Ever since it was established as the capital of Indiana in 1820, Hoosiers have been building roads to Indianapolis. Rustic highways cut through native forests and prairies and, later, a mammoth canal system that became swamped by its debts were residents’ early efforts to plug Indianapolis into the grid of national commerce. An intricate railroad system, then an inter-urban network, and finally the highways and interstates of today, have made Indianapolis a crossroads not only for the state but also for the nation.
Indianapolis: Small-town tradition and big-city innovation
Firmly planted in this country’s fertile Corn Belt, Indianapolis enjoys a prosperity borne from Hoosiers’ longstanding ability to adapt to change. One need not look long to recognize that Indiana’s agricultural and small-town traditions are equal contributors with dynamic innovation and inventiveness in this thoroughly modern urban center.
Four major interstate highways meet here in the Circle City, more than any other American city. That, combined with the fact that more than 65 percent of the U.S. population lives within a 700-mile radius of Indianapolis, is why the Chamber of Commerce boasts that Indianapolis is one of the country’s most accessible cities.
Convention and trade-show holders and visitors regularly find their way here, bringing $188 million into the city at last count in 1996. A $45 million expansion at the Indiana Convention Center and RCA Dome is underway to accommodate even more conventioneers. In addition, Indianapolis is the headquarters for leading pharmaceutical manufacturer Eli Lilly and Company and other international companies such as Thomson Consumer Electronics/ RCA and Boehringer Mannheim Corporation, providing inroads to the global economy. As the site of United Airlines’ new $800 million maintenance facility, as well as the state’s only medical school, at Indiana University, and home to the NFL Colts and NBA Pacers, Indianapolis is undeniably a business, medical, and sports mecca on the prairie.
Thirty years ago, however, Indianapolis was a case study in the deep decline of urban America. The central city, home to state government, was losing shops and commercial offices while the suburbs exploded. Crime was increasing as city services faltered. Its unflattering nicknames—the Brickyard and Naptown— were painfully apt.
Former Mayor Richard Lugar, now a U.S. senator, helped turn things around when he succeeded in pushing through the consolidation of city and county government in 1970. The city’s Uni-Gov system eliminated duplication of services inherent with the old, overlapping systems, introduced private sector competition for the provision of government services, and positioned Indianapolis as a model in the “reinventing government” movement.
Not always a hometown booster, Indianapolis native Daniel Lueders is pleased with the way his hometown has developed over the last two decades. “Frankly, when I went away to college in Chicago, I never thought I would come back,” says Lueders, a 1983 graduate of Northwestern University School of Law.
“Fortunately, the city has sort of grown up over these years, and everything is better. There are the major sporting events, the symphony has gotten a lot better, there are more restaurants. It just has all the things that go along with having more people,” says Lueders, who works as a patent attorney.
New construction is changing the Indianapolis skyline. The $175 million Conseco Fieldhouse, a downtown multiuse arena designed to look like a high school fieldhouse, will be home to the Indiana Pacers as well as other entertainment events. New hotels, restaurants, and businesses are being built downtown and early next summer, the Soldiers and Sailors’ Museum will become home to the Col. Eli Lilly Civil War Museum. The $1.5 million addition will present true-to-life vignettes built around letters, photos, and diaries of Hoosiers who participated in the Civil War.
In White River State Park, Indiana’s first urban state park located on 250 acres in downtown Indianapolis, construction has begun on two major attractions. On a three-acre site in the park, the National Collegiate Athletic Association (NCAA) is building a new 160,000- square-foot national headquarters and a 40,000-square-foot Hall of Champions museum. Indianapolis native and internationally known architect Michael Graves is lead designer of the $50 million project.
At the Indianapolis Zoo, also in the park, work continues on a $14 million 5,000-square-foot conservatory and White River Gardens, which will anchor a new entrance to the zoo and connect the park with a promenade along the river’s west levee. White River State Park also is home to Eiteljorg Museum of American Indians and Western Art, the National Institute for Fitness and Sport, and Indiana’s only IMAX 3D Theater.
