, to visit. Also with the offspring in mind, he and his wife chose to live in nearby Virginia Beach. “My youngest daughter is an equestrian, and that’s where we keep her horse,” he says.

Another plus for Bleznak: “There’s more sunshine here, and   we can be out of doors more,” including on the nearby beach. It’s also a better place for people with allergies, he says.

Sometimes the out of doors involves viewing the Norfolk Tides, a farm team of the Baltimore Orioles. But Bleznak is selective. “We’re Philly fans, so we go (to the stadium) when the Lehigh Valley IronPigs come in.” Ditto for the Norfolk Admirals of the American Hockey League. Bleznak holds out for the Phantoms, the Philadelphia Flyers farm team.

Other residents can find good sports alternatives to the major leagues. Says Alan Boring, Norfolk’s business development manager, “If you like baseball, hockey, basketball, football, soccer…you’ve got it.”

Old Dominion University fields a very popular men’s basketball team, and its Division I football games have sold out every home game. “The oceanfront,” he adds, “is just 15 minutes away, with beach volleyball, surfing and beach marathons.” Or just plain swimming, relaxing and watching giant ships coming into port.

Nautical history buffs should be prepared to spend hours—and hours—in two area museums, plus a tour of Battleship Wisconsin anchored alongside the exhibit-filled Nauticus National Maritime Center, and harbor cruises take passengers past other ships and unloading piers for huge commercial cargos. According to one tour guide, “It’s said that all the ships in the world could anchor there and still leave room for more.” A few miles north, in Newport News, is the spectacular Mariners’ Museum, cited as one of the world’s largest of kind.

But when it comes to well-being, most Norfolk residents feel more reassured by the presence of the city’s four acute care hospitals. Under Sentara’s aegis are two acute care facilities—Sentara Norfolk General Hospital and Sentara Leigh Hospital. The mix also includes the specialty Sentara Heart Hospital, as well as several subsidiary facilities.

Norfolk General was founded as the 25-bed Retreat for the Sick in 1888. Almost a century later, its modern-day facility was the setting for the birth of America’s first in-vitro baby.

As of today, its surgeons have checked off more than 2,200 heart, kidney, pancreas and kidney/pancreas transplants and saved hundreds of lives because of its eICU remote monitoring capability. It was the region’s first magnet hospital, recognizing its quality care, nursing care and innovation—and first in the U.S. to fully deploy and independently test the intensive care management system.

Its full-service maternity pavilion is a mere down-the-hall walk from the NICU in the Children’s Hospital of the King’s Daughters. The two hospitals are physically linked but part of separate corporations. Its modern version is still the only freestanding facility of kind in Virginia. Not only is it connected to Sentara Norfolk General, but, says marketing/public relations manager Sharon Cindrich, “Our physicians and surgeons can go over to Sentara to check on babies, if needed.”

With a network of 109 pediatricians, Cindrich says, “We’re constantly innovating and updating.” Physicians in Cancer and Blood Disorders Center follow hundreds of patients with cancer, sickle cell and coagulation disorders, but its worldwide attention-getter has been a minimally invasive surgical technique devised by Donald Nuss, M.D., to repair chest wall deformities.

On the lighter side is the Buddy Brigade, organized in 2005. Volunteers bring dozens of dogs, reports Cindrich, “in every size and breed and age” to cheer bedridden patients.

“It’s wonderful and highly appealing to the folks here,” she says.

Norfolk’s Bon Secours DePaul Medical Center dates to 1855 when nuns went door-to-door treating yellow fever victims. Fast forward to 2013 and a Catholic health system with 19 acute-care hospitals and other facilities in six states. Among its notable state-of-the-art services are its hyperbaric and neurovascular centers and the region’s only Midwifery Birth Center, complete with private family rooms and queen-sized beds, plus Jacuzzis for relaxation during labor.

An important medically related source of pride for Norfolk residents—and hospital personnel—is the Eastern Virginia Medical School, which opened in 1973 with a student body of 23. In 2013, there were 332 graduates, about half from its companion School of Medical Health Professions composed of 11 nationally recognized disciplines. Its first building was completed in 1978.

There are 10 today, with a full- and part-time faculty of 461, complemented by 1,387 volunteer teaching physicians. As an aside to the benefits of producing so many valuable graduates, the 2012 economic impact for the community was $824 million, equivalent to $1 billion in good economic times. The local Economics Club cited the school as “one of the region’s most powerful economic engines.” And that’s no old seaman’s tale.

Eileen Lockwood is a frequent contributor to PracticeLink Magazine.

 

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The Great Outdoors – The call of the wild

In some American cities, the appreciation of nature is, well, “second nature” to residents, who have made concerted efforts to protect, promote and enjoy it.

By Eileen Lockwood | Live & Practice | Summer 2013

 

There’s still more than a trace of rugged independence in these four cities spread across the U.S., and it translates, among other things, to a near-multitude of opportunities for outdoor enjoyment and sports from kayaking along the coast to speeding down ski hills in the scenic Northwest. Take a look at Asheville, N.C.; Portland, Maine; Bozeman, Mont.; and Knoxville, Tenn.

Where Nature’s Never Far Away
Knoxville, Tenn.

If recent efforts are any indication, Knoxville may be the American City of the Year in terms of efforts to promote outdoor activity.

Eastern Tennessee called back native Katy Stordahl, M.D., who grew up about 35 miles east of Knoxville. “We are very blessed to have the resources of the Great Smoky Mountains National Park,” she says.

The evidence includes three major city and volunteer developments in recent years. Work has been completed on the Volunteer Landing and Marina at the edge of the Tennessee River. The Ijams (pronounced “Eye-ams”) Nature Center is a 300-acre wilderness paradise. And Outdoor Knoxville, with hundreds of acres of al fresco opportunities, is the result of a recent mayor’s “urban wilderness” initiative to assure that nature is never far from city hustle and bustle.

“I am so thankful to be back in my home of East Tennessee,” wrote Katy Stordahl, M.D., in a recent web site testimonial for East Tennessee Children’s Hospital (ETCH), where she has worked as a pediatrician in the emergency room since last July. “We are very blessed here to have the resources of the Great Smoky Mountains National Park.”

Stordahl grew up in Gatlinburg, about 35 miles east, a descendant of a family that had lived, since the 1890s, in what is now the national park. “My mom was in one of the families that had to leave when it (was established),” she notes. “My husband’s family is all in Minnesota. They’re also outdoorsy people, because there are so many lakes in the state.” One of the things her husband misses, she says, is the northern cold weather. “He says it’s not cold until the temperature is 0.”

ETCH serves 16 counties in East Tennessee and provides care in at least 30 pediatric specialties, including several advanced procedures. It’s a center of excellence for cystic fibrosis, has one of the largest cochlear ear implant programs in its part of the state and one of the locale’s most comprehensive cleft lip and palate programs.

Although ETCH and several others have remained “untouched” in recent years, there have been a few dramatic changes in Knoxville hospital ownership. The former St. Mary’s Medical Center and three Baptist hospitals developed untenable financial problems and were forced to close a few years ago. Two of the Baptist institutions closed permanently, but the third, as well as St. Mary’s, was purchased by Tennova Healthcare, an area group whose title is a combination of “Tennessee” and “innovation.” They now operate as Turkey Creek Medical Center (formerly Baptist) and Physicians Regional Medical Center (formerly St. Mary’s). Both have made impressive strides since the change. As spokesperson Lisa Stearns summarizes, “Tons of exciting things are happening.”

One development: “Turkey Creek quickly became a technical center for our system—and maybe the area.” Among current stars of the show: 1. MAKOplasty, a robotic and minimally invasive procedure to treat hip and knee pain. The hospital itself has become one of 24 hospitals nationwide designated to train other surgeons in the technique. 2. A unit dedicated to bariatric surgery, also using robotic procedures. 3. Use of the Parachute IV device to reverse congestive heart failure. As she summarizes, “Knoxville is now on the cutting edge of heart care.”

The flagship service line at Physicians Regional is orthopedics. It was recently named a “Blue Distinction Center Plus” by BlueCross BlueShield. Tennova also holds an option on land to build a replacement for the now landlocked 1930 current facility. In addition, the former St. Mary’s Medical Center North, now North Knoxville Medical Center, which was opened as a boutique extension, is now being groomed to expand into full general-hospital status.

There are currently seven full-service hospitals serving the area. The largest, University of Tennessee Medical Center, holds the distinction, among others, of being the region’s first certified primary care stroke center, first dedicated heart hospital and sole Level I trauma center, with centers of excellence including brain and spine, cancer, women and children and a heart-lung vascular institute. Its medical staff is now developing plans to deliver high-quality, lower-cost care.

Knoxville’s business life has hardly been neglected. With memories of its successful 1982 World’s Fair still lingering, companies and organizations have been redefining the site. “There’s been significant new corporate investment,” reports Doug Lawyer at the Knoxville Chamber. Among new arrivals are a large manufacturing facility of Green Mountain Coffee and ProNova, a manufacturer of proton therapy cancer treatment equipment. The Knoxville Museum of Art is also on the site, Scripps Network (HGTV, Food Network et al.) is expanding its corporate headquarters, and a new hotel is in the works. Another growth area is the Knoxville Oak Ridge Innovation Valley, which welcomes new “idea” firms to set up shop.

Meanwhile, Outdoor Knoxville offers opportunities for getting acquainted with the area’s many natural resources, including forests, park and greenway settings, fields of flowers, lakes developed from former marble quarries, creeks and bluffs to climb. And miles of hiking trails. A new nature center oversees activities and adventures open to all ages during all seasons.

The Ijams Nature Center may be the granddad of area outdoor sanctuaries. It was founded in 1910 by Harry Ijams, a commercial illustrator and dedicated birder, and his wife, Alice, who was known as the “First Lady of Knoxville Garden Clubs.” Among its organized offerings, all aimed at spreading knowledge of nature, are field trips for kids and camps where they can learn crafts such as making bird nests.

Reports Jennifer Roder, the education program officer: “Our main goal is to get folks outdoors and learning about nature.”

High Mountains, Big Snows
Bozeman, Mont.

The southwestern Montana town of Bozeman is the northern gateway to Yellowstone National Park, but it seems equally well-known to sports enthusiasts for its outdoor opportunities, winter and summer.

James Loeffelholz, M.D., president of Bozeman Deaconess Health Group, settled in the area about eight years ago. The area offers a wealth of opportunities for fishing, skiing, mountain biking and more.

For James Loeffelholz, M.D., it’s the capital of mountain climbing and backpacking, activities that have consumed his leisure time since his high school days. And when the snow gathers on the nearby Bridger Range and Spanish Peaks, he’s ready for cross-country and downhill skiing. Among popular destinations for the snow crowd is the Big Sky Ski Resort about 40 miles south, created by one-time renowned network newsman Chet Huntley. The Bridger Bowl, opened in 1955, was Bozeman’s first public ski area. According to Daryl Schleim, president/CEO of the area chamber of commerce, “A nice thing about the area is that you can ski four different types of slopes in a three-day time period. They’re within an hour and a half of each other.”

Alternative winter sports include ice skating, snowmobiling, ice fishing, Nordic and cross-country skiing. Warm-weather possibilities also abound, such as hiking, biking, horseback riding, fishing, rafting and golfing.    Loeffelholz was no stranger to the locale. “I have been coming out here for years,” he says. He had considered relocating several times, but the clincher was an opportunity too good to ignore.

Surprisingly, considering the dramatically different natural environments, he discovered an unexpected comfort zone in his new location, a certain Midwestern flavor not unlike Iowa City, Iowa, where he grew up and earned his medical degree.

He moved to Bozeman eight years ago to join a group of internists and subspecialists. “Then we sold the practice to the hospital and now have 52 physicians and about 65 providers.” It’s now the Bozeman Deaconess Health Group, and Loeffelholz is the president. His clinical practice, he says, is “old-time internal medicine,” and that’s what he likes, although treatment is 21st-century state-of-the-art, and several top-line specialists have joined the practice in recent years.

Bozeman Deaconess Hospital celebrated its 100th anniversary two years ago, growing from a small 1911 sanitarium to a modern hospital in 1986 with 86 all-private rooms. In recent years, Deaconess has been renovated, and more specialists and treatment centers have been added, including a wound clinic, and centers for sleep disorders and diabetes. A health partnership has been formed with 16 area school districts, and a new Community Care Connect bus travels to three counties providing health screens and vaccines. In recent years, the hospital has also received several high-grade awards.

