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February 25, 2016

Live & Practice: Family Friendly Cities 2016

Savannah combines historic Southern charm with an eclectic arts scene, plus everything from fishing to dolphin watching.

Dwayne Gard, M.D., D.C., was familiar with Savannah before he moved there. "This is where my wife’s parents are from," he explains. "Even while I was going through medical school in Augusta and my residency in Charlotte, we were frequently coming down to Savannah to spend holidays and long weekends with her family."

Savannah: Friendly and simple to navigate

So when Gard and his wife looked for a place to raise two children of their own, Savannah was an easy choice. "I find Savannah to be an ideal-sized city for raising a family. It’s a place where you have extracurricular activities right at your fingertips, and it’s a very friendly town that’s easy to get around."

Dwayne Gard

Dwayne Gard, M.D., D.C., was familiar with Savannah before he moved there - it’s where his in-laws are from. "I find Savannah to be an ideal-sized city for raising a family," he says.

Gard began his career as a chiropractor in Georgia. After a few years of practice, he decided to go to medical school at the Medical College of Georgia in Augusta. He completed his residency at Carolinas Medical Center in Charlotte, North Carolina, and moved to Savannah in 2008 to become a hospitalist at Memorial Health.

Memorial Health in Savannah

A rapidly growing hospital, Memorial Health offers a wide range of specialties. "We don’t find ourselves referring out very often," Gard says. "We have subspecialists all the way from neurosurgeons to interventional radiologists to interventional vascular surgeons. We have all the medical subspecialties that I call on."

"You have to have a fantastic ER in order to take care of a Level I Trauma Center," says Mark Kolbush, a physician recruitment and retention executive at Memorial Health. "We see all kinds of traumas here, and people get flown in by helicopter every day. We take care of the sickest of the sick. On top of that, the quality of our care is exceptional."

The Leapfrog Group, which independently evaluates health care quality, gave Memorial Health a Grade A safety score.

"Our actual mortality is better than our expected mortality," Kolbush says. "We have it graphed out so we can see the lives we save every year. It’s a great place to work."

Healthcare is Savannah’s 2nd-largest industry

Erica Backus, director of public relations for Visit Savannah, says Savannah is economically healthy and that health care is the region’s second largest industry. "We have two major health systems: Memorial Health and St. Joseph’s/Candler," she says. Memorial University Medical Center is an academic hospital with 604 beds. St. Joseph’s Hospital is an acute care facility with 330 beds. And Candler Hospital, which has 384 beds, is the oldest hospital in Georgia. It was founded in 1804.

Savannah’s natural beauty draws physicians to the area. "Savannah sells itself," Kolbush says. "It’s a beautiful historic city, and it’s very charming with lots of squares filled with live oak trees. And the cost of living in Savannah is 6.5 percent lower than the average American city."

He adds: "Savannah is a growing population. It’s a mixture of people who have been here generation after generation, as well as people new to the area. Savannah is home to Savannah College of Arts and Design [SCAD]. It’s a very good school, and that school has grown over the years and is a destination for students from all over the country."

Savannah

At more than 20 city squares, Savannah has the nation’s largest National Historic Landmark District.

Another major draw to Savannah is Gulfstream Aerospace, a major area employer that designs and manufactures small aircraft. "They’ve done fantastic, and they are continuing to grow. So between SCAD, Gulfstream and tourism, we have a stable economic base, which makes it easier to grow the [Memorial Health] facility and add more jobs," says Kolbush.

Backus agrees that SCAD has had a major influence on life and culture in Savannah. "We were once a sleepy Southern town that hung its hat on its terrific historic architecture. Now, it’s really been infused with a new vibrancy. We have four colleges, and we’re aptly described as a young, hip town," says Backus.

A coastal city

Savannah’s coastal location influences its economy and culture. "We have 100 miles of coastline," says Backus. "It’s great for boaters, kayakers and fishermen. People here tend to be pretty outdoorsy."

The location has even affected the area’s cuisine. "It influences the way we eat - lots of seafood, especially shrimp," Backus says. "We have a year-round growing season, so we cook with abundant in-season produce." The coastline also makes for good family fun. Backus recommends day trips to nearby Tybee Island, where families can take dolphin-watching excursions.

