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December 26, 2014

Cities with both excellent medical communities and thriving sports communities

Few sports may ever outdistance the Big Three - baseball, football and basketball - in American hearts, but more and more soccer fields and stadiums are proving a burgeoning interest in the game, especially in Baltimore; Foxborough, Massachusetts; Appleton, Wisconsin; and Scottsdale, Arizona.

Baltimore, the star-spangled city

Danny Liang

Danny Liang, M.D., and his family enjoy the parks and museums in and around Baltimore. As his family gets older, chances are they’ll check out The Baltimore Blast, the city’s professional soccer team, which draws some 6,000 fans to each game.

In dawn’s early light on Sept. 14, 1814, during the War of 1812, a young Baltimore lawyer, Francis Scott Key, was aboard the British Navy flagship negotiating the release of an American prisoner. The Brits had been shelling the city and its Fort McHenry for some time. Watching from a porthole, Key could see by the rocket’s red glare that our flag was still there. And so he wrote a poem that would eventually segue into America’s national anthem.

This year, the city and nearby communities pulled out all the stops for a 10-day Star-Spangled Spectacular to celebrate the bicentennial of that day. Festivities included tall ships and Blue Angels, battle reenactments, living history programs, a patriotic concert and fireworks, all climaxed by a flag-raising ceremony at Fort McHenry at the exact moment when Key spotted the soon-to-be immortal banner.

On a more permanent basis, history buffs can visit, among other sites, the Fort McHenry National Monument and the Star-Spangled Banner Flag House, where seamstress Mary Pickersgill produced the immortal 15-star/15-stripe flag.

Patriotic events notwithstanding and long before Key was born, Baltimore’s Inner Harbor was a prosperous port, beginning in 1706. Ironically, considering today’s heavy medical concentration, this success was launched by the tobacco trade.

Over the years, Baltimore has had its ups and downs, but it has found its way to modern prosperity, spurred significantly by success in the field of medicine. Among its 11 acute care hospitals - one dating back to 1854 - are two world-famous research institutions: The Johns Hopkins Hospital and Health System and the University of Maryland Medical System.

Danny Liang, M.D., can testify to the quality. After growing up in southern New Jersey and earning undergraduate and medical degrees at the University of Pennsylvania and University of New Jersey Medical School at Rutgers, he completed his residency at UMMS, then left for a fellowship at the MD Anderson Cancer Center in Houston. Because of friends in New York City and good career prospects for his wife, he accepted an offer to practice there. But after two and a half years, they decided to join the UMMS family. "New York City was big; Baltimore is not too big. And I got a good offer," he says.

Early this year, he joined the University of Maryland Baltimore Washington Medical Center in nearby Glen Burnie, where he specializes in neurosurgery and spine surgery, is director of neurosurgical oncology and a clinical assistant professor at the university’s medical school.

As for the location itself, he notes that it’s "somewhere quiet where the kids can grow up," not to mention "lower living expenses." Another reason for moving was that "the medical climate in New York is very, very competitive, with little time for a personal life."

Liang’s interest in soccer started early. He played the game as a boy. He gave it up early in high school, but his interest continued. "I was watching the World Cup," he says, "but haven’t gone to games in Baltimore yet. So far, the family takes up most of my time." That includes visiting parks and museums, partly in nearby Ellicott City, where they now live. The children, now 3 and 8 months old, have helped him discover that "there are a lot of parks around here."

His previous Baltimore experience showed him some of the many leisure-time opportunities, which he intends to pursue when the children can appreciate them. A good bet, though, is that before too long, he’ll be introducing the family to Baltimore Blast, the city’s professional soccer team. The Blast’s inaugural game in the Baltimore Arena was on Nov. 29, 1980. Diehard fans remember that its new heroes defeated its Philadelphia opponent 10-7. Since then the team has captured seven championships, and it currently attracts some 6,000 fans per game.