Plunging down mountainsides on long, skinny wooden boards was not what John Bozeman had in mind when he made his way west in the early 1860s to join the Pike’s Peak Gold Rush. The trail that would be named for him was a new northern offshoot of the Oregon Trail. It provided the easiest access to the Montana gold fields. He was a key founder of his namesake city in 1864, but didn’t live to celebrate its incorporation 19 years later. He was murdered along the Yellowstone River in 1867 at age 32.

Eventually the open and fertile land attracted settlers. The arrival of the Northern Pacific Railroad in 1883 also helped. So did the founding 10 years later of the land grant college that would become Montana State University. Today its student body of 14,500 is equal to almost two-fifths of the city population. Local residents are welcome at concerts and Bobcat sports events, as well as MSU’s Arboretum and Gardens and its Museum of the Rockies with the largest collection of dinosaur remains in the U.S. and the largest Tyrannosaurus skull yet to be discovered. (Prehistory aficionados can also follow Montana’s Dinosaur Trail, with 14 museums, state parks and other attractions in 12 communities.)

By the early 1900s, farmers were planting more than 17,000 acres of peas for processing by major area canneries. The one-time label of “Sweet Pea Capital of the Nation” soon segued into an annual Sweet Pea Carnival. It was short-lived but was resurrected as a three-day arts festival in 1977 and is one of the state’s largest events of kind.

The city also offers a good variety of children’s activities as well as, according to Loeffelholz, “fantastic public schools.” The elementary school attended by his three children is considered a Blue Ribbon School nationally, he reports.

Bozeman’s modern-day prosperity is also fueled by a variety of businesses from laser and biotech companies to three breweries using local barley seed in its beer production. One of the country’s three Gibson Guitar facilities strums along in the city, and, for fine liquor connoisseurs, there’s the RoughStock Distillery, creating “pure mountain whiskey,” from homegrown grain and pure mountain water.
Daryl Schleim, president/CEO of the Bozeman Area Chamber of Commerce, notes a major upswing in area highway construction, allowing better traffic flow to Yellowstone. A $38 million airport renovation is also underway. Adds Schleim, “For a community of our size, we could end up with three or four large airlines.”

Loeffelholz himself has noticed a considerable amount of change, such as an increasing population, since he settled into the Bozeman environment. “The hospital,” he says, “has been transitioning from a primary-care-based community to a regional care center and gradually increasing services. We’re still in the awkward stage of ones and twos (in terms of patients needing specialty care), so it’s hard to offer 24/7 service from certain specialists.” But with an increasing population, that problem is likely to resolve itself before long. He calls it an evolutionary stage.

Growing prosperity has spawned enough higher living standards to support at least one luxury housing development called the Yellowstone Club. And the outdoor opportunities have attracted celebrities temporarily escaping the Hollywood razzmatazz. Among them, Loeffelholz himself has spotted Dennis Quaid, Johnny Depp and Jane Fonda.

“The interesting thing about practicing here,” Loeffelholz notes, “is that one afternoon I can see a farmer, and the next day a retired president of Paramount Pictures. People in other parts of Montana are beginning to call this city Boze-angeles.”

The Biltmore Estate has more rooms than any other private home in America. Built by George Vanderbilt, the Estate’s 8,000 acres include beautiful gardens and a winery among its attractions. Many of the Estate’s sweeping views were designed by Frederick Law Olmstead.

The Land of the Sky
Asheville, N.C.

As long ago as the 1790s, Americans were hearing about the healing effects of the Appalachian Mountain areas, none more than the town of Asheville, nestled among the Blue Ridge and Smokies. Thousands of hopeful patients made their way to the picturesque North Carolina town, where many grand facilities were built to accommodate them. The trend finally petered out in the 1950s and the advent of antibiotics. But some of the “hospitals” survive today as homes, offices and apartment buildings.

One wealthy patient was George Vanderbilt’s mother. He himself is well remembered today, thanks to his celebrated home, the Biltmore Estate, with more rooms, even today, than any other private home in the U.S.

Another remnant of the “TB era” is the 6,000-square-foot, 29-room boarding house where many of the patients lived and ate. It was owned by Julia Wolfe, whose famous son, writer Thomas Wolfe, lived there and later fictionalized in the novel, “Look Homeward, Angel.”

The rush for “nature’s cure” ended, but the lure of Asheville did not, thanks to its magical scenic ambience and almost unlimited outdoor adventure possibilities. Two major rivers, the Swannanoa and the French Broad, converge at the city, providing boating opportunities from whitewater rafting to placid float trips. The demand for kayaks alone is great enough to support a local manufacturer. Within an hour and a half, winter fanatics can get to some of the highest peaks east of the Mississippi River and enjoy gliding down more than 30 slopes. Children’s tubing slopes are also available. Less snowy pursuits seem endless, including hiking, biking, camping, tennis and golf.

According to the Convention and Visitors Bureau, “Mild winters are the norm, and they go hand-in-hand with snowy slopes, while downtown remains cozy, dry and romantic.” As for the city’s lure, spokeswoman Cat Kessler adds, “People visit here for vacation, wellness and recreational purposes and decide they want to come back. I’ve heard of people who have gone home, sold their houses and moved here, some in just a few months’ time.”

Christopher Sander, M.D., fits into another category—people who move away and then pine to come back. “I had lived in Watauga County, about an hour from here,” he reports. “My mother and brothers live in Raleigh, and I wanted to be near them.” Not to mention that the mountainous area is “a very special place.” He got an undergraduate degree from Appalachian State University in nearby Boone, but interrupted his education with a volunteer stint in Angola. “I was an average student,” he says, “and I wanted to see another part of the world, so I did that. I returned a different student.”

His life from there included medical training in Puerto Rico and residency with the Lehigh Valley Health Network in Allentown, Pa., interspersed with another volunteer stint in Africa, this time in Kenya. He had met his Spanish wife, Susana, in Angola, and she had joined him in medical school. They now work together in nearby Arden at Vista Family Health, an affiliate of Asheville’s Mission Health. They recently moved into a home in Asheville with their 6-month-old son.

“We used demographics to make our decision,” Sander reports. “Basically, there was one place where we wanted to live, and this was it.” Bottom line: “We just called Mission Health and asked what they could offer us—a cold call.” It worked.

The result, as he explains it: “I love where I work. I couldn’t have landed myself in any better place. I took over more than 2,100 patients from a guy who had opened a bilingual practice coming out of his residency. He was a well-respected and loved member of the community. It made for a rocky transition, but I think I’ve won over the hearts of these people, so it feels good.” Not only that, “Everyone I work with is young and vibrant and always looks for new things to learn.”

Sander loves outdoor opportunities and savors tennis, camping, hiking, mountain biking and “all things outdoors.” The Blue Ridge Parkway and well-kept mountain roads also beckon for spins on his Harley-Davidson.

Sander’s employer is affiliated with Mission Health, which has roots dating back to 1885. Asheville is home to Mission Hospital, its flagship institution. The hospital is known as the second busiest surgical center in the state. It recently expanded services to two outlying total-service clinics in a program titled Mission My Care Plus, where comprehensive care, X-rays, lab tests, pharmacies and physical therapy facilities are available for the whole family.

Nature and health care have combined as cordial hosts for several related Asheville industries, especially the Bent Creek Institute, whose research materials are found in the large variety of plants and flowers growing in the nearby North Carolina Arboretum and in many local species.

Among other medical-related Asheville manufacturers or branches are Thermo Fisher Scientific (immense production of lab equipment, research supplies, chemicals, etc.), Emdeon (computer programs for health care systems) and G3Medical (sterilized medical equipment).

Over the years, Asheville’s general atmosphere has made it a mecca for artists and other free spirits. These days, tree-lined brick streets are alive with buskers, bars, boutiques, cafes and more than 30 galleries featuring frequent art walks.

Today, the city has more Art Deco structures than any Southeastern city but Miami Beach, including City Hall with its unusual octagonal tower and the Grove Arcade with its open hallways, high atrium and “greenhouse” roof. Its current lineup includes 38 shops, plus offices and apartments.

Rugged and Beautiful
Portland, Maine

The Portland Head Light Station in Cape Elizabeth, Maine was commissioned by George Washington in 1787.

Joseph Yu, M.D., was in private practice in the New Haven, Conn., area when he received an out-of-the-blue letter from the recruiter for Mercy
Hospital in Portland, on Maine’s southern coast.

“I’d never been up to (that area of) Maine, so I said, ‘Let me just check this one out.’ I really liked the place,” Yu says. “It has many beautiful surrounding areas, and a lot of natural beauty—and I liked the city itself.” Bottom line: “My wife and I decided to make the move.” As of February 2012, he’s been part of Mercy Gastroenterology at Casco Bay.

Getting to work now is an easy commute across the Casco Bay Bridge, and, unlike the New Haven area, Yu says, “There’s no traffic.” This also means somewhat easy going if he decides to visit his son and daughter in New York, where he grew up. “I can leave on Friday evening, get to Connecticut on Saturday, then to New York, and on Sunday I can come back to Maine.”

Since their move, Yu and his wife have savored the outdoors, the culture and restaurants known, of course, for their abundance of fresh-from-the-sea fare. They’ve discovered picnic areas in parks and on beaches, as well at lighthouse sites, especially the Portland Head “sentinel,” which dates back to 1791.

“You can picnic there and visit the museum and watch the ocean hitting the rocks,” Yu reports. “At one park, you can bike or hike all the way to the Bug Light.” (It’s actually the Portland Breakwater Light, but got its nickname because it’s so tiny.)

It’s a short trip from Portland to other interesting locales, such as Freeport, home of the celebrated L.L. Bean store.

Portland is actually a collar-shaped piece of land jutting between two bodies of water: Casco Bay, formed when the Fore River reaches the ocean, and Back Cove. The setting creates irresistible opportunities for sailing, canoeing, kayaking, seal watching, plus lobster catching expeditions. Yu also mentions daily ferry rides to some of the Bay’s 108 islands. “I took a boat last summer,” he says, “and it was nice, very nice!”

Portland’s location has also made it a mecca for cruise lines. At least a hundred ships now make stops there. Nearby, entrepreneurs and shopkeepers have transformed a once-seedy wharf area into a thriving shoppers’ haven.

On the more practical side is the cost of living. Yu reports that property and income taxes are lower than those in Connecticut, where he practiced for 20 years, and in New York, where he grew up. Another serendipity: a much lower crime rate than in either location.

Before establishing his previous practice near New Haven, he had been educated at Yale University and the Albert Einstein College of Medicine, followed by a GI fellowship at New York-Presbyterian Hospital and four years of treating inmates at Rikers Island, a payback to the National Health Service for his medical education.

As for Mercy Hospital itself, it’s much smaller than in his previous location. “The hospital there was kind of impersonal. You were just one among thousands of people. But in this hospital, everybody knows you right off the bat. I think the patients are also very friendly people. When I first came here, I told my wife, ‘This place kind of reminds me of the U.S. in the 1960s when I was a little kid.’”

But neither of Portland’s two hospitals fall into the 1960s category, although their roots go back as far as 1872.

Maine Medical Center today is the state’s premier referral hospital. It’s rated fourth safest in the U.S. and its nursing staff is rated among the top 3 percent in the world for excellence. It’s also the largest hospital in northern New England.

Mercy Hospital recently became part of the Eastern Maine Medical Center group headquartered in Bangor, which includes seven hospitals plus nine nursing homes and retirement communities. In 2011, Mercy was the first all-private-room hospital in Greater Portland.

Portland’s ethnic complexion has also changed considerably in recent years when the city became an official refugee resettlement location. With newcomers from African countries as well as Vietnam, Cambodia and China, the locally spoken languages have increased to 59 or more. Schools, hospitals and other institutions have adapted well to the changes.

About 20 years ago, when an economic slump brought Portland’s downtown to its knees with a vacancy rate of 40 percent, city leaders decided on a new tactic, turning the long main artery, Congress Street, into a haven for the arts. Today designers of all kinds are ensconced in former store spaces. There’s a law firm concentrating on the arts, the nearby Museum of Art, offices and performing spaces for arts organizations and antique shops.

Eileen Lockwood is a frequent contributor to PracticeLink Magazine.

 

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Rural Gems – Escape the city

Not every small community fits comfortably under the label of “farm town.” Here are four locations more properly considered “rural gems.”

By Eileen Lockwood | Live & Practice | Spring 2013

 

For some physicians, big cities, complete with their many amenities, are the destinations of choice. But there are a number of smaller locations offering good positions, surprising family opportunities and—perhaps best of all—easy integration and heartwarming patient acceptance, not to mention state-of-the-art facilities.

Here are four welcoming examples: Ruidoso, N.M.; Wellsboro, Pa.; Crete, Neb.; and Ironwood, Mich.

