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August 30, 2016

Live & Practice: The Great Outdoors 2016

When Hashem Shaltoni, M.D., moved to Houston in 1999, he thought he would only be in the area for a year. He had graduated from medical school in Lahore, Pakistan, where he expressed an interest in neurology early on. "In medical school, I realized I was spending more time to really understand neurology than my peers. I found that I was unique. I understood it better. I stood up many times and asked neurology questions in class." When Shaltoni’s father had a silent stroke, it sparked Shaltoni’s specific interest in stroke training and interventional neurology.

Shaltoni moves to Texas

Shaltoni moved to the U.S. and did a preliminary residency in internal medicine at the University of Texas Health Science Center in Houston. "Our agreement was: ’We will check you out, and you check us out.’ I thought it would be just one year in Houston. But in the first few months, I was really impressed by the neurology chairman." At the end of his internship, Shaltoni was accepted for a residency in neurology at the University of Texas.

"I got into UT because they liked me, and I thought it was a cool city. But I still felt like I lived in Houston temporarily because I was going to do my fellowship somewhere else."

But by the time he needed to choose a location for his fellowship, Shaltoni felt so connected to the Houston area that he wanted to stay. "I really liked the city. It’s large. It’s handsome. It has great diversity. And I got married."

Clear Lake Regional Medical Center

So Shaltoni stayed for two fellowships: one in neurology and one in vascular neurology. Today, Shaltoni works for Clear Lake Regional Medical Center, part of HCA. Clear Lake is located between Houston the Galveston Bay shoreline.

Shaltoni uses his education to serve his community. In fact, he established Clear Lake’s Brain & Spine Institute to offer advanced care to patients living near the coast. "Our goal is to provide neurology and neurosurgery care to the community," he says. "I’ve recruited three new neurosurgeons, and I’m recruiting for two more neuroscientists. Now, highly complicated cases no longer need to be transferred to the medical center in downtown Houston."

Galveston TX

Galveston, Texas

Michael Herrera, a physician recruiter for HCA, says of the center: "It is our flagship hospital. It has 586 beds. It is located between the downtown Houston area and Galveston, Texas. For those interested in working here, it’s in an ideal place in terms of being close to the city and being close to the beach."

Tropical, charming Galveston

The town itself is also pretty ideal. Leah Cast, public relations manager for the Galveston Island Convention & Visitors Bureau, says, "Galveston is unlike any other place. People take pride in Galveston. It’s a mix of having a beautiful tropical atmosphere with that southern charm and southern hospitality. People definitely feel at home."

Cast says Galveston and the outlying areas have a "huge outdoor culture." She raves, "It’s this small island that is tropical but also very historic. We have 32 miles of beaches. The island is 32 miles long but only two and a half miles wide. When you drive to work in the morning, you can see the sunrise over the Gulf of Mexico."

But the island life isn’t isolated. With a population of 50,000, Galveston boasts a bustling downtown. Residents enjoy boutique shopping, outdoor musical performances and excellent restaurants with coastal fare. Cast adds, "We have a beautiful historic downtown. It’s a gorgeous place and at the center of a lot of outdoor special events and activities. Top chefs move to Galveston. We have a great food scene that is really high quality compared to what you’d think of for a beach town."

Another unexpected benefit of this coastal town is its job opportunities. Galveston’s proximity to Houston and several midsize towns between the two cities provide a patient population large enough to keep medical professionals busy.

"HCA has 160 hospitals in 20 states. We have a pretty big presence in the greater Houston area. We have 10 hospitals in the greater Houston area and several more in south Texas," says Herrera, adding that there are several draws for physicians contemplating a move to Texas. "We seem to attract a lot of attention from physicians who are looking for a warmer climate, and we have no state income tax. Real estate properties are a good value here. You factor all those in, and it’s a great place to live and work."

Shaltoni and his wife are optimistic about raising their son, who is now 18 months old, in the coastal Texas area. "From my experience, the schools are fantastic," Shaltoni says. "I started late to have a family, so I have friends who have kids who are 8 or 9 or 12. I see them and the way they’re raised. Everybody is happy."

Shaltoni’s son will start daycare soon, and Shaltoni says he is lucky to have a wife who understands how Shaltoni’s work is not just a job but also a calling. "I went to school for a long, long time. My dad was always like, ’When are you finishing school?’ I was dedicated to really learning what I was learning. Now, I feel blessed that I live in a country that has allowed me to make a difference."

Husband-and-wife physicians Brandon Hankey, M.D., and Kelsey Schultz, M.D., needed to think strategically as they searched for jobs during their second year of residency at Michigan State University in Grand Rapids. Hankey had chosen a specialization in emergency medicine, and Schultz had chosen family medicine. Naturally, they needed to make sure they ended up in the same city. They both received offers from St. Luke’s Health Care System in Duluth, Minnesota, and by both physicians’ accounts, the situation has been more than ideal.

