ognizing their limitations in terms of commercial creativity, many healthcare facilities are taking baby steps toward an expanded retail base by reinventing the traditional hospital cafeteria, providing coffee kiosks and offering frills such as video rentals in the gift shop, Whelan says.
Whelan's firm, which has worked with more than 100 healthcare clients, is the architect and lead designer of the new 204-bed Florida Hospital Waterman, a $129 million facility in central Florida just north of Orlando. The 450,000-square-foot hospital, expected to open in 2003, features a huge atrium and "mall concept" that funnels or directs all foot traffic back to the building's main spine--a central retail hub that will include a food court with an "open-cafe design" and a wide sampling of foods.
"The key issue," Whelan says, "is to control the environment--customize and merchandize."
While most successful retail ventures in hospitals depend on high traffic volume in busy central locations, Dartmouth-Hitchcock has thrived in an isolated locale. "In this rural location, we recognized we'd need to do something, so we went about asking patients, visitors and employees what they thought would be useful," says Gail Dahlstrom, director of facilities planning for the medical center, which employs about 5,000 and includes the 304-bed Mary Hitchcock Memorial Hospital.
Boasting about 20,000 square feet of leased retail space, the medical center includes a deli, pizzeria, a full-service bank, a convenience store, hair salon and a dry cleaners that features a shoe service and tailor shop.
At Northwestern, where customizing and merchandizing are something of an art form, officials have scattered retail outlets over three floors of two new buildings--a 16-story, 492-bed hospital and an adjoining 22-floor outpatient pavilion connected by a sky bridge and covered walkway. Besides being near a major shopping district, the 2.2 million-square-foot hospital employs about 5,700 people and attracts a daily stream of patients to the affiliated 900-physician multispecialty practice. It's a custom-made market for retailers.
The types of leases vary by the kinds of operations, Przybylek says. For instance, the Au Bon Pain restaurant, which is open 24 hours a day, pays a monthly rent along with a percentage of sales. The bank pays a monthly rent.
Don Barliant, owner of Barbara's, a small bookstore that features about 4,000 titles in about 850 square feet of space, says revenue in his little corner of Northwestern has exceeded expectations in his two years of operation. Barliant, who operates 10 bookstores--including outlets at New York's LaGuardia and Philadelphia International airports--says revenue at the Northwestern site has increased about 25% each year, and he's turned a profit comparable to the high-volume operations for travelers at his two busy airport locations.
Moreover, he says he pays about $2,250 per month to rent his shop at Northwestern--or a fraction of the price at a place like LaGuardia, which charges about $15,000 per month for about 1,000 square feet of retail space, Barliant says. The hassles over security concerns and high construction costs are other problems he doesn't face at Northwestern, Barliant says.
"It's been a wonderful location--it works for us," Barliant says. "I think there's lots of opportunities here. That's why hospital complexes can be very good for retail."
While some observers are comparing Northwestern's big retail renovation with the revolution that swept U.S. airports in the mid-1980s, Barliant doesn't hold out much hope that healthcare facilities will ever reach that level of commercialization.
"I've heard a lot of talk... but I don't see a lot of activity," he says. "The comparison with airports is a good one, to an extent. You have a location that has not exploited the full potential for retail development. It's a good idea. Where the comparison falls apart is when anybody believes the market (for hospitals) is as large as it is for airports. It isn't. There's nowhere near the same kind of foot traffic."
The budding renaissance in hospital retailing goes beyond the traditional. In fact, the great potential for durable medical goods--everything from canes and wheelchairs to prosthetics and specially designed workout attire--could be far greater than the relatively modest margins associated with regular retail ventures, Plantes and other observers suggest. Many hospitals are now trying to corral at least a portion of this growing business.
"It's an incredible opportunity," says Mindy Thompson, who heads Simply Retail, a Golden Valley, Minn.-based firm that is working with several healthcare organizations to design customized retail outlets catering to the specific needs of patients. "It's a $220 billion industry (in durable medical goods), but this money is being spent outside hospital facilities. It's cash leakage for a hospital."
