For more than fifteen years I was privileged to work with Bronson Healthcare in Kalamazoo, MI. Since 1997, when I was a member of the design team for their replacement hospital, until I retired in 2013, I participated in dozens of planning, design and operations projects. During that time Bronson grew from a 280-bed community hospital to a teaching hospital and regional healthcare system with over 500 inpatient beds and ancillary facilities in several Michigan communities. Bronson is a leader in innovative medical care, wellness, and education. It has received many awards for medical care and a supportive work environment. In 2005 Bronson won the prestigious Malcolm Baldridge Award.

I met with Mike Way, Vice-President Facilities Services & Materials Management, and his ‘Innovation Team’ to discuss tomorrow. One hallmark of my experience at Bronson is that every communication is a two-way dialogue. Although many of my profiles take the form of an interview, where I learn about the person or group I am meeting with, the Bronson group was as interested in what I am learning in my travels as they were about outlining their own ideas about tomorrow.

Mike opened the discussion by establishing the broad parameters of the discussion. “Bronson’s vision, to be a national leader in healthcare quality, is based on our 4C’s: (clinical distinction, customer experience, corporate vitality, community health). Recently I have been thinking we need to articulate a fifth C, though I don’t know what that word would be, that promotes healthy living and sustainability. We need to move from the realm of diagnosis and treatment into the realm of healthy living. When we look at the big issues facing us, things like chronic disease and obesity, we realize that we have to be more proactive on health. I see the crux of this as mobility – getting people to move more and getting them to move in vehicles less.”

Steve picked up the thread. “Cars give us a sense of freedom, and owning them as private property give us a sense of security. How do we make sustainability not a burden, but the preferred way that we want to live?”

I told the group about David Owens book, The Green Metropolis, which argues that Manhattan is the most sustainable place in the United States. Not only is per capita energy use there 13% less than average, it happens because of the way life is organized, without cars, rather than by any conscious effort to be sustainable. He argues, ‘once you get in your car, you’re not sustainable.’

The conversation turned local, to the specific issues that Kalamazoo, like so many small cities, faces to both thrive and be sustainable. Mike is part of a City Commission that the mayor formed to address revenue shortfall without cutting services. The focus, naturally, goes to revenue enhancement. But Mike wants the focus to be on revenue growth. He sees pent-up demand for housing, commercial activity, and services in an around downtown, near Bronson’s main campus. Kalamazoo has a sizable ring of underdeveloped land immediately outside the downtown area, but it is easier for developers to go to outlying areas than it is to redevelop in the middle of town. “We need to make zoning, density, and regulatory changes that encourage development in the city.”

There are some practical impediments that are difficult to surmount. Michigan restricts property tax increases to no more than 5% a year. After the huge property value drops that occurred during the 2008 recession, many properties were reassessed. Values are climbing back up, but the city cannot recoup that in revised assessments. Also, in the 1960’s the city used Federal monies to expand water service to adjacent communities. This fueled their expansion at the expense of Kalamazoo, but now, because of federal requirements, Kalamazoo is required to continue to supply water to these communities that are undermining the economic and cultural center.

“Kalamazoo city has 78,000 people. Bronson employs almost 5,000 people in its main campus, close to 10,000 people work downtown. Yet, there is hardly any place to live within walking distance of downtown. Now we have a medical school adjacent to our campus, affiliated with Southwest Michigan University, and we are developing the Healthy Living Campus, a $46 million, three building nutrition and food complex affiliated with Kalamazoo Valley Community College. The culinary curriculum is already filled to capacity. We are creating all these opportunities to learn and work in town, but there’s no place to live.”

How will we live tomorrow?

“We are not in the hospital business. We’re moving way beyond that. I want to develop a strategy for for healthy living and community wellness.”