"When we were looking for jobs, we wanted a great mix of pleasant people but also an environment that was still busy and professionally challenging. We wanted a future-minded city. Duluth was perfect for us. I would put Duluth in the same list as Asheville, North Carolina; Burlington, Vermont; and Ithaca, New York. It’s a city that’s the right size but really unique," says Hankey.

Duluth: A mixture of city and country

"Duluth is 80,000 people, which is big enough to have a busy Level II trauma center with all the challenges I want for my career. You see a nice mix of people from the city and people from the country, especially those who work in the timber and mining industries. You see a great cross-section of people," says Hankey, who works in the emergency room at St. Luke’s Hospital, a 267-bed facility.

Schultz agrees, saying, "I have a really wide scope of practice. I work in Two Harbors, Minnesota. I have a rural family practice, both inpatient and outpatient, that affords me a lot of variety. I like the huge variety of practice. It’s a wonderful patient population as well. They’re really grounded, down-to-earth people. You get a lot of interesting pathology and pleasant people overall."

Schultz’s practice is in a more rural area, but the commute is easy. And Duluth is a comfortable place to live. Hankey and Schultz just closed on their first home in Duluth, a six-bedroom Victorian house. Hankey says this is small by Duluth standards. Other houses in their neighborhood have up to 14 bedrooms.

Hankey shares an interesting bit of Duluth trivia: "At the turn of the 20th century, Duluth had more millionaires per capita than any city on earth." Schultz adds, "It has a lot of beautiful Victorian architecture. The homes and neighborhoods in Duluth are just beautiful."

Duluth’s outdoorsy community

Duluth, MN
Duluth, Minnesota

Meghan Anderson, a physician recruiter for St. Luke’s Health Care, says, "As far as the city goes, there is definitely a personality type that is attracted to Duluth. There is a big outdoorsy community. Of course, we have hunting and fishing and things you would picture for north Minnesota, but we also have a big running scene, a mountain biking scene and a big hiking scene. People who live here like to be outdoors and be active. They’re hiking and camping even in the winter. People do it all year long."

Schultz says, "Once you set foot in Duluth, you realize it’s a special place. It’s worth the winter. Something people say is, ’The cold seals in the freshness.’"

The No. 1 outside city

"In 2014, we were ranked the No. 1 outside city by Outside magazine. That really speaks to the lifestyle and to the recognition of the fact that there’s a diversity of outdoor offerings," says Anna Tanski, president of Visit Duluth. "It’s not just skiing. People take in all that Lake Superior has to offer." She says that paddleboarding, canoeing and kayaking tend to be the most popular water sports. She also says that Lake Superior influences the culture beyond recreation activities.

"I’m a lifelong resident here, and our life is centered around Lake Superior," says Tanski. "It is focused on the outdoors. It’s ingrained in part of our culture, and it creates an active community."

One of Minnesota’s healthcare hubs

While Duluth has a tight-knit population of 86,000, the city’s role as a healthcare hub draws a much larger patient population from surrounding areas. Anderson says that figure is closer to 450,000, explaining, "People drive a long way to get their health care. If you look at where we are on the map, we are on the tip of Lake Superior, so there’s not much between here and the Canadian border. We see a lot of patients from Wisconsin and from the upper area of Michigan."

To serve this diverse group, St. Luke’s Hospital stays current with state-of-the-art equipment and facilities. "The most notable thing is that we just completed an expansion to our surgery center," says Anderson. "We just built a bunch of ORs. We also built a hybrid operating room. That just opened in August of 2015. Everything that the physician uses, everything comes down from the ceiling; there’s nothing on the floor. We have a da Vinci robot, and a dedicated operating room for the da Vinci robot. We also have dedicated ORs for open heart surgery and neurosurgery."

Hankey says another advantage to working at St. Luke’s is the friendliness of the hospital staff. "Duluth is the classic ’Minnesota nice.’ This is the most pleasant, professional staff I’ve ever been lucky enough to work with. The people make Duluth a great place."

St. Luke’s Health Care System also has primary care clinics throughout the region, including the one in Two Harbors where Schultz works.

Essentia Health is another of Duluth’s major healthcare players.

"Physicians are very much attracted to Essentia Health," says Kris Olson, vice president of physician and professional services. "We are a physician-led organization, so there’s a really strong focus on keeping the patient and the family a priority."

More than 800 physicians - and 13,000 total employees - help Essentia address the changing needs of healthcare through 68 clinics and 15 hospitals throughout the Upper Midwest.

