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April 13, 2012

Shore Duty

"I must go down to the sea again, to the lonely sea and the sky, And all I ask is a tall ship and a star to steer her by…"

These days, there’s much more than poet John Masefield’s "tall ship and a star" waiting to greet physicians who decide to pursue their life’s work in one of the hundreds of American towns and cities abutting lakes, oceans, rivers, ponds and bays.

Interesting, well-paid practice opportunities are available at small clinics and urgent care facilities in resort communities such as Gulf Shores, Ala., and Smith Mountain Lake, Va. Big-city aficionados can find the best of both worlds in Corpus Christi, Texas. And there are Great Lakes locations like Sandusky, Ohio, where tempting features include large, well-equipped hospitals, congenial colleagues, beaches, boating - and enough varieties of fresh fish to satisfy anglers for miles around.

Gem on the Gulf of Mexico
Gulf Shores & Orange Beach, Ala.

George Astin, M.D., recently settled down in Orange Beach, Ala., where he believes he’s found the best of both worlds - a satisfying practice and an idyllic lifestyle. For 25 years he practiced in his hometown of Carrollton, Ga. But, as he tells it, "My wife and my mother came down to a wedding in 1982. My mother just loved it and decided that she was going to build a house here."

That was chapter one of his own affectionate relationship with the area.

Chapter two was selling his Carrollton practice to the hospital there, "with the intention of relocation, specifically here in Orange Beach, and looking for work opportunities in the area."

Chapter three was getting to know the people at American Family Care, a network of family and urgent care clinics headquartered in Birmingham, Ala. AFC currently operates 30 facilities, almost all in Alabama. Owner and founder Bruce Irwin, M.D., plans to add five new clinics in various cities every year. The Orange Beach facility, Astin explains, is "somewhat of a blend of urgent care and family medicine," handling both episodic care for tourists and longitudinal care for residents.

South Baldwin Medical Center of Gulf Shores, another facility and not part of the AFC family, is located in Gulf Shores.

Fancifully speaking, Orange Beach and Gulf Shores are "joined at the hips," one an extension of the other with "32 miles of the world’s whitest beaches" on the Gulf of Mexico. Within about an hour’s drive of the clinics in opposite directions are both Mobile (Ala.) and Pensacola (Fla.), where seriously ill patients can be transported to major hospitals. Less than 15 miles separate the beach locations from the 112-bed South Baldwin Regional Medical Center in Foley, Ala., another critical care alternative.

In recent times, Gulf Shores has become a thriving resort, and no wonder. "I’ve been all over the Caribbean and seen lots of beautiful beaches," says Astin, "but there’s really nothing that rivals the beauty of the beaches down here."

Some are wide, with sand dunes, and are staging areas for picnics and watching charter boats. Others provide facilities for picnics, boating, hiking and birding.

In recent years, Mother Nature has dealt two bad blows that could have permanently spoiled the party. But in the long run, local citizens wouldn’t allow it. Hurricane Ivan ravaged the area in 2004, wiping out, among other things, a venerable - and heavily used - fishing pier. In 2009, the longer, wider, fancier Gulf State Park Pier replaced it, where hundreds of hobby - or addicted - anglers can hook tarpon, speckled trout, grouper, Spanish mackerel and a host of other varieties. Many fishers also go down to the sea in boats. That’s where Astin recently captured two 12- to 14-pound redfish.

In 2010, the area was ravaged again, this time by sticky oil and tar washed onto shore after the horrific explosion on British Petroleum’s deep-sea rig in the Gulf. The combination of oil spill and economic downturn brought tourism figures down by 47 percent, according to Grant Brown at the mayor’s office in Gulf Shores. The good news has been a dramatic comeback in 2011. Reports Kim Chapman of Gulf Shores and Orange Beach Tourism: "2011 is shaping up to be a great year."

Brown says the dramatic turnabout is partly because of a massive beach cleanup by BP, the Coast Guard and city workers. He still marvels at the giant sifting machines used for a foot-deep cleansing of the sands. Once again, lovers of sand and sea can find fun and relaxation.

But wait, there’s more, says Brown. In the last few years, sports have become a new local byword with a successful campaign to attract major amateur sporting events and tournaments.

Youth and adult baseball, softball, soccer, football, tennis and even a power lifting championship tournament and martial arts camp have attracted enormous numbers of participants and families, filling hotels and motels. Facilities for everyday visitors and residents have been added as well, such as up-to-date beach and sand volleyball areas.

For those more interested in their palates, Gulf Shores leaders are happy to be accommodating - in a big way. That translates into the Annual National Shrimp Festival, which celebrated its 40th anniversary in October with more than 200,000 participants.

Comebacks from the two major "disruptions" seem to prove that disasters can’t mar local enthusiasm for the towns. But perhaps the best endorsement of all comes from Astin: "I’m planning on making this my home for the rest of my life."