Skiing, skiing and more skiing
Ironwood, Mich.

In Michigan’s Upper Peninsula, Jim Hubbard, M.D., enjoys his access to skiing.

Say but the word “skiing,” and Jim Hubbard, M.D., is a happy man. “When we were kids in Washington State,” he reminisces, “my folks would haul us up to the mountains four or five times a year, and we would cross-country ski.” Now in Ironwood, Mich., this Upper Peninsula transplant says: “Now it can be four or five times a week.”

The UP is well-known for its huge piles of the white stuff in winter. In fact, Yoopers, as the residents are nicknamed, like to define their climate as 10 months of snow and two months of poor sledding.

Ironwood conveniently offers no fewer than five ski resorts to accommodate enthusiasts like Hubbard and is also a link in the cross-country Wolverine Nordic Trail System. One resort, on Mount Zion, is owned and operated by the local Gogebic Community College, which uses it as a training facility for its ski area management program.

Hubbard’s route to this town near the Wisconsin border was, in a word, circuitous. The University of Washington School of Medicine, where he received his degree, focuses heavily on training physicians to work with underserved populations. After a residency in Tacoma, where this emphasis continued, he says, “I looked all over the country, including lots of places in the Midwest. In Ashland, Wisc., a recruiter told me, ‘If you like this job, you should also look at (an opening) in Michigan.’ I had to get out a map because I thought the whole Upper Peninsula region was part of Canada.”

In Ironwood, he says, “I liked the doctors, the area, the people and the hospital. They met all my professional criteria, and my wife really liked the area, so we came here.”

After 12 years, he’s still enthusiastic. “Besides winter, it’s gorgeous up here with not too many people, and there’s no shortage of things to do,” he says. “We also joke about there being traffic. There’s never any here, except for two or three cars on the road.” Not only that; his wife has been able to start a chain of shoe stores (Superior Shoes, with a bow to nearby Lake Superior) with her brother in Indiana. With online sales, it’s possible for her to live in a small town.

As for Hubbard’s own professional progress, when he arrived, “a lot of patients were migrating out to have babies because of a lack of obstetricians. Now I personally do 90 to 100 deliveries a year, and my partner does the rest—a total of 150.”

Hubbard’s employer is Aspirus Grand View Clinic. The Ironwood hospital is a critical access facility with full surgical center, urgent care, in-home physical therapy service, a sleep lab, the sole retinal specialist in the entire UP and specialty care including cardiologists, oncologist and physical/occupational therapist, with on-site radiology and lab services. In June, work will start on a major ER renovation.

Ironwood’s place on the map became important with the discovery of iron ore in the 1870s, but the lumber industry played a heavy part in the mix, thanks to the abundance of trees in the wilderness. The railroad arrived in the 1880s, and immigrants from locales such as Finland, Sweden, Germany, Italy and England began arriving to fill the job openings. Today the heritage persists (and so does a tasty food from Wales, the pasty).

In modern Ironwood, neither snow nor sunshine keeps residents from enjoying other forms of culture, such as performances by two theater organizations and the Ironwood Dance Company. With no professional sports within easy reach, local residents lend their cheers to the athletes at Luther L. Wright High School, especially when they meet Hurley High, one of the longest-running rivalries in American high school sports.
The field is larger for Hubbard, who takes off in his airplane during the summer to enjoy minor league baseball games in Ohio and downstate Michigan. The “local” team for him is in Appleton, Wisc.­­—four hours south by car but a mere hour by plane.

GASLIGHTS AND GOOD FOLKS
Wellsboro, Pa.

Wellsboro is home to Pine Creek Gorge, aka The Grand Canyon of Pennsylvania (above). Below, gaslights contribute to the town’s charm.

It was a cold, windy, snowy January day when the husband-and-wife team drove into Wellsboro, Pa., for the first time. Edmund Guelig, M.D., was finishing his residency at the Geisinger Clinic and, recalls his wife, physician assistant Daria Lin-Guelig, “We were looking for a (good) community to practice in.” But on that day, she recalls with a chuckle, “it seemed like we would reach Neverland before Tioga County.”

Their fortitude was rewarded. That was 22 years ago, and the trip is still vivid in her mind. “One spin down the gas-lit, snow-covered Main Street—the gaslights will do it every time—and I said to Ed, ‘This is it. We can cancel the rest of the interviews. This is where we need to be.’”

Today they work together under the aegis of Soldiers + Sailors Memorial Hospital, itself a tribute to sturdy perseverance. In 1919, five local families filed a building application. The Great Depression literally depressed, but didn’t end, their plans. Twenty-three years later, on August 25, 1942, the hospital opened. In the next two years, some 4,000 patients were treated and 600 babies were born there.

After a number of expansions and upgrades, the hospital became part of the Laurel Health System, which was integrated into Susquehanna Health last October­—providing greater patient access to a bevy of specialists and the 226-bed Williamsport Regional Medical Center. Also in 2012, Soldiers + Sailors opened a new emergency department and a same-day surgery unit. In keeping with the spirit of community friendliness, it provides a physical and aquatic therapy center, sponsors an annual golf tournament and supports a number of recreational programs in cooperation with Wellsboro Parks and Recreation.

For the Gueligs, it was a good move indeed and their practice has been rewarding in many ways.  “We had a vision of working together in a rural setting,” he recalls, “where you’re not just in it for yourself and just for your career. You are truly part of the community.” Lin-Guelig adds an interesting perspective: “Small towns are like spider webs,” she says. ”Our relationships are intertwined, and therefore stronger, more meaningful and more personal.”

In 2011, Guelig was named Pennsylvania’s Family Physician of the Year. He’s also medical director of the Soldiers + Sailors hospice program—and a firm advocate of the “rewards and sense of gratification that come from being a family doctor in a small rural community. (Only in this setting can you have) the experience of treating three generations of a family in a small town,” he says. His childhood experiences growing up in a small Wisconsin town (Waupun) played a big part in shaping his life, and they stayed with him as an undergraduate at the huge University of Wisconsin and then as a medical student at West Virginia University.

In Wellsboro, “intertwining” became part of their four children’s lives, too. “They got to experience real community life in a way that may be disappearing,” Guelig says. “I delivered babies of their teachers, and I can’t go anywhere where you don’t expect to see people on three or four different levels.” Although his now-grown offspring have scattered to cities across the country, he adds, “We reflect on what they took away (from their childhood experiences), and we know that a part of them understands human relations.”

Another experience that he cherishes has been an offshoot of his woodworking hobby. Several patients operate the sawmills where he gets his wood. When he questioned one owner who undercharged him, he was told that it was his “doctor discount.”

Wellsboro, about 120 miles east of Scranton and an hour’s drive northwest from Williamsport (famed for its annual Little League World Series), was named for Mary Wells, the wife of one of the 1806 town founders. To this day, it exudes the New England aura that captivated Lin-Guelig—wide boulevards, spreading elm and maple trees and, of course, gaslights, not to mention its historic district encompassing structures dating from 1835 to the 1950s. The mix includes early homes and grand 1890s mansions, as well as several churches and public buildings. About 600 are now on the National Register. As one city promoter puts it, “The district is among Pennsylvania’s architectural gems.”

The area’s natural beauty hasn’t escaped the Gueligs, either. Three state forests surround Wellsboro, but the most notable feature, in Tioga State Forest, is the 47-mile-long Pine Creek Gorge, aka the “Grand Canyon of Pennsylvania,” which descends at its deepest point to 1,450 feet and encompasses waterfalls and other scenic wonders. Canoeing and rafting are among the Gueligs’ favored activities, as well as hiking and bicycling. Enthusiastic winter visitors—and locals—can strap on their cross-country skis for a trek on the nearby Rail to Trail route—or zoom along some 800 miles of groomed snowmobile trails.

But the main “hobby” for this husband-and-wife team is a farm on the edge of town, complete with horses and chickens. “When the kids were young, we also raised lambs,” he says. “There’s also an orchard, and my wife also does a lot of canning. (All in all) we feel that this is a nice complement to medicine.”

Its bucolic atmosphere aside, the city is doing “quite well economically,” says Mary Worthington of the Wellsboro Area Chamber of Commerce. Five nearby major highways help make it an attractive location for several small industries. Worthington notes that nine substantial employers attract an influx of workers. One of those companies, Osram Sylvania, is carrying on a long tradition. Wellsboro is the site of one of the first factories where light bulbs were mass-produced.

YEAR-ROUND Playground
Ruidoso, New Mexico

Gary Jackson, D.O., and his family moved to Ruidoso, N.M., 22 years ago. They were attracted by the community, educational opportunities for their children, and the skiing.

High in the mountains of south-central New Mexico, the town of Ruidoso beckons to dedicated skiers and horse racing enthusiasts, not to mention hunters and fishermen. But, more than that, it offers residents and newcomers a captivating combination of mountain/forest surroundings, friendly togetherness and a certain urban sophistication.

For Gary Jackson, D.O., the skiing possibilities were too hard to resist. After growing up in Pittsburg, Kan., attending the University of Kansas and getting his medical degree from the Kansas City College of Osteopathic Medicine, he and his wife-to-be entered the Army. To complete his military commitment, he eventually became assistant chief of pulmonology at William Beaumont Army Medical Center in El Paso, Texas. The short distance from there to Ruidoso, N.M., (about 2 and a half hours) was too tempting to ignore, so New Mexico became the couple’s frequent snowy downhill destination. Before long, the lure of Ruidoso itself became too hard to resist.

Today, Jackson is the medical director of Lincoln County Medical Center and also provides coverage for four other area groups. The hospital itself is part of a unique partnership among the County of Lincoln, a local board of trustees and Presbyterian Health Services. The latter operates eight facilities in the state.

In the 1990s, the hospital was recognized by the Centers for Medicare and Medicaid Services as one of the top small hospitals in the U.S. “One of our big changes,” Jackson reports, “was that we became a critical access institution. In the last two years we’ve been bringing on board a hospitalist system. Our ER is open 24 hours a day, seven days a week. We’re building a new physicians’ office building directly across from the ER, for both current practitioners and for outreach specialists such as cardiologists and neurologists.”

One specialty is particularly important in a winter resort area: orthopaedics. With specialists from Alamogordo Orthopaedics and Sports Medicine, Lincoln can provide close-to-home joint replacements for visitors and residents alike. There’s also a strong in-house physical therapy program.

But Jackson and his wife had other reasons for settling in Ruidoso 22 years ago. “I think we moved because we wanted a nice environment for our children to grow up in and a good educational opportunity for them as well.” Sierra Blanca, 7,000 feet high and frequently living up to its “snowy mountain” name, is another plus. “I appreciate it every morning, and when I travel I really am eager to
get home,” he says.
]Not only that. “We’re a friendly area, with a community spirit that I think is unique to Ruidoso. Community members hold together to help each other.”

When winter disappears, the recreation of choice is horseracing at the Ruidoso Downs Race Track. The  Hubbard Museum of the American West, unique gift shops, interesting restaurants and children’s attractions also attract visitors to the area.

CORN AND CARE
Crete, Neb.

The odds are heavy that anyone breakfasting on Corn Flakes or munching on Fritos can trace them to the Crete, Neb., area cornfields—and the local Bunge Milling Co., whose roots date to 1869—two years before the town was officially organized.

It was one of the first corn processing operations in the U.S. As early as 1878, its goods were being shipped to points as distant as Scotland.

Nebraska is Cornhusker territory, right down to Crete’s cornfields and the Bunge Milling Co. pictured here from a tower at nearby Doane College.

Leon Jons, M.D., surely has treated a good number of Bunge employees during the 22 years that he’s been practicing family medicine with Saline Medical Specialties, a practice affiliated with Physicians Network, which in turn is part of Catholic Health Initiatives. Jons arrived in Crete in 1990 after earning his degree and completing residency at the University of Nebraska Medical Center in nearby Lincoln, where he now lives and where his wife is a teacher.

As for his own choice of work area, he reports that University of Nebraska medical students were encouraged to consider rural locations. He ran a private practice for nine years, then joined the Saline group, where he finds much satisfaction. “Practice in a rural community is much different than in the city,” he says. “Over the years we’ve worked with complicated obstetrical patients, done some of our own surgery, taken care of our own hospital patients and done a lot of public relations work.” He’s also found that patients are more cooperative.

But there are other advantages. “I think that financially, rural physicians do better than physicians working in the city. We’re a rural health clinic where Medicare and Medicaid reimbursements are much higher.” Another reason: “Rural physicians tend to do a lot more procedures, with much higher reimbursements. Also, there’s a malpractice cap, so insurance rates are low. Another advantage is that we have a great deal of autonomy and a lot of leeway in what we practice and how we want to practice.”