The arena also became a major spur in a 1960s city resurgence after the harborside and some other city areas had frayed around the edges following World War II. The basketball Colts had helped enliven the scene starting in 1953, but they defected to Indianapolis in 1984. The blow was greatly softened by the fact that the Inner Harbor was in full-blown redevelopment by then.

Today it’s home to the widely known National Aquarium, plus the Maryland Science Center and, at last count, seven other museums, some in striking, innovative headquarters, including the offbeat Visionary Art Museum and Geppi’s Entertainment Museum, a tribute to the comic arts. The shore that once welcomed thousands of immigrants and cargo-laden ships now hosts thousands of tourists at both its World Trade Center and Convention Center.

Not far away, baseball multitudes can cheer on the venerable Orioles and tour a sports museum at Camden Yards, then visit the home of the immortal Babe Ruth.

However, the revived harbor area has created some friendly jealousy in town. "Visitors are often so overwhelmed by the Inner Harbor that they overlook other thriving city neighborhoods," says Katie Caljean at the Maryland Historical Society, one of the anchors of the Mount Vernon Cultural District, a haven of spectacular 19th-century architecture, arts and culture galore, outdoor cafes and upscale restaurants.

Also conveniently located near the harbor and central business district is the Bromo Tower Arts & Entertainment District, with the renovated Hippodrome Theatre featuring Broadway performers. Rising above the scene is the Bromo Seltzer Arts Tower itself, built by the antacid inventor and later renovated to house 15 stories of artists’ studios.

The urban mix includes some 6,000 acres of parkland and 25 miles of waterfront, with public boat launches and piers for crabbing and fishing. At least three yearly public rod-and-hook events are held, including the Fall Fishing Derby.

Also notable is the work of mayor Stephanie Rawlings-Blake, who has mounted a SaferCity Campaign. Among strategies are public safety forums in police districts, as well as at town hall sessions and youth connection centers. There are also forums for young people to speak directly to administration and city leaders. Added to the mix is a new police commissioner who has streamlined the force for quicker responses to criminal activity.

Mayor Rawlings-Blake also shepherds work toward a greener and healthier city.

One thriving endeavor is the wellness program for city employees, featuring a $250 health reimbursement benefit. This can be used for such items as gym memberships and eyeglasses and a new community-supported agriculture program with weekly farm-to-office deliveries of fresh produce. "These are good examples of what happens when everyone works together, (in this case) a lot of good people who care deeply trying to do their best every day," says Daniel Atzmon, prevention specialist in the mayor’s criminal justice office.

Baltimore’s hospitals have vigorously pursued the "health incentive," especially the internationally known Johns Hopkins and the renowned University of Maryland Medical System.

Quaker merchant Johns Hopkins bequeathed a huge sum of money to be used for the hospital system that now bears his name. The first building opened on May 7, 1889. Today the system includes six hospitals, some 30 outpatient care sites and four suburban health and surgery centers. Its heavy focus on research has produced many solutions and new surgical techniques, some of them nothing short of miraculous.

Well-publicized in recent years has been the success of recently retired pediatric neurosurgeon Ben Carson, M.D., in separating conjoined twins. In 2012, W.P. Andrew, M.D., led a team to perform a double-arm transplant that was preceded by two years of planning.

Among current striking research is development of a combination drug therapy that cures chronic hepatitis C in a majority of patients also infected with HIV. It’s now in a phase three clinical trial. Yet another recent breakthrough has been coaxing adult stem cells to build themselves into a retina. Researchers hope this will lead to building other body parts as well.

Meanwhile, with 12 general facilities and a pediatric hospital, UMMS is Maryland’s largest health system and is accomplishing its goal of "reaching every part of the state and beyond," says Meghan Scalea, the communications account director. And critically ill patients can reach it. "We receive the sickest of the sick patients from across the state," she adds. "And our helipad can accommodate four flights at a time."

Among other hospitals in its group, St. Joseph Medical Center recently received a three-star quality rating for coronary artery bypass grafting surgery and aortic valve replacement. At another, UM Charles Regional Medical Center, patients can now view their medical information online.