22 miles of shore, 17 roller coasters
Sandusky, Ohio

Sandusky, Ohio, has "tourist destination" written all over it, at least along its Lake Erie shore. It seems there’s hardly a person alive who doesn’t think of the city as a kind of adjunct for Cedar Point Amusement Park. Nicknamed "America’s Roller Coast" and currently boasting 17 of the sky-hurtling nemeses, the park fills a 364-acre peninsula jutting into the lake and comes complete with a multitude of other rides, water parks, two marinas, go-karts, mini golf - and a white sand beach.

But Sandusky hardly lets the "playground" windfall dampen its other business involvement.

By the time Cedar Point made its debut in 1870, energetic residents were already taking advantage of one of the finest and best-protected Great Lakes harbors to develop a now thriving shipping business and one of the largest coal ports, not to mention a prosperous fishing industry. Today, long piers jut into the lake like horizontal skyscrapers, and the current two-mile Sandusky Bay Pathway offers walkers a lake view while they make their way past parks, piers and boat ramps just on the edge of downtown.

No fewer than 26 islands dot the bay. The two largest, Kelleys and South Bass, are popular destinations for fishermen and picnickers, with frequent ferry service for those without boats.

"Being on water means that everyone wants to live on the lake, so there are lots of big houses," says Anna Enderle, the assistant city planner. But life beyond the water’s edge goes on, with many historic Victorian homes and newer homes as well. Adds Enderle, "We’ve got a really beautiful downtown, with original limestone buildings, and it seems like there’s a festival every week."

But the pride of downtown is Washington Parks, four quadrants of green heavily punctuated by flowerbeds and a "Celebration Mound" rented by citizens or groups and customized to advertise civic organizations, personal celebrations and special events. Flowers and greens for these plantings come from the Sandusky Greenhouse, a source of city pride since 1908. In fact, city employees install more than 100,000 plants each year in parks and other areas. Their dedication was rewarded in 2004 when the city received an America in Bloom Award.

Sandusky, whose name was probably derived from the Native American "San Too Chee" (cold water), began in the 1740s as a British trading and military post. After the Revolutionary War, survivors of brutal Connecticut battles started new lives in the area. It also came with a nickname, Firelands, a bittersweet reminder of the Connecticut settlers’ incendiary past. This nickname lives on today. Among the "mementos": Firelands Symphony, Firelands Winery - and, most significantly, the 400-bed Firelands Regional Medical Center.

Serving five counties, Firelands opened four floors of a new five-story tower in 2008, which includes patient floors and 13 relocated surgical suites. It’s recognized as number one in Ohio in overall orthopedics and among the nation’s top 5 percent for patient safety.

Within only 15 minutes of Cedar Point, it’s also the facility of choice for vacationer emergencies, although communications director Leslie Mesenburg reports that accidents are infrequent. The proximity has a downside for residents, though - traffic jams. "I go to work past there every day," says Mesenburg, "but on Saturdays I find another way to go."

Firelands is the largest participant in an unusual arrangement involving four other area hospitals. The Community Care 5 (CC5) are independent facilities in a business partnership to "fill in the blanks" on patient care, pool resources and collaborate on new ventures.

"At a time when the health care industry is becoming increasingly competitive, we’re working together to ensure that (our communities) have access to the best possible health care - right now, close to home, 24 hours a day, seven days a week," says Elisabeth Brand, the marketing and public relations director at the smallest of the CC5s, Magruder Hospital in Port Clinton.

Officials at Magruder, a 25-bed critical care facility, pride themselves on having one of the first all-digital hospitals in the U.S. "A lot of specialists come to the area once a week from Cleveland (65 miles east) or Toledo (60 miles west), and they’re really surprised," says Brand. "We’re a small hospital, but we took a huge step forward."

The small-hospital arrangement definitely appeals to Jennifer Casey, M.D., a Cincinnati born-and-educated family practitioner who moved to Port Clinton six years ago.

"From a medical standpoint, working in this area is unique," she says. "I love Cincinnati, but here you truly do family practice, whereas in Cincinnati, with the insurance climate and the size of the city, you don’t get to see the same patients back all the time. Here I get more of a sense of community medicine and family medicine."

Casey might have stayed in Cincinnati, but her private practice was bought out by an insurance company, and, she says, "I didn’t want to be employed by the insurance company."

As she tells it, "A headhunter said, ’You’ve got to come to Port Clinton. We have the perfect office for you. You will love the town, love the area and love the lake.’ And she was right. In Cincinnati I loved the Ohio River, but when I came here, I liked the lake better."

She also developed a new, compelling pastime. "Some of my best friends have a sailboat," she says. "I have learned to sail, and I absolutely love it." As a matter of fact, she continues, "I’m in the perfect boater position. My friends have a sailboat, and my parents, who have purchased a condo up here, have a motorboat. I’ve gotten to know the islands, and I’ve gone perch fishing." And, she adds, "I was surprised that the beaches are real beaches."

"By February," she says, "I’ll probably get really tired of the second or third snow, although I like the first. Someday, some headhunting group will call and say it has other practice options, but no way do I want them. I love it here."