Jons’ idea of recreation is relaxing at his cabin on the Missouri River, but he also enjoys exercising and spending time with his family. All in all, “the quality of life in rural Nebraska is really good. I think people shy away from rural areas thinking that there’s nothing to do and they’re too far away from entertainment (and other city attractions). I find that not to be the case. I think that most doctors find that wherever they are they can have a vibrant social life if they want one.”

There’s also room for innovation. The city’s hospital, Crete Area Medical Center, is Exhibit A. In the last three years, it has become one of the nation’s pioneers in embracing a new philosophy and system of health care—the “patient-centered medical home” initiative. So far, it’s the only recognized program in Nebraska outside of Omaha, according to CEO Carol Friesen. “In the U.S., 75 cents of every health dollar is spent on chronic disease care,” she says. “We made the commitment to spend time working with patients to achieve better control of the three biggest of them—diabetes, hypertension and hyperlipidemia. Today, for instance, the national average of uncontrolled diabetes is 36 percent. Ours is under 6 percent.”

By encouraging patients to carefully monitor blood sugar, for instance, and contacting them often to make sure they’re complying and following other healthy practices, doctors and nurses help prevent repeated hospital stays, thus reducing health care costs. “We don’t think it’s right to take patients’ money or insurance unless we’re giving them the best care possible,” adds Friesen.

A second aspect of the medical home program is open access. “We will take care of every sick patient today,” she says. “We believe that health care is where you need it and when you need it. That has always been our goal.” So that local residents can get more complicated treatment close to home, the medical center brings in 20 to 25 specialists each week from Bryan LGH Health, its parent in Lincoln. In the meantime, the hospital provides several services beyond what might be expected in a 25-bed critical care facility, such as surgical suites, imaging, emergency and rehab departments, an in-house lab and a pharmacy. All of the above probably played a part in its 2012 National Rural Health Quality Award from the National Rural Health Association.

Even though Crete is a mere 25 miles from Lincoln, Neb., Mayor Roger Foster notes that “Most of the community is surrounded by farmland, and probably 40 percent of the kids in school have some sort of rural relationship.”

It’s a population mix that has become unexpectedly diversified in the last 10 years. Over the years, the immigrant stream has included many Eastern Europeans, and Crete became what Janet Jeffries, the spokesperson for Crete’s Doane College, describes as a “hotbed of Czech culture.” More recently, there have been new population influxes. In fact, according to Foster, minority groups comprise about 50 percent of students in the school system.

Physicians at Saline Medical Specialties are now seeing a large Hispanic influx. “I have learned a little Spanish as the years have gone on, and it’s a good thing. I do about 30 percent of my visits in Spanish, and we also have four people in the clinic who can translate,” Jons reports. “I’ve enjoyed learning how to deal with these patients culturally.”

Eileen Lockwood is a frequent contributor to PracticeLink Magazine.

 

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Live and Practice: Family friendly spots for physicians

Four cities where nature and humans seem to collaborate to provide an environment conducive to family well-being.

By Eileen Lockwood | Live & Practice | Winter 2013

 

Remember Cinderella, the stepchild literally from the fireplace cinders who triumphed in the end when she enchanted the handsome prince? This is the happy life of the fairy tale world.

But wait! Some of the make-believe may be seguing into reality. The good life seems to have become a fixture in some American cities, thanks to a convergence of energetic citizens, dedicated government, good schools, concerned employers and, in some cases, almost-heavenly natural surroundings.

PracticeLink searched the country and focused on four communities that seem to meet these family-friendly qualifications. It’s time to meet Hagerstown, Md.; Provo, Utah; Rochester, N.Y.; and Kansas City, Mo.

The Hub City
Hagerstown, Md.

An aerial photo of Hagerstown’s main street can be misleading. Low-slung buildings, a liberal sprinkling of leafed-out trees and a few cars cruising through an intersection seem like the hallmarks of a sleepy, out-of-the-way burg. “I can’t think of a time except really early morning when it’s not busy,” says Richard Wright, the communications officer for Washington County Public Schools (headquartered in Hagerstown).

Near that intersection, reports Sidney Gale, physician recruiter for Meritus Medical Center, there are businesses, a TV station, the visitors bureau and a thriving coffee shop, not to mention popular restaurants. A nearby two-block area is home to the Arts and Entertainment District, the Maryland Symphony Orchestra and the Maryland Theatre, all with healthy servings of music and stage shows. A recent newcomer in the district is the Barbara Ingram School for the Arts, a perfect location for dedicated students.

Not many GPS degrees away, cars, patients, doctors and nurses come and go in the thriving 55-acre Meritus complex. Hagerstown’s population may be small (about 40,000), but Meritus offers care to a metro-area population of more than 269,000 and is the hub for much of western Maryland and nearby Pennsylvania and West Virginia areas. The stage is also set for an ever-increasing patient population. Located in the Cumberland Valley between the Allegheny and Blue Ridge Mountains and not far from the celebrated Skyline Drive, the area is cited as Maryland’s fastest-growing metro area.

In its new quarters since 2010, Meritus provides care facilitated by the latest state-of-the-art technology. Imaging and lab facilities, computerized physician order entry, electronic documentation and even a pneumatic tube system that cuts wait time for medications are all strategically located near the ER. A connecting building, the huge, “full-service” Robinwood Professional Center, houses 125 care providers, lab facility, pharmacy, medical devices dispensary and offices for home health services, not to mention a café for hungry patients and professionals.

“I call it the Mall of Doctors,” says family specialist Joseph Asuncion, M.D. “It’s one-stop shopping. You can find any specialist you need there.”

Joseph Asuncion, M.D., and his family enjoy all that Hagerstown, Md., has to offer—from the Maryland Symphony Orchestra to hiking nearby.

Asuncion is well acquainted with this northern part of Maryland, where the “skinny” area of the state begins and then meanders to the west. He arrived with his parents at age 6 and grew up in the area. When his parents wanted him to touch base with his heritage, he returned to the Philippines to study medicine, but the lure of Maryland was too strong to resist. He began practicing in Frederick, 25 miles south of Hagerstown, but after 15 years, he joined Meritus. Two years later, weary of the 40-minute commute, he moved his family north. “A lot of patients followed me from Frederick,” he says. “They said, ‘You look a lot happier.’ And I am.”

The grand hospital facilities were by no means the only draw for him and his family, although he adds, “They take care of the doctors. Good pay, a good office, good facilities and good workers. (Professionally), what else could you ask?”

Hagerstown has been a good family location for him, and the Asuncions have taken ample advantage of the Maryland Symphony Orchestra, “wonderful plays and shows” and “terrific restaurants.” Not to mention other educational offerings. For instance, says Gale, the recruiter, “Hagerstown has the most certified museums of any county in Maryland.”

“Here,” Asuncion says, “you have the city life but basically the outdoor life, too. The mountains are within 30 minutes, it’s an hour to major ski areas and it’s two hours to the beach. We take advantage of it all!” Not to mention the proximity of Baltimore and D.C. On a recent Washington trip, he was fascinated with the International Spy Museum in particular. “I was actually crawling in the duct work with our daughter and spying on people,” he says with a laugh.

Education is also alive and well—and thriving—with a total of 46 public and at least 13 private schools, including several gifted or magnet institutions as well as schools for those who might have fallen into the cracks along the way. There’s an evening high school for those who want to retake courses or accumulate additional credits, a “non-traditional” night school for those unable to attend during regular hours and a “family center” for young parents to finish their education at times when they can find babysitters. “We worked hard to develop programs to fit students who may not fit into traditional settings,” says Wright at the education office. “We want them to have a great start in their next phase of life.”

The pleasant, family-friendly life was not always thus in this strategically located city near the Potomac River. In 1762, a multitasking German immigrant (farmer, fur trader, politician) from Pennsylvania, Jonathan Hager, acquired 10,000 acres and laid out a plan for a new town. He had cleverly set up shop at the crossroads of an important Native American trade route. The town became a transportation hub, especially after three railroads converged in a wagon wheel pattern.

But the happy ending became a distant dream with the start of the Civil War. Hagerstown’s excellent trading location in the Cumberland Valley between the Blue Ridge and Allegheny Mountains became an excellent strategic military location. The inescapable conclusion: Not one, but four major campaigns, including the Battle of Antietam, the one-day bloodiest conflict on American soil. The city itself was occupied off and on, and local doctors and citizens aided men from both sides. After the war, some 2,800 Confederate soldiers were buried in a special section of the city’s Rose Hill Cemetery.

Today the area’s natural beauty and opportunities for hiking and other mountain activities are natural draws for residents—and vacationers. The city business climate includes branches of several national corporations, including Volvo Powertrain, First Data, FedEx Ground and a Staples distribution center, as well as state and federal government enclaves. But, lest we forget, a Civil War Plaques District serves as a reminder of bad times past.

Battle reenactments also draw large attendances. Although the subject is serious, Asuncion recalls one expedition with a twist. “It was so real,” he remembers. “You had a line of a hundred guys in front of you, with a hundred people aiming guns at you. Cannons were going off on the hill. People were marching. Then it brought you back to reality—when a yellow fire truck came down the hill!”

Welcome Home!
Provo, Utah

“Welcome Home” is Provo’s new slogan, complete with bright artwork symbolizing water, mountains and sunrays. It’s part of a new city makeover plan, “Vision 2030,” with the tagline, “How well are we doing, and how can we improve?”

However, it’s hard to believe that there’s room for much more enhancement, beginning with the environment. City spokesperson Helen Anderson reels off the natural assets of the area—mountains, lakes, bike trails, climbing…But that’s just a start. Provo is located in the Utah Valley beneath Mount Timpanogos, a massive, rugged peak of the Wasatch Range at the western edge of the Rockies. It’s an inspiring setting for the circular, high-spired white Provo Utah Temple that stands out against the stark gray mountain. The great outdoors is a perfect accompaniment, filled with mountain and riverside trails, fly-fishing, inner tube floating, boating, trail riding and journeys of exploration along picturesque highways.

Actor Robert Redford’s Sundance Ski Resort is a mere half-hour northeast of Provo Canyon and offers a surprising lineup of other amenities, such as a summer theater, Utah Symphony concerts, an author series, and, of course, the well-known Sundance Film Festival.

Jordan Blanchard, M.D., notes that his residency program has been particularly family friendly. He plans to practice in rural Idaho after residency.

All of the above enhance the good life for Stephen Welsh, M.D., and Jordan Blanchard, M.D.  Both are outdoors oriented and in family medicine residency programs at the Utah Valley Medical Center and have settled on specific career paths. “Growing up,” says Welsh, “I wanted to do something where I was with people. I didn’t want to sit at a desk. I love a long-term relationship with people, because it keeps primary medicine more interesting. In Provo, it’s also fun to take care of a population that cares about its health and people who listen to my advice.”

Says Blanchard, “I want to go rural in Idaho.” More specifically, he’s looking to a career life in the ER.

As homegrown Utahans, they’ve long been aware of Provo’s assets and outdoor advantages. Welsh’s undergraduate experience was at Brigham Young University, the Mormon-founded and oriented institution that has become the city’s signature identity. Blanchard attended BYU-Idaho. Both earned medical degrees at the University of Utah in Salt Lake City. They’re each married, with children (three for Welsh, four for Blanchard), whom they enjoy introducing to the great outdoors just beyond their doorsteps. “Probably our favorite thing,” reports Welsh, “is the mountains. It’s only takes about 20 minutes to get up to a canyon, and we go hiking a lot.” The ambience includes “really cool parks in the mountains where we take the kids to play and see the leaves.”

For special excursions, two choices are within easy reach. Welsh’s wife takes the brood to Seven Peaks, a water and amusement park. For an even bigger treat, both the Welshes and the Blanchards take a short ride to Thanksgiving Point, a 312-acre wonderland with activities for all ages, including a demonstration farm, the Museum of Ancient Life (a huge collection of mounted dinosaurs), a new Museum of Natural Curiosity and 55 acres of gardens. A yearlong family pass is a bargain at $175.

Provo parents are committed to quality education for their children. Almost all schools have been built since the 1990s, and four since 2002. The oldest (1931) has been retrofitted with an iPad and Apple TV to connect students with teachers, and some schools boast several desktops in each room. But Laken Cannon, community relations director for the system, credits the 90+ percent graduation rate not only to “phenomenal classroom instruction,” but to the many volunteers. “One thing I really appreciate is that we have such involved parents,” Cannon notes, also citing at least one unusual program. “One school is across from the BYU law school, and every fourth grader is assigned a law student as a kind of big brother who will help with homework if needed or simply play catch with a group. It’s someone they can look up to who is doing something good.”

