COVER STORY, SEPTEMBER 2008

STEMMING THE TIDE
As Baby Boomers reach retirement age, Texas’ health care industry rushes to prepare.
Coleman Wood

One of the most popular health care stories lately has been the impending retirement of the Baby Boom generation and what that means to our country’s health care industry. The news coverage has even given rise to the phrase “gray tsunami”, which is used to describe the event and the subsequent strain it will put on hospitals and health care practitioners nationwide.

Many in the industry are taking ample steps to prepare for this event, including Texas’ medical schools, private and public health care providers, and others deeply involved in the industry. The health care business is booming right now, and Texas is leading the way.

“I believe in a ‘gray tsunami,’ but in Texas, it’s more than that,” says Rod Booze managing principal and CEO of Arlington-based Ascension Group Architects.

As one of the health care industry’s leading architects, Ascension is fully in tune with the trends in the industry. Booze says that a huge driving factor in health care development in Texas has to do with a World War II-era federal law.

Passed in 1946, The Hill-Burton Act provided federal dollars to help improve the nation’s hospital system. The law made it much easier for smaller communities and charitable organizations to fund the construction of a new hospital, which caused a slew of hospitals to be built in many of Texas’ rural communities, especially in the central part of the state.

The new Winkler County Memorial Hospital, located in Kermit, Texas, will total 34,000 square feet upon completion in December.

“Now it’s come full circle, because most of those hospitals are 50-plus years old, and they require replacement,” Booze says. So there’s a big push in Texas to get those facilities replaced.”

Ascension Group is currently designing such a facility in Kermit, where Winkler County Memorial Hospital is being replaced with a new $13.1 million facility. Once complete in December, the new hospital will total 34,000 square feet, including 27,400 square feet of new space.

Forest Park Medical Center is a medical/surgical hospital located in North Dallas.

In the Dallas/Forth Worth market, Ascension is also designing numerous projects that do not fall under the umbrella of Hill-Burton. The company is working on Forest Park Medical Center, a $36.4 million medical/surgical hospital located in North Dallas. Expected to open in the first half of 2009, the hospital will comprise 66,100 square feet and two stories. The program manager for the project is The Staubach Company, with Physician Synergy Group serving as operation manager. Ascension is also designing two more developer/physician group joint venture projects in Southlake and Sunnyvale.

A concern that many in Texas have, though, is having enough trained physicians to fill these new projects currently under development. 

Two different angles of the 120,000-square-foot education building currently under construction at the University of North Texas in Dallas. The project is the first step in the school’s 1 million-square-foot expansion plan.

“Health care professionals are desperately needed at this time, and more so in the future,” says Greg Upp, senior vice president of community engagement for the University of North Texas in Dallas. “Just from a physician standpoint, we currently rank 51st out of 51 [in the United States] in physicians per 100,000 residents.”

Responding to this professional shortage, the Texas legislature has put out the call for the many colleges of Texas to step up.

“The Texas legislature has asked all of the Texas medical schools to expand their enrollment, and they’re currently looking at the potential for several additional medical schools in the state,” Upp adds.

UNT is in the beginning stages of a master plan that will drastically increase the size of the university. The college recently acquired 15 acres of new land to add to its existing 18-acre campus. This month, construction will begin on the first project, a 120,000-square-foot education building. The school will approach the Texas legislature when it reconvenes in January about issuing tuition revenue bonds for the construction of a 150,000-square-foot research building.

“We completed a master plan about a year ago for our complete 33-acre campus, and it identified that over a 10- to 15-year period of time, we would need to add an additional 1 million square feet of educational, administrative and research space,” Upp says. He adds that with the university already totaling approximately 1 million square feet, the expansion would double its size.

The university is also actively involved within the surrounding community; it has students that rotate through the hospitals in Fort Worth’s Hospital District, and has partnerships with many of the area’s research companies. It also is part of a public/private partnership that operates a small business incubator in the area, complete with wet lab space for researchers.

“We’re in an elite group now, but we want to become truly world class and truly top-10 in the area of primary care,” Upp says.

Texas A&M University also recognized the coming physician shortfall, and sought to address it early. Dr. Christopher Colenda, dean of Texas A&M’s Health Science Center College of Medicine, says that the university needed to get its expansion efforts underway as soon as possible, mostly due to the amount of time needed to educate physicians. In addition to 4 years of undergraduate work, physicians require anywhere from 3 to 7 years, depending on their area of specialty, to be licensed and practicing.

Texas A&M University is building new medical campuses in Bryan (shown here) and Round Rock.

The plan calls for the creation of a new clinical campus in Round Rock, in addition to the college’s Bryan-College Station and Temple campuses. The Bryan-College Station and Temple locations will comprise 4-year campuses, while the Round Rock campus will be a clinical campus for third- and fourth-year students.

“That should be able to accommodate the clinical training needs for our students at the hospital systems that we are partnered with in each of those communities,” Colenda says.

The Board of Regents has approved the construction of the new Health Science Center campus in Bryan, and hopes to break ground in the fall. The campus will contain the four-story, 127,500-square-foot Medical Research & Education Building, as well as the four-story, 128,160-square-foot Health Professions Education Building.  The Research Building will contain seminar rooms, a scientific display area, a vivarium, an imaging lab and faculty offices. Connected to the Research Building via an outside plaza, the Education Building will feature a education/conference center on the ground floor during the initial stages of development that will contain lecture halls, seminar rooms and classrooms. The rest of the building will include staff offices, an information technology hub, a teaching and learning resource center, a simulation center, deans’ suites, and faculty offices for the College of Medicine and College of Nursing.

The infrastructure is also in place at Temple for its 4-year campus, but construction details were not released. The university has also broken ground in Round Rock for an education building, which will tentatively come online in November 2009. It will comprise a four-story, approximately 134,000-square-foot structure, and will include a 200-seat lecture hall/auditorium, health clinics, student support services, staff offices, an information technology hub, a simulation center and deans’ suites. Colenda also notes that the school admitted 135 first-year medical students this year. Next year, the school will admit 170, and 200 will be admitted once the expansion is complete.

“This is a school that is on the ascendancy, and we intend to contribute to the clinical and academic environment here in the state of Texas,” Colenda says.

But these two universities — Texas A&M University and the University of North Texas — are just the tip of the iceberg. Rod Booze notes that Southwestern University’s medical program is constantly working on new projects, and other schools in the University of Texas System are equally as active.

“The University of Texas, on various campuses in Dallas, Galveston, Austin and so forth, has continued to develop their research programs on those campuses,” Booze says.

It has been recently reported that the University of Texas in Austin has held discussions about the creation of a medical school, but officials from UT did not return calls seeking comment.

Still, health care is on every school’s mind in Texas, as the rush to prepare for the Baby Boomers’ retirement continues. Between the renovations to many of the state’s hospitals, the expansion of its medical school programs and the continued growth of the state’s urban health care districts, Texas should be well prepared for the coming wave.

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