All physicians practicing at the hospital are also members of the University of Maryland School of Medicine, founded in 1807 and the U.S.’ oldest public medical college. Over the years, it has led the way in teaching improvements from making anatomical dissection compulsory to offering courses in preventive medicine and, more recently, a dedicated, multidisciplinary trauma program. It’s been the site of the most extensive face transplant to date.

But, for hospitals, city involvement does not stop at the doors. Johns Hopkins, for instance, is involved in more than 300 city revitalization programs, including community building ventures, a children’s early head start program, a summer jobs incentive, housing support for male substance abusers and a women’s substance abuse program.

If Francis Scott Key were living today, he would undoubtedly dream up an anthem to praise not only hospital improvement efforts but also all of the other caring citizens involved in them.

Appleton, Wis.: Fox River Odyssey

Appleton Bridge

A former paper mill has been transformed into apartments and town houses, many with great views of the Fox River (above). Below, the Ganther Race the Lake sends bicyclists on a 90-mile ride around Lake Winnebago, the largest lake that sits totally within Wisconsin’s borders. Appleton sits on the lake’s north side.

There can’t be many places in the U.S. where colleges were founded before the cities themselves were incorporated. Perhaps Appleton is unique in that category.

The college in question is now Lawrence University. It has been consistently listed in America’s 40 "Colleges That Change Lives" rankings.

You could say the university was an early example of "If you build it they will come." The Lawrence Institute opened in 1847. By 1853, there were enough settlers to incorporate the village of Appleton, named for Lawrence’s father-in-law, who had contributed $10,000 for the college library.

Before long, newcomers were lured by an emerging paper industry, which was spiked by the fact that falls on the river could be harnessed to provide electricity for ever-increasing production. Today, the Fox River Valley includes at least 20 municipalities in three counties and is home to the highest concentration of papermaking facilities in the world. While nearby Neenah has become the area’s major "paper city," complete with the giant Kimberly-Clark Corporation, Appleton has cultivated other paper-oriented businesses. It’s the site of a $35 million printing and distribution facility located at one of four business parks. Other products include coated papers, labels, corrugated boxes and packaging for food and pharmaceuticals.

The region is home to some 367,000 and is one of the state’s most urbanized and industrialized areas. From its northern beginning, the Fox River itself runs 182 miles to flow into the huge Lake Winnebago, which in turn flows into Lake Michigan. Winnebago is Wisconsin’s largest inland body of water and is a destination for fishermen both in the winter and warmer months.

But not alone by paper does Appleton thrive. Its economy flourishes with some 50 information technology companies, more than 70 computer hardware and software firms, about 20 medical equipment and device manufacturers, 130 machinery and equipment producers, and several banks and investment firms.

In the meantime, business growth has been accompanied by other serendipities, not the least of which is soccer.

"We have been ranked one of the top 10 soccer cities in the U.S. by Livability Magazine," says Matt Ten Haken, the sports marketing director at the Fox Cities Convention & Visitors Bureau. One reason: "We’ve had a tradition of really great coaches and great leaders and parents. And it’s only going to grow." The Appleton Soccer Club, one of three in town, provides programs for boys and girls from 8 to 14. Youth baseball is alive and well, too, with Little League teams for kids.

Adding to the sports enthusiasm in general has been the USA Youth Sports Complex, which was built in 1996 and incorporates 15 soccer fields and four for baseball. "It’s the largest soccer complex in Wisconsin and one of the largest in the Midwest," Ten Haken says. Now teams from as far as Kentucky and the Dakotas head to Appleton for 15 annual sports tournaments (five or six are soccer). Visitor spending adds an estimated $3 million to the city coffers.

Other aspects of the city’s sports ambience are golf clubs, a roller rink, a family ice center, and the Appleton Curling Club. Wisconsin winters in this area are also conducive to ice skating as well as cross-country skiing and snowmobiling.