Meanwhile, back at the hospital, Blanchard had discovered a heartwarming adjunct to his job—an unusually family-friendly program. He recently noted, “My wife went to lunch today with the head of the residency program and the other wives. He wanted to check up on how things are going.” But there’s more. “Almost every week, the spouses go out for lunch. There are picnics, and they get together with the kids for play groups or at the park.”

The hospital itself is one of 22 facilities operated by Intermountain Healthcare, an organization that enjoyed a moment of national recognition when, in the first presidential debate, Mitt Romney equated it with other celebrated American clinics. Utah Valley Regional Medical Center strives to deliver “quality care at the lowest appropriate cost.” It’s now a Level II trauma center with several programs of excellence, plus a 24-hour life-flight service and 12-hour InstaCare on the BYU campus.

Recent additions include a sleep center, expanded NICU and an emergency baby-delivery simulation program. A new outpatient center incorporates, among others, a women’s center, same-day surgery, sports medicine and orthopedic procedures.

About eight years ago, Intermountain also started its LiVe program to improve fitness and eating habits among teens. An intriguing and popular feature is a group of mobile vending machines. The contents are packaged to look like cookies and candy, with no coins required. The packages contain helpful health tips.

An outsider impression about friendly places is probably that they must all be small towns. Not so in this case. The Provo population is about 112,000, and the metro totals some 527,000. Another surprise, for its size: the strong sense of patriotism, which culminates every year in the huge America’s Freedom Festival.

Also, in its size group, Provo is considered the most conservative city in the U.S. However, that doesn’t dim its friendly reputation—for everyone, including thousands of foreign students who attend BYU. There’s also the nearby Mormon missionary training center.

As for the “Welcome Home” slogan, it translates to newcomers as well. “People not familiar with Utah might think there’s a lack of diversity here,” says Welsh, “but Provo especially is one of the most diverse areas in the state.” For his family, proof is just up the street. “We have neighbors from Nepal and Mongolia.”

Flower City
Rochester, N.Y.

Considering the array of floral-related events in Rochester, N.Y., it’s easy to joke that the flower population is exponentially larger than the people population. Exhibit A: the 10-day Lilac Festival in May, a fixture since 1898. Today, it’s become an “international springtime party,” headquartered among some 1,200 lilac bushes in the city’s Highland Park.

The Maplewood Rose Celebration takes over in June, offering jazz, wine and a Father’s Day Picnic in a setting of 5,000-plus roses. Flower City Days at the Market absorb five Sundays in May and June, when growers show off hundreds of plants at the huge Rochester Public Market. And there’s more: seemingly insatiable floral devotees attend garden talks in spring, summer and fall.

The flower scene, of course, is just one of Rochester’s considerable assets, both natural and manmade. Early settlers—and travelers—were attracted by the High Falls of the Genesee River, which flows through the city. The falls’ 96-foot drop created an ideal location for many gristmills—and prompted the city’s previous nickname, the Flour City. Other manufacturing followed, but the business climate eventually concentrated on technology, as in Kodak, Xerox and Bausch and Lomb, the company that progressed from monocles to contact lenses, implants and many other vision-related products.

Not surprisingly, this trio attracted some of the best and brightest employees. “Kodak is in trouble (these days),” noted Mayor Thomas Richards in his 2012 state of the city address, “but its workers have provided the area with an extremely skilled workforce that has been able to rebound into other industries.”

One way or another, Rochester is now noted for the fifth most patents per capita in the U.S., and as one of the top 20 most innovative cities, according to a city spokesman. Hand in hand with the technical brainpower is an unusual number of colleges in the area, but with a special spotlight on the University of Rochester and Rochester Institute of Technology.

Ana Molovic-Kokovic, M.D., and family enjoy Rochester’s many cultural activities.

This concentration was important in the decision of internist Ana Molovic-Kokovic, M.D., to accept a position with Rochester General Hospital after finishing a residency in New York City’s crowded borough of The Bronx. “With a bachelor’s degree in mechanical engineering from my country, Serbia, my husband was looking to continue his education,” she says. In fact, thinking ahead for her daughter’s education, she was pleased to learn that all of the Rochester public schools are rated among the hundred best in the nation, according to U.S. News and World Report. (Suburbs such as Brighton, Fairport and Pittsford are often cited among the best.) Overall, the city is “not quite the same as Boston or other big cities,” she says, “but big cities have crowds and long commutes. Here there’s no rush hour. And it’s only 17 to 20 minutes from my home to the hospital.”

She cites two other major motivations: “I wanted to be in the Northeast. I like New York State for many reasons, and I wanted to live somewhere at a lower pace where it was more affordable and easy to start a new family.”

Molovic-Kokovic soon discovered other serendipities for children. Her daughter, almost 3, is enrolled in music classes for children at the Eastman School of Music. For fun and fascination, she “absolutely loves” the immense National Museum of Play, an endlessly fascinating playground, featuring not only a collection of some 400,000 toys but many captivating interactive opportunities, from “Sesame Street” to the history of video games. Its architecture alone is irresistible. A huge tumbling set of colorful blocks houses one display area, a caterpillar-like corridor links buildings and a wing-shaped structure encloses a butterfly garden.

The original museum was established by super-philanthropist Margaret Woodbury Strong, whose most prominent philanthropy has been Strong Memorial Hospital, flagship facility of the University of Rochester School of Medicine and Dentistry. It’s noted for its tertiary—and quaternary—care, especially research and treatments above and beyond other hospitals in the region. Also in the UR orbit is Highland Hospital, one of the first homeopathic hospitals in the U.S. when it opened in 1889.

Current excitement is about the groundbreaking for a third UR facility, the 245,000 square-foot Golisano Children’s Hospital, thanks to the generosity of yet another benefactor. The university’s largest capital project in history, Golisano Children’s will include 52 private rooms, a greatly expanded NICU and a “hospitality” suite almost equal to an extended-stay motel.

Rochester General, where Molovic-Kokovic practices, has been noted for its “unparalleled level of personalized attention and compassionate care.” Spokesman Marty Aarons also notes that it’s been cited the most visitor-friendly hospital in Rochester and among the top four in New York State. One example is a new service—Tuesday afternoon tea and scones for patients and visitors.

The list of General’s quality care awards runs as long as three pages. One “item” is its strategic RIT alliance to collaborate on biomedical research. Two unusual “offerings” are a school of medical technology and a two-year youth apprenticeship program for up to 32 high school students that provides 10-week rotations through
20 departments. Director Kimberlyn McDonald notes that all participants for the last seven years have been accepted to college.

The medical technology school, begun in 1934, is probably the second oldest in the U.S. and still survives in a time when many hospitals have eliminated the sequence. “In this economy, it is a wonderful thing to be in this major,” says the program director, Nancy Mitchell. “The day they finish (the program) they can step into a position.”

But medical care and tech business startups are not the only evidence that Rochester is alive and well and keeping up with the times. More than 50 renewal and reconstruction projects are marked on a city business/redevelopment map.

There’s no shortage of leisure activity, either, including 80 or 90 city-sponsored annual events. In addition, special events range from a cookie contest to a summer concert series at High Falls, plus professional sports teams to follow, golf courses and summer swimming programs at 24 locations. Or, a simple but favorite activity of the Molovic-Kokovic family—walking and jogging along the banks of the Erie Canal.

City of Fountains
Kansas City, Mo.

This Midwestern American city on the banks of the Missouri River features at least 250 fountains.

This is a thriving metropolis surrounded by suburbs on both sides of the Kansas-Missouri state line. Its can-do attitude has spawned public and private funds to build spectacular entertainment centers such as the new Kauffman Center for the Performing Arts and the huge, rubber-tire-shaped Sprint Center.

You could say that Kansas City has not one, but four downtowns, starting with the original business district near the Missouri River.

The Crown Center area is about 30 blocks south, followed by the Westport District, the 1800s jumping-off point for four historic westbound trails.

Finally, edging a picturesque creek, is the Country Club Plaza, an upscale version of a Spanish marketplace with hanging flower baskets, sculptures, fountains and art tiles. One land developer has noted, “The Plaza has had the longest life of any planned shopping center in the history of the world.”

While he’s impressed by all of the above, Greg Canty, M.D., succinctly sums up his impression of the city. “The nicest thing is meeting nice Midwestern people.”
He adds, “It’s a very easy city to live in. There’s a short commute time, and there’s hardly anyplace where traffic is so bad that it makes you late.”

Canty moved his family into Brookside, one of some 200 designated city neighborhoods, this one a comfortable 1930s-oriented area with cozy shops and restaurants. Although he doesn’t give high marks to the school district, he notes that “Most folks choose private schools.” As an alternative, the Missouri Charter Public School Association lists 24 schools in the area. Kansas City public schools, unfortunately, have been on a rocky road for some time, with at least two dozen superintendents in the last 40 years and significant low academic performance that has led the state education board to rescind the district’s accreditation.

Not all is gloom, though, says Kent Yocum, a teaching and learning coach in a neighboring district who lives in the Coleman Highlands. “There certainly are superstars (as well as) some not pulling their weight. I really don’t think it’s probably any different from any other environment.”

Canty, who grew up and was educated in Kentucky, moved to Kansas City two years ago to become medical director for the sports medicine program at Children’s Mercy Hospital, focusing on adolescent and school-age athletes. He has since hired two more specialists and expects to be seeking more. “The clinic is full about every day,” he reports.
Like other KC hospitals, Children’s Mercy has satellite facilities in other metro locations. Among other services, it treats 90 percent of area pediatric cancer patients and boasts the highest survival rates (also 90 percent) in the country…a third of the way into a 15-year major expansion plan.

It wouldn’t be too much of a stretch to rename the city Hospital Town, considering the number of facilities per capita in Kansas City proper, plus several in adjoining suburbs, as well as the colossal University of Kansas Medical Center just across the border.

The largest, in terms of beds (611 at last count), is easily Saint Luke’s Hospital, the flagship of a network of 10. It’s one of only three Missouri hospitals to receive a Malcolm Baldrige Award. Among its more advanced services are kidney, heart and, as of 2012, liver transplants, the latter requiring one of the shortest wait times in the U.S.

With more than 80 smoke-grilled pork bistros and 35 jazz clubs and restaurants, not to mention dozens of other leisure-time possibilities, it’s hard to believe anyone who says he’s bored in Kansas City.

 

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Saturdays in the Stadiums

Tradition and excitement join hands every fall in campus cathedrals of sport, but it's the everyday quality of life that makes for happy living and working.

By Eileen Lockwood | Live & Practice

 

Sports, games and competition have been part of life since long before discuses were being hurled in Greek Olympic fields and Ben-Hur raced his chariot, but those old-timers would be astounded if they could see what the last century and a half has wrought in college towns across America.

The Civil War was a not-so-distant memory when the University of Michigan’s first organized baseball competition began in 1866. The team won all three of its games that season.

Today, game attendance often doubles hometown populations of some towns, which are overtaken by the massive accompanying celebrations. But massive as it may be, sports mania does not a permanently successful city make. Universities add culture, sometimes great research successes and job opportunities 365 days a year. Location, natural resources and climate also add appeal to other businesses while history, the great outdoors, entertainment and general ambience are magnets for townspeople and prospective residents. Ann Arbor, Mich.; Columbus, Ohio; Athens, Ga.; and Norman, Okla., are thriving examples of all of the above.

THE CRIMSON AND THE CREAM
Norman, Okla.

Not to be outdone by its fellow institutions, the University of Oklahoma in Norman has its own sports traditions, at least one so unique it seems to have come from outer space. Consider 82,000 fans today at the Gaylord Family-Oklahoma Memorial Stadium shouting out, “Hi Rickety Whoop-te-do!” That’s officially The Yell, which seems to date back to the first football game in 1895. That same year, university officials adopted the team colors now trademarked into the minds of all loyal Sooners.

The crimson and cream emerged in a traditional Oklahoma way. A committee proposed them, and the students approved. About two breaths later, the hues sprang up all over town as banners and pennants, and soon the local merchants ran out of stock. The combo became so ensconced that “cream” is still the word of choice, even though today’s version is now white.

Ted Boehm, M.D., moved to Norman, Okla., after high school—and stayed through undergrad, med school, residency and fellowship. He’s now a sports medicine physician raising a family there.

