LEFT, Miami’s famous Art Deco
hotels adorn Ocean Drive in South Beach.
RIGHT, An aerial view of Aventura Beach
shows Biscayne Bay, Miami Beach, and downtown Miami in the
distance.
@ 2005 Paul Morris
@ 2005 Paul Morris
Miami, Florida (continued)
A laid-back lifestyle
“There’s a panache and marquee
value to the South Beach area, but this is really a wonderful
family community with a lot of spectacular suburbs and good
schools,” Katz points out. In reality, Miami is a big
city spread out across an entire county, with virtually no
downtown core that resembles the high-rise office clumps most
cities offer. Ciraldo describes it as a “unique urban
environment that feels like the suburbs.” Both physicians
chose to live on Miami Beach, where the cost of housing has
skyrocketed in recent times. But fellow physicians get around
this, they note, by purchasing housing in areas such as Coral
Gables, Aventura, and Hallandale.
“The trade-off
is the less expensive the houses, the more likely you are to be
away from the action,” Katz says. And the closer you want
to live to the beach, the more you need to sacrifice the notion
of a single-family home surrounded by the white picket fence.
“You can’t
go east because of the ocean, and you can’t go too far
west because you run into the Everglades,” Osinski says.
“As a result you find that housing prices continue to go
up because there aren’t a lot of locations in close to
where you need to be.” But there is good news on the
horizon: Miami-Dade County recently approved
approximately 55,000 new condominium permits, after building
just 15,000 in the last 10 years. Osinski will leave it to the
realtors to determine what this means in terms of glut and
price—for him, it means physicians will have enough
property available to find living quarters.
Even the prices
don’t necessarily daunt Ciraldo. When the cost of living
comes up in conversation, she reminds her audience of her son,
who works on Wall Street. “For the rent he pays for his
studio apartment in Greenwich Village, he could live in a
luxury one-bedroom place here with a pool and other very nice
amenities. It just gets back to this is a really nice place to
live.
“I have to admit
that no matter how hard my work day has been, I still drive
home and feel like I’m on vacation. The weather is just
so beautiful, our weekends wonderful. It’s a very
leisurely kind of lifestyle compared to so many other major
cities in America,” she adds.
But unless
you’ve lived under a rock in the past few years, the
words South Florida also conjure images of hurricane damage:
downed trees and power lines, twisted heaps of metal and
brick that once were homes, lines of residents waiting for food
and water. Osinski admits the previous two hurricane seasons
have discouraged a number of physician candidates from
exploring their options here. But those who already consider
Miami home simply shrug their shoulders at this bad news and
move on. “It’s a part of the way of life,”
Katz says philosophically. “We just tell people this is
one of the trade-offs for living in paradise. We’re
willing to take that chance, far and away.”
Paging doctors
Because Miami covers a lot of ground, it
has attracted a lot of hospitals to match, enough to ensure no
one player dominates the field. “There is a tendency for
people to want to go not only to places that have excellent
care and excellent doctors but that are convenient to
home,” Katz says. “So while there are a few
hospitals in the area who have an edge on the competition in
certain areas, there are a lot of full-service hospitals here
doing everything.”
And good news for
physicians: The competition means you can secure
privileges at more than one location. Lock boxes in this market
simply wouldn’t make sense.
It also shakes out as
state-of-the-art everything at the hospitals. From the press
releases hospitals send out, they offer a plethora of services:
• South Miami Hospital, part of the Baptist Health South Florida network,
touts its wards in maternity services, help for infants and
children with developmental delays and disabilities, addiction
treatment, weight-loss surgery, cardiovascular services,
diabetes services, and cancer program. The American Nurses
Credentialing Center recognized it as a Magnet Hospital for Nursing Excellence in
2004. It recently opened a
$130-million expansion of a six-story medical arts building.
• Mercy
Hospital recently won the J.D. Power and Associates Distinguished
Hospital for Service Excellence.
Its orthopaedic institute presented nine original projects at the American
Association of Orthopaedic Surgeons in October 2005, a coup in
light of the fact that 5,000 projects are submitted for
consideration but fewer than 50 are accepted. In raw numbers,
it means 18 percent of the meeting was dominated by this one
facility.
• University of
Miami/Jackson Memorial Hospital
takes pride in the fact that its Ryder Trauma Center
is the only adult and pediatric Level 1 trauma center in South
Florida. That’s just the start—its 66-bed Level III
neonatal intensive care unit represents Florida’s largest such
facility, while the Jackson Transplant Center is ranked the seventh busiest in the nation and is
the only Florida hospital to perform every kind of organ
transplant. Finally, the Rehabilitation Center is one of a handful in the nation designated as
a Regional Spinal Cord Injury Center.
• Mt. Sinai
Medical Center & Miami Heart Institute offers the most active cardiac surgery program in South Florida, which helped earn its spot on Solucient’s list of top 100 cardiovascular hospitals. It’s also
the only hospital participating in clinical trials with the National
Cancer Institute.
This array of
facilities creates a wide-open field for every physician with a
desire to practice here, according to recruiters and
administrators. Katz is always on the lookout for surgeons and
surgery subspecialists, but he insists there are no saturated
fields. “Everybody who practices is doing well—they
are busy and in growth mode,” he says. If you truly want
a taste of how busy these practices get, insiders say, randomly
call a doctor’s office for an appointment and see how
long you are put on hold compared to elsewhere in the country.
Recruits typically
hail from the New York area, South America, Mexico, or the
Caribbean, in Osinski’s experience. After all, it’s
a non-stop flight from here to Honduras or Nicaragua.
Katz’s records show different patterns with the same
results. “There are people who say they are tired of
dealing with winter,” he says. “There are a lot of
people who come here because of the multi-cultural nature of
the city and access to Central and South America. And there are
people who want to be near the water and the lifestyle
associated with that.”
And new graduates and
the 40-something crowd are beating out those nearing retirement
in joining the private practices of the Miami medical scene.
Pay rates for those starting their careers, as is the case in
any major metro market, are less than the national average but
eventually catch up to the rest of the country, if not better,
Osinski says.
As the president of the Dade
County Medical Association,
Ciraldo admits physicians here won’t escape the bugaboos
of the profession. Malpractice premiums often discourage
high-risk specialties like neurosurgeons, trauma surgeons, and
ob/gyns, for example. To fight back, the society has chosen to
lobby for legislation holding expert witnesses accountable as
one of its platforms in 2006. “We really believe that it
can significantly cut down on frivolous lawsuits,” she
explains. “Unfortunately, there are people with a modicum
of medical training and some credentialing who go around making
themselves high-paid witnesses to testify against doctors.
Clamping down on them should lessen doctors’ fear of
attack.”
Osinski describes the
market as “heavily penetrated” with managed care.
Katz estimates it in 40 percent-plus range, with the bulk of
the action coming from national companies—but stabilized.
“They are all very aggressive, but there are still a
number of physicians not participating in managed care
contracts because there’s enough volume here and they
have built a reputation so they can pick and choose,”
Katz adds. “Not everybody jumped onto the managed-care
bandwagon.”
Nor have these
professional difficulties created barriers between doctors and
patients in Miami. According to Osinski, physicians are still
well-thought-of for the most part, with frustrations aimed at
the health-care system overall rather than specific doctors. In
fact, the Hispanic population in Hialeah traditionally sets
aside a “doctor day” when they present gifts and
special tokens of thanks to their medical providers.
“If you’re a
doctor who would like to be in an atmosphere where you can
really become part of a growing and very humanly oriented
environment, then I’d invite you to come to South
Florida,” says Ciraldo. g
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