In warmer weather, "camping, hunting and fishing are only an hour and a half away as well," reports Nathan Grunwald, M.D., who adds that Milwaukee, the same distance to the south, offers a wealth of cultural experiences. He can cite a plethora of reasons for returning to his hometown after going afield for his education, first to Case Western Reserve University in Cleveland, then to the Medical College of Wisconsin in Milwaukee, followed by residency at Waukesha Memorial Hospital, 15 miles from the Beer City. He now practices family medicine with ThedaCare Physicians in nearby Menasha and has affiliations with the seven member hospitals in the ThedaCare group, including Appleton Hospital. The group itself recently joined a pioneering statewide partnership of five hospital organizations.

Aside from the fact that he’s affiliated with one of America’s most forward-looking hospitals, Grunwald lists life assets not always found in many of today’s cities.

  1. "It’s a great place to raise a family. Wisconsin generally consistently ranks high, and the Fox Valley in particular, in (publications) like U.S. News & World Report and USA Today."
  2. "The cost of living is below average, but average reimbursements across all jobs are actually above the national average."
  3. "Schools and educational systems are fantastic."
  4. "I like that the Fox Cities are, from a physician’s standpoint, large enough that I can maintain some level of anonymity but small enough that I do run into patients from time to time."

Recruiting notwithstanding, he adds, "I think it speaks volumes that we have so many physicians who come back home because they know how good it is here."

Some programs of both health care institutions in the city - Appleton and St. Elizabeth Hospitals - could be models for some of America’s most prestigious institutions.

Beginning with first physician encounters at Appleton Hospital, the keyword is efficiency, as well as high-quality care. In fact, notes spokesperson Megan Wilcox, "We bring patients in to help us educate care team members and improve processes," such as making appointments at more convenient times and providing same-day lab results. FastCare clinics are open 24/7. A Community Health Action Team has helped improve care in the hospital itself. Extending care to the wider area includes "community plunges" to determine residents’ needs, taking services to many county families and matching poor families with community mentors.

St. Elizabeth Hospital is in a multi-year process to completely renovate and update its campus, much of the plan based on suggestions from some 700 patients and 300 staff members, reports spokesperson Angela Brumm.

The most recent dramatic achievement has been the opening of a spacious hybrid operating room this spring. The 1,200-square-foot chamber is equipped with super-state-of-the-art equipment. Pre-operative procedures and tests can be done in one location. Then surgeons can select a robotic option, but, if not, available space makes it possible for several specialists to function comfortably, performing complex procedures in less time and "using spellbinding accuracy and the least possible amount of radiation," according to printed information. "It’s one of the most technologically advanced ORs in the world," enthuses Brumm. "It has the latest endoscopic video equipment and surgical technology and the first imaging system based on robotic technology."

An added advantage for both hospitals is the Fox Valley Technical College with several hospital-related sequences.

Meanwhile, after a hard day at the office, Grunwald can look forward to a "date night with my wife with the kids at home, a nice adult evening in any number of different dining establishments - and end up at the Performing Arts Center. I love that (in Appleton) we have our own PAC that has all sorts of great cultural opportunities."

Dr. Matthew Rogalsk

"There’s a nice style of living in this area," says Matthew Rogalski, M.D., a gynecologist at The Foxboro Center for Women’s & Family Health. "There’s a full office every day and plenty of people to take care of."

Foxborough, Mass.: The Gem of Norfolk County

’’We are a municipality with a dual identity, and we wear both names proudly." That’s how Jack Authelet, Foxborough’s (or Foxboro) town historian, describes his city.

Most of the town’s established institutions stick with the more traditional "ough" ending to the name, but various businesses, the U.S. Postal Service, and probably many residents, prefer the shortened form, Foxboro.

