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Beyond Boston, patients find specialized care closer to home

Glenn Rosander and Linda Holland at Emerson Hospital.
Glenn Rosander and Linda Holland at Emerson Hospital.mark lorenz for the boston globe

Boston-based hospitals and national health care companies are spending millions of dollars in the suburbs, building everything from cancer centers to specialist doctors’ offices, changing the way suburban consumers get their medical care.

“The old model for health care for people who didn’t live in cities was you went to the local community hospital and if things went bad, you went into the heart of the city to get your more complicated health care,” said Dr. Ashish Jha, a professor of health policy at the Harvard School of Public Health. “That model has changed. Now you can get a lot of the health care you want without having to drive into the city.”

Jha said the trade-off — convenience and comfort locally versus the expertise and experience of the city hospital — is disappearing as more Boston hospital staffers work at the suburban outposts.


In Needham, that means access to experimental procedures and Harvard-affiliated physicians at a three-story cancer center, which opened at Beth Israel Deaconess Hospital-Needham in September 2014. The 30,000-square-foot facility offers radiation, chemotherapy, and surgery in treatment areas that overlook a healing garden.

In Milton, the two-year-old Center for Specialty Care at Beth Israel Deaconess-Milton brought Boston specialists in 16 fields to the former community hospital — including weight loss surgery, sleep disorders, neurology, and cardiology. Close to 4,000 patients visited from October 2014 to September 2015, said hospital spokesman Robert McCrystal.

The expansion trend isn’t limited to urban medical centers staking out space in the suburbs. For example, Lahey Hospital and Medical Center in Burlington is expanding its emergency room in response to increased local dependence on the suburban facility, said spokesman Dan Marra.

The current emergency room opened in 1980 to serve 17,000 patients annually and now sees 40,000 patients a year, he said. The expanded space, scheduled to open in 2017, will accommodate more than 50,000 patients annually, Marra said.

The 45,000-square-foot facility will provide more privacy and include three behavioral health rooms for patients with mental-health or substance-abuse issues, he said.


Elsewhere, Emerson Hospital, an independent community hospital in Concord, opened a $3 million Center for Rehabilitative and Sports Therapies in May.

“Our volume had increased so much we were just bursting at the seams,” said Terrie Enis, Emerson’s director of rehabilitation services.

The new building, about a mile west of the hospital, includes a therapeutic pool that uses an underwater treadmill with underwater cameras; separate gyms for pediatric, orthopedic, and neurologically impaired patients; and a concussion center geared to student athletes and others with concussive brain injuries.

Enis said about 210 patients ranging in age from infants to 90-year-olds visit daily.

The center has a “very robust” Parkinson’s disease program, she said, as well as a partnership with an elite youth soccer team that helps injured members safely return to play.

In Newburyport, Anna Jaques Hospital teamed up with Beth Israel Deaconess to open an in-house cancer care center in February.

Meanwhile, a $56 million surgical wing is under construction at Lawrence General Hospital, with an anticipated completion date of late 2016, according to spokeswoman Jill McDonald Halsey. She said the space will replace the existing surgical facilities.

Much of the construction activity in Greater Boston is aimed at improving delivery of services to consumers closer to where they live.

Beth Israel Deaconess-Milton’s $2.7 million specialty care center was carved out of billing offices on the ground floor of the old Milton Hospital and has significantly increased its surgical volume, both inpatient and outpatient, said McCrystal, the hospital spokesman.


Among the center’s patients was Maria Zervos of Randolph, who chose to have her spinal surgery at Milton this spring.

“If the doctor is here, why bother to go to Boston?” she said.

More than 800 patients a day go to Foxborough’s Patriot Place mall for health care at the four-story Brigham and Women's/Mass. General Health Center, which has expanded since opening in 2009, according to spokeswoman Elaine St. Peter.

Not all the expansion is bricks and mortar.

Since February, heart attack victims arriving at the former Jordan Hospital — now Beth Israel Deaconess-Plymouth — have been able to get life-saving stent surgery in a new cardiac catheterization lab. More than 50 patients have gotten the emergency treatment, according to hospital spokesman Christopher Smalley.

Previously, the closest hospitals that could do the procedure were Cape Cod Hospital in Hyannis or South Shore Hospital in Weymouth, he said.

“If you’re having a heart attack, there’s a very short time window — 90 minutes — before you have permanent damage,” Smalley said. “We wanted to be able to provide that service here.”

That approach is key to changes at the hospital, he said. “Our recent advertising campaign said it: Plymouth has come a long way, so you don’t have to.”

Harvard’s Jha pointed out that the cost implications of the push to the suburbs are still unclear. “Will they be able to charge academic medical center prices when they’re in Waltham or wherever? We don’t know,” Jha said.

He also said there appears to be a focus on services that pay well — “sports medicine pays better than substance-abuse treatment,” he said — although that may be more a reflection of the needs of a family-heavy, suburban clientele.

“Whether it’s driven by trying to do right by that population, or by the bottom line, or a combination of both, that’s ultimately in the hearts of the people driving the decisions,” he said.


And not all hospitals are growing.

Since 1980, 63 hospitals in the state have closed — seven in the last five years, including Quincy Medical Center — according to the Massachusetts Hospital Association.

“A lot of community hospitals either have been bought out or they’re going to shut down,” Jha said, “and we will see more losers.”

Johanna Seltz can be reached at seltzjohanna@gmail.com.