The current craze for Ted Boehm, M.D., though, is gymnastics, an interest that began after his 4-year-old son joined a class. “Ever since then,” Boehm says, “it’s been pretty amazing to watch the gymnastics teams at OU. They’re always in the top five in the country—the top six for women and top one or two for the men. For the guys, it’s at an Olympic level.”

Boehm is a sports medicine physician affiliated with the Norman Regional Health System. He officially takes care of both Norman high school teams and has no regular family patients, but he does see people with sports-related medical problems or injuries.

Although he graduated from high school in Merced, Calif., he relocated to Norman after his father, a government contractor, was transferred there. When college time arrived, he decided to give other universities a fair chance, so he visited several California campuses. But, he says, “OU was by far the prettiest campus. It’s gotten even better than when I went there. It’s amazing what a good football team will do for you,” he says.

After receiving his degree, he ended up “going the distance”—medical school, residency and fellowship.

As an undergraduate, he joined the marching band and played the saxophone­ in part to get good seats at games. A true serendipity, though, was marrying one of his band mates. “My wife’s family has had land here since the Land Run, so she wasn’t going to move anywhere. I was OK with that.”

Oklahoma’s “Sooner” nickname stems from the hardy—and quick-footed—“entrepreneurs” who arrived on the scene “sooner” than everyone else when the Oklahoma border was opened for the great Land Run of 1889. The memory of those hardy pioneers is honored before every football game when two white horses, Boomer and Sooner, make the rounds of the stadium pulling a covered wagon, the Sooner Schooner.

But life in Norman doesn’t begin and end in the arena or at the edge of a campus. The city itself, in spite of being a mere half-hour drive to Oklahoma City, with its professional teams and top-notch attractions, has a life of its own, complete with a steady economy. “The unemployment rate is 3.7 percent, the same as before the recession,” reports Don Wood at the Norman Economic Development Coalition.

One of the mainstays is the National Oceanographic and Atmospheric Administration (NOAA) and several related organizations that share space in the 244,000 square-foot National Weather Center building with the OU College of Meteorology.

Several companies are adding jobs, including Hitachi Computer Products, now completing an expansion with a projected total of 375 jobs. Some 700 jobs have sprung from activity in two business incubators.

The health care industry is one of the largest employers. The Norman Regional Health System, with two local facilities and a third just north of the city, is also the umbrella for more than 32 facilities, such as doctors’ offices and outpatient services. City officials like to say of this municipal service that it’s “a stand-alone health system, and people here are proud of that.”

Although a general services hospital, NRHS has carved out several centers of excellence focusing on diabetes, stroke, weight loss surgery, hyperbaric treatments and joint replacement. It was recently cited as the state’s Number One orthopedic service provider by HealthGrades.

It has intensivists on duty around the clock and has recently introduced a service known as “Patient 2 Patient” that allows patients to share their hospital experiences with each other.

Hospital spokesperson Kelly Wells says, “A lot of doctors are from here—and want to be here.”

Wood, at the economic development coalition, likes to say, “Sooners have a passion to provide great services and a great product. There’s something about the State of Oklahoma that’s sticky. There’s something about Oklahoma that makes people want to stay.”

Health Care Facilities:
Norman Regional Hospital: 324 beds
Norman Regional HealthPlex: 136 beds

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THE BUCKEYES
Columbus, Ohio

Learning about the most famous athletes from The Ohio State University does not require a manual, only a map of the campus in Columbus. Jesse Owens Memorial Stadium, honoring the immortal 1936 Olympics hero, is a little west of Buckeye Field. Other sports facilities, including a tennis center, are named for him. The latter is a little south of Woody Hayes Drive, which honors the immortal football coach. Then there’s the Nicklaus Museum, as in Jack the golf great, whose “neighbors” include a 19,500-seat basketball venue, the Woody Hayes Athletic Center and a baseball field.

The athlete-named facilities are just a couple of the campus’s many sports fields and arenas, including an aquatic pavilion, shooting range, ice rink and more.

“I think everybody in Columbus is a sports fan to one degree or another.”
­­—­Tom Ryan, M.D., director of the Heart and Vascular Center at The Ohio State University Wexner Medical Center

“I think everybody in Columbus is a sports fan to one degree or another,” surmises Tom Ryan, M.D., who’s been director of the Heart and Vascular Center at The Ohio State University Wexner Medical Center for the last five years. Ryan himself points out that he’s been affiliated with one university or another since he was 18, starting as a student at Indiana University, followed by 12 years of teaching at Duke, and now a medical administrator at Ohio State. As a result, “I’m a big basketball fan, and I’ve always been interested particularly in college sports.” For that reason, among others, “it was easy to move to Columbus.” However, his decision was mostly influenced by Wexner’s new Richard M. Ross Heart Hospital, “a beautiful new state-of-the-art facility,” and one of five university-connected hospitals.

For the professionally oriented, and like Athens, Ann Arbor and Norman, the Ohio capital is within easy reach of big-time teams in Cleveland and Cincinnati. Columbus itself is home to the Blue Jackets (ice hockey) and the Crew (soccer), which both draw enthusiastic crowds.

Back on campus, a variety of women’s and men’s sports make it easy to follow everything from rowing and swimming to wrestling, gymnastics and baseball. But the size of its stadium alone (102,329 seats) is a giveaway that football is the perennial winner.

Like other universities, Ohio State has its firmly embedded and unique traditions. Two examples: The marching band traditionally practices in the old basketball arena before every game, attracting its own hefty audiences. Then, during the half-time show, the musicians march into its Script Ohio formation.

With a population nearing 800,000, Columbus offers more than enough other entertainment and cultural avenues, among them an arts district, theater productions, concerts and museums, including COSI, the Center of Science and Industry, and the Columbus Zoo and Aquarium.

Columbians are also proud of their special gardens, including the Franklin Park Conservatory with, among others, gardens representing four exotic world regions and a butterfly aviary; and Whetstone Park, with one of the U.S.’ largest municipal rose gardens.

But most unusual is The Topiary Park near downtown, where visitors can enjoy sculpted evergreen figures based on Georges Seurat’s famed painting, “A Sunday Afternoon on the Island of Le Grande Jatte.”

A few neighborhoods are throwbacks to the city’s past. Columbus began as a fur trading settlement in 1797 and, in 1812, a capital that was mostly dense forestland.

That soon changed. As road building proceeded west, the city, with its links to two canals as well, became a transportation hub—and a locale readymade for immigrants, especially Irish and Germans. Today German Village is a window into the past, complete with ethnic restaurants and shops.

In addition, adds Ryan, “We try to take advantage of all the things a big university has to offer culturally.” But culture is almost a sideshow to the educational opportunities provided by a monumental center of learning.

With such gargantuan proportions, it’s hardly surprising that OSU hosts one of the largest and most diverse academic medical centers in the country.

The city is home to seven acute care hospitals, some nationally lauded for quality of care. Individually, they surpass many single-hospital cities in bed numbers. In fact, the hospitals of The Ohio State University Wexner Medical Center admit 58,000 patients a year. That, plus OSU’s research component, is an overwhelming presence, although Ryan points out that “we have tried to move a lot of our clinics and diagnostic facilities out into the community and region to provide more convenient access for patients.” Nevertheless, he mentions that Wexner continues to expand, currently with “a new, $900 million cancer center to open in 2014.”

In the meantime, Wexner has become a leader in incorporating one of medicine’s most recent innovative concepts—personalized health care.

It’s a founding member of the P4 Medicine Institute (“predictive, preventive, personalized and participatory”). The idea is to tailor care to each patient’s unique biology. “Looking to prevent rather than react is at the forefront of what we do here,” says spokesperson Marti Leitch.

Although state government and OSU are huge contributors to Columbus’ economic prosperity, business and industry have carried a heavy load, beginning in the 1870s, when the city became known as the “Buggy Capital of the World,” the Detroit of its day, with at least two dozen factories. Three decades later, it began “upgrading” to aviation, still an economic mainstay.

The flight into modernity continued. Four years ago, Forbes magazine named Columbus the U.S.’ number one up-and-coming tech city.

All of the above could be justification for the state—and university—nickname, officially adopted in 1950. The buckeye tree is an Ohio native. It grows where others can’t seem to make it, is hard to kill and adapts to whatever curves nature throws its way. A speaker in 1833 put it this way: “In all our woods there is hardly a tree so hard to kill as a buckeye.” The message: “Buckeyes are not easily conquered.”

More recently, the nickname has assumed another meaning. Says Ryan, “Everybody I think I know has at least one buckeye tree in the backyard. Good luck, I suppose.”

Health Care Facilities:
The Ohio State University Wexner
Medical Center: 1,229 beds
OhioHealth: Doctors Hospital: 225
OhioHealth: Grant Medical Center: 392
Mount Carmel East: 337
Mount Carmel West: 469
Nationwide Children’s Hospital: 451
OhioHealth: Riverside Methodist Hospital: 826

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THE MAIZE AND THE BLUE
Ann Arbor, Mich.

There’s at least one way that the University of Michigan in Ann Arbor can “outnumber” its old sports rival, Ohio State, even though Columbus dwarfs the city population about eight times over. With 109,901 seats, U-M has the overwhelmingly largest college football stadium in America. Added bench seating made room for the all-time largest crowd, 114,804, when Michigan hosted Notre Dame in 2011.
Numbers aside, stadium information indicates there’s always one “extra” seat honoring H.O. (Fritz) Crisler, the revered coach who helped propel the Wolverines to greatness when he designed the “winged” helmet. The added streaks of blue and yellow helped players identify their teammates down the field.

Loyal U-M alumni have kept careful track of the Wolverines’ statistics vs. their traditional OSU rivals. The rivalry has veered off onto some helpful paths. Instead of destructive stunts, the two schools compete in food bank collections and a “blood battle” benefiting the Red Cross.

But, in spite of the teams’ nickname, the one critter never to be found in a U-M stadium is…a wolverine. There’s no reliable story about its emergence, and most, pardon the word, Wolverines think a mascot is “unnecessary and undignified,” according to the Bentley Historical Library account.

As for sports, fans’ enthusiasm hardly ends with a pigskin ball. In fact, the first organized sport on campus, in 1866, was baseball. U-M triumphed in all three games that year. These days, 28 other varsity men’s and women’s sports can vie for fan loyalty. One major example: “Ice hockey is huge here,” says Christopher Kaiser, an athletics spokesman. “It attracts student players from Canada, Sweden and the rest of Europe.”

Adds Dennis Doyle of the Convention and Visitors Bureau, “We’re hoping [for] 114,000 spectators here for the upcoming NHL Winter Classic.”

Skating prodigies are not the only international arrivals. In fact, it’s said that when former President Lech Walesa of Poland arrived in Ann Arbor as a lecturer, he attended a football game, saw a Royal Shakespeare Company play and heard a Kirov Orchestra concert. Later he exclaimed, “I feel like I’m in the middle of New York City!”

Some 250 bistros, mostly owner-operated, offer unusual foods. There are some 30 independent bookstores, dozens of galleries, the U-M Museum of Art, and the World of Discovery, a 5,000-square-foot “reptile zoo” and rescue center that opened last year.

The city’s pièce de resistance, though, has to be the four-day Ann Arbor Art Fairs held every July, a four-in-one celebration with art works, music and family activities in various areas. The annual attendance hovers around 500,000.

All in all, Doyle assesses the city as “a small, friendly town with big city sophistication.”

A major lure is the U-M Matthaei Botanical Gardens and Nichols Arboretum, which share park and wooded space along the banks of the Huron River flowing through the city. The area is the setting for a possible one-of-a-kind feature—“Shakespeare at the Arb,” presentations whimsically dubbed “moving performances.” Each act takes place in a different location, with audience members following the actors as they move along.

The peripatetic actors, in a rather tenuous way, have something in common with Paul Lee, M.D., JD, whose journeys have taken him from a small upstate New York community to the U-M Medical School to an internship in Boston, residency and fellowship at Johns Hopkins University, then to a first job at the University of Southern California (concurrent with work at the Rand Corporation) and on to a 14-year stint at Duke University. He returned to Ann Arbor in February to accept positions teaching at the medical school and as chairman of the ophthalmology department at U-M’s W.K. Kellogg Eye Center.

His reason for the recent move: “Health care, education and research are going to change a lot in the next few years, and Michigan is set up to take a leadership role. It was an opportunity to come back and work with (highly competent) colleagues, and with folks in engineering and other departments to build new models that we all need (in the future).”

He finds the city itself compatible with his temperament. “I’m a big fan of understanding that everybody has his own desires and passions,” he says, “and Ann Arbor offers a wide range of easily accessible choices for people to follow.” Diversity of restaurants and activities notwithstanding, he cites the diversity of housing and school choices. It’s possible to live in a new or “historic” home, in town, on farmland or at lakeside. Better yet, “All options are within great commuting conditions.” He also mentions high-quality public and private schools, all also in easily accessible locations.