Baylor University Medical Center in Dallas is a prime example of this idea, opening Ernie's Apparel Center about five years ago on the ground floor of the Charles A. Sammons Cancer Center. Ernie's, named for a cancer survivor and longtime Baylor supporter, provides protheses, special mastectomy bras, swimsuits, wigs and other products to oncology patients, and it uses proceeds to fund cancer research.
Despite the success stories, there's ample reason that adding retail outlets hasn't exactly caught fire. Existing hospitals often cannot renovate existing plants to accommodate new commercial centers.
"At this point," says RTKL's Whelan, "this is more of an enhancement for hospitals than a revolution."
Indeed, take the case of 643-bed Swedish Medical Center in Seattle, where retail outlets are only now enjoying modest success after years of financial difficulty, officials say. Retail outlets were included at ground level under city zoning rulings when the first attached medical office building was constructed about 15 years ago.
The facility now provides about 20,000 square feet of retail space on its campus, four blocks north of the central business district, says Don Audleman, senior vice president of Trammel Crow Co.'s national healthcare group, which works with Swedish and about a dozen other healthcare institutions.
Primarily on the street level of three medical office towers, Swedish's retail outlets include a local drugstore, a barber/hair stylist, a flower shop, two Starbucks shops, a Jamba Juice outlet, a Quizno's sub shop, a Hallmark card shop and Pallino's, a table-service Italian restaurant.
"It's paid for itself," Audleman says. "But it hasn't been a home run for anyone--the tenants or the hospital."
Like Northwestern, Swedish signs tenants under a straight lease arrangement, which includes a clause that mandates profit-sharing when sales volume exceeds a certain level. None of the tenants has been so successful that the hospital has received more than the basic rent, which runs about $22 per square foot, comparable to other retail space on the periphery of the central business district but still several dollars shy of what Swedish charges office tenants in the buildings.
Despite Swedish's location in downtown Seattle, about a half-dozen retailers--mostly small mom-and-pop operations--have failed over the past several years, Audleman says. Prospects have become slightly brighter in the wake of new development and a booming market in residential space. This "critical mass" has helped boost revenue, but concerns persist among retailers, Audleman says.
"There's a lot of people pushing this as the next hot thing who maybe don't have the experience with the fragility of the concept," he says. "It's a great amenity for employees and patients. But it's tough to make it work."
Yet Przybylek, far more sanguine, expects that the concept of greatly expanded retail operations in hospitals will catch on in a big way sometime down the road.
"In the past, hospitals never thought about putting retail in because people came to your building for such a specific reason," she says. "Over the last 15 years or so, you've seen a shift in what patients--and consumers--expect to find at a hospital. These days, they expect certain amenities: a TV with cable channels, an inviting room, control over their food choices. Because of all these new expectations, retail has become a natural evolution for hospitals.CCL (Cranial Cruciate Ligament) tears and damages are common in pets and can even significantly affect their health. Like humans, ACL tears usually happen when we’re doing routine activities and workouts. There are numerous reasons dogs snap their ACL, but repetitive tension is the common cause.
Most pet parents love throwing tennis balls for their dog to go after since it is a natural reaction in most canine breeds. However, repetitive movements and abrupt changes in direction can cause injuries in their stifle joints over time. Thankfully, this injury might be prevented with the helpful prevention guidelines we will discuss as we keep going.
The stress and pressure dogs put on their joints in their lifetime can cause damage that will ultimately cause the ligament to snap or give out. However, there are numerous useful tips pet parents can take to keep their canines from this injury. Below are four of them.
Make sure the foods you feed your canine have good amounts of protein as this is needed and responsible for their hair growth and tissue repair. You might also add healthy oils like Omega-3 and Omega-6 fatty acids to their diet, as these can help with joint and bone care.
Struggling to find the best balance of diet for your pet’s breed? You may ask the veterinarian