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March 31, 2014

Community profile: Some of the most friendly cities

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!"

Colorado Springs: Resort town to full-fledged city

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.

Greenville, S.C.: Welcome to the new south

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."

Houston: The heart of Texas

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."

Wichita, Kan.: From cattle town to air capital

’’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 healthcare 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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