Future of Design December 19, 2023

“Medtail” is making healthcare more accessible and rejuvenating commercial districts.

person walking down a corridor with decorative ceiling
person walking down a corridor with a decorative ceiling
For many, the regional hospital is the only place to go for medical treatment, a trip that often entails a long commute and, once you arrive, a massive building that’s difficult to navigate. But a new trend called “medtail,” in which former retail spaces are converted for healthcare, is rewriting how medical organizations exist in and form relationships with their communities.

According to NRC Health, 80% of respondents in a survey said they would switch to medtail for the convenience factor alone. But the trend is not just increasing the accessibility of healthcare; it’s also helping to revitalize commercial districts that have been gutted by e-commerce.

Take the U.K.’s National Health Service North Central London Integrated Care System (NHS). In August 2022, the NHS opened a Community Diagnostics Centre (CDC) in a former furniture store in London’s Haringey borough due to an increased need for routine diagnostic testing spurred by the COVID-19 pandemic. The 8,070-square-foot facility offers x-ray, ultrasound, ophthalmology, phlebotomy, CT, and MRI services. Located at The Mall at Wood Green, which serves as a hub for the community, CDC is proximate to 50 other businesses, including retailers like Primark and a cinema. Since opening, more than 130,000 patients have come through its doors, many of whom have gone on to patronize neighboring stores.

“Getting people back into town centers helps us all,” says Nicola Theron, director of estates for NHS. “And we’re seeing that if you bring people into places they want to be at, they might access a whole range of different services, one of which is healthcare.”

The CDC is just one in a planned series of 40 outlets that will serve the same purpose.

But as smaller medtail storefronts become increasingly common, one organization set out to offer more involved forms of care with a much larger retail renovation. In 2023, UR Medicine opened its Orthopaedics & Physical Performance Center in a former Sears that served as an anchor store to Rochester, New York’s Marketplace Mall.

UR Medicine’s Orthopaedics & Physical Performance Center in Rochester, New York is an adaptive reuse of a vacant Sears. (Photo: David Lamb)

“The advertising takes care of itself,” says UR Medicine’s Dr. Sonia Pyne. “Everybody knows where the mall is. Everybody went to that Sears. It put a lot of public interest into the site and ultimately, people wanted to see its success.”

The need for the new facility arose out of overcrowding at UR Medicine’s other locations, as well as recent advances that have turned many common orthopedic surgeries, such as knee replacements, into outpatient procedures—also known as ambulatory care. Ambulatory services tend to come with a large volume of cases and high rate of patient turnover, something big hospitals are typically not designed to handle. UR Medicine leadership realized that they needed a new location, one specifically focused on orthopedic outpatient care. Their search for a site off-campus that came with easy patient access, an abundance of parking, multiple entrances, and proximity to freeways and public transportation led them to the vacant Sears. The choice of reusing an existing structure as opposed to constructing a new building from the ground-up also meant the facility would open on a shorter timeline.

The facility includes exam rooms, operating and procedure rooms, an injury prevention center, and an outdoor courtyard. (Photo: David Lamb)

UR Medicine took over the entirety of the 330,000-square-foot former department store. Designed by a team led by Perkins&Will designers Robert Goodwin and Carolyn BaRoss, in partnership with architecture firm SLAM, the Orthopaedics & Physical Performance Center can handle over 500 outpatient surgeries per month, with the goal of eventually offering more complex procedures like reconstructions and even spine surgery. It includes 140 exam rooms, three operating rooms, three procedure rooms, and a human performance and injury prevention center.

The design team had to reinforce the structure of the old Sears to minimize vibration caused by mechanical systems, human activity, and wind so that UR Medicine could conduct MRIs and robotic surgeries. (Photo: David Lamb)

Retrofitting the old Sears to be up to code to handle surgery was no small task. The team reinforced the structure to minimize vibration caused by the building’s mechanical systems, human activity, and wind,  providing MRI machines and the equipment for robotic surgeries a more stable environment for surgeons to perform precise procedures. The team also worked closely with Dr. Paul Rubery, chairman of the department of orthopaedics at UR Medicine, on design features that would improve patient outcomes. One goal was to bring as much natural light into the building and to patients as possible. Though the Sears already had a few skylights, the team added four more around the perimeter of the building, where they allow daylight into corridors and waiting rooms, and a courtyard at the center of the building doubles as a sunlit rehabilitation space.

Movement of the human body inspired the curvilinear form of the exterior façade, referencing the facility’s concentration on orthopedic care.

To signal that the building is now a medical facility and not still a Sears, the design team introduced a new façade whose curvilinear form is inspired by the movement of the human body—an architectural gesture that reflects the orthopedic care provided within its walls. This humanized exterior serves as the facility’s main entrance, inviting visitors and patients from the mall parking lot, though the center can also be accessed from inside the mall itself.

Like the CDC across the Atlantic, UR Medicine’s Orthopaedics & Physical Performance Center is stimulating growth in its neighborhood. Restaurant and hotel developers are planning new projects in the vicinity, a sure sign that medtail has the potential to heal the urban realm as well as the patients it serves. “It’s common in the U.S. to stay at a hotel near the hospital with a nurse for more invasive procedures such as knee or hip replacements, so it just makes sense,” says UR Medicine’s Dr. Mike Maloney. “We’re giving the area some new life.”

Main Photo: David Lamb