Riverside, CA – Orange Groves and Beyond

In Riverside, of California's Inland Empire, "green" is replacing "orange" as the dominant color - including verdant pastures for physicians.

By Eileen Lockwood | Live & Practice | November/December 2008

 

Built between 1902 and 1932, and now considered to be Riverside’s “symbol,” the Mission Inn is a masterpiece mixture of Mission and Spanish Revival, Moorish, and Asian architectural styles.

Built between 1902 and 1932, and now considered to be Riverside’s “symbol,” the Mission Inn is a masterpiece mixture of Mission and Spanish Revival, Moorish, and Asian architectural styles.

You could say Riverside’s march to prosperity started with Mrs. Eliza Tibbets. In the early 1870s she planted two navel orange trees sent from the U.S. Department of Agriculture.

Citrus growing wasn’t new to California’s Inland Empire, now made up of San Bernardino and Riverside Counties, 50 miles west of Los Angeles. Missionaries planted oranges around 1800, and lemon growers helped stave off scurvy among Gold Rush prospectors. But Mrs. Tibbets’ trees were special—Brazilian Bahia navels—with the sweetest flavor around and, another plus, no seeds.

The orange trees loved the climate and soil, and soon more and more people were loving their fruit. Groves spread throughout the region, and California’s Second Gold Rush was off and running.

The juicy crop went national when rail service arrived, and the first commercial refrigerated freight shipment proceeded to points near and far in 1887. California citrus groves multiplied from 3,000 to 40,000 acres. In 1893, growers organized a co-op that would become Sunkist Growers, Inc. Riverside became known as the Citrus Capital of the World. more »

 

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Upper Valley Area, NH – New England Gem

The Upper Valley of New Hampshire and Vermont offers diverse employment and pace of life

By Lisa Rogak | Live & Practice | September/October 2008

 

Looking down onto Quechee Gorge (known as Vermont's Little Grand Canyon) from Vermont's oldest standing steel arch bridge on Route 4, which spans the 165-foot chasm.

Looking down onto Quechee Gorge (known as Vermont's Little Grand Canyon) from Vermont's oldest standing steel arch bridge on Route 4, which spans the 165-foot chasm.

Simply put, most people who live in the Upper Valley area of New Hampshire and Vermont consider themselves to be thoroughly spoiled. The region is rich in everything you’d ever want: small-town life, lots of four-season outdoor activities—summer’s hiking trails become winter’s cross-country skiing trails—a surfeit of culture, great food, unique shopping possibilities, intellectual stimulation, and last but not least, friendly people. Quaint little towns and old-fashioned general stores dot the region, heralding a view to a bygone agricultural era that’s still alive and kicking.

The towns that make up the core of the Upper Valley—Hanover, Lebanon, Lyme, and Enfield on the New Hampshire side, and Norwich, Hartford/White River Junction, Thetford, and Hartland in Vermont—vary widely in terms of real estate, culture and population. For instance, Hanover is home to many Dartmouth College professors, so there’s a real intellectual air that permeates the town, but come fall weekends, football fever predictably reigns. Though it’s right next door, Lebanon has more of a melting-pot feel to it demographically speaking. It’s also the one town in the region with the most national retail chains, on Route 12A in West Lebanon, which parallels the Connecticut River. Lyme boasts to numerous horse farms and second homeowners while Enfield is generally regarded as suburban. more »

 

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Upper Peninsula, Mich.—Call of the Wild

Never mind it's reputation for snow and cold. The Upper Peninsula is a Valhalla for outdoor aficionados and the independence-minded who revel in small town solidarity but embrace modern medical technology.

By Eileen Lockwood | Live & Practice | May/June 2008

 

Gateway to the UP, Mackinac City overlooks the harbor.

Gateway to the UP, Mackinac City overlooks the harbor.

Anyone with less than a B.A. in geography might think of Michigan’s Upper Peninsula as a kind of Bali Ha’i, that mysterious “special island” hidden in the mist.

