Regional hospitals vie to be big-league players

Needham health club owner John Atwood says he is alive today because he took his sore right quadricep to Beth Israel Deaconess-Needham.

Perry Davis says he owes his quick return to his post as superintendent of Dover-Sherborn Schools to MetroWest Medical Center, where he was taken by ambulance after a heart attack at work.

Regional hospitals are touting stories like those of Atwood and Davis to persuade surburbanites they shouldn't bother going to the Longwood Medical Area in Boston for every medical concern.

It's a 180-degree change from years past, when many suburbanites with a serious -- or not-so-serious -- medical problem preferred to be treated in Boston.

The region's community hospitals, the former Glover Hospital in Needham, Newton-Wellesley Hospital, Leonard Morse Hospital in Natick, Framingham Union, and Marlborough Hospital, though solid, were frequently dismissed as second-best -- farm teams to the major-league players downtown.

But technological advances, ambitious building projects, and staff-sharing partnerships with big names like Beth Israel Deaconess, Brigham and Women's, Massachusetts General Hospital, and Children's Hospital are reshaping the suburban health care landscape.

Aggressive campaigns aimed at medically savvy suburbanites advertise ''downtown Boston care right in your own backyard" or feature a grim shot of gridlock and the catchy slogan ''Fight cancer. Not traffic." ''Lose wait," says another for a new Children's Hospital outpost in Waltham.

In a recent ad campaign, Marlborough Hospital touted its short wait for a mammogram -- usually less than 3 weeks -- which produced a 10 percent increase in appointments, according to the hospital.

Real-life medical crises recounted by prominent community figures are another way to reach suburbanites needing a little more reassurance about the quality of their hometown hospitals.

Davis received an emergency cardiac catheterization, angioplasty, and stent. Less than 1 percent of his heart muscle was permanently damaged, he said in an interview printed in a newsletter published by MetroWest Hospital, which comprises Leonard Morse Hospital in Natick and Framingham Union Hospital. Had the heart episode occurred the year before, he would have required ''a bumpy ride down Route 9," he said, as primary angioplasty was a recent addition to Metrowest's surgical offerings.

Atwood's story is even more harrowing. When he limped into Beth Israel Deaconess-Needham in January 2003, he was the unwitting carrier of necrotizing fascitis, the notorious ''flesh-eating" bacterial infection that kills many victims before doctors can even make a diagnosis.

But the attending physician at the Needham hospital had seen the rare infection before. Atwood was quickly shipped to Beth Israel Deaconess's Boston campus for three emergency surgeries. He spent a month in a drug-induced coma, underwent 10 more surgeries, and had eight months of rehab, but emerged alive and walking.

Atwood, owner of HealthFit Fitness Center in Needham, had watched the former Glover Hospital's transformation into a Beth Israel Deaconess branch, featuring Harvard-trained physicians on rotation. ''Three or four years ago, maybe we might have gone straight into Boston," said Atwood. ''Who knows what would have happened if we had?"

The hospital hopes to launch a $15 million project over the next five years that would increase the number of beds by 50 percent and triple the size of the emergency room to accommodate 23,000 cases annually. Two floors would be added to a wing, expanding the hospital's size by about one-quarter, or 22,000 square feet.

The effort to keep patients in the suburbs is both by choice and design, and marks a change in local healthcare strategy. For decades, the big Boston hospitals routinely profited by taking complex, and profitable, medical cases away from community hospitals, said Roberta Clarke, a Boston University healthcare management professor.

Well-educated patients were so concerned for their health, they endured the long commute, pricey parking, and crowded waiting rooms. But the big-city teaching hospitals became victims of their own reputations, overwhelmed with minor medical cases and strapped for bed space.

Financial concerns and expansion ambitions also prompted city hospitals to share staff, equipment, and resources with less prestigious regional ones. Healthcare in the suburbs quickly became more sophisticated to preserve the corporate brand name, Clarke said.

''You can't send people out west and have them think they are getting Partners-quality care, for example, and have them be unhappy and disappointed," she said.

Consumers still have to do their homework, said Clarke. Despite the liberal sharing of Boston-trained doctors, the experiences may not be entirely equal -- despite the feel-good ad campaigns.

''It can be a little misleading," she said. ''Most patients think only about the doctors."

Patients at smaller hospitals should ask questions about every aspect of their care. Even if a prestigious surgeon is doing the work, how well-trained are the facility's anesthesiology and nursing staffs? How up-to-date and well-maintained is the medical equipment?

''It may not be 100 percent clear that what you are getting is as good as the teaching hospital, just because it's the same doctor," she said.

These urban-suburban partnerships are possible in large part by communication tools that allow doctors to share charts, scans, X-rays, and opinions.

''Underlying this phenomenon is a technological revolution," said Michael Jellinek, president of Newton-Wellesley Hospital, which is capitalizing on partnerships with Brigham and Women's and Mass. General to become an ''outstanding regional teaching hospital," said Jellinek.

But not everything has changed. Old medical snobberies still persist in the suburbs.

''The biggest challenge is changing people's well-entrenched and longstanding perception that community hospitals are OK for minor things, but if you want state-of-the-art tech you have to go to the city," said Bob McCrystal, spokesman for Marlborough Hospital, an affiliate of UMass Memorial Medical Center in Worcester.

All of UMass Medical's marketing messages have been crafted ''specifically to drive home the point that . . . you don't need to go to Boston for a top academically affiliated medical center," he said.

Convenience and familiarity -- for the patient and his or her family -- are also big selling points, said Jeffrey Liebman, president and CEO of Beth Israel Deaconess-Needham.

''We are a hospital that can take care of you as well as anywhere else, but we're still a community hospital in a neighborhood, with staff who is familiar and knows you on a first-name basis," he said.

Despite the improved suburban care, some hospital business will stay in Boston for the foreseeable future. Complex neurosurgery, open-heart surgery, organ transplants, and certain high-risk pregnancies require big-city hospitals with specialized staffs and equipment, said doctors from several suburban hospitals.

But the suburban hospitals hope to be the first choice for minimally invasive surgery, chemotherapy and radiation treatments, and outpatient care for diabetics and heart patients.

Dr. Michael Gottlieb, chief medical officer at MetroWest Medical Center, which is owned by for-profit Vanguard Health Systems, said persuading suburbanites to stay home will happen one patient at a time.

''We provide excellent service, and people go home and tell their friends about it," Gottlieb said. ''That's the best marketing."

Erica Noonan can be reached at enoonan@globe.com.