What man has wrought
Smith Mountain Lake, Va.

Like many another body of water across the United States, Smith Mountain Lake, Va., was once part of a river - in this case two rivers, the Blackwater and the Roanoke, dammed in the 1960s. With 500 miles of shoreline, a scenic location in the Blue Ridge Mountains and easy access to nearby cities and towns, it eventually became a magnet for water addicts, retirees, northern "refugees," commuters and others pining for a break from big-city hubbub.

One of the more recent arrivals is Douglas Kells, M.D., a non-operative orthopedic specialist. Raised in Minnesota, Kells had tasted southern style - and temperatures - as a medical student in Richmond. He practiced for two years in Lancaster, Pa., but then made his way south again to Suffolk, Va., where he worked until retiring in 2007.

During that time, a friend with a home at Smith Mountain Lake piqued his interest in the area, so he joined the "lake crowd" in 2000, with a home of his own for vacations.

In 2008, he found a new professional niche at Carilion Roanoke Memorial Hospital, where he commutes for three workdays a week. He and his wife, a retired RN, moved permanently to Smith Mountain Lake. "I’m not a beach person," he says, but he does bask in "very relaxed and casual" surroundings, somewhat reminiscent of the lakes, rivers and trees from his Minnesota boyhood. The lake is also a lure for his four waterski-loving grandchildren from Raleigh, N.C., and Richmond.

For others, the area is a boaters’ paradise where fishermen can find many species, and landlubbers can find golf courses.

In 2009, Carilion Clinic, the parent organization of Kells’ Roanoke employer, added to the mix with an urgent care facility, Carilion Clinic Westlake. Carilion itself operates eight hospitals, plus outpatient specialty centers and advanced primary care practices serving about 1 million people in more than 23 counties.

Says Eric Earnhart, spokesman at Carilion headquarters in Roanoke: "People at the lake have a lot of choice."

Naples of the Gulf
Corpus Christi, Texas

"Texas is one of four states that people move to if they don’t know a soul." That’s Scott Hurst’s take on the hospitality reputation of the Lone Star State. Hurst is director of physician alignment and recruitment for CHRISTUS Spohn Health System in Corpus Christi, a Texas location he thinks of as a particularly good place for newcomers, not to mention long-timers.

With a population of more than 305,000, the city is home to two military presences, the Corpus Christi Army Depot and a Naval Air Station. As the sixth largest port in the U.S. - and one of the deepest - as well as one of the closest to Latin America, its business climate is heavily concentrated in shipping, but with a deep bow to the petrochemical industry. The area also nurtures cultural activities, including a symphony orchestra, ballet and playhouse. A performing arts center at Texas A&M’s local campus adds to the mix. Dozens of festivals help fill in any possible activity gaps.

The sandy playgrounds have developed thanks to a quirk of geography. A curve of shoreline known as the "coastal bend" has "hidden" the area from most violent weather. As Michelle Horine at the Convention & Visitors Bureau puts it, "The way we’re situated seems to be a little more protected." The area has escaped major storms for the last 20 years or more. Credit for this also goes to bordering Padre Island, the longest undeveloped stretch of barrier island in the world.

Robert McClimans, D.O., owns - and dotes on - a sailboat. "My wife and I had been to Corpus Christi many times," he reports. So he did a daring thing, deciding to "come down here for a season to see how it fits." He left his practice in Austin and has been involved in family medicine for several months so far at a clinic affiliated with CHRISTUS Spohn. "I get to live in a small town on a boat, and (my wife) likes the boat, too."

There’s another reason for McClimans’ choice of water transportation. After working long hours at the clinic, sometimes from 7 a.m. to 7 p.m., he’s seeking release from the day’s hubbub. "I like silent when I’m sailing," he says.

Because their grandchildren still live in the Austin area, the McClimans’ maintain their home in the state capital. Each weekend, they alternate driving between Corpus Christi and Austin, while he makes the boat his home during his five-day workweek.

CHRISTUS Health operates almost 350 medical facilities and services in the U.S. and Mexico, including three hospitals in Corpus Christi itself. CHRISTUS Spohn’s Shoreline location is the flagship of the group. The next biggest is Memorial, and then the South location. Other area hospitals include Corpus Christi Medical Center with its four locations and 583 beds, owned by Hospital Corporation of America, and Driscoll Children’s Hospital.

Hurst, the CHRISTUS Spohn recruiter, can testify to Texas generosity - and then some. "We have a very, very supportive community and foundation that gives millions to the system," he reports. "If a doctor comes in and needs something, very rarely do we not go out of our way to get it," he says.

But, he adds, "The absolutely biggest advantage is that we have documented a significant shortage (of physicians) in every area. (Therefore, a newcomer) never has to worry if there’s enough business here." Not only that. "We can document an immediate need for 60 physicians over the next three years. We have the advantage of a state where there is malpractice tort reform, the cost of living is exceptionally low, and there are many private practice and employee opportunities."

Eileen Lockwood is a frequent contributor to PracticeLink Magazine.



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