The more knowledgeable might recall this 16,452-square-mile piece of real estate as a territorial leftover the state got stuck with after losing the so-called Toledo War in 1836. Giving up a thin strip of northern Ohio was the price Michiganders paid for statehood. Most thought no good would come from owning this region cut off from “civilization” by cold Lake Superior, Lake Huron, Lake Michigan, and—more logically—part of Wisconsin. Some said its weather could be defined as “ten months of snow and two months’ poor sledding.”

Skeptics would soon discover the advantages, and, much more recently, so would some enthusiastic physicians from other parts of the U.S., some with nostalgic childhood memories. Richard Armstrong, MD, grew up, coincidentally, in Toledo. “My uncle,” he fondly recalls, “used to spend time at a cabin near Black Lake. I liked Northern Michigan probably better than anywhere I ever went as a kid. One morning, (a recruiter) called me. She kept going on and on about this great opportunity in the Midwest in a beautiful recreational area on the Great Lakes. I said, ‘Where is this?’ She said, ‘In the Upper Peninsula of Michigan. Now don’t hang up.'”

The opportunity was in Ironwood with another doctor practicing solo after his father’s retirement. “I flew up from Chicago. He took me out to a fish fry in a local bar.” The next morning, they talked business, inspected the hospital, and Armstrong agreed to make the move. But, the clincher, as he describes it, was “the solitude, pine trees, sand, smell of the trees, the lake like glass, the sun coming up in a mist. They reminded me of my feelings when I was a teenager, and I guess it was that, more than anything, that persuaded me to come. more »

 

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Towns of Central Penn.—Pennsylvania Refuge

Physicians in many specialties have found they can enjoy small-town life and big-city practices in central and southern Pennsylvania.

By Eileen Lockwood | Archives 2007 | Live & Practice

 

“We used to talk about being in the middle of nowhere. Now it’s the middle of everywhere.” That’s how Joseph Bisordi, MD, describes the demographics in southern and central Pennsylvania. In fact, he says the whole state is unique, at least in one way:  “It has the most people living in places with less than 2,500 population, the U.S. government definition of a rural town.”

Scores of towns in this area fit the description and are often named for their founders, such as Wernersville (pop. 1,934) and Campbelltown (pop. 1,609). Comedians like to joke about going through Intercourse (pop. 1,200) to get to Paradise (pop. 1,043).

Pennsylvania Hills

Pennsylvania Hills

There are “big sisters,” too. Harrisburg, Reading, and York add a metropolitan flavor to this region that’s been described as an area of fertile fields, rolling hills, and sparkling streams. The Appalachian Mountains rise along the western part of the region.

In Danville, population 4,897, Bisordi, a nephrologist and the chief medical officer at Geisinger Health Center, believes he’s found the perfect setting for his practice and his life.

Bisordi well remembers his first encounter with Geisinger, a huge complex complete with 394-bed hospital, extensive residency program, and state-of-the-art research facilities. “A friend from Georgetown was coming here for an orthopaedics residency. He said, ‘It’s one of the places you ought to think about, a different model, a full-time clinical faculty dedicated to patient treatment.’ I really was surprised at the opportunity to learn directly from specialists. And the interview wasn’t a perfunctory session with one physician, but a whole day with five or six. It was clear to me that I wanted to be in this kind of high-clinical setting.”

Thirty-two years later, he’s still convinced it’s the right place for him. “I wanted to be, in New York vernacular (he’s a native), a maven, an expert, and to be in a place that had a critical mass of specialists who could provide care for my patients.”

Often likened to the Mayo and Leahy Clinics, Geisinger reached its current zenith gradually, but it all started with a gift from one woman. Abigail Geisinger, the 88-year-old widow of iron magnate George F. Geisinger. The hospital opened in 1915 with one operating room, seven nurses, and 70 beds. Geisinger Health System now encompasses three hospitals, 38 community practice sites, and some 12,000 employees. Physician recruiter Elaine Tomaschik jokes, “Geisinger employs more people than there are living here (in Danville).”
John Bulger, DO, a Geisinger hospitalist, makes a distinction, though:  “We’re rural, but we’re not frontier.”