"If you’re a high-end specialist, you can participate in the architecture of that program and have a direct say in what takes place," Olson says. "You’ll be involved in the programming, the operations, and the understanding of what we do."

In Duluth, it’s possible to find a successful work/life balance.

"It’s a really neat, four-season, multifaceted location," Olson says. "You get the opportunity to work and play in the same place. . . . It’s fun to recruit to Duluth. It’s really the icing on the cake."

Rebecca Whitesell, M.D., has seen much of the U.S. "My dad worked for the National Parks Service when I was growing up, and we moved all over the place," Whitesell explains. Now a pediatric orthopedic surgeon at Mary Bridge Children’s Health Center (operated by MultiCare Health System), she attended high school in Texas and stayed in the state to attend Texas Christian University, where she majored in pre-med.

Her decision to study medicine stemmed from personal experience. She explains, "When I was young, I was a pretty serious dancer. Unfortunately, I also had several injuries. I had an orthopedic surgeon that I really liked. I thought what he did was really cool. That’s how I got truly interested in medicine."

Rebecca Whitesell MD
"I can look at Mount Rainier right outside of our operating room," says Rebecca Whitesell, M.D., who moved to Tacoma after completing fellowships in Atlanta.

She earned a master’s of public health at the University of North Texas before heading to medical school at the University of Texas Health Science Center in San Antonio. Whitesell then stayed in the South for her residency at the University of Alabama and completed fellowships in Atlanta.

Falling in love with Tacoma

When she started interviewing for jobs, she wanted a new experience. "I interviewed and immediately fell in love with the people in Tacoma. It was really the right time for me, coming out of residency. I liked the setting, and I was very drawn to what I’d be doing and who I would be working with."

She also liked the surroundings. "I can look at Mount Rainier right outside of our operating room," Whitesell raves. And according to Matt Wakefield of Travel Tacoma + Pierce Country, the mountain is a big part of the Tacoma experience for everybody who visits.

"When you come to the area, if you’re flying in, you’ll see Mount Rainier," he says. "It’s iconic. It’s the tallest mountain in the contiguous 48 states. You can see it from Seattle. Whenever the clouds part even a little bit, the mountain is front and center. A phrase people say is, ’Oh, is the mountain out today?’ It means, ’Did the clouds part enough?’ When you see it, it looks magnificent."

Wakefield says the mountain provides plenty of space for recreation. "There are 130 hiking trails on the mountain. There is snowshoeing in the winter. It was named the No. 1 place in the country to view wildflowers."

Another popular Tacoma destination for outdoor activities is Five Mile Drive. Says Wakefield: "It’s this five-mile stretch of roads with views of the Puget Sound. On the weekends, it’s closed until early afternoon so people can go running. There are lots of people here who are really into the outdoors and fitness, and we have an infrastructure that supports them in that."

Health-conscious Tacoma

It makes sense that the Tacoma population is health-conscious. After all, healthcare companies are major area employers. Amber Bishop, a recruiter for MultiCare Health System, says, "MultiCare is a not-for-profit organization with more than 11,000 employees. The employee population is spread through two counties, staffing 120 sites of care." MultiCare has five hospitals, each of which uses da Vinci robots. A sixth hospital is under construction, and MultiCare also operates the MultiCare Institute for Research & Innovation in Tacoma.

One benefit of working for MultiCare Health System is that their processes take full advantage of electronic patient records. MultiCare was an early adopter. The organization started using electronic patient records for their outpatient clinics in the late 1990s.

Naturally, the size and growth of the organization affect their recruiting efforts. "At any given time, we probably have more than 100 searches open, and that includes primary and specialty care," says Bishop. "Right now, urgent care is a big focus."

Bishop says there are many benefits to working for a larger health system. "Because we employ so many different providers, they have a built-in network to refer their patients to. Any specialty you can think of, we have in our system."

That includes Whitesell’s specialty. "In medical school, everyone always says, ’I’m going to be a cardiologist,’ or, ’I’m going to do internal medicine.’ They made up their minds. I knew I was interested in orthopedics, but I went through medical school pretty open-minded. When I did my third-year rotation in surgery, I fell in love with surgery. When I did my first surgery in orthopedics, I was like, ’I’m never doing anything else ever again.’"

It’s clear that Whitesell’s work isn’t just a paycheck for her. She says, "There’s something about taking care of kids that’s infectious in a good way! There’s an element of taking care of a kid and taking care of their parents. You take care of them in different ways."

And when she’s not taking care of families, Whitesell enjoys taking care of her 10-month-old chocolate lab. She and her puppy go for walks and occasionally go running together.

"I really love all the outdoor activities," says Whitesell. She also appreciates Tacoma’s versatility and overall feel. "It’s a big enough place that you can have anything you want living in a city," she says "You’re close enough to Seattle, but Tacoma doesn’t feel like the suburbs. You’re living in its own place."