There’s another "contradiction," too. In the fall, on most Sundays, the everyday population of about 6,000 swells to more than 70,000. That’s when the New England Patriots move into Gillette Stadium. Residents aren’t complaining, though. The Patriots’ home field, which opened in 2002, has been a welcome contributor to the city’s economy. One example: At a typical game, fans consume, among other foods, a ton of Italian sausage and 186 gallons of clam chowder.

More important to soccer aficionados, Gillette is also home to the New England Revolution, although game attendance isn’t quite as big - yet. To make it easy for fans to view replays in either sport, the field is equipped with the largest HDTV screen in an outdoor NFL stadium. The venue also hosts international soccer matches, NCAA lacrosse championships, high school football super bowls and numerous concert tours and special events.

One good thing led to another when a smart developer added the nearby Patriot Place shopping plaza. Now it’s a year-round destination for area residents complete with shops, restaurants, supermarkets, movie theater and afterhours entertainment venues.

Even more conveniently located next to the stadium is the Brigham and Women’s/Massachusetts General Health Care Center, an "outpost" of the renowned Boston institution. It’s equipped with a day surgery unit and offers such services as diagnostic imaging, sports medicine, gynecology, urology, pain treatment and physical therapy follow-up care. There’s an on-premise rehab pool, plus cardio training equipment.

"Essentially Patriot Plaza is like a large outlet store center," reports gynecologist Matthew Rogalski, M.D., whose place of employment is located on the road to the stadium. The Foxboro Center for Women’s & Family Health is equipped to manage all aspects of women’s health. Foxborough itself has no hospital, but the center is one of 17 outlying arms of Sturdy Memorial Hospital in Attleboro, Massachusetts, 10 miles south of Foxborough. He and his colleagues follow through at the "mother" hospital with deliveries and more complicated cases. There are no full-service medical centers in the city.

Rogalski earned an undergraduate degree at the University of Connecticut, then went on to Wake Forest University School of Medicine followed by training at Drexel/Hahnemann University Hospital in Philadelphia, where he was the administrative chief resident.

He was happy to find a conducive atmosphere in Foxborough, which, in spite of its current stadium/shopping-mall hubbub, has kept its New England small-town charm. "There’s a nice style of living in this area," he says.

While Rogalski follows the Revolution, plus English and French leagues, two of his three children, 8 and 5, play soccer in school. "They both really enjoy it," he says.

As for his practice, low city population notwithstanding, he reports, "There’s a full office every day and plenty of people to take care of. In a prior hospital where I was, there wasn’t a busy enough environment for me." He and the family moved to Foxborough late last year.

"(The health center) turned out to be a great fit between my personality and the rest of the group, so we decided to go ahead and do a long-term relationship." His photographer wife has found a satisfying work schedule, too.

As for Foxborough itself, Authelet, the historian, is elated by the continuing sense of community. He says he’ll never forget one demonstration of neighborliness: As editor of the local newspaper, he published a story about the tragic death of a mother and two children. "The next day, firemen were on every street corner selling papers to donate money for the family survivors. That, for me," he adds, "is the true Foxborough."

The town location also makes it a good takeoff point for short getaways. "We’re very, very close to the Berkshire Mountains and to Cape Cod," says Authelet. Not to mention the bigger cities, as it is close to the conjunction of I-95 and I-495. "At one time this was called the Golden Crossroads," he says. A quick map check proves that it’s still true.

Scottsdale

The Scottsdale Arts District has hosted an ArtWalk for 30 years each Thursday - a self-guided tour of the area’s galleries, fountains and restaurants.

Scottsdale, Arizona: In the Valley of the Sun

Many people think of Scottsdale as a great winter getaway town. In fact, when it gets cold in the northern latitudes - including Canada - the city population swells with "returning seasonal visitors," aka snowbirds. And not by the thousands, either - but by millions, according to city authorities. This warm desert refuge is ready for them. Hotel accommodations abound, and there are more than a thousand restaurants.

Homes of new residents soon begin to blossom with southwestern and Native American art works, as well as exquisite handmade art pottery. Art shops in Old Town Scottsdale, many with outdoor sculptures, are ready to satisfy the demand.