Gard and his family like to take advantage of Savannah’s arts offerings as well as the entertainment provided by proximity to the water. "There are enough activities here that I felt like I didn’t miss the big cities. There are multiple restaurants in the historic part of Savannah and a real nice environment by River Street. We’re right here on the ocean with plenty of water sports and fishing. Savannah is definitely influenced by being a coastal town. We have a lot of good seafood. I grew up doing more freshwater fishing on lakes, so it took me a little while to adapt to saltwater life."

With its seafood, dolphin watching and job opportunities, Savannah seems to be well worth the adjustment.

As he planned for his future, Gregory Carlson, M.D., knew two things for certain: He wanted to be a surgeon, and he wanted to raise kids in an athletic, outdoorsy environment. He got his wish. Carlson is now a vascular surgeon at Memorial Hospital in Colorado Springs.

Vascular surgery was in Carlson’s blood (no pun intended). His father had also been a vascular surgeon, so Carlson knew the job’s variety and challenge would suit him. "I always wanted to go into surgery because of the variety in your day," he says. "I was attracted to vascular surgery because it was challenging and evolving."

Returning home to Colorado

Carlson grew up in Denver and attended Jefferson Medical College in Philadelphia. After finishing his residency in Massachusetts, he returned to his home state, this time to Colorado Springs. "There were not a lot of barriers to starting my career here," he says. "I got in with a group of good doctors and joined a private practice."

After that, Carlson joined Memorial Hospital as a vascular surgeon. When he started there, Memorial Hospital was a large, private, for-profit hospital. Over the past few years, University of Colorado Health acquired Memorial along with four other community hospitals.

Colorado Springs

Colorado Springs

Carlson says this change benefited patient care. He explains, "When the hospital transitioned, it brought an opportunity to physicians to step up and meet the community’s needs."

University of Colorado Health

University of Colorado Health is one of the city’s two major healthcare employers.

"We are proud to have Memorial Hospital as part of our health system," says Kelley Hekowczyk, physician recruitment manager for University of Colorado Health. "The hospital is a 500-plus-bed facility, and over 100 beds are dedicated to the Children’s Hospital of Colorado." According to Hekowczyk, Memorial Hospital Central manages 320 open heart surgeries and over 100,000 ER visits each year, making it the busiest ER in Colorado.

"We have three CAT scanners, a PET scanner and an intraoperative CT scanner in the OR. We have 12 da Vinci robots, which perform robotic surgery primarily for gynecology and urology patients, as well as an O-arm [a surgical imaging system] that we use for spinal work for neurosurgeons. We have a 37-bed stroke unit."

Memorial Hospital Central also has 11 operating rooms, 36 ICU beds and five isolation rooms. These certainly keep the 800 physicians on staff busy.

In northern Colorado Springs sits Memorial Hospital North, also a part of University of Colorado Health. "Memorial Hospital North operates more like a community hospital," Hekowczyk says. "Patients needing more acute care will go to Memorial Hospital Central."

Recruiting in Colorado Springs

Hekowczyk is hard at work bringing newcomers to Colorado Springs. She is actively recruiting for primary care, as well as a full range of positions, such as trauma surgeons interested in the growing trauma center. According to Hekowczyk, administrators are focused on strengthening this program. "We are currently a Level II facility. We are actively working to become a Level I Trauma Center."

Another big player in Colorado Springs is Penrose-St. Francis, a part of Centura Health that includes Penrose Hospital and St. Francis Medical Center, which together offer 522 beds.

"St. Francis Medical Center houses our women’s services: women’s, OB/GYN, and also orthopedics, pediatrics and general surgery. We’re also a Level III trauma center," says physician recruiter Susan Jenkins. "Penrose focuses on cardiothoracics, vascular, and also some orthopedic. We’re a Level II trauma center." Penrose-St. Francis has also been named one of America’s 50 Best Hospitals by Healthgrades for the past eight years, and is southern Colorado’s only Magnet Recognized hospital. Penrose’s hybrid OR is attractive to their surgical specialists. Their clinics are all based on the patient-centered medical home model - and are either accredited or on their way to becoming accredited.