Gareth Davies, M.D., didn’t need to be sold on Portsmouth. He had spent time in New Hampshire and already knew he loved its New England feel, so when he got the chance to move back after his residency, he didn’t think twice.

"I am originally from Pennsylvania, but I went to Middlebury College in Vermont. In college, I knew I liked biology - from microbiology to organism-type biology. The year 2000 I was a freshman there, and that was the first year that neuroscience was offered as a major. I noticed that every course that I signed up for was one of the neuroscience courses." Naturally, Davies declared a neuroscience major.

Falling in love with New Hampshire

"I knew I wanted to go to medical school. I made that decision in high school actually," says Davies. And at Dartmouth Medical School, Davies felt right at home. "I fell in love with New Hampshire."

As Davies neared the end of his residency at Penn State University, he felt a pull to return to New Hampshire.

Gareth Davies

Already familiar with New England, Gareth Davies, M.D., was drawn to New Hampshire after residency at Penn State. He’s now a neurosurgeon at Portsmouth Regional Hospital.

"I was thinking about where I would like to settle. I started looking again at coastal New England. I always loved the coast. I was looking for a vibrant small town with a young population, like Portland or Portsmouth or the Cape. From there, I started looking at what practices were hiring. One of my mentors from my residency had done his residency with one of the neurosurgeons at Coastal New Hampshire Neurosurgeons."

Neurosurgery in Portsmouth

Davies liked what he saw there. He says, "I was immediately very impressed by their neurosurgery practice." So he accepted a neurosurgeon position with the group, which is operated by Portsmouth Regional Hospital, part of HCA.

Dean Carucci, CEO of Portsmouth Regional Hospital, says, "Portsmouth Regional Hospital is a leading provider of cardiovascular surgery as well as neurosurgery." The hospital has 209 beds and operates a Level II trauma center. It stays up to date with state-of-the-art equipment. Carucci says, "Portsmouth has dedicated cardiovascular operating rooms as well as a hybrid room. In addition, we have three distinct catheterization labs and an interventional radiology suite. The facility has also invested in high-end imaging including a 3-T MRI, 3-D mammography, 3-D echo, EBUS [endobronchial ultrasound] and a host of others." Portsmouth Regional Hospital also operates outpatient facilities in the area.

State-of-the-art operating rooms are a plus for Davies, who has felt drawn to surgery since the beginning of his career. "I’ve always leaned more toward surgery because I enjoy having a defined problem and being able to go in and fix it. I like when I can respond and fix something structural."

When Davies isn’t in the OR, he’s outside enjoying Portsmouth. "I fell in love with Portsmouth as a town. It’s very outdoor-oriented. It seems most people like to run, hike and sail."

Portsmouth’s outdoor adventures

Portsmouth residents as a whole tend to enjoy the outdoors and exercise avidly, according to Valerie Rochon, interim president and tourism director of the Greater Portsmouth Chamber of Commerce. "It’s a lifestyle choice to live here and be on the seacoast. It’s a quality-of-life choice. You’re making the decision to have a much higher quality of life."

Rochon recommends visiting the beaches, trying out Portsmouth Kayak Adventures, enjoying the boardwalk or even sailing on a replica of a 16th-century barge. "We are so involved with the water," she says. She recommends families with kids who want to get even closer to marine life visit the Blue Ocean Society, explaining, "It’s the organization within the Seacoast Science Center, which is the marine mammal rescue organization for all of New England."

If this lifestyle sounds appealing, you should know that Portsmouth Regional Hospital is hiring. Carucci says: "We are currently recruiting heavily for vascular surgeons, hospitalists, psychiatric physicians and primary care, both internal medicine and family practice."

Respectful coworkers of Portsmouth

Pleasant surroundings aren’t the only perks of the workplace. Davies says other hospital employees are one of the best parts of his job. "Across the board - from management to the other physicians and nurses and techs - people are very respectful. Because people are so respectful, it’s a pleasant place to work. Everyone is very proud of the community and very focused on providing top-level care for the community. People get close to their patients."

Davies considers Portsmouth the perfect size. He says it offers just the right amount of amenities for doctors who have busy schedules.

"When I was thinking about where I wanted to live, the important thing for me was looking at what was offered in the area and what would it actually be like to live there. There’s a tendency to think that there’s so much more to do in a big city. In the daily life of the average physician, you tend to work long hours, and you work late regularly. I don’t know that you necessarily need access to the thousands of restaurants in a big city."

Davies is engaged, and he has a dog. What could be better than taking your dog for a walk on the boardwalk, enjoying the sun and breathing in the sea air? In Portsmouth, it isn’t a vacation. It’s your life.



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