Greater Greater Washington

Posts about Hospitals

Transit


Three ways to build in Forest Glen without creating more traffic

As new homes, offices, and shops sprout around the region's Metro stations, Forest Glen has remained a holdout due to neighborhood resistance to new construction. But that may change as WMATA seeks someone to build there.


Metro wants to redevelop this parking lot. All photos by the author.

Last month, the agency put out a call for development proposals at Forest Glen, in addition to West Hyattsville and Largo Town Center in Prince George's County and Braddock Road in Alexandria. WMATA owns 8 acres at Forest Glen, most of which is a parking lot, and developers have already expressed interest in building there.

Forest Glen should be a prime development site. While it's on the busy Red Line, it's one of Metro's least-used stations. It's adjacent to the Capital Beltway and one stop in each direction from Silver Spring's and Wheaton's booming downtowns. Holy Cross Hospital, one of Montgomery County's largest employers with over 2,900 workers, is a few blocks away. But since Forest Glen opened in 1990, not much has happened.

On one side of the Metro station is a townhouse development that's about 10 years old, while across the street are 7 new single-family homes. The land the parking lot sits on is valuable, and it's likely that WMATA will get proposals to build apartments there because the land is so valuable. But zoning only allows single-family homes there, the result of a 1996 plan from Montgomery County that recommends preserving the area's "single-family character," due to neighbor concerns about traffic.


Townhouses next to the Forest Glen parking lot.

As a result, whoever tries to build at Forest Glen will have to get a rezoning, which neighbors will certainly fight. It's true that there's a lot of traffic in Forest Glen: the Beltway is one block away, while the adjacent intersection of Georgia Avenue and Forest Glen Road is one of Montgomery County's busiest. While traffic is always likely to be bad in Forest Glen, though by taking advantage of the Metro station, there are ways to bring more people and amenities to the area without putting more cars on the road.

Make it easier to reach Metro without a car

Today, two-thirds of the drivers who park at Forest Glen come from less than two miles away, suggesting that people don't feel safe walking or biking in the area. There's a pedestrian bridge over the Beltway that connects to the Montgomery Hills shopping area, a half-mile away, but residents have also fought for a tunnel under Georgia Avenue so they won't have to cross the 6-lane state highway.

Montgomery County transportation officials have explored building a tunnel beneath Georgia, which is estimated to cost up to $17.9 million. But county planners note that a tunnel may not be worth it because there aren't a lot of people to use it.

And crossing Georgia Avenue is only a small part of the experience of walking in the larger neighborhood. Today, the sidewalks on Forest Glen Road and Georgia Avenue are narrow and right next to the road, which is both unpleasant and unsafe. WMATA has asked developers applying to build at Forest Glen to propose ways to improve pedestrian access as well, and they may want to start with wider sidewalks with a landscaping buffer to make walking much more attractive. Investing in bike lanes would also be a good idea.

Provide things to walk to

Another way to reduce car trips is by providing daily needs within a short walk or bike ride. The Montgomery Hills shopping district, with a grocery store, pharmacy, and other useful shops, is a half-mile away from the Metro. But it may also make sense to put some small-scale retail at the station itself, like a dry cleaner, coffeeshop or convenience store, which will mainly draw people from the Metro station and areas within walking or biking distance. Some people will drive, but not as many as there would be with larger stores.

Putting shops at the Metro might also encourage workers at Holy Cross to take transit instead of driving, since they'll be able to run errands on their way to and from work. Encouraging this crowd to take transit is important, since hospitals are busy all day and all week, meaning they generate a lot of demand for transit, making it practical to run more buses and trains, which is great for everyone else.

Provide less parking

Whatever gets built at the Metro will have to include parking, not only for commuters, but for residents as well. While Montgomery County's new zoning code requires fewer parking spaces, each apartment still has to have at least one parking space. Even small shops will have to have their own parking. The more parking there is, the more likely residents are to bring cars, which of course means more traffic.

Thus, the key is to give future residents and customers incentives to not drive. The new zoning code does allow developers to "unbundle" parking spaces from apartments and sell or rent them separately. Those who choose not to bring cars will then get to pay less for housing. The code also requires carsharing spaces in new apartment buildings, so residents will still have access to a car even if they don't have their own. If Montgomery County ever decides to expand Capital Bikeshare, the developer could pay for a station here.