"We are recruiting for everything," Jenkins says. "We have a huge need for primary care, but we are also growing our orthopedics service line. We have embedded behavioral health in our primary care clinics."

The great outdoors in Colorado Springs

Colorado mountains

There are plenty of activities for outdoorsy families in Colorado Springs.

Medical opportunities aren’t the only things that draw physicians to Colorado Springs. Hekowczyk says the call of the great outdoors also plays a role. "We attract outdoorsy people," she says. "We have four seasons of outdoor activities."

Carlson certainly takes advantage of this in his free time. When he’s not treating patients, he hikes, bikes and skis. "This is a great place if you like outdoor sports," he says. "There is sunshine almost every day. It’s also a fantastic place to raise kids. There are safe streets and bike paths. It’s the right size small city with lots of culture."

"It’s a great place to live and practice," Jenkins concurs. "Colorado Springs is very livable. It has lots to offer, including a thriving cultural arts scene and lots of college level sports. We have three colleges in town: Colorado College, the U.S. Air Force Academy, and the University of Colorado Colorado Springs. Professional sports are just up the road in Denver."

Colorado Springs native Chelsy Offutt is director of communications for the Colorado Springs Convention and Visitors Bureau. "Waking up to the gorgeous Colorado Rockies and Pikes Peak is pretty hard to compete with," Offutt says. "The panorama is a draw. The mountains are visible from anywhere in town. We are well-known for the easy access to outdoors. We’ve been on lots of magazines’ top lists for everything from safest community to most active community to how to raise an outdoorsy kid."According to Offutt, Colorado Springs’ most popular place to hike is Pikes Peak, also know as America’s Mountain because it inspired "America the Beautiful." People also hike the Barr Trail, and the mountains offer other attractions for those who don’t hike. "Cheyenne Mountain Zoo is America’s only mountain zoo," Offutt says, explaining that this makes it very different from the typical zoo. "It’s built into the mountainside, and they spend a lot of energy on conservation and making sure the animals have really beautiful, realistic habitats."Offutt also recommends the kid-friendly Colorado Springs Science Center and the Colorado Springs Pioneers Museum.

In Carlson’s neighborhood, he reports, "We counted that there are 31 kids between the ages of 2 and 16. We have block parties, and we have a yearly back-to-school campout for all the kids who live on the cul-de-sac. There are always kids running around the neighborhood, and it’s nice to see parents around, too. You get to know everyone. It’s a fantastic place to live."

"I was originally on a path to be a surgeon, but my wife was on a similar path," says Sidney Jones, M.D. "We realized that our lifestyles would not be conducive to spending much time together." Jones is now an internist and primary care medical director at Bon Secours Medical Group, and his wife is a child psychiatrist. They’re practicing happily ever after in Richmond, Virginia.

Richmond: Rich in academics

Sidney Jones

"It’s a very family-friendly city," says Sidney Jones, M.D., of Richmond. "You can walk to restaurants, and it has a great proximity to the beach and to Washington, D.C."

Jones grew up in rural southern Virginia. He attended Davidson College just outside of Charlotte, North Carolina, but returned to his home state for medical school.

Jones found Richmond’s school system to be excellent. His two children, now 23 and 19, both went through Richmond public schools and had very positive experiences.

"Richmond is rich in academics," says Karin Guye, a recruiter for JenCare Neighborhood Medical Centers. She adds: "I think from a professional perspective, there is a lot of opportunity for continued growth and learning."

Richmond neighborhood

Richmond features both historic architecture and tall buildings.

Richmond is growing fast

The city itself is also growing, says Chelsea Miller, director of physician integration for Bon Secours Richmond Health System. She says, "Compared to when I grew up out in the suburbs of Richmond, Richmond has grown exponentially and has become increasingly culturally diverse."