As for "playground" accommodations, reports family medicine physician Mark Heisler, M.D., "The only state in the country with more new golf courses is Florida." The current total, new and older, is 125.

Other visitor attractions have multiplied in the last couple of decades and now include two spring training stadiums for Major League Baseball teams, not to mention several arts and entertainment venues in the city. The city holds a Spring Training Festival every February.

Though baseball mesmerizes winter visitors and locals, too, soccer has been building up its numbers and appeal in recent years. Many a school has lively student teams, but the city itself has several clubs both amateur and professional. In fact, a girls’ team, Phoenix Rush, is now the largest youth soccer club in the world. Not only that, the game has found its way onto the huge new 71-acre Scottsdale Sports Complex in the northern reaches of town. Besides soccer, its fields accommodate lacrosse, football and rugby. "(Soccer) is huge here - in the valley and all over," says a spokesman, who adds, "We are booked solid for soccer practices and tournaments on weekends."

But this thriving suburb of Phoenix is much more than a winter playground - and it too has grown exponentially in recent years.

When Heisler began his practice, his office was on the northern "rim" of Scottsdale, he recalls. Ditto for the first hospital, Scottsdale Healthcare Shea Medical Center, which was on Shea Boulevard, one of the northernmost roads in the town. Civilization now extends some 15 miles north of Shea to the Tonto National Forest, twice as far as the city’s stretch south from Shea.

Scottsdale Healthcare has blossomed into three hospitals, and the northernmost, Thompson Peak, opened in 2007, is considerably farther north of Shea. And busy. Scottsdale Healthcare Osborn Medical Center, first of the three, opened in 1962 near the southern area of town. Except for the Mayo Clinic, which opened in 1987, the three currently are the city’s exclusive care centers.

The three Scottsdale Healthcare entities encompass a few unusual endeavors. For instance, its Virginia G. Piper Cancer Center, among other research, focuses on translating medical innovations into solutions and speeding breakthrough therapies for "treating devastating and debilitating disorders." Another example: Working with the Translational Genomics Research Institute, the research arm has developed personalized therapeutic options that can help doctors determine best treatment options. A third example is its military partnership to train medical personnel to meet requirements necessary for deployment. A second related program helps nurses transition into military service.

Heisler remembers his days as an employee practitioner at the Shea location, where he worked for two years before opening his own office. "When I started at Shea," he says, "I had nine admissions one weekend, and that was 60 percent of the hospital census." Not anymore. When he and three colleagues opened a practice much farther north, he recalls, "there was one other doctor up here, and we were saying, ’Why did we want to go up north when there’s nobody up there?’ We did it - and really got busy pretty fast."

The current swelling population may blur the fact that the mountains stand sentinel throughout the whole metro area, not to mention nearby stands of Ponderosa Pines, the Tonto National Forest and the McDowell Mountain Regional Park and the 30,000-acre McDowell Sonoran Preserve with superb natural sites. All offer hiking and/or biking possibilities.

Scottsdale residents have seen some ups and downs over the years. Once upon a time, a southern section along Scottsdale Road was dubbed the Motor Mile because of its many auto dealers. Its companion was a mega-shopping mall. As the car kingdom moved away, the mall closed.

However, a few years later, along came SkySong, the Arizona State University Innovation Center. Passersby can’t help but notice the massive canvas wings covering the entrance to the first building, which is being joined by office buildings and a variety of residential properties.

Not far away are other mammoth undertakings, especially the Scottsdale Fashion Square and a development of high-rise apartment buildings along the canal that flows through the city.

In the meantime, Shea Boulevard and vicinity has emerged as the Cure Corridor, encouraging partnerships among biotechnology companies and the two healthcare facilities on the street.

In some places, climates akin to summer in Arizona may bring on lassitude. But not in Scottsdale, where newcomers keep arriving - and people keep plowing ahead.

Eileen Lockwood is a regular contributor to PracticeLink Magazine.



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