And the developer could offer some sort of discount or incentive for Holy Cross employees to live there, allowing hospital workers to live a short walk from their jobs.

No matter the approach, there are a lot of ways to build in Forest Glen without creating additional traffic. A creative approach can do wonders for the area's profile and elevate the quality of life for residents there.

Public Safety


Prince George's picks Metro station site for new hospital

Prince George's County Executive Rushern Baker made the smart growth choice early this week, selecting the Largo Town Center Metro Station for a new $650 million, 259-bed regional medical center.


Photo by the author.

The decision caps a year-long campaign by the Coalition for Smarter Growth and community smart growth advocates to demonstrate the benefits of putting the new hospital at a Metro station. It will replace the existing Prince George's Hospital Center in Cheverly.

Operator Dimensions Healthcare will announce its official decision tomorrow. The organization's full board will vote on the recommendation for a new hospital site after its executive committee meets today.

With a projected influx of over 2000 workers each day, the new hospital will spur mixed-use development at one of Prince George's 15 mostly-underutilized Metro stations. Thousands of workers and visitors in this transit-accessible location presents a prime opportunity to create a walkable, mixed-use facility that could ultimately anchor a vibrant new downtown for Prince George's.

During the selection process, officials seriously considered rival site Landover Mall, which is over a mile away from any Metro station. From the beginning, placing the hospital at the shuttered mall seemed to be a given, especially considering that the University of Maryland Medical Systems Corporation was rumored to seek a site with 120 acres. In the end, a much smaller site with Metro access emerged as an important component for the winning site.

There are major economic, environmental, and social justice advantages to putting the hospital at a Metro station. While much hospital construction of the last 50 years has been increasingly spread out on large campuses, many new successful hospital centers take advantage of leading urban designs, compact footprints, access to transit, and mixed-use environments.


Area around Largo Metro considered for possible site(s). Map courtesy Prince George's County.

Smart growth advocates have pushed hard to encourage Prince George's officials to choose such a location for the medical center. Together with leading hospital design and construction experts, the Coalition for Smarter Growth released a series of case studies to encourage officials to choose the Largo site in February.

Building on the momentum of those case studies, the Coalition for Smarter Growth delivered a petition with over 1000 signatures and sent hundreds of emails to county officials asking that the hospital be placed at a Metro station. In February, a community meeting drew over 300 Prince George's residents in overwhelming support for a Metro-accessible medical center.

The path to a smart growth hospital is not over yet. Many decisions can happen during the design and construction phase that will advance or diminish the positive impact the medical center can have on the county. The IRS and Census Bureau headquarters at the New Carrollton and Suitland Metro stations are prime examples of "what not to do" when locating a major employer at a Metro station.

Despite future hurdles and a history of sprawl projects like Konterra and Westphalia, this decision shows the Baker administration's and state's commitment to smart growth and transit-oriented development. Putting the new regional medical center at Largo Town Center pursues the promise of real transit-oriented economic development with a more than half-billion dollar investment.

The effort offers Prince George's the opportunity to take advantage of existing transit connections not only to provide better access to quality healthcare, but to build the kind of mixed-use district that study after study shows is where people want to live, work, and play. This regional medical center can be a true catalyst for that kind of healthy smart growth development.

If you live in Prince George's and think this is a good decision, you can take a moment to thank County Executive Baker for his leadership and smart choice here.

Architecture


Hospital case studies point the way for Prince George's

What's the difference between a hospital that's a springboard for economic development, and one that's not living up to its potential? Answer: Design, location, and connectivity. Local groups compiled a set of case studies to point the way as Prince George's County moves forward with its proposed Regional Medical Center.


Image from ZGF.

The new hospital is an important healthcare facility for the county, and as an employer of 2,000 workers, it can also catalyze economic development in an area where new investment has lagged.

Hospital officials are rumored to be interested in a sprawling 80-120 acre suburban-style site away from Metro, likely the old Landover Mall site. The sponsors of the case studies hope that these examples of great hospitals, designed by leading architectural firms, can help decision-makers understand the benefits of a more mixed-use, compact and transit-oriented site.


Matrix of case studies. Click to view full size.

Envision Prince George's Community Action Team for Transit-Oriented Development, the Coalition for Smarter Growth, and American Institute of Architects Potomac Valley collected the design case studies. They provide examples of mid- to large-scale hospitals with footprints of 1.5-48 acres. In fact, larger hospitals (measured in number of beds) are at the lower end of this range of acres, while the smaller hospitals tended to occupy more land area.