Bon Secours is one of the major health systems in Richmond and is growing fast, Miller says. "Bon Secours Health System is in six different states. Virginia is our largest market. We have been growing exponentially." Bon Secours Richmond Health System has five area hospitals: St. Mary’s Hospital, St. Francis Medical Center, Memorial Regional Medical Center, Richmond Community Hospital and Rappahannock General Hospital.

"It’s a Catholic health care system, and the major tenet is our willingness to see all patients regardless of race, ethnicity, sexual orientation, whether you’re here legally or illegally, insured or uninsured," Miller says. "We really care for the people who are on the margins of society who might not have access to health care."

"In 2011, St. Francis was voted one of America’s most beautiful hospitals," says Miller. "It feels like a five-star hotel. It’s very soothing and calming. And St. Mary’s has repeatedly been voted the favorite place in Richmond to have a baby."

Virginia Commonwealth University

Virginia Commonwealth University has also helped drive area growth, such as through its adaptive reuse approach to creating medical and office space in Richmond. "They have done a lot in terms of buying up old buildings and turning them into academic buildings or office buildings and dormitory space," says Erin Bagnell, public relations manager at the Richmond Metropolitan Convention and Visitors Bureau.

VCU Medical Center, a 1,125-bed Level I Trauma Center, is in the middle of a large renovation and expansion of its operating room, and physician input plays an integral part. Aisha DeBerry, manager of physician recruitment for VCU Health, says that the physician leader in charge of the project often tells her, "When you are recruiting physicians, please tell them that I want them to be part of this revamp of the OR. Let them know that I would like to meet with them to hear their voice, to hear how we can make the OR more conducive in a perioperative space."

VCU Medical Center also serves as the only NCI-designated cancer center in the area. It also has the area’s only full-service children’s hospital.

Virginia Community Healthcare Association

Virginia Community Healthcare Association is also based in Richmond, with member health centers both in the area and throughout the state. Suzanne Speer, a clinical recruitment services specialist for the organization, explains the association’s distinct mission: "Our health centers serve people of all ages, all incomes, whether or not you have private insurance, Medicare or Medicaid. We also serve those who fall into that insurance gap and don’t qualify for any public health insurance, and they can’t afford private insurance on the exchange, even with the Affordable Care Act."

To do this, Virginia Community Healthcare Association’s member health centers provide services on a sliding fee scale. "We are able to see everybody in the communities we serve," Speer says.

In Richmond, there are scores of family activities. Bagnell recommends the Science Museum of Virginia, the Children’s Museum of Richmond and the Lewis Ginter Botanic Gardens, which has a children’s garden with a splash pond.

Another major local family attraction is Maymont. "It’s a 100-acre estate within city limits, focused on nature programming for children," Bagnell says. "There’s an Italian garden, a Japanese garden, and a bamboo maze."

Family-friendly Richmond

Jones agrees that Richmond is great for raising children. "It’s a very family-friendly city," he says. "You can walk to restaurants, and it has a great proximity to the beach and to Washington, D.C. It’s a great place to live. It’s great to be here, and it’s great to enjoy the broader area."

That broader area has plenty of places to eat. "We’re one of the best foodie towns in the region," DeBerry says. "There is a corridor in downtown Richmond where there are no chain restaurants allowed."

Even though Richmond is an attractive place to live, housing costs aren’t sky-high. "Richmond is a little more moderate in terms of the housing market," says Guye. "It’s probably more consistent with what the national median or norm is. Certainly, it’s way cheaper than D.C. or New York."

One unique feature of Richmond is the James River, which divides the city - and offers rafting on class-four rapids right downtown.

On both sides of the river, homebuyers and renters can choose from distinct neighborhoods. Jones, a historic architecture buff, says, "The city has rich history with preserved architecture. It has become vibrant, eclectic." Bagnell concurs: "We’re a historic city - over 400 years old. There is beautiful historic architecture, and there are lots of new properties being built."

Helena Missouri River

Helena sits halfway between Yellowstone and Glacier National Parks, close to the Missouri River.

Don Skillman, M.D., has seen the world. During his 28 years as a U.S. Army internist and infectious disease specialist, he lived in Brazil, Kenya, Egypt, Thailand and Belgium. But for this native Montanan, nothing tops his home soil.

