Huntsville Healthcare Deserts: How Close to Care Should You Buy?

Welcome back to the Boomtown podcast. Today we're going to talk about Huntsville healthcare, and we're going to look at it in three different facets. We're going to look at Huntsville healthcare deserts, those areas surrounding Huntsville where you don't have as much access to healthcare as you do when you're closer to the city or some of the suburbs.

We're going to talk about those areas where you do have more access, but we're also going to talk about the premium that comes along with it because of the population density around those areas. And then we're going to talk about some ways where you can get a little arbitrage, leveraging buying somewhere now that will have more access to healthcare in the future, which is a pretty good play for getting some equity in a home a few years down the road. So, I'm going to kick it over to Megan.

She's the one that coined our phrase, "Huntsville Healthcare Desert." So, kick it over to you to talk about those.

I think what we're talking about here is places where it's not easy to access healthcare. And that can be very specific depending on your specific need. It can be places where there isn't a local pediatrician or places where you don't have access to an ER if that's something you think you're going to need.

Places where it might take over 30 minutes to get to an emergency facility, and that might be a big factor for you if you have health concerns. So, all areas are not equal when it comes to this. When we look at the Huntsville metro area, and I would define that as Huntsville, Madison, probably now Athens as well, even though a lot of that is rural development, all the way up to parts of Harvest and Tony, you have pretty good access.

These are areas where an ambulance will come to you and you'll be in a hospital in a reasonable amount of time. We have emergency centers, and you could be airlifted somewhere else; if it's big enough, you get the whole shebang in terms of healthcare in these areas. But you go a little further out, and the picture gets a little bit more complicated.

It's all based on need, like you mentioned, an eye doctor versus a dentist versus a pediatrician versus a heart doctor. I'll give you a prime example. My dad lives about two hours from us, but still in Alabama, and what most people across the US would consider rural.

Locally, it's almost a suburb of the nearby city. That nearby city is smaller than Madison, but he had to have a heart catheter done yesterday and he needed to go into Birmingham to do it, because in the area he's in, they just don't have specialists like that. Versus in Huntsville, they'd be able to do that kind of procedure here.

But you are going to have to come into town to do it. Even if you do live in Tony, Harvest, or Hazel Green, there's only going to be a few pockets in North Huntsville where you could do that. Again, though, if you need to go see a pediatrician or a family doctor, you're not going to have a 45-minute ride in to do that in most areas.

And what people might not consider is that they think, "Well, an hour is not that big of a deal. I could drive that now if I needed to see a specialist or take my kid to that." But when you get older, it becomes a bigger deal.

When you're actually in need and you have to do this, when you're not feeling well and you have to drive an hour, it's a much bigger deal than it is when you're in your 30s and you're taking your kid to see a specialist for their braces.

Absolutely. My whole family mobilized because my dad was having this heart cath done. He's fine, by the way, perfectly healthy.

But it was like this whole big ordeal because he's in his mid-70s. It was like, "Okay, if it goes sideways, what happens? If it goes well, what happens?

Who's taking him? Who's picking him up?" And it's because he had a two-hour ride in to get the procedure done, and it's a two-hour ride home once he's out.

Versus, like you said, when I get my kid braces, it's a 15-minute drive in morning traffic across Madison to go see the orthodontist. It's a whole different ballgame.

I think that there is this push and pull because when people are thinking of a place to retire, they're thinking of where they can save. They have this vision of themselves saving a bunch of money and being in an environment that's very low stress. That is a more rural part of Alabama, and that might be an area that is going to stress you out in the end because you're not going to be able to access the healthcare that you need.

Absolutely. You do have to think about the future, the condition you're in, what your needs are, and what they could be or will be. Some people live well into their 90s, almost perfectly healthy.

You can look in the mirror and see if you're one of those people or not, based on your own healthcare history. That is important to consider when you're buying, but to your point, people don't always factor that in. That's research you need to do in advance.

Alabama and the federal government have put together a package where you can measure access to healthcare in different parts of the state and different counties. They break it up by eye doctor, dentist, family doctor, pediatrician, heart doctor, and so on. The way they grade it, the higher the score, the worse the access.

We'll have that on our website with a link or a QR code on the screen. You can point your phone at it, click the link that pops up, and you'll have access to that information. We can't list every kind of medical professional in every county that we serve, but just know that there is a measurement for these things.

Looking into that and prepping for this, I was not too surprised, but I didn't realize the metrics would be available. Did you know that in the rural parts of Alabama, they have half as many family doctors per capita as they do in the more developed areas?

I didn't know the exact number, but I knew that Alabama is one of the states that suffers from this situation and that healthcare access does get very hard. There are a lot of rural areas that are not very affluent, and it's not profitable for people to put hospitals there; these are for-profit.

That leads into a little bit about what's going on here with Huntsville Hospital. Over the decades, they've really absorbed a lot of the other facilities into their conglomerate. There's some good and bad with that.

They bought out a lot of these hospitals, I know Athens, Madison, and now they're buying Crestwood down in the south. I think they're 14 or 15 deep now in hospitals between southern Middle Tennessee and Northern Alabama. That's really good because some of those areas might have gone bankrupt if they were on their own, just because the cost of healthcare versus what they're bringing in.

But then all your decisions are made centrally. So you don't have the local decisions in those areas that maybe you'd want. And in Huntsville, you don't have that element of competition where you have two competing hospitals trying to be better; it's just a monopoly basically.

So they make decisions, and that's the healthcare you get. Now it's good, I don't have a problem with it, but depending on who you talk to, everyone has a different opinion.

Something