While Prince George's continues to pursue additional federal offices (like the new FBI headquarters), a new $600 million medical center could be one of the best opportunities to jump-start transit-oriented development at one of the county's 15 underutilized Metro stations.

In contrast to courting federal agencies, the state and county control the decision about where to locate and how to design a new medical center. Not encumbered with stringent federal security requirements, a regional medical center offers a better opportunity to connect to surrounding uses and fuel spinoff economic activity than an FBI or Homeland Security building.

Why a smaller, urban footprint?

Hospitals must plan for growth, and a working "rule of thumb" for traditional suburban or rural 200-bed hospitals (similar in size to the Prince George's facility) is a minimum of 40 acres. This footprint provides a suburban or rural site with room for the initial building, associated drop-offs, parking, and room for future growth. Growth is common in medical facilities, whether for outpatient clinics, specialty centers, or the hospital itself.


Seattle Children's Hospital. Photo from ZGF.

Hospitals in a more urban context plan for similar growth, but within sites that are typically 10 acres or less. This smaller footprint offers several benefits over a suburban medical campus. Connecting a hospital center to a larger mixed-use environment where people can work, shop, and live helps attract and retain highly sought-after skilled healthcare workers. By better integrating into the surrounding community, an anchor institution like this can support a vibrant, walkable, thriving new hub.

Designers also point to sustainability benefits from a more urban design and context. A limited footprint disturbs less land and reduces the heat island effect. Placing a more compact medical center in an urban hub also allows for more environmentally-friendly transportation choices with frequent transit service, and walk and bicycle options for short trips. Driving and parking will remain an important mode of access, but a more urban hospital allows for lower parking supplies, greater access for those who do not have a car, and the choice to take some trips on foot or by bicycle.

While a footprint of 10 acres may seem small compared to a suburban campus of 40 acres or more, hospital complexes around the country and beyond are developing successful, busy hospitals on sites as small as a few acres.

The just-released case studies of 11 successful moderate to small-footprint hospitals of comparable size to the planned Prince George's regional medical center share 3 common success factors: access, flexibility for future growth, and a connection to the surrounding environment.

Success factor: Access

An important factor for any healthcare facility is convenient and easy access to and from the site. High-quality public transportation, stores and services, and housing within walking distance create opportunities for staff and visitors to get outside the hospital while still being nearby, and enable some to come and go without having a car.


Access to Champ de Mars medical center. Image from CannonDesign.

Several of the examples in the report show major hospitals that are integrated into city blocks. Hospital staff and visitors have easy access to a local services and transit options. For example, the Kaiser Permanente Los Angeles Medical Center is a 448-bed hospital, 7 stories tall situated on 3 acres of land. Within a block is the Red line light rail station and major bus routes.


GWU hospital entrance. Photo from Smithgroup JJR.

Closer to home, the 6-7 story, 371-bed George Washington University Hospital occupies 2 acres. The front door of GWU Hospital opens onto the busy entrance of the Foggy Bottom Metrorail station and is embedded in a thriving urban district that mixes health, university, private office, retail and housing uses in a highly walkable, transit-accessible environment.

Medical facilities woven into the fabric of a larger mixed-use district served by transit can have an advantage when competing for medical professionals who desire to be in a lively, diverse place, and need flexibility with their commutes in a two-worker household.

Success factor: Flexibility for future growth

While suburban hospitals are typically designed with extra acreage to accommodate future growth, urban medical centers can anticipate similar growth, but plan smartly within a more constrained footprint.


Main entrance, American Hospital Dubai. Image from AECOM.

Planning a smaller-footprint facility guides planners to take into account their overall surroundings, making better use of pedestrian connections to the surrounding community and supporting services. In the case of both the vertical high rise addition to Mercy Medical Center in Baltimore, with the 260-bed Bunting Center inpatient hospital on 1.5 acres, and the 350-bed American Hospital Dubai campus on 11 acres, planning for growth accounted for the sites' larger surroundings.

The hospital designers from AECOM point out that an urban design and location provides significant advantages in offering the ability to walk to a nearby restaurant to avoid yet another meal at the hospital cafeteria or the convenience of staying at a nearby hotel for someone visiting a sick relative.

