January 3, 2011 | last updated June 1, 2012 9:30 am

'Medical Malls' Growing

PHOTO/PABLO ROBLES
PHOTO/PABLO ROBLES
Left: Dr. Steven Weinreb is one of five primary physicians at Hartford Medical Group's annex in Wethersfield. They treat everything from sniffles to cuts to broken bones. Such ambulatory care, while convenient for patients, he and others say, also frees hospitals for more serious cases.
PHOTO/PABLO ROBLES
Hartford Hospital runs this suburban medical-office annex at 1025 Silas Deane Highway in Wethersfield. More hospitals find them a convenient, relatively low-cost way to deliver quality, efficient care beyond the traditional hospital setting.
PHOTO/PABLO ROBLES
Among the benefits of suburban medical malls is the ability to consolidate scheduling and back office functions.

Editor's Note: A previous version of this story incorrectly stated that Yale-New Haven Hospital and Casle Corp. are partners in Casle's development of a medical mall in North Haven.

As a modern prescription for patient care, medical-office annexes are fast becoming havens for outpatient treatment that is convenient, high quality and efficient.

But as bricks and mortar, they also give a shot in the arm, authorities say, to a Connecticut and national commercial real estate market on its sick bed in recent years due to high numbers of foreclosures and vacancies.

In many cases, landlords can't resist building or renovating space for hospital-physician practices, tenants whose steady stream of paying clients effectively anchors them to the community — and their spaces.

Hartford Hospital, with 13 suburban medical annexes, and Saint Francis Hospital and Medical Center, with 17 plus two more on the drawing board, are the major players developing and operating Class A medical office buildings in Greater Hartford. But even some smaller players are getting in on the act.

Just recently, Avon developer Casle Corp. announced a $15 million, three-building medical office mall in North Haven.

At the same time, Casle is underway with construction in South Windsor on a medical annex expansion on Tamarack Avenue , next door to Evergreen Walk shopping plaza, for Eastern Connecticut Health Network.

ECHN, a hospital partnership that includes Manchester Memorial and Rockville General in Vernon, plans to move its Women's Health Center into a new building going up next door to its current home on Tamarack Avenue, joining a new obstetrics/gynecology practice that also will be housed there. Three more annexes are on the drawing board.

"It's the modern way to deliver medicine,'' says Kent Stahl, medical director/CEO of Hartford Medical Group, the med-center arm of Hartford Hospital. "Patients crave the care they want and need when they want and need it. That's a high standard for the delivery system to provide, but that's what we aspire to.''

California, Florida and Texas lead the growth of medical office buildings — also known as access centers. (Care providers bristle at calling them "clinics.'')

In Connecticut, they are most visible as one-story, free-standing buildings alongside suburban shopping centers. Indeed, patient demands for convenient office location along busy thoroughfares and ample free parking are the reasons developers and care providers say they can't build or expand them fast enough.

"What we know is patients want the practitioner to be close to home,'' said ECHN Senior Vice President Dennis McConville. "They don't want to travel to get to them.''

Medical office buildings have existed in some form for decades, experts say. Mostly they were built to house individual physician's and dentist's practices, usually anchored with a pharmacy or wholesale-retail medical supplier.

Connecticut health regulators say they don't know precisely how many medical annexes exist in the state.

However, they are frequently recognizable from their logos hanging out front as satellite outpatient treatment centers to many of the region's private hospitals. Others are run by non-hospital affiliated providers of such specialty care as physical rehabilitation, obstetrics-gynecology, cardiology and radiology.

Moving ambulatory treatment to suburbs where land is cheaper and more available also benefits hospitals by freeing up their limited and more expensive main campuses to care for their sickest patients, doctors and administrators say.

The way it works can be seen at one of Hartford Hospital's health annexes that offers primary and urgent care and rehabilitation service under one roof in Wethersfield. West Hartford landlord Steven Neiditz spent $5 million erecting the 19,205-square-foot building at 1025 Silas Deane Highway.

Tucked on the edge of the Wethersfield Shopping Center, the annex houses five primary care doctors who see as many as 100 patients a day on weekdays for everything from colds and sprains to physicals and surgery follow-ups. The center also treats patients on weekends and holidays, including Thanksgiving and Christmas.

Some medical centers can run to $8 million to $9 million to build and outfit. With all the attention on getting the proper staff and the right medical equipment and supplies, care providers take pains to make their facilities comfortable and inviting for patients and staff.

The patient waiting area resembles a living room, with upholstered chairs and sofas. Magazines are spread on wood coffee and end tables. Dark-stained wood frames interior doorways and windows. The floor is carpeted and framed photo scenes shot by a staff physician adorn fabric-covered walls.

But beyond the waiting area, the 19 exam rooms are all business. All have a computer screen that physicians use to call up patients' digital records. Every room has the same medical kit — a cabinet filled with tongue depressors, thermometers, and sanitary gloves.

Color-coded tags track medical supplies and alert staff when they need to be replenished, a key part of the health center's "lean-process management'' for efficiency and to keep costs down, Stahl said.

Staff have kitchen-style break room, a locker room, even a shower for staff who bicycle to work or jog on lunch break.

Oncology surgeon Robert Piorkowski devotes several days a week to seeing patients at the Wethersfield office minutes from his home instead of them traveling to his main office in Hartford Hospital to meet him.

Technology also has a role in the evolution of medical office centers. In addition to health records available electronically, doctors can review digitized X-rays of broken bones and magnetic resonance image tissue scans on a set of video monitors. Even better, the information can be viewed simultaneously by doctors in other remote offices.

In some cases, the medical center can provide urgent care — but only up to a point. The medical staff can diagnose and stabilize an emergency patient, "but after that we have to call 911 for an ambulance just like everyone else,'' said Dr. Steven Weinreb, one of five primary care physicians staffing the office.

In Hartford, Hartford Hospital transformed a two-level building that was a car dealership into a new home for its Women's Health Services unit. The move freed space from a building on the hospital main campus a block away for more acute care, said Dr. Peter Beller, who oversees the women's health unit.

The unit, in return, got more room for its 80 to 100 outpatients daily, many of them Hartford Latinas, Beller said. In addition, patients have two separate ultrasound suites, and no longer share one suite divided by a curtain, he said.

The benefits of medical office centers extend beyond doctor and patient.

Landlords embrace them because they have proved easier to keep fully leased than other forms of commercial real estate during the economic slump, said Eric Johnson, managing director for Transwestern, which has 6 million square feet of medical offices in Houston. It also manages similar space for institutional clients.

"Medical office now is clearly very popular,'' Johnson said.

Health care insurers like them, too. Aetna Inc. spokeswoman Susan Millerick says the centers "fit well into the health care delivery system … to help engage people earlier in the health continuum where hopefully they can be treated before needing to be hospitalized.''

In West Hartford, Blue Back Square originally opened three years with 40,000 square feet to house Hartford Hospital's outpatient surgical center on the fifth floor of the Rutherford Building. Since then, the hospital has added another 8,000 square feet.

The hospital's presence has helped draw other medical tenants to Blue Back, including a dentist, an obstetrician, a dermatologist, a psychiatrist and a radiology/MRI facility, says landlord Ronus Properties LLC. So far, only about 5,000 square feet of the total 71,000 square feet of medical office space at Blue Back is vacant, says Will Lorenz, senior property manager for Ronus.

As the number of people undergoing knee and shoulder surgeries and outpatient visits to Blue Back has risen, so has the volume of shoppers and diners at the properties retail tenants, Lorenz says.

"It's great for Blue Back because it puts feet on the street,'' he said.

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