hoods. The health care infrastructure obviously is right up there with
transportation and communications.”
Gilbert estimates a nine-to-10-year timeframe for obtaining the necessary approvals, demolishing the O’Toole Building, constructing the new
St. Vincent’s facility and finally putting up low-rise apartment buildings.
Partnerships on large-scale projects aside, healthcare and commercial
real estate in the city may not always be on the same page. “The world
of medical practice in New York City is pretty much a world unto its own,
particularly the fact that New York City medical practitioners are still
practicing, for the most part, in ones and twos,” Manley says. “Elsewhere
the trend is definitely toward larger group practices.” M.D.s in the city frequently occupy space in the retail component of residential buildings,
she adds, partly because office tower
owners may balk at practitioners’
requirements, including heavy-duty
plumbing.
Two projects north of Manhattan
represent trends that are more
prevalent in other parts of the US.
Simone Development Cos.’
Hutchinson Metro Center, an office
campus at 1200 Waters Pl., in the
Bronx, has attracted a sizable number of medical practitioners. “Due
to the fact that we have some major
hospitals right next door to us—
Albert Einstein College of Medicine,
Montefiore Medical Center, Jacobi
Medical Center and Calvary
Hospital—we felt pretty confident
that it wouldn’t be difficult to attract
doctors because they had been
used to working there and had a big
patient base to begin with,” says Joe
Simone, president of Simone Development. “Sure enough, it’s been
proven true and we’ve got an unbelievable medical practice going on
there.”
Simone cites shifts in the medical landscape to explain both the
demand for healthcare space at Hutchinson Metro and his company’s
reasons for targeting this tenant base. “There’s an awful lot of outpatient
care taking place and there’s not the need and the demand for prolonged
hospital stays that there used to be,” he says. “By the same token, hospitals have become extremely expensive places to operate. The Bronx in
particular has been underserved in terms of medical facilities and treatment for outpatient care. We designed a class A facility that has a combination of public transportation and abundant parking as well as a state
of the art facility. We knew early on that a portion of it would be dedicated to the medical field.”
As Hutchinson Metro expands from its initial 460,000 sf, more healthcare tenants are clamoring to get in. The first 260,000-sf tower of phase
two is under construction, and Simone says medical practitioners could
account for 100,000 sf by the time it opens.
Because the tenant roster at Hutchinson Metro encompasses a variety
of specialists, Simone says patients could theoretically make the campus
a one-stop shop for their healthcare needs. This also makes communication among those specialists easier. “That’s a concept that I believe in
very much, and down the road you’re going to see a lot more of what I
call ‘medical malls.’ You’re going to be able to go into a facility and have
any sort of specialty taken care of, and they’ll going to have your records
in a central database.”
Westchester Medical Group’s recently opened facility at One
Theall Rd. in Rye could serve as an example of a medical mall. The
65,000-sf facility, located in the former headquarters of Lillian
Vernon Co., houses 50 physicians, advanced radiology and ancillary
CAT SCAN and MRI services, a seven-day a week urgent care facility, a private pharmacy and optical store.
“The usual model is that physicians make patients their own general
contractors,” says Dr. Simeon Schwartz, president of WMG, a private
multi-specialty group practice based in White Plains. “You go to one doctor, he sends you to a lab, you get your bloodwork, he sends you to
another to get your X-rays, then he sends you to a consultant halfway
across town. If you’re in your 40s or 50s and you’re basically healthy, you
can deal with that. But if you’re actually sick and you need five or six
physicians to manage your care, then you need to have some system and
organization that provides coordinated services.”
Therefore, Schwartz says, “Patients
want not only physical coordination,
which is what the facility provides, but we
also have an extensive technological backbone of electronic medical records that
provide functional coordination of care.”
Could a facility of this kind work in an
urban as well as suburban setting?
Schwartz thinks so. “If you were able to
put together 50 doctors to operate under
one tax identification number, you could
certainly do this tomorrow in any of the
outer boroughs,” he says. “Space is available and pricing is okay. Montefiore has
already done some components of this. In
Manhattan, the rent would be greater, but
there’s nothing to prevent you from taking
40,000 sf on one floor. It’s maybe $20 per
square foot more compared to a suburban
location, but that’s a million dollars more
for a facility that can generate $50 or $60
million annually. I’ve actually been over to
London to discuss this concept with the National Health Service; they
plan to do this in London proper, and certainly their real estate prices are
no better.”
In fact, the UK is looking at WMG as a model, Schwartz says, with
plans to close down some hospitals and open more outpatient clinics. “I think the reason this hasn’t happened more in New York is that
the real challenge is putting together the governance structure to
manage the physicians,” he says. “Look at law firms, and think of how
the market has changed in the past 20 years. Twenty years ago a big
law firm was maybe 50 lawyers. Now it’s 500. And what are the real
estate demands for a 500-lawyer practice versus 50?”
In designing the Rye facility, WMG sought to make the interiors a
little easier on the eye than the typical physician’s waiting room.
“Like in any other project, the ambience counts, and healthcare facilities have traditionally been built to look like institutions,” says
Schwartz. “Office space has traditionally been built to
be more inviting and has finishes that are different from the
industrial-strength, indestructible finishes of a healthcare institution.
Our facility is more typical of the corporate image than the institutional image.”
Even so, an institutional setting can be designed with ambience in
mind. For example, Cannon Design recently completed a 160,000-sf,
five-story addition to South Nassau Communities Hospital in
Oceanside. The addition was intended to complement the existing
building, which dates from 1928, while allowing substantially more
natural light to flow through the building and providing more open,
airy, attractive environments. The result, says Megan Foley, a spokeswoman for the design firm, was “one of the most successful projects
Cannon Design has undertaken.” —RENY
Westchester Medical Group’s new facility in Rye follows the
“mall” format that’s more common in other parts of the US.