Success factor: Connection to green spaces

Numerous studies show that access to outdoor places and views of green spaces create a state-of-the-art healing environment. But urban hospitals don't need to concede healing green features to their suburban and rural counterparts. Roof gardens, courtyards, and natural light are all achievable in small-footprint hospital centers.


Roof garden view, Bunting Center at Mercy, Baltimore. Rendering from AECOM.

The centerpiece of the Bunting Center at Mercy Hospital healing environment is a multilevel roof garden, accessible on various floors and overlooked by room occupants above the midway point along the rise of the building. The 9th floor garden offers direct access from the ICU waiting room.

On the 28 acre campus of the 600-bed Seattle Children's Hospital, 41% of the campus is dedicated as open space. Pedestrian paths are provided throughout the facility to promote walking and offer outdoor connections.

Innovative design and urban context show the possibilities

The 11 case studies offer examples of innovative architectural design, connectivity to the surrounding context, access to transit, green features and compact footprints. These features highlight how a regional medical center for Prince George's and Southern Maryland could establish a new leading healthcare facility that not only attracts the staff and patients it needs to succeed, but fits into a larger district that thrives on the influx of activity.

Development


Prince George's hospital site starts and stops with Metro

Prince George's County and Maryland leaders say that bringing jobs to the areas around Metro stations is one of their top priorities. They can follow through on this promise by making sure that the $600 million regional medical center planned for the county lands at a Metro site.


Photo by shindoverse on Flickr.

When Metro came to the region starting in 1976, suburban counties handled it in different ways. Arlington zoned the areas by its stations for lots of new residences and offices while keeping lower densities farther away.

As a result, more than half of the county's property tax assessment value comes from only 11 percent of its land areaits two Metro corridorsand it enjoys consistently low property taxes as a result. While the Rosslyn-Ballston Metro corridor added tens of thousands of jobs and homes, traffic levels remained largely unchanged, while rates of riding transit, walking and bicycling spiked.

Continue reading my latest op-ed in the Washington Post.

Development


New medical center belongs at a Prince George's Metro stop

Rumors are flying about potential locations for a new $600 million regional medical center in Prince George's County. Some point to a huge, low-density, car-oriented medical campus. A transit-oriented site at one of the County's underused Metro stations would be a much better choice for patients, visitors, and the county in general.


Photo by UCSF Medical Center at Mission Bay on Flickr.

It's hard to tell which way county officials lean. They mention that Metro station sites are under consider­ation. At the same time, they've talked about needing 100 to 120 acres of land for a regional medical center.

100 acres means a suburban, automobile-oriented layout, not a Metro station site. But why need it be 100 acres, or any specific number? Farm fields are measured in acres. Medical facilities should be measured in number of hospital beds and square feet.

Major hospital complexes can use far less space, and do so efficiently, if they are designed to be transit-oriented. A more compact site design will allow room for the facility to grow and will better connect to a nearby mix of housing, retail, and other uses that would thrive on a large workforce and steady stream of visitors. A design with great pocket parks and plazas would create health benefits by encouraging walking and offering cleaner air through transit. It would also ensure access to new jobs for those without cars.

Housing a leading regional medical center at one of Prince George's several underused Metro stations is a tremendous opportunity for the county. The regional medical center will be a major investment to address health care needs for the county, Southern Maryland and the region. It also brings to Prince George's one of the most important economic development opportunities in many years.

UCSF shows the way

Prince George's County should look to the University of California, San Francisco (UCSF)'s Medical Center at Mission Bay for an example of a transit-oriented medical center. The Mission Bay complex will anchor a medical and biotech research cluster that is attracting young professionals to live, work, and play in an emerging neighborhood built on old industrial land and rail yards.

UCSF is adding 3 hospitals to its current 43-acre satellite research campus for a total of 878,000 square feet, but it will only take up 15 acres. This expansion will add 289 beds and give the new complex a 58-acre footprint.

Mission Bay has great public transportation access, including two stops of the new Third Street light rail line and the local bus system. Transportation assessments of current users show most get to the UCSF Mission Bay facility by a mode other than single-passenger cars: 25% ride with others, 23% take light rail or other transit, 9% walk or bike, and 43% drive alone.

Making the proposed center a truly regional destination requires connecting it to the region while offering a distinctive experience once you arrive. Metrorail access and walkable design can create that connectivity and sense of place. A sprawling hospital campus that requires patients and visitors to drive from one parking lot to the next will not. Navigating a campus like that is frustrating, stressful, and can put patients and workers at risk, particularly those with mobility challenges.

