Being in the business, some of the reasons why physicians have moved away from the old downtown clinics (Wpg/Mb clinic, Medical Arts, Boyd Bldg) to the suburbs:

-traditionally very high and inflexible overhead...more autonomy and control business wise with your own clinic
-downtown clinics in desperate need of upkeep/updating
-rooms so small that you have to leave the room so you can turn left
-inability to customize space for your needs (meeting rooms, larger reception desk, therapy areas, storage, etc)
-patients typically don't mind traveling to the suburbs if they no longer have to pay for parking or worry about an expiring parking spot

Specialists are just as much in this game is any other doctor. It is often easier for them to be targeted directly by pharmaceutical companies though, ie we are having a conference for all the specialists about the latest developments in the field you are treating. It happens to be occurring in some warm, sunny, beach resort in the middle of winter. Your costs are fully paid if you attend the timeshare style presentation on our latest drugs for this specific area. The costs for that five-start resort conference are then baked into the pharmaceutical company's budget as a "marketing expense" for the drug and included in the crazy cost that patients end up having to pay for non-generic drugs. There are actually some drug therapies which are covered by our tax dollars that approach people's entire salaries and we aren't talking end of life cancer type treatments but things that people could be on for years.

The whole pharmaceutical industry is really ugly when you start looking at the how they operate and most it has nothing to do with the consumer level pharmacists either.

That said, back to the Medical Arts issue. I think what happened is back in the day the building was running near full occupancy. As a new graduate if you weren't joining an established practice you then needed to find a place to operate, aka the suburbs. This lead to more of the younger patient group looking for doctors close to home and started fueling the trend away from centralized medical buildings. In terms of specialist, similar things have happened, just look at the Concordia Hip and Knee facility and Pan Am sports, two examples of specialists that would have traditionally been in the Medical Arts that are now in the suburbs.

Yeah, for sure. But I was really talking more at the retail level. Specialists are always prescribing, but they're also doing research and follow-up care and hospital rounds and all that stuff that takes time away from being able to prescribe! When you're running a basic clinic, it's all about patient flow. Each doctor needs to write ~25-30 scrips per day and there are 3 physicians on staff. And that number fluctuates with the overhead of the clinic and the deal with the pharmacist, but that's generally the gist. The Pharmacist is then paid on the dispensing fee and the rebates from the manufacturers which is both higher for generic drugs and based on a percentage of total sales. That's why the kickbacks are important - the pharmacist is beholden to the volume of scrips in few different ways. And this is most easily accomplished when you can have basic maladies being churned through and addressed quickly with some form of antibiotic or otherwise easily dispensed pharmaceutical and the cash register rings. This is sort of why you see the pharmaceutical industry pushing for more integration of nurse practitioners into the basic clinical structure - they can do the same thing and demand much less.

It drives the way in which most clinics structure their practices these days. And you'd be surprised how many hundreds of thousands of dollars can emanate from a 500 square foot pharmacy in a busy walk-in clinic. Many.

Why are we under the impression that scrips are filled in a small pharmacy attached to a clinic? Costco and Superstore are much cheaper, Safeway gives 9X Air Miles on drugs. I'm sure that's where a great majority of the drugs are sold in the city.

That and Air Canada park.

That's funny.

Lots of scrips are filled at these pharmacies. There's no question that Costco and Superstore are cheaper, but nobody is driving across town to pick up a $9 bottle of antibiotics. These pharmacies fill a short term need. But you're right; they'll never compete with Costco for somebody's diabetic gear or their heart pills. Those are material differences in cost and they're regular enough to be scheduled.

And delivered.
Haha

Any word on whether this project is being tweaked to get rid of that ghastly void on the Graham Ave side as seen in the initial renderings?

Yes, Ron Lemieux has said the surface lot will not be there, and principals of better urban design will be followed.

Take the vitural tour...:D


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^At first I was confused because the parking lot and everything was still there, then realized it was published in September. I'd ok with losing one floor of the addition in order to expand out to the sidewalks on Graham and Kennedy, with main floor CRUs.

So, nearly half a year later, any word on whether the initial turkey of a proposal has been cleaned up yet? I'm anxious to hear whether they're going to build the extension right up to Graham Avenue.

Prov. election can't come soon enough and with a change in govt. maybe this can be re thought out.

They should have just rented space by their giant new store. I don't see the point of building this any more.

After looking at the renders again, what a POS. Why is the building angled when everything is square on site? Parking lot, ha.. Hopefully this is better thought out.

Didn't they buy the building? With governments buying office towers on Graham that nobody else seems to want, I think we may be stuck with it.

Hard to say. Leasing space at TNS allows another bone to be thrown to TNSE which appears to be a major provincial priority, but it also allows MLLC to pull out if it turns out that opening a liquor megastore is not such a great idea after all. If they put it in the HQ building then they'd be stuck with a big retail space if the mega liquor mart didn't work out... although I guess it could always be repurposed.

Also, the Medical Arts Building was so cheap that it's hard to make the argument that MLLC should have leased pricy new Class A space... even for the province that's a bridge too far.

You have to wonder if there wasn't a missed opportunity for the City to unload their vacant money pit of an office tower on MLLC. It might have been a win-win for both levels of government...

Yeah, it's total crap. Seriously, the site design is like something from 1998.

All part of the speNDP ideology of empire building!

The mantra must become: we can do better. If this were 1995, and downtown was witnessing nil development, fine. At this point, this proposal is unacceptable. I do suspect it was a half-ass design for press release purposes.

I, too, hope the new provincial government analyzes this plan and makes a sound decision that will not hurt taxpayers.

I'm pretty sure there is enough office space available for the MLL within downtown with out having to do a horrific re-do of an existing building. Poor planning by both the MLL and speNDP govt. go hand in hand.

I hear there's a bunch of space in 201 Portage that just got freed up!