UO > Community Profile > Cleveland, OH

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Simpler pleasures of hiking, jogging, and biking lie in nearly everyone’s backyard, thanks to the city’s park system, officially called Cleveland Metroparks, but affectionately known as the Emerald Necklace, which graces the city. More than 42 million people pass through the 20,000 acres of these14 parks annually, many of them at the Cleveland Metroparks Zoo alone.

Cleveland’s downtown is a vital, evolving entertainment center. To date, approximately $1.7 billion has been pumped into projects like the Rock ‘n’ Roll Hall of Fame, the Great Lakes Science Center, and the theaters in Playhouse Square. The effort is paying off: Officials report nearly 16 million people flood downtown for events and attractions every year. City planners are looking at a long-term plan to reconstruct the interstates to create more of a boulevard feel along the lakefront, a la Lake Shore Drive in Chicago, to give folks more access points to the lake.

Housing has followed the downtown entertainment scene, with the number of market-rate units from the Flats to the Quadrangle doubling to 5,175 in the past few years. Retail has begun to swing hammers and rev up the power drills to support this potential population, but the area better suits singles than families. Physicians Coulton works with haven’t been persuaded to buy into the idea. “The area has always had very nice suburbs and public schools,” he says. “I wouldn’t have my kids in the public schools within the city limits.”

Families prefer the suburban neighborhoods, where $200,000 buys a lot of house. According to Georgalis, the hot spots on the east side of the Cuyahoga River are Aurora, Bainbridge, Zoland, Twinsburg, and Hudson, while Rocky River, Strongsville, and Westlake attract professionals on the west side. Of course, the river’s divide is merely a technicality. Commuting times are quite reasonable for a large city. Bowers, for example, lives 24 miles from the Kaiser Permanente office, and budgets less than 35 minutes to get there. “In some cities, that would be an hour and a half,” he says.

“You don’t have to fight to live in Cleveland,” Coulton agrees. “You don’t get on a lot of different freeways to go to work. We’re just an easy place to live.” It’s also a convenient place to leave: Cleveland is within 500 miles of 43 percent of the U.S. population, less than a day’s drive from major cities along the East Coast and Chicago on the west.

No wonder Cleveland is a cosmopolitan city that attracts a variety of ethnic groups. Its sister cities include Alexandria, Egypt; Bangalore, India; Cleveland County, England; Taipei City, Taiwan; Ljubljana, Slovenia; and Segundo Montes, El Salvador. “And we have an Orthodox Jewish community, so Orthodox physicians are automatically attracted here,” Bowers adds.

But when asked, residents proudly declare themselves Midwesterners, through and through, Coulton says.

Both UHHS and Cleveland Clinic have openings in a majority of specialties. According to spokesperson Julie Phillips, UHHS is currently on the lookout for dermatologists, emergency physicians, radiologists, family physicians, and orthopaedists. Bowers adds gastroenterology, hematology, oncology, and cardiology to his wish list. Marymount Hospital is in the market for primary care physicians, although that’s an area where Bowers sees a healthy supply.

“We were recently recruiting for primary care positions, and I didn’t even have to run an ad. I just saved all the CVs and inquiries I’d received over the past two years. We contacted those names, and out of the 12, all but three were available and still interested,” he says.

“Hey, the medical marketplace adjusts very quickly. Young people see what’s happening in the marketplace for jobs and adjust their specialties, so the flow of people seems to balance out quite well,” Coulton says. He’s always willing to meet with physicians in this moment’s red-hot niches, which include MD’s qualified to do invasive procedures in cardiology and gastroenterology.

Everyone agrees Cleveland needs ob/gyns. That’s because this specialty has suffered the most casualties from a poisonous medical malpractice environment in Ohio that mirrors the headline-making situations in neighboring Pennsylvania, West Virginia, and nine other states the American Medical Association has labeled “crisis” states. It’s been severe enough to give Michael Nowak, MD, a surgeon who grew up in Cleveland, second thoughts about living in his hometown.

“There was a statistic on one of the billboards in town that said 40 percent of the docs practicing in northeast Ohio have left or retired in the last five years,” he says. To underscore this fact, competing billboards, Yellow Pages covers, posters in the airport concourses, television, radio, and any other advertising spaces are plastered with messages from lawyers. Such a litigious environment meant insurance companies either fled the state or stopped writing new policies until the handful remaining jacked rates through the roof. To add insult to injury, physicians left high and dry without coverage then had to contend with soaring rates for tail coverage. One health-care system says it paid as much as $400,000 just in tails to bring on three obstetricians with clean records.

The malpractice insurance problems combined with the fact that the acquisition fever eroded Nowak’s referral base have caused him to worry. He readily admits the situation over the past five to 10 years kept him nervous and eyeballing other cities.

Today, he and other doctors are breathing a bit easier, thanks to new state tort reform legislation that took effect on April 7, 2005. Of course, as Isenberg points out, “It’s expected lawyers will subsequently challenge the law with the Ohio Supreme Court with time, as they have done previously. But currently, malpractice insurance rates have stabilized and two new insurers have entered the Ohio marketplace.”

Nowak found a more solid answer to both of his worries by joining Kaiser Permanente and scooting underneath its self-insured umbrella. “It’s been a pleasant experience working with a larger organization,” says Nowak. “I’ve been very satisfied with the change I made. It’s made living here very comfortable.

“But the pendulum does tend to swing. I think in the next five to 10 years you’ll see some sort of revival or renaissance as the malpractice and insurance issues subside somewhat,” he adds. “It means you’ll probably see more opportunities in the future.”

And, in the plus column, physician recruiters across the city say potential recruits don’t get hung up on the salaries offered, and Medicare reimbursement levels are reasonable. “During tough times, the practice patterns, the community involvement, the resources available to them keep doctors in the area,” Georgalis says. “For the most part, our medical staff is stable and doing well.”

Count Nowak among those staying. “You have to ask yourself what’s important to you. If you’re young and ambitious and want to take on the world and some risks, there’s that opportunity for an entrepreneur everywhere. There are always opportunities in Cleveland for people who are knowledgeable and willing to work,” he says. g