Beyond smart growth advocates, industry leaders also see transit-oriented development as the future. Eric Fischer, Managing Director of Trammell Crow Healthcare Services, a major real estate development company commented, "A hospital on Metro is a good thing. It provides easy and affordable accessibility for workers, patients, and vendors. It would be an unfortunate opportunity for Prince George's not to deeply consider the use of one of its Metro stations for such a facility. We have found that public transportation is a key component to the long-term viability for these kinds of institutions."

Landover Mall and Bowie State are not adequate substitutes

Rumors suggest that the Landover Mall site, more than a mile from the nearest Metro, is a leading contender. It's a long, unpleasant walk from Metro at a time when the county has sufficient vacant land at Metro stations like Largo Town Center, Morgan Boulevard, and Branch Avenue.

The Bowie State University MARC station may also be in the running. While MARC commuter rail offers a certain level of transit access, it provides a fraction of what Metrorail service provides: dozens versus hundreds of trains during the week, with no MARC service on weekends.

Running a hospital requires 3 rush hours and a 24 hour, 7 days per week schedule. MARC simply doesn't have the frequency or operating hours to meet more than a small portion of the access needs. Also, the outside-the-beltway Bowie site is far from where most county residents live, forcing long trips for many, whether staff or patients.

Locating the new medical center at a Metro station is a key part of a strategy that will attract and retain workers. With a great walkable design, it can also draw in the large share of Prince George's residents who currently leave the county for their healthcare. Prince George's and the state of Maryland should seize this opportunity and build a truly transit-oriented medical center.

Education


Where will Georgetown get 100 acres?

The agreement on the Georgetown University campus plan says that so long as relations go well, the parties will start discussing in 2018 some long-term goals, including one to "identify and develop next 100 acres."


Photo by the author.

The agreement doesn't give context for this goal. Given the timing, I'd guess the purpose of this new 100 acres is to relocate the hospital and medical school. But regardless of what purpose this 100 acres would serve, the bigger question that jumps to mind is: where is GU going to find 100 acres?

Georgetown University's main campus is 100 acres. There aren't many available parcels close by that are that large. But there are a few:

St. Elizabeths

St. Elizabeths is a historic psychiatric hospital located across MLK Ave. in Ward 8. It has 350 acres spread over its west and east campuses. At one point the hospital served 8,000 patients. Nowadays it serves only a very small group of patients, primarily those determined mentally incompetent to face trial (including Albrecht Muth).

In 2007, the Department of Homeland Security announced plans to consolidate its many offices around the DC area onto the west campus of St. Elizabeths. The District kept the east campus, and is planning to redevelop it. The east campus is 170 acres itself. So there's definitely room if GU wanted to be an "anchor tenant" of the development. The city would probably be happy to make a deal with GU if it meant the construction of a top notch hospital square in the middle of the city's poorest ward.

Alternatively, DHS has dragged its feet actually moving to the west campus. A senior DHS official said that they doubted the move would ever happen. It's remotely possible that DHS might be looking to back out of the deal, and GU could step in.

Old Soldiers Home

The Old Soldiers Home is a massive 250-acre plot of land in Ward 5 that contains the historic Lincoln cottage, where Abraham Lincoln escaped the summer heat. Right now the campus still houses a small population of retired veterans, but about half of the property is a golf course.

In 2005, the administrators of the home proposed to develop the southern section of the property. After some pushback from the surrounding neighborhood (and, as I hear it, from retired generals who like to golf) the plans seem to have been shelved.

It's a lot less likely an option for GU than St. Elizabeths, but you never know.

Reservation 13

Reservation 13 is the location of the old DC General hospital. The city has been working on plans to redevelop the parcel for years. Despite having issued an RFP several years ago, the city recently went back to square one on the project.

If building a hospital is part of plans, rebuilding a hospital on the site of the old DC General could make GU's pitch appealing to the city. But I doubt this would happen.

For one, the whole Reservation 13 is only 67 acres. And the city doesn't want to go from one single use to another for the property. Second, even if the city thinks it's a good idea, the neighbors really don't want one large institutional use for the property.

Those are the only properties I can think of in the District proper. GU, of course, could explore site in Virginia or Maryland, but I suspects they want to remain more central.

So if I had to bet, I'd say St. Elizabeths.