For diversity in sports, Detroit, with Lions, Tigers, Pistons and Redwings, is a mere 40 miles away. For other forms of entertainment, he cites shows, concerts and festivals, especially the Art Fairs.

The University of Michigan Health System had its beginnings with the opening of its medical school in 1850. By the end of the 19th century it had incorporated all four components of modern medicine, including a hospital, nursing school and research department. Its dramatic growth and the dedication of its participants would put it in the forefront of many new treatments and techniques. Recently it was one of the few health care organizations selected to vet the Pioneer Accountable Care Organization (ACO), a model for providing better care while reducing Medicare/Medicaid costs.

The city’s other area hospital, St. Joseph Mercy Ann Arbor, is actually located in nearby Ypsilanti, but notes that it offers, among other services, the U.S.’ leading senior ER program, has Michigan’s most advanced robotic team, provides specialty education to surgeons nationwide and has been named one of 50 top cardiology hospitals in 2012.

Health Care Facilities:
St. Joseph Mercy Ann Arbor Hospital: 537 beds
University of Michigan Health System: 610 beds

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THE RED AND THE BLACK
Athens, Ga.

City Hall in Athens, Ga., sits about 70 miles from Atlanta. Athens is home to more than 400 bands, the University of Georgia, and music and arts festival AthFest.

This is what happens on a football Saturday in Athens, Ga., a city heavy with sports traditions: University of Georgia fans begin arriving in town on Thursday. By game time, the city population has almost doubled to about 200,000. Tailgate parties spread across the campus. Ticketholders swarm into Sanford Stadium (92,746 seats). But never fear! The “unlucky” can view the game on massive TV screens as the Bulldogs, in striking red and black, take on the adversaries.

Not to be overlooked is Uga (pronounced “Ugga”), the legendary white English Bulldog now the ninth generation in a mascot line dating to 1956. Uga is also a familiar face in town as a “spokesperson” for the Convention & Visitors Bureau (CVB), one of whose slogans is “Athens: Life Unleashed.” Subtitle: “Loosen your collar.” The ubiquitous Uga is also a hint that Athens is a super pet-friendly city. For example, one upscale hotel schedules canine cocktail hours—themed cocktail specials for adults and snacks for Fido and Missy.

Starting with baseball in 1886, sports has been a mainstay at the university. But athletics are hardly the only big asset of the University of Georgia, and similarly, while it’s the biggest act in town, UGA is only one important feature of this area near the Blue Ridge Mountains foothills. Nature provides the setting for hiking, biking, and boating on the Oconee River.

For one physician, Georgia born-and-bred Patrick Willis, M.D., the state was too good to leave. He grew up in Brunswick, graduated from Mercer University in Macon and the Medical College of Georgia, then completed residency and fellowship at Emory University in Atlanta, about 70 miles from Athens.

He was well versed in UGA sports by the time he accepted his current position as a cardiologist with Oconee Heart and Vascular Center and affiliated with St. Mary’s Health Care System, one of two hospitals in town. “My wife, a psychologist, and I like Athens as a place where we can raise a family,” he says. “It isn’t a big city like Atlanta, but it’s close enough to a big city when we need to get to it.”

He adds, “It’s a good hybrid, with a good small-town flavor, but large enough that you do get some diversity.” In particular, there’s the diversity of restaurants. “There are a lot of little bistros and a lot of little mom-and-pop shops.”

At the CVB, marketing/communications director Hannah Smith echoes the thought. For a city of its size, Athens can boast restaurants with “nationally known local chefs doing creative things with local products,” she says.

“Several very famous bands got their start here, including REM, the B52’s and Widespread Panic,” Smith reports. “In fact, we’ve become so well-known as a music center that many groups have moved here.”

“There are 400 bands living and working here—and 75 music venues,” says Sandy Turner, the city’s public information officer. “The city of Austin, Texas, is 10 times bigger than Athens, and has the same number of groups.”

Although it’s called The Classic City, with 16 vintage neighborhoods on the National Register, Athens is hardly living in the past. In fact, in a move yielding considerable economies in government, area residents voted to make the Unified Government of Athens-Clarke County the 28th consolidated city-county government in the U.S. It’s a good talking point for businesses considering relocation. “There’s only one government entity to work with,” Turner says.

Still, says Chamber of Commerce president/CEO Doc Eldridge, “The biggest economic event in my time was when we finally got a medical school here.” UGA has entered a medical partnership with Georgia Health Sciences University at the venerable Medical College of Georgia in Augusta. The UGA affiliate opened in 2010 with two upper classes of 40 students each, expanding to a full four-year program this August and eventually to 60 students per class.

It couldn’t have happened at a better time. Georgia is one of the 10 fastest-growing states and already has a severe physician shortage. GHSU is designed to emphasize small group learning and student/teacher interaction and “allows for innovative teaching opportunities,” according to spokesperson Alison Bracewell McCullick.

The medical campus is on the site of a former U.S. Navy school, conveniently located near the city’s two hospitals, St. Mary’s and the Athens Regional Medical Center. Both chose to open intern and residency programs.

A decade ago, in addition to its general services, St. Mary’s began focusing emphasis on five medical specialties most needed in the area. The reason, as public relations manager Mark Ralston explains it: “We are in the belt buckle of the heart and stroke belt of Georgia.”

St. Mary’s also established a Children’s Specialty Services Clinic, where specialists regularly schedule appointments. In general, Ralston reports, the goal is to improve and upgrade all services. “We have dedicated ourselves to being excellent. Our CEO says, ‘Average is not good enough.’”

This may have been a factor in the “huge influx of doctors” in the last few years, as he also reports. And it may play a part in the influx of jobs. Caterpillar, Inc., for instance, is building a new construction equipment manufacturing facility in the area, with a projected labor force of 1,400 by 2020, plus 2,800 supply-chain-related jobs.

The combination of all of the above leads the Chamber of Commerce’s Doc Eldridge to proclaim: “It’s a wonderful place to live.”

Health Care Facilities:
Athens Regional Medical Center: 375 beds
St. Mary’s Health Care System: 196 beds

 

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Here’s to your health!

North, West, East and South, American cities and hospitals large and small are working to ensure better, longer and healthier lives.

By Eileen Lockwood | Live & Practice | Summer 2012

 

In recent years, gerontology researchers have trekked into a remote mountainous region of Sardinia to interview one of the largest groups of long-lived people in any single area of the globe.

How did they stay healthy for such a long time, and what can other populations do to emulate them? Is it gene selection controlled by isolation? In one area, outside contacts have been almost non-existent since the 11th century. Or is it diet and hard work?

As one 103-year-old told writer Jason Wilson, “Everybody wants to know the secret, but there is none.”

That doesn’t quell the search for answers.

PracticeLink selected four “healthy” cities to learn about reasons for their citizens’ robustness, including the role played by medical professionals. Not all of their approaches are quite the same.

Each city and its hospital(s) have developed programs and activities to promote healthy living. But equally important, each in its own way has become a mecca for physicians seeking new locales and challenges.

Good health—or else!
Burlington, Vt.

When 92 percent of a city’s residents say they’re in good or great health, there has to be a reason—or many reasons. In Burlington, Vt., the explanation combination may start with the fact that Vermonters are legendary for their sturdiness. Abundant opportunities for outdoor activity also play a large role. But the trump card in recent years has been an all-out campaign by the medical community to promote wellness practices.

To set the stage, “It’s a very health-conscious town, and a very active town,” says Steven Grant, M.D., an internal medicine hospitalist with Fletcher Allen Health Care (FAHC) for 12 years.

“For the kind of people who want to come here, it’s a little bit of self-selection. They like a smaller place, a place where having the outside is part of their priorities and where it’s not just fast food around the corner.”

In an arrangement unusual for a small city, FAHC is one arm of a medical “empire” including 30 patient care sites in nearby towns and rural sections of Vermont as well as towns across Lake Champlain in northeastern New York State. FAHC is also the teaching hospital for the University of Vermont’s College of Medicine. Both are on the same campus.

“If you were a ‘triple-threat doctor,’” Grant points out, “meaning clinician, teacher and researcher, you could be doing your research, go to the hospital and meet medical students, all right there, all walkable, all in one place.”

Steven Grant, M.D., has been with Fletcher Allen Health Care for 12 years. The hospitalist enjoys skiing, snowboarding, snowshoeing, hiking, running—and mountain biking. The culture and environment in Burlington, Vt., offers numerous outdoor opportunities.

Clinical convenience aside, he talks enthusiastically about the great outdoors and the ease of getting drawn into the skiing, boating and hiking crowd. “Burlington is in a beautiful location—a city on a big lake and surrounded by mountains on either side. You have the Green Mountains here in Vermont, with beautiful rolling hills, and on the New York side, the Adirondacks, which are bigger and much more rugged.” Plenty of outdoor opportunities—and they all meet his good-place-to-live specifications.

Although he went south for medical school and residency at Emory University in Georgia and Charlottesville, Va., growing up in the Detroit area and attending the University of Michigan cemented Grant’s outdoor preferences. “I grew up in snowy winters, and I was a skier. Snow sports were one of the things that definitely attracted me to the Burlington area.” His more recent favorite, though, is snowboarding. “I switched when my daughter (now 14) was just learning to ski. I said, ‘I need to learn something, too, so then we’ll both be learning.’”

But his outdoor pursuits don’t end there. Add snowshoeing, mountain biking, biking to work, hiking and running, plus “doing weights a few days a week.” He concludes, “I like to keep some variety going. And if you ask most of the doctors I work with, they all do the same. It’s just part of the culture.”

The long-term, overriding reason for the region’s good health probably lies in the many and aggressive efforts by FAHC to establish programs encouraging healthy practices by residents. Penrose Jackson, director of Community Health Improvement for the hospital, ticks off some of the initiatives covered by her team, which has grown from about two members in the 1980s to more than 60 now: Poison prevention, child passenger safety, pre-diabetes and diabetes checkups, early hearing screenings for babies and children, tobacco cessation programs. Most ambitious, though, are three more wide-ranging efforts.

Aggressive Community Health Teams teach people to take better charge of their own health and be better proactive patients. “The results have been pretty remarkable around reduction of admissions and readmissions to the hospital,” she reports.

A community needs assessment partnership with other organizations is a brief intervention program available to some 150,000 persons in the hospital’s care area.

FAHC is also a major player in the Vermont Blueprint for Health. It features health teams, including physicians, that establish medical homes so patients can have their care monitored, learn about services they may not have known about and be reminded of routine tests.

Grant’s own career “journey” began with a suggestion from his wife, a UVM graduate, that he might like the town. “I took one look around during a beautiful sunny day,” he reminisces, “with all of the Christmas lights on downtown in our cobblestone-street mall, and I said, ‘Yeah, I think this town will do for me.’”

The influence of students and faculty from the city’s colleges has generated a lively town atmosphere that includes unusual restaurants, concerts by nationally known groups and a large jazz festival every summer. Grant points out that there’s plenty of big-city activity just an hour and a half away in Montreal. As he summarizes, “It really is a paradise of different opportunities that you can have here.”

Though colleges and the hospital are the mainstays of the local economy, the Burlington region supports almost one-third of Vermont’s manufacturing employment, which includes everything from electronics industries and health care software to the Vermont Teddy Bear Company, now a worldwide provider of the cuddly pets. The area is also headquarters for one of the largest commercial oven companies in the U.S., a snowboard manufacturer and Bruegger’s Bagels.

As for the city’s “hale and hearty” status, the secret is out. Gallup-Healthways surveys cite it as one of America’s Top 10 well-being smaller cities. Among other kudos, Men’s Health Magazine has christened it number one.

The lure of the ocean
Oxnard, Calif.

After working several years in Palm Springs, Calif., including a few as assistant medical director of the Desert Regional Medical Center there, Jeffery Davies, D.O., answered to the call of the sea—and an excellent job opportunity. A year ago, he relocated to the Oxnard area, where he accepted the position of chairman and medical director of the ER at St. John’s Pleasant Valley Hospital in Camarillo, the sister institution of St. John’s Regional Medical Center in nearby Oxnard.

“My wife is from this area,” Davies explains, “so that’s probably the biggest pull. I wanted to be closer to her family, closer to Los Angeles (about 60 miles away)—and to the ocean. I thought, ‘This is the place I could live for the rest of my life.’” Lifestyle possibilities and his professional goals seemed to be in sync.

Jeffery Davies, D.O.