"I love to visit all those beautiful places, but Montana is just spectacular," he says. He now lives in Helena, and says it tops all the places he has traveled.

Skillman was born in Livingston. He attended high school and college in Missoula. He went to Bethesda, Maryland, for medical school at the Uniformed Services University of the Health Sciences.

When Skillman left the armed forces in 2006, he, his wife and their three sons moved to Helena. His youngest son, now 18, was raised in Helena, and Skillman says the town offers great educational options.

Helena’s small-town atmosphere

"This is a tremendous place," he says. "The public schools are outstanding, and there’s a wonderful small college called Carroll College that is ranked sky high by U.S. News & World Report. It gives us a college town atmosphere. We’re the state capital, but it’s still fairly small."

In Helena, St. Peter’s Hospital - where Skillman works as an infectious disease specialist - is the only hospital. (Fort Harrison VA Medical Center is just outside downtown.) Kendra Lenhardt, director of clinic business operations and physician recruitment at St. Peter’s, says this makes things easier on physicians. "A lot of doctors like it because they don’t have to cover more than one facility," she explains. "There’s only one facility they need to be on call for."

St. Peter’s: Helen’s standalone hospital

"We are a standalone hospital. We’re not part of a huge system, but we are state-of-the-art," Lenhardt says. "We have 123 beds. Our floors are set up so we have surgical and oncology on one floor. Medical has its own floor, and then the next floor is set up for OB and pediatrics. We have an inpatient behavioral health unit, and we are the only place in the state that has inpatient geriatric psychiatry."

The hospital had a $55 million expansion project four years ago, which included a new four-story patient wing. Lenhardt raves about the new addition, saying, "Every single room we have is single occupancy, so there’s no double-upping on anyone. We just updated all of our ORs. Our OB rooms for our moms are LDRP rooms. We have an OR on that floor as well, so we can do C-sections there. Moms don’t have to go downstairs. They can stay on that floor."

Lenhardt says there are many advantages to working for a smaller hospital. "We’re a not-for-profit community hospital that doesn’t report to anybody, which is really nice because if you want to change something or something’s not working out, you can do it that day - make a change. It’s really nice."

Skillman also enjoys the collaboration that comes with being in a small hospital. "I like the collegiality. There’s never any sense of competition between groups," he says. "We all know each other very well because it’s a small number of orthopedists and surgeons and medical subspecialists. We have three cardiologists, one rheumatologist and two GI docs, so we’re like a small family. …I don’t think the family practice doctors would hesitate one bit to ask specialists about a patient. They certainly call me all the time."

Work/life balance in Helena

Staff members at St. Peter’s support each other, and the administration supports them. Skillman says employees are able to achieve work/life balance. "The administration of the hospital is very fair," he explains. "They are totally dedicated to finding out what makes each one of us happy and then optimizing that. They are certainly very happy to help with a balance of lifestyle and work. …The key feature is doctors can make just as much as they could in Cleveland or Dallas or LA. But the homes here are not expensive, and the lifestyle here is superior in its own way."

Heidi O’Brien, executive director of the Helena Tourism Alliance, has lived in Helena for 15 years. "It’s definitely an outdoor-oriented culture, and it’s definitely a family-oriented place," she says. "There are kids’ fun runs and kids’ festivals in the fall and summer."

According to O’Brien, the town also has well-developed sports programs and other activities. "There’s really no shortage of things for kids to do," she says. The public pool at Memorial Park is popular for kids, and Centennial Park - which has mountain biking and a rock climbing wall - is also a favorite.

Families in Helena also have the luxury of being a short car ride away from national vacation destinations. "We’re right between the national parks - four hours from Glacier and four hours from Yellowstone," says O’Brien.

O’Brien finds that people who don’t know the area well have misperceptions. "With Montana, sometimes people look at it like it’s the end of the earth. They wonder, ’Will I be able to buy shampoo when I’m there?’ But it’s a happening place. We have a lot of things going on here. I equate it with cities like Portland and Seattle but on a much smaller scale."



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