Development


New hospital a prime opportunity for TOD in Prince George's

A recently announced healthcare partnership could bring a much-needed new regional medical center to central Prince George's County. However, at least one commentator is floating suggestions for a massive sprawling complex instead of a compact campus located near one of the county's many barren Metro Stations.


University of Maryland Medical Center, Baltimore. Photo by UMMC.

Maryland Governor Martin O'Malley, Lieutenant Governor Anthony Brown, Prince George's County Executive Rushern Baker III and other state and local officials announced the partnership agreement during a recent press event in Upper Marlboro.

It is the latest and most promising effort in what has been a multi-year attempt to stabilize the delivery of quality healthcare in Prince George's County and to improve residents' access to primary and emergency care across the region.

Currently, the financially strapped and poorly managed Prince George's Hospital Center (PGHC) in Cheverly is the only trauma center serving southern Maryland, including Prince George's, Calvert, Charles, and St. Mary's Counties.

The partnership, which involves the University of Maryland Medical System (UMMS) and Dimensions Healthcare, seeks to develop and implement a strategy that will bring a new state-of-the art regional medical center to central Prince George's County.

The new hospital will be supported by a comprehensive ambulatory care network, including the existing PGHC facility in Cheverly. An initial study by UMMS estimates that it will cost $600 million to implement this new strategy.

Barry Rascovar, a communications consultant and state legislative columnist, correctly notes in a recent Gazette op-ed that this partnership agreement is only a first step, albeit an important one, to realizing the goal of a new regional healthcare center. However, one assumption that he makes is rather alarming for those of us who value the ideas of TOD, environmental sustainability, urban revitalization and sprawl avoidance.

Rascovar posits that the success of the new facility "assumes 100 acres of land can be found in the central part of the county, preferably near the Capital Beltway and US Route 50." One hundred acres? Really?

It is unclear upon what authority Rascovar is basing his assumption. The 100-acre requirement does not appear in the partnership agreement, and I could not find any statement from UMMS, the state, or the county imposing such a requirement. Forcing the hospital to be located on such vast acreage would almost guarantee that it could not be placed near an existing Metro station in central Prince George's County.

Fortunately, there are countless examples of urban regional medical centers being built on substantially fewer than 100 acres, and near rapid transit stations. New York City's Columbia University Medical Center, for example, is located on 20 acres in uptown Manhattan, immediately adjacent to the 168th Street subway station. The George Washington University Hospital, located next to the Foggy Bottom Metro Station in northwest DC, is on substantially less than 20 acres. GW's entire downtown campus, including the hospital, occupies less than 45 acres.

Instead of trying to find 100 acres of nonexistent land next to the Beltway and US-50 for this new regional medical center, why not locate it at the Morgan Boulevard Metro station, on the Blue Line? Aside from Redskins games and other FedEx Field events, the station gets very little use. WMATA actually proposed closing the station on weekends in 2010 due to very low daily ridership.


Google Map image showing the undeveloped location around the Morgan Boulevard station.

As you can see from the above map, the Morgan Boulevard station sits virtually undeveloped on 56 acres, at the corner of two existing major arterial roadsCentral Avenue (MD-214) and Garrett A. Morgan Boulevard / Ritchie Road. It is also within one mile of the Capital Beltway, and within central Prince George's County. As such, it meets all the major location criteria that state and local officials have articulated for the new regional hospital facility.

The site is fully accessible to cars and would require no expensive new roadways and interchanges, thus making it a more economical option. There is space enough to build hospital facilities more than twice the size of the Columbia University Medical Center.

Moreover, the hospital would be convenient to patients, visitors, and staff who don't own and/or can't afford automobiles. This is fully consistent with the mission of the partnership agreement to provide high-quality, affordable, and accessible healthcare to the region's residents.

Over time, the influx of skilled professionals coming daily to Morgan Boulevard will create increased demand for quality housing and retail amenities throughout the Central Avenue corridor, and particularly at the nearby Addison Road and Largo Town Center stations.

In short, locating the new Prince George's regional medical center near existing rapid transit at Morgan Boulevard will prove to be both an economic boon to the county and a better service to the region's residents. Who could argue with that?

History


Doctors' Hospital, a "hotel for the sick"

It seems that as long as hospitals have been around, they've seemed dreary and depressing, or at times even unhealthful. The first DC hospital, for example, was a decidedly morbid place, opened at the Washington Asylum for indigents during a cholera epidemic in 1832.