With a recent change in hospital leadership, the goal, he says, was to rehaul the entire medical system and upgrade the quality of care. “I liked the chance for problem solving and to grow the ER,” he says.

Davies cites upgraded cardio procedures as one good example of the new regimen. Medical involvement doesn’t stop when atrial fibrillation patients go home, he says. “Now we’re trying to improve communication with their primary physicians every time they come into an ER situation. For every single patient, an automatic copy of the procedure is sent to his or her physician, including every single medicine we’ve prescribed. We also have an educational discharge program,” he says.

Promoting good health is an ongoing activity throughout the St. John’s domain, such as through anti-diabetes and obesity education programs among youths and a Healthy Beginnings program for mothers-to-be.

A perfect growing climate enticed farmers to the area, and at the nearby Oxnard Harbor District, the Port of Hueneme attracted the attention of the U.S. Navy in World War II and major shippers after that. Today, cargo worth some $7 billion passes through every year, and 4,500 jobs in the county are related to these shipping activities.

Green technology and recycling are also part of the area’s fabric. Two examples are the greenhouses of Houweling’s, where probably billions of tomatoes are grown hydroponically under glass, and Gills Onions, one of the U.S.’ largest family-owned onion growers. Then there’s Agromin, a huge “organic management” company that produces “rich, living compost,” mulch and other top-notch products for farmers in the area.

“In Michigan, the place shuts down in the winter, and there’s pretty much nothing you can do,” Davies says. “Here you can get out every day and walk and hike and play golf and do all the other great outdoor things.” Not to mention excursions up the coast. As he says, “It’s a great, great opportunity and a great location. I was handed a golden gem. It’s called the Gold Coast for a reason.”

Along “Tobacco Road”
Raleigh, N.C.

In spite of being one of the country’s largest tobacco-raising regions, the North Carolina “Research Triangle” of Raleigh, Durham and Chapel Hill is viewed as one of the healthiest areas in the state, according to Alan Wolf, the media relations coordinator at Rex Healthcare, one of three large hospitals in Raleigh. Each city is home to a major university well-known for its strong scientific investigations.

The Gallup-Healthways sleuths have dubbed this City of Oaks (nicknamed for its many trees of the same name) one of the healthiest large cities.

A good place to pinpoint some reasons might be the Senior Health Center operated by Rex Healthcare in southeast Raleigh. Its director since 1985, Leroy Darkes, M.D., has been an energetic crusader for wellness among a large African American community. An Atlantic City native with undergrad and medical degrees from Rutgers University, Darkes made his way South after several frustrating years with HMOs in Camden, N.J.

At that point, he reminisces, “I got a call to come down to Raleigh, and I came out of curiosity.” His reaction to a Rex offer: “I was actually thrilled.”

The assignment was to develop an inviting medical “home” that would provide treatment and tests, plus instruction on healthy living. “My mission,” he says, “was to build some bridges in the community that really had felt disenfranchised—and to be consistent and persistent.” At a gathering to discuss goals for the new center, one participant was the general manager of a local radio station. “I’ll get you on the air once a week,” he promised Darkes. Here was a golden opportunity to connect with potential patients and explain benefits of the facility.

“Long story short,” says Darkes, “I’ve done more than a thousand hours of community broadcasting. It has become a significant staple as far as dissemination of essential information. Once folks started calling in, it became rather addictive.” Before long, he was explaining his mission from the pulpits of churches, enlisting civic organizations to help promote men’s awareness of, among other things, free prostate screenings. Screening sessions were set up at churches. “I chose prostate as our vehicle,” he reports, “but the principle could be (and was) applied across the board.”

Twelve acres of woods, gardens and lake comprise the grounds of the Umstead Hotel and Spa in Cary, N.C., just outside Raleigh.

Besides Rex Healthcare, Raleigh is home to two other hospitals, each promoting better health practices.

WakeMed Health & Hospitals has been aggressive in developing new treatment methods and speedier access to necessary care. It opened North Carolina’s first freestanding children’s emergency department, and has a dedicated ICU, both staffed 24/7 by pediatric intensivists. Among adult services, it became an early participant in mothers’ milk banks, has one of the highest-volume heart centers in the U.S.—and the sole neuro-ICU in the county.

Duke Raleigh Hospital, a sister facility to the large Durham institution, offers a variety of better-health activities, events and lectures, holds an annual community education event focusing on heart disease, a free-care clinic for uninsured adults and special diabetes programs for women and the Hispanic community. It also sponsors a weekly farmers market from April to November.

Rex Healthcare, opened in 1894, derives its name from an 1800s tanner, John Rex, who bequeathed building funds. Today’s mix includes a satellite in nearby Cary. Besides Darkes’ senior center, Rex’s activities include a few other good health stories. For instance, thanks to a chef’s initiative, all fryers were removed from the kitchen in April, the first such action in the state.

All of the above are enhancements to the beauty and charm of North Carolina’s tree-filled capital. Gracious Victorian and early 20th-century homes dominate a 30-block area, Historic Oakwood, where spring and Christmas tours are reminders of the gracious days of yore.

Children might yawn among Victorian houses, but not in Pullen Park, a downtown green area with kiddie-style train and 1911 carousel. There’s a lake with pedal boats and other rides. The park borders the Pullen Aquatic Center and a hiking trail, additional enticements for healthy activities. The Greenway network system is also a popular walking and biking area.

For the culturally inclined, Raleigh provides theater, ballet, symphony and opera—but the Triangle has a clamp like no other area on the college basketball scene. From North Carolina State University in Raleigh itself to Duke University in Durham, the University of North Carolina in Chapel Hill and Wake Forest University in Winston-Salem, the “Big Four” routinely reach NCAA tournaments. Fans respond accordingly. And—big surprise—the territory linking this quartet has an appropriate nickname: Tobacco Road.

The Iowa Way
Cedar Rapids, Iowa

“Iowa has the richest land, the lowest illiteracy rate . . . and the most moral and forward-looking cities of all the States.” That’s a quote from Sinclair Lewis’ Arrowsmith, the Pultizer Prize-winning novel about a young Midwestern doctor trying to make his way through a career life more complicated than he had expected. Its copyright is from 1924.

The world today is 1,000 percent different from the era Lewis wrote about. But to a certain degree, the description of Iowa still seems apropos.

Stanley Mathew, M.D., can attest to it. Mathew, whose parents immigrated to New York City from India, has had a much more cosmopolitan upbringing than the young Martin Arrowsmith. His medical degree is from the Medical University of Lublin, Poland, followed by residency at New York Medical College. Along the way to his current position at St. Luke’s Hospital in Cedar Rapids, Iowa, he co-founded a firm that, as he describes it, conducts clinical trials and services pharmaceutical clients in drug discovery and development.

Seeking work in 2009 after his residency, he learned of an opening with St. Luke’s. From the beginning, it was a fit. “I came out for an interview that went phenomenally,” he reports. “New York City is a great place. I never thought I’d leave, but when I finally moved to Cedar Rapids, I couldn’t believe how nice, accommodating and warm the people were. The New Yorker in me thought it was all a façade, but the longer you live here, the more you realize it’s the real deal.”

Stanley Mathew, M.D., did his residency in New York City—and never thought he’d leave it. But after an interview brought him West, he made his home in Cedar Rapids, Iowa.

Among other discoveries: “There are more bike trails and joggers than I have ever seen. There are a lot of very nice parks in the area that have great walking trails.” This lifestyle coordinates well with his specialty, physical medicine and rehabilitation. “We talk a lot about exercises,” he says. Mathew follows his own advice, taking advantage of “more opportunities to be outdoors, going for hikes and heading to the gym a few times a week.”

The city itself, second largest in the state, offers a multitude of opportunities for outdoor exercise and fun, including 74 parks, miles of trails, golf courses and aquatic centers. Opportunities multiply at the nearby Pleasant Creek State Recreation Area for hiking, biking, snowmobiling, cross country skiing and horseback riding.

It all verifies the area’s high ratings in the annals of healthy cities. So does RAGBRAI, an acronym for the Register’s Annual Great Bike Ride Across Iowa.

In the meantime, numerous good-health incentives are incorporated into the general routines at both Cedar Rapids hospitals, St. Luke’s and Mercy Medical Center. Among other efforts, Mercy schedules adult vaccinations in its lobby, has held a Save Your Lungs event at a local mall and was the first hospital kitchen in the region to replace its deep fat fryers with convection/steamer ovens.

St. Luke’s “healthy roster” includes programs on childhood obesity, blood pressure checks and fund-raising walks. “There’s also a nice track on the hospital’s third floor,” reports Sarah Corizzo, the media relations specialist. “It’s mostly for heart rehab patients, but city people can use it, too.”

If Mathew needed any additional proof of hardworking, indomitable Iowans, his best example could be the city’s recovery efforts after its worst-ever flood of 2008, when water rose 31.12 feet and inundated more than 7,100 properties in a 10-square-mile area, at least 14 percent of the whole city. Four days later, 2,680 local residents attended three public open houses to discuss plans for recovery, reinvestment and revitalization. Four years later, several new and rehab projects are complete, and the work continues.

Says Mathew: “Over the last two years, the city has become more vibrant, with more restaurants and stores opening up in downtown, and the rest of the city is still growing and doing well.”

Business and industry are also doing well. Cedar Rapids is noted as the largest corn-processing city in the world, not a surprise to anyone who has passed farm fields in late summer. It’s also the second-largest producer of wind energy in the U.S., and one of North America’s leading bio-processing and food ingredient centers. But the best news may be that employment is expected to grow 14.2 percent within three years, the strongest forecast of any American metro area.

Also alive and very well is its cultural and recreational life. The city is part of the Iowa Cultural Corridor Alliance, which includes 150 organizations in 11 eastern counties. Orchestra Iowa has been a staple since its founding in 1921. There are performances at the opera theater and plays in at least four theaters. A children’s museum keeps company with others devoted to history, African American culture, art and collectible cars, as well as a museum and library devoted to the state’s large Czech and Slovak heritage.

And, just for fun, there’s the whimsical Cedar Rapids slogan: “City of Five Seasons.” It all started in 1968 when an advertising agency touted the city’s short commute time as evidence that there’s more time for enjoying life—a fifth season.

Eileen Lockwood is a frequent contributor to PracticeLink Magazine.

 

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Lincoln slept here

Across the continent, some U.S. cities are proving they can keep faith with the fascinating past while they move into the roaring present - and the health care of the future.

By Eileen Lockwood | Live & Practice | Spring 2012

 

What makes a place historic?

A hard-and-fast definition is elusive, but here are some likely possibilities. Maybe an important event took place there, such as the turning-point battle in Gettysburg, Pa. Or maybe it was the starting point of a significant expedition, such as the three-year Lewis and Clark Voyage of Exploration that departed from St. Charles, Mo. Perhaps it’s America’s oldest continuous state capital (Santa Fe, N.M.), or the seafaring tradition of Mystic, Conn.

These are four examples of cities whose residents take pride not only in maintaining their historic ambience, but also in working to move into the modern world.

With the exception of Mystic, which has a walk-in clinic, each supports at least one state-of-the-art health care facility with frequent employment opportunities for physicians. more »

 

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Golf Spots- Of birdies, mulligans and holes-in-one

For fairway fiends, here are four cities representing diversity in geography, size and climate, not to mention a surprising variety of fairways and greens

By Eileen Lockwood | Fall 2011 | Live & Practice

 

Amid the hustle and bustle of Indianapolis, one of America’s most thriving cities, it may be hard to believe that there are acres—and acres—of well-groomed greens where physicians can spend hours swatting little white balls. The fact is that there are some 35 PGA-recognized golf courses within the Marion County boundaries, with about 20 just a few miles beyond.

In another context, the city is hardly lacking when it comes to health care. The list covers no fewer than 11 full-service hospitals, from IU Health Methodist to St. Francis Hospital—Mooresville. The university is home to the state’s sole medical school, the nation’s second largest (after Illinois).

But the overarching appeal of this Midwestern metropolis may be its rejuvenation as a thriving place to live, practice and enjoy life. It’s been enough to convince Stephanie Wagner, M.D., that it was time to come home after years of training and practicing in other cities. “I felt there was more of a vision here as far as my specialty,” she says. Wagner is a neuro-oncologist with IU Health Physicians and the medical director for the neuro-oncology program at IU Simon Cancer Center and IU Health Methodist Hospital—and one of two such specialists in the state. “I think in the last five years it’s changed so much for the better. It’s become more progressive and a little more diverse.”

Three other American cities across the country are among communities that offer the best of two worlds for physician golfers. more »

 

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