By Nathan Crabbe | The Gainesville Sun
With the landscape of health care shifting, Shands HealthCare and the University of Florida are seeking to build new facilities in Gainesville and other parts of the state.
This week's groundbreaking of a primary care practice called UF&Shands Family Medicine at Main marks the latest part of the health system's expansion. Next month, a groundbreaking will be held for a new facility combining some of Shands' specialty care practices near Shands Vista and Rehab hospitals on Northwest 39th Avenue.
On campus, UF is planning a new medical education building that would include a tower that would be the health science center equivalent of Century Tower. Beyond Gainesville, Shands is planning a new hospital in north Jacksonville, considering a medical facility in The Villages south of Gainesville and discussing a partnership with Orlando Health.
David Guzick, president of the UF&Shands Health System, presented the ideas to UF trustees at a recent retreat in St. Augustine. He said the campus construction will accommodate a new medical school curriculum, allowing for new technology and a shift from large lecture halls to smaller rooms that allow students to work in groups.
The expansion of clinical facilities also comes in the context of broader changes to health care.
Guzick said declining state and national funding and other changes will force Shands and other health care providers to alter the way they operate.
“We need to think regionally if we're really thinking about the future,” he said.
Family practice on Main Street
The past practice of Medicaid and Medicare simply paying for services is moving to more of a managed care model, Guzick said, in which providers get a fixed amount to care for a population of patients. Constructing the Family Medicine at Main facility is part of preparing for that shift by providing services that reduce emergency room visits, he said.
“It's really more than building a building. It's really about building what we call a medical home for the people of east Gainesville,” he said at the groundbreaking. “It's about creating a model of family centered primary care that promotes health and reduces the need for hospital admissions.”
The two-story, 24,200-square-foot building at 1707 N. Main St. will house 24 examination rooms, two procedure rooms and rooms for counseling and group visits. The $6 million facility replaces the Family Medicine at Fourth Avenue practice, located near the old Shands at AGH hospital site. The new building, which opens on July 1, will have nearly 40 percent more space.
The practice will be staffed by 10 College of Medicine physicians, 26 residents, two sports medicine fellows, a pharmacy faculty member, a licensed clinical social worker and a nurse/midwife. It will continue the role of the Shands family practices in training future physicians, said Dr. R. Whit Curry Jr., chairman of the department of community health and family medicine.
The American Academy of Family Physicians predicts a shortage of 40,000 family medicine physicians by 2020. Since the UF family medicine residency program started in 1973, it has produced 247 graduates to date — 160 of whom practice in Florida, including 72 in Gainesville.
“We're quite proud of that record of getting physicians out into the community to practice,” Curry said.
Changes also are happening on the UF campus. Guzick noted that the colleges of medicine and dentistry are the only health science center colleges that haven't had new facilities built in recent years. Dentistry is going through a master plan process and has proposed an expansion to the state that would include a renovation of existing and possibly new facilities.
Guzick said the 100,000-square-foot medical education building for the College of Medicine is planned next to the Health Professions/Nursing/Pharmacy Complex on Newell Road. It would include a tower that mirrors Century Tower on the academic campus.
The $40 million project would be funded in a similar way as private universities using donations and out-of-state tuition of medical students, Guzick said.
“We're not asking the state to provide funding,” he said.
Out-of-state students would be added in the same way that the College of Veterinary Medicine has done, he said. Veterinary Medicine used to have 88 students, eight from out of state. It expanded to 100 students, 12 from out of state. The additional revenue funds college programs.
The College of Medicine would similarly keep its current enrollment of mainly Florida residents steady while adding about 15 out-of-state students, Guzick said. The revenue would help pay down about half of the cost, he said, while donations would pay for the remainder. The college is now in discussions with a donor about a $10 million contribution.
Guzick said the new facility would accommodate changes to the medical curriculum by providing space for small groups and team learning with other health-science disciplines.
“The idea of the building is to fit form and function,” he said.
The facilities outside of Gainesville are still in the planning stages. Last month, Shands filed a letter of intent with the state that would pave the way for a hospital in north Jacksonville. The first phase of the development would be a medical office building with primary and specialty care practices and ambulatory care services at the corner of Interstate 95 and Duval Road.
Guzick said the growth in north Jacksonville has created a need for such a hospital. North Jacksonville has grown by 22 percent over the past decade, 50 percent faster than the rest of Duval and Nassau counties. Future phases of the facility would include a 110-bed hospital that could grow to 300 beds.
The plan would still need approval from the appropriate governing boards. A possible facility in The Villages is at an even earlier stage. Shands now only serves a small percentage of the population of 360,000 in that area, so sees it as a place for growth. Guzick said a new Shands facility there might be a primary or specialty care practice, but not a hospital.
“I think it’s pretty obvious that we should do something in The Villages,” he told trustees.
Last year, Shands signed a memorandum of understanding with Orlando Health to negotiate forming joint programs in a number of areas. Guzick said discussions are moving forward on an agreement, which would likely create a clinical network with common standards and medical records. Orlando Health operates five community hospitals, three specialty hospitals and a cancer center in Central Florida. Creating a network with Orlando Health would put Shands in a better position to present itself to a government or private employer as a system that could provide care for its workers, Guzick said.
“We can’t be localized to Gainesville,” he said.