Medical practitioners have been trying for a long time to do better than that. One major step forward occurred downtown in 1940, when a group of doctors realized their long-held vision of constructing a modern, private, un-hospital-like hospital in the 1800 block of I Street NW. The immense International Square complex, completed in 1982, fills the block now.

This particular group of doctors, led by acclaimed surgeon Dr. Charles S. White, were no strangers to building construction. Originally a group of eight, they had organized themselves in 1924 to build a medical office building on the corner of 18th and I Streets NW.

In those days physicians were increasingly relying on laboratories and other technical facilities for support, and they needed a centralized building where offices and labs could be close by.

That first eight-story building, called the Washington Medical Building, was completed by the end of 1925. It was fully occupied less than a year later, and soon more space was sorely needed. Thus a second, twin office buildingcalled the Columbia Medical Buildingwas completed in 1929, at the opposite end of the block, at 19th and I.

In the middle of the block between them was a site they wouldn't be able to get their hands on for another ten years. It had been occupied since the city's earliest days by the Quakers, who secured it for a meetinghouse in 1808 for $465.60. By 1883 a schoolhouse was built next to the meetinghouse, and the Quakers hired a 24-year-old teacher from Baltimore, Thomas W. Sidwell, to run it.

The school, of course, flourished. Beginning in 1911, property on upper Wisconsin Avenue was bought and originally used by the school for a clubhouse. In 1937 the school consolidated at that semi-suburban location and finally sold the old I Street property to the doctors who had been coveting it for years.


The former site of Doctors' Hospital as it appears today.

The plan was to build a hospital in the center of the block, connecting it to the office buildings on both sides and thus creating a giant block-long medical complex. While the zoning commission had limited the two medical buildings to 8 stories each, they allowed the hospital building to go up to 10, which had the effect of setting it off as the centerpiece of the block.

Groundbreaking occurred in 1939, and the hospital, which cost $1.6 million to build, was ready to open its doors in March 1940. It was equipped with 250 beds, 10 operating rooms, 4 delivery rooms, and nurseries for 65 babies.

The Doctors' Hospital building was a very restrained art moderne edifice, strikingly solid, perhaps more like a bank building than a hospital. The idea was that it shouldn't resemble any hospital you would recognize. Walking in the front door, the lobby was supposed to look like that of a hotel.

"The first noticeable departure from the usual in hospitals is the inviting and attractive lobby, furnished and decorated completely with 18th-century authentic reproductions," announced a commemorative book published when the hospital opened. The lobby featured a walnut wainscot and cream-colored walls. The builder, Lee Paschall, was a successful hotel man from Richmond, Virginia, who had been collaborating with the doctors since they built their first medical building. He knew what people wanted in a hotel, and he did his best to give Doctors' Hospital that same feel.

Reviewing the new hospital in February 1940, the Washington Post quoted its administrator as saying that it was to be a 'hotel for the sick.' "Beds will be furnished with foam rubber mattresses and pillows. Wooden furniture, of French provincial design, will be used throughout and every room for patients will have Venetian blinds and gaily colored drapes."

The paint schemes were muted pastels; gray-green "of a soft and restful shade" in the elevators, according to an admiring Post reviewer. Patient rooms with a southern exposure were painted with "cool, subdued shades" while those on the northern side had "warmer, creamier tints." What more could an invalid want?

More importantly than the soothing decor, the new hospital was intended to be a model of machine-age automation and efficiency. The architects, Francisco & Jacobus of New York, were primarily an engineering firm that had built factories and power houses.

For the operating rooms, specialized treatment facilities, and other support areas at the back of the building, they designed large expanses of glass-block windows, giving that part of the building a semi-industrial feel.

In addition, much was made in the press of the hospital's communications systems. Apparently unaware that electronic signals can be ignored as readily as mechanical bells, the Post reported:

"Special measures have been taken to eliminate the ancient complaint about nurses who fail to answer patients' calls. Instead of a bell system, patients will have two-way communication with the central office for the floor. A secretary or floor administrator will be on duty on each floor to receive calls from patients, route directions to nurses and receive guests."
More elaborately, the delivery rooms had foot-operated emergency call buttons, which "ring a bell at the obstetric nurse's station, light a corridome over the delivery room door, sound a buzzer, and light a lamp at the nurse's annunciator." With all that commotion, somebody was sure to take notice.

