Sometimes some of the best ideas do not come from state or national planners or “inside the Beltway.”

A group in western North Carolina in the out of the way mountain tourist area of Blowing Rock-Banner Elk, NC, led by a local innovative thinker has come up with a variation on a genre of an idea kicking around the country for over a decade nows. Its core idea is preservation and re-purposing of old, abandoned but still intact properties. The property of concern is typical of a growing number of such relatively new “leftovers” as medical care models in this country continue to evolve from the 50 years ago widespread model of cottage industries small private group practices of doctors and small community hospitals serving local communities and areas.

Modern medicine for at least 3 to 4 decades has moved into the big business model, over bigger and bigger regional hospital systems that are built upon the model of a big central hospital and several to over a dozen or so moderate sized satellite hospitals, outpatient surgery centers, and specialty clinics and larger primary care practice centers. The latter have been fueled by the continuing wave since primarily the 1980’s of regional hospital enlarging their referring bases and sources by buying up and taking over the management of private medical and family medicine practices. As every knows, doctors drive referrals/patients,  to hospitals. Without such referral streams, big hospitals could not survive. They have higher overhead costs etc. But they have the capital to fund all the needed specialty services that the older smaller model community hospitals could not afford, various levels of trauma care, larger and more sophisticated intensive care units and the specialist physicians and ancillary staff to do the higher levels of medical care. Examples are pediatric surgeons of all kinds, interventionist/electrophysiology cardiologists and “heart centers,” state of the art radiation cancer therapy centers, state of the art oncology/hematology physicians, hospitalists internists, more pediatricians, more obstetrician-gynecology and delivery services especially given the rising rate of higher risk pregnancies if for no other reason that women delaying in greater numbers, the ages at which they elect to start having children, and yes even psychiatrists and behavioral medicine specialists of different, but essential disciplines.

AS Medicare and Medicare reimbursements have shrank, smaller community hospitals mostly NOT located in hotbeds of local wealthy blocks of citizens have been squeezed out of business as their long standing, “no choice or alternative” long-standing revenue sources have dried up and put them out of business. And this has not happened in just the small communities of American; long-standing hospitals that for decades have been names of stellar reputations, teaching centers and homes to highly regarded teaching programs have closed in “Big Citees” like the famous slightly anti-NOrthern accent Texas Pete hot sauce example. One of the most famous hospitals and teaching centers that years ago, I myself gave serious thought to applying to for residency training was St. Vincent’s Hospital formerly of New York City. I do not have exact figures of the numbers of hospitals that have closed in just the last 10 to 12 years nationwide, but in my stomping grounds in western North Carolina within roughly a 100 miles, I can easily think of 3 hospitals that have shuttered, and of others that hanging on by an economic thread.

In an article entitled, ” Legacy Art Farm: Ambitious Plan for Old Cannon Hospital Property in Banner Elk,”, a local group in Banner Elk, North Carolina, has been working on a credible idea to convert a closed community hospital and its properties into a regional art center and “art trial.” In other parts of North Carolina and other states as well there are fabulous art trails and colonies for anyone interested in all kinds of arts, traditional and modern, that are making a comeback nationwide and more than holding their own economically. An old decrepit beautiful road running along the French Broad River just blocks from downtown Asheville, has for years been staging a building by building property revitalization as all kinds of artists buy or lease properties renovated into suitable studios for their work. It is starting to gain critical mass and regularly attracting art lovers and purchasers, building on the downtown art enclaves of Asheville. Another relatively local example of which I know and have visited is the fairly well known Seagrove North Carolina  potters’ colony which has been in existence, up to over 200 years, if you count the time period in the 1700’s when its clay was so highly prized that the world famous (still today) Lennox and Limoge china and art pottery firms sent expeditions by ship to central North Carolina to excavate and transport back to Britain tons of Seagrove area pottery from which to fashion their still famous products. Even more close to my part of North Carolina for years has been forming a modern glassmakers’ scattered colonies of artisans north of Winston-Salem, Morganton and in the Asheville areas, that rival any in the world now (including Venice critics now aver).

Let us hope this movement continues, as “the world can always use more artists.”