When Dr. Thomas P. Barnett set up his surgical practice in Dover 17 years ago, he was surprised to learn how little confidence some of the residents had in their doctors.
Patients would thank him for a diagnosis, then tell him they would rather have the procedure done by a “real” doctor at Christiana Hospital.
Barnett figured it wasn’t a question of expertise that was driving their doubts, but a matter of perception. People expect offices to have a clean, modern look. Dover physicians were working out of outmoded medical-arts buildings or old houses that had a host of structural and environmental problems.
So when the Eden Hill Farm went up for sale after closing in December 2004, Barnett and a group of colleagues thought it would make an ideal location for a state-of-the-art medical center that would raise their profile and burnish their image.
Their vision became a reality in October when a ribbon-cutting ceremony marked the official opening of the Eden Hill Medical Center.
Roughly the size of three football fields, the $36 million project feels more like an upscale mall than a medical office. The main entrance features a two-story atrium and an expansive lobby with a white-tiled circular staircase. Three stretcher-compatible elevators ferry patients to and from appointments. Satellite radio is piped throughout the building, and the walls are soundproof. A café awaits those who want to do more than read a magazine in the doctor’s waiting room. The exterior is landscaped with as much greenery as possible, and a mansard roof adds a decorative touch to the colonial architecture. The parking lot can accommodate more than 800 vehicles.
Though the planners didn’t set out to build anything fancy, they admit the aesthetics do have their rewards.
“It’s like when you walk into Christiana Hospital, you think, ‘Wow, these people must really know what they’re doing,’” says Barnett, who toured other medical centers like Glasgow and Limestone in northern Delaware. “It’s just a general good feeling you get when you’re a patient, and it’s important to have confidence in your physicians.”
Medical malls offer the widest possible array of services and provide a convenient, one-stop environment designed for the healthcare consumers it serves. Eden Hill includes urgent care, laboratory, imaging, urology, podiatry, pulmonary, a sleep lab, ophthalmology, optometry, primary care, cosmetic surgery, infusion, pain management and a pharmacy.
“You can walk in the door and in one day see three or four or five different specialists, if you can arrange it,” says Stephen F. Dobias, a healthcare consultant with Indianapolis-based Somerset CPAs, which was instrumental in planning the project. “The efficiency you get by having all these services in a single building is significant.”
Medical malls also reflect the healthcare industry’s effort to keep costs down by providing an alternative to the hospital emergency room.
“It’s a great access point. The strategy complements what we need for our economic demographic,” says Gary Shaw, vice president of operations for the northern region of Bayhealth Medical Center, which has a one-sixth ownership in Express Care. “We need walk-in points for people that are less expensive than an emergency room, so we’re happy to be a part of it.”
The medical mall also serves as an effective platform for interaction between physicians and other healthcare providers.
“I think it’s human nature to develop relationships with people who are your neighbors,” Barnett says. “You get to know them and get to work with them, and it makes it a lot easier.”
Dr. Jeffrey Barton of Kent Foot and Ankle Center, for example, says he can tell the pharmacy to stock the medications he routinely prescribes so patients can pick them up before they leave.
He also recalls the time a patient suffered a fall before his appointment.
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“I sent him downstairs for an X-ray of his hip, which is not something I would ordinarily do—I’m a podiatrist,” he says. “But his hip film was negative, and we could continue right where we were before.”
Barnett has had Express Care call to have him look at a patient who showed up with an incarcerated hernia.
“Before, they’d have to send them to the ER, where they’d have to wait three or four hours,” Barnett says. “I’m able to reduce the hernia and save them a trip to the ER.”
The center also provides an ideal setting for healthcare conferences and patient education. Eden Hill has two conference rooms—2,000 and 600 square feet respectively—that can host community activities, physician meetings and patient seminars.
“Bayhealth wants to use it for some of their educational sessions, and the OB/GYN doctors are talking about having Lamaze classes for their patients,” Barnett says.
Planning a medical center presents unique challenges. The list of special needs can be a lengthy one. Eden Hill is a co-op, meaning each tenant leases space from the corporation that owns the facility. Just about every tenant owns shares in the corporation, Barnett says.
One advantage is that the tenants were able to customize their space to optimize the patient experience.
Dr. Carolyn Apple, president and medical director of Express Care and one of Eden Hill’s seven board members, says that starting from scratch allowed her and her partners to consider such specifics as how they wanted to enter a room, where they wanted the examining tables placed, and where they wanted to sit in relation to the patient.
Setting up at Eden Hill allowed the Delaware Surgery Center to expand to four times its previous size, consolidate its departments under one roof, and design its space to allow for better patient flow, says COO Suzanne Roderheiser.
“The hemi-circle on the left is administration and the hemi-circle on the right is for patient flow,” she says. “So you go from reception to admissions to the OR to recovery and then out. We have a portico now where cars can drive up and pick the patients up.”
Barnett says designers purposely kept some services clustered, such as radiology, the lab and walk-in medical care.
So can X-rays and cosmetic surgery be sold like jeans and big-screen TVs?
“It will be up to the patients to decide,” Barnett says.
The hope is that while they’re at the center, patients might be prompted to get a flu shot or a mammogram or to investigate a health concern.
Barton is already seeing results.
“I’ve already had patients just because they see my name on the board when they come to see another doctor,” he says. “I think it’s going to pay off very big for all of us in this building.”
Apple has had a similar experience at Express Care. “I had a woman whose husband was having same-day surgery down in the surgery center,” she says. “She had some problems with her knee for a couple of days, so while she was waiting for her husband to come out of surgery, she decided to come down to Express Care and be seen. They definitely see it as a convenience.”
One thing is certain: Eden Hill has generated a lot of enthusiasm among Dover physicians. Plans are already underway for a second 30,000-square-foot building on the 25-acre campus. Tenants are being lined up, and Barnett hopes to add an orthopedic practice and physical therapy.
“I think, as a physician, if you’re coming to Dover, you’ll want to be in a place like this as opposed to one of those stand-alone buildings,” Barnett says.