The idea of industrial efficiency surely resonated deeply with the successful early-20th-century doctors who had built this hospital. And let's be clear; they were nothing if not hard-nosed businessmen. By the time the block-long medical complex was completed, it was owned by a corporation with some 300 stockholders, most of them doctors.

All three buildings had been constructed as inexpensively as possible, were funded entirely with private funds, and were expected to turn a profit. Further, they wouldn't take anyone who couldn't pay. "The person who is unfortunate enough to become ill should not be expected to contribute to the support of the indigent," Dr. White said at the hospital's groundbreaking. "That is the responsibility of the municipality and not the duty of a small percentage of our citizens.... We expect to conduct the institution on a sound business basis..."

Doctors' Hospital prospered during its first couple of decades. In 1950, Dr. White reported that the hospital was reliably filled to capacity, and "we always have a waiting list." An addition was built to the rear of the hospital in 1957, bringing the total number of beds to 368, and plans were being made for a further addition as late as 1966, although those apparently were not realized.

In an article for the Post entitled "Doctors Hospital Joins The Community," Stuart Auerbach wrote in 1968 that the formerly aloof, profit-oriented institution was beginning to loosen up a bit. A group of younger doctors had took the leadership of the hospital's board in 1965 and made changes, including adopting a "not-for-profit" status, opening an emergency room, and accepting approximately 3 percent of patients as charity cases.

Hopes were high that the days of worrying about paying for the indigent sick were over. With the new Medicaid and Medicare programs in place, the hospital's administrator told Auerbach that "every patient will be a private patient."

So, with everything going along swimmingly, whatever happened to Doctors' Hospital? It used to be right there in the heart of the downtown medical community, which is still quite extensive. But Doctors' vanished without a trace. A combination of factors seems to have done it in, including hard-to-resist development pressures, some hints of scandal, and a dose of bad timing.

By 1973, the complex had already lost one of its three componentsthe original Washington Medical Building, which was torn down to accommodate Metro construction. An entrance to the Farragut West station is now on that corner.

In January of that year, the hospital owners announced grand plans to redevelop the entire property. The idea was that while the Doctors' Hospital  block would be redeveloped as commercial office space, a new hospital would be built in the next block to the west, where land was (inexplicably) much cheaper. The hospital, of course, wouldn't move until its new home was completed.

But the plans started to fall apart almost immediately. In August, the Post published a six-part exposé on the hospital industry by Victor Cohn in which Washington-area hospitals were blasted for planning extravagant and unneeded additions and replacements.

The unneeded hospital beds would surely drive up health care costs, Cohn argued. The fallout of the series was increasing scrutiny by government regulators of hospital building plans. Doctors' was nevertheless able to retain a "certificate of need," which gave it approval to plan a replacement facility (some said as a result of connections between a key board member, parking-lot magnate Dominic Antonelli, and the head of the DC Department of Human Resources, Joseph P. Yeldell).

But that planning effort grew shakier all the time. Financing supposedly was difficult at the originally intended location, though health professionals favored it, and that site was sold. Other sites were proposed, as were alliances with other organizations that sought hospital space, but all ultimately fell through.

Soon Doctors' Hospital was getting squeezed on both ends. By 1977, the first segment of the new International Square complex, on the K Street side of the block, was completed, and yet Doctors' had nowhere to go.

One of its last gambits was to propose moving into a facility known as the Metropolitan Hotel (not to be confused with the famous hotel of the same name on Pennsylvania Avenue), which had been constructed in 1971 as an extended-care center but had been converted into a regular hotel. Much haggling with the DC government ensued over several years. The specific arguments were over financing and planning details, but the larger issue was always whether another hospital was really needed.

In September 1979, Doctors' suddenly announced that not only had it been unable to obtain adequate financing to convert the Metropolitan Hotel into its new facility, but that it was bankrupt and would close its doors for good within weeks.

While some commentators expressed shock, other suggested that the impact of the closing on health care would be minimal, since other area hospitals indeed had extra capacity. The hospital building was torn down in 1980, and by 1982, the International Square complexone of the few brutalist structures in DC that does not spark immediate revulsion in the eyes of most observersfilled almost all of the block. Incidentally, the Metropolitan Hotel also went bankrupt; it was renovated and is now the Renaissance Washington DC Dupont Circle Hotel.

Cross-posted at Streets Of Washington.

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