Not your rural stereotype
The sophisticated rural environment suits these physicians. Bisordi says, “I spent the first 20 years here raising a family. I coached my son’s soccer team for 13. I could go to a game and be back at the hospital in five minutes if I was needed. I love the commute!” Not only that, “In New York (my son) would have had to be a top college prospect to make a high school basketball team. Here he could participate without that kind of competition keeping him off of a team.”

Bulger grew up in rural Martinsburg, PA, but got his fill of dense population while studying at the Philadelphia College of Osteopathic Medicine and completing a residency in that city. “In Philadelphia,” he grimaces, “every time I get on the Schuylkill Expressway I thank my lucky stars that I’m here. And, by the way, I can see the stars here at night.”

 

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Cleveland, Ohio – Rockin’on the Lake

By By Julie Sturgeon | Archives 2005 | Live & Practice

 

When the health-care industry employs more people than any other in the city, you know that’s a place to which doctors gravitate.

But what if we told you we’re talking about Cleveland, Ohio?

This is the city once dubbed the “mistake by the lake” after the Cuyahoga River tributary of Lake Erie caught fire and burned in June 1969, thanks to the petrochemicals dumped there by Ohio cities. But Cleveland has cleaned up its act and its reputation. Today, just as many other Midwestern cities, it’s chugging along in relative obscurity.

“People aren’t just going to look at a map of the United States and say, ‘Well there’s a place I’d like to be,’” admits Andrew S. Bowers, the director of recruitment and credentialing at Kaiser Permanente. Indeed, he recruits his fair share of BLTs—code for “born, licensed, or trained in Ohio”—because “obviously those people have ties to the area and know something about it already. But when people do not, they’re very pleasantly surprised about what they see here,” he says.

Cleveland Lakefront

The centerpiece of Cleveland’s shimmering lakefront is the Rock ‘n‘ Roll Hall of Fame and Museum.

That’s why Amy Georgalis, the administrative director for medical management and physicians’ services at Marymount Hospital, recently landed a recruit who chose Cleveland over the sexier Orlando, Florida. Bowers likes to troll for candidates in California and New York because “there are so many people in those two states who aren’t from there anyhow and jobs aren’t as plentiful there.” In other words, they’re ripe for the picking.

Gerard Isenberg, MD certainly represents that population. He and his wife arrived from southern California for his residency in gastroenterology and fell in love with the city. “It’s quite a secret jewel,” he says. “Housing is extremely affordable, many neighborhoods have mature trees, manicured lawns and quiet streets.”

“This is an old community—and I speak for the Detroits, Pittsburghs, Clevelands of the world,” says Robert Coulton, the administrator of professional affairs at The Cleveland Clinic Foundation. “Residents have been here for a long time, so they’re stable. They’re insured. They’re working and they value quality health care, value the practice of medicine the way it’s been practiced for a long time.”

Tuning up
University Hospitals Health System and The Cleveland Clinic Foundation are the largest systems in the city. The Cleveland Clinic alone encompasses nearly 1,000 beds across 10 hospitals, employs more than 1,700 physicians, and supports one of the largest graduate medical education programs in the country with more than 800 students currently enrolled. Modeled after the Mayo Clinic–in fact, the Mayo brothers attended the grand opening in 1921–the clinic is essentially a group practice that owns its own hospital, research institute, medical school, and graduate program. “The idea was for a group practice of physicians to teach younger colleagues and conduct research. They each drew a salary and the rest of the proceeds go back to building the practice,” says Coulton “That’s continued for 80 years without any real change.”

University Hospitals Health System looks remarkably similar:  One of its trustees, Samuel Mather, visited Johns Hopkins hospital and medical school in 1981 and returned home fired up to follow in its footsteps. So today, UHHS’s tertiary medical center, University Hospitals of Cleveland, is the primary affiliate of Case Western Reserve University. Together, they claim to form the largest center for biomedical research in Ohio. UHHS has approximately 25,000 folks on its payroll (including physicians) who operate 11 hospitals and “centers of excellence,” such as the Rainbow Babies and Children’s Hospital, Ireland Cancer Center, and MacDonald Women’s Hospital.

 

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