Central Canal Walk is a 10-1/2 blocklong, 19th-century canal that features some of most beautiful spots in downtown for walking, bicycling, and paddleboating. Built in 1839 as part of a plan to crisscross Indiana with 400 miles of canals, the capital city’s portion languished for 150 years after the debt-ridden state abandoned it. In 1984 the canal was renovated.
Other must-sees on Indianapolis’ museum roster are its Children’s Museum, the largest of its kind in the world, and the Indianapolis Museum of Art, which is among the oldest art museums in the U.S. It features a 52-acre park including gardens, five pavilions, a lecture hall, theater, concert terrace, restaurant, shops, and greenhouses.
Although the Indianapolis 500 isn’t actually in the city, but in the western suburb of Speedway, the world’s largest single-day sporting event brings the world’s spotlight on Indianapolis each Memorial Day weekend. Visitors to the Indianapolis Motor Speedway Hall of Fame Museum can see more than 30 Indy 500-winning cars and take a bus tour around the track when it’s not in use for racing or testing.
The speedway is getting a facelift too, with construction of a 160-foot-tall tower to house electronic and public address equipment. Replacing the 70-foot-landmark, the new tower will resemble the historic pagoda structures that stood at the track before the 1950s.
At the Indiana Basketball Hall of Fame in New Castle, about 30 miles east of Indianapolis, visitors revel in another of the state’s sporting passions with videos and artifacts depicting famous high school players and their great moments.
Practices and hospitals in Indy
Mergers and new partnerships are the name of the game as practices and the city’s major hospitals reposition themselves in the managed-care environment. For several years, the organizations have been expanding in the city and beyond, creating opportunities in both primary care and the subspecialties.
The four-hospital system of Community Hospitals Indianapolis and St. Francis Hospital and Health Center, which has two hospitals, are awaiting approval of a proposed partnership. Driven by the demands of managed-care systems, the partnership would give its physicians “more access to referrals and resources, and strength in managed-care negotiations,” says Mary Ellen Wolfsie, Community Hospitals’ vice president of marketing.
Wayne Michael Ellis, MD, a pediatrician and internist, began working for St. Francis Medical Group’s Fairland office in Shelby County, east of Indianapolis, in June. He’s fulfilling his commitment to work for three years in an underserved community in return for the Indiana Primary Care Scholarship Program that paid most of his tuition at IU Medical School.
Ellis is happy with the size of the group and the hospital, especially after interviewing with several smaller communities. “With pediatrics, it’s hard to find a hospital large enough that wouldn’t want you there all the time to deliver all the babies. At St. Francis, I’m in the office most of the time and I’m only at the hospital to cover for my partners.” The only drawback to St. Francis, Ellis says, is its lack of pediatric subspecialties, requiring him to refer patients out of the St Francis system. “When that happens, I’m not able to follow the patients,” he says.
In January 1997, the Indiana University Medical Center, which includes Riley Hospital for Children and Indiana University Hospital, merged with Methodist Hospital of Indiana. Under the new name Clarion Health Partners, the organization has since acquired hospitals in LaPorte County, which is southwest of South Bend, and in Bedford. Clarion also has a management contract with Tipton County Memorial Hospital, 30 miles north of the city, and runs a managed care-system for Union Hospital and Health Group in Terre Haute.
While each hospital has its own recruitment office, Deb Davis of Clarion’s marketing department, says there are opportunities for physicians in all specialties within the large Clarion system. Pediatric subspecialists can find their niche at Riley, the largest intensive care children’s hospital in the country and home to the state’s only pediatric burn unit, or at Methodist Children’s Hospital within Methodist Hospital. “Both hospitals are well-established in pediatric care, and we are able to make a
unique offering to parents and children who need care in those types of specialized situations,” Davis says.
Last March, St. Vincent Hospitals and Health Services challenged Clarion’s hegemony over pediatric care by opening its own pediatric unit.
“We did it because of a number of requests from payers, from private pediatricians and from hospitals in the surrounding counties throughout the state,” says Philip N. Eskew Jr., MD, the medical director of St. Vincent’s Women and Children’s Services Line. “We’re doing some things that are unique,” he says, referring to the establishment of the state’s only pediatric rehabilitation hospital for long-term and acute care and the organization’s plans to create a pediatric hospice.
Even though he’s filled most of the subspecialty positions at St. Vincent, Eskew says Indianapolis in general “has great opportunities for pediatrics.
“[Indianapolis] has a lot of young people living in this area with young families and it’s a growing community. Conventions are big here, sports and cultural opportunities are great, and with new businesses like United’s project at the airport, it’s going to keep expanding,” Eskew says.
Over the past five years, St. Vincent also has been building a network of primary- care physicians within a 60-mile radius of Indianapolis, and owns or operates several small, community hospitals. It is also in the process of establishing relationships with rural health-care centers to provide services to the poor.
“We believe the (physician) market in Indianapolis is pretty saturated,” says John Ayers, MD, JD, the vice president of St. Vincent’s Network Development and Primary Care Network and an internist. However, he says the rural practice opportunities he has to offer aren’t that remote.
“I could take 10 primary care physicians to communities within 45 minutes of a metropolitan area like Lafayette or Columbus,” Ayers says. The problem for recruiters, according to Ayers, is that most physicians want to practice in larger communities, similar to the cities where they’ve studied. “After university, med school, and residency, you’ve been in a big city 10 to 11 years, and it’s difficult to pull up roots.”
Ayers says that by associating with a system like St. Vincent, doctors who do venture out to rural communities have the security of a larger organization behind them. “With the volatility of reimbursements right now, we can stabilize that and even provide income guarantees. We also provide access to benefits and office technologies that you couldn’t buy in private practice,” he adds.
Family comforts in Indianapolis
Urologist John Ramsey, who has been in specialty group practice in Indianapolis since 1992, says he enjoys the best of Indianapolis both professionally and personally. In his group practice, he sees patients at seven different office locations in the city and outlying communities. “We’re often petitioned to provide more services for more communities,” he says of the rural demand.
“I do the simpler surgeries in the county hospitals, but for the more complicated procedures, we bring them to St. Vincent’s. We do fertility work at [Columbia] Women’s Hospital, and we use the lithotriptor for stones at Methodist Hospital.”
Ramsey has strong family ties to the area. His wife is from Indianapolis and his in-laws live in the downtown historic Lockerbie Square neighborhood. “Our children spend the night with their grandparents at least once or twice a week,” he says. That, combined with the fact that he is a native of West Lafayette and his own parents are just 60 miles away, means he has no intentions of ever leaving.
“I can’t imagine that for the world. You can spin the entire globe and put your finger anyplace you want to, and you will find the quality of life is better in the Midwest and maybe the Southeast than any place else,” Ramsey says.
“Indianapolis is a neat town in 100 respects,” he says, “from the Children’s Museum to the library, the swimming pools, the major universities . . . and the Pacers doing well.”
The NBA basketball team is important to Ramsey, but not the most important thing about Indianapolis. “Our group has tickets to the Pacers, so I go to those games four of five times a year, and my father-in-law has Colts tickets, so I can go to those games. But you know, the quality of my life wouldn’t change that much if I didn’t have the sports or the theater or the other things Indianapolis offers,” Ramsey says.
With small children, my life is pretty wrapped up in that, and I’m more interested in the playground up the street and if it’s got good swing sets and whether we can go fishing in my little subdivision pond.”
As Ramsey and other physicians have found, the roads to Indianapolis lead to small-town comforts, big-city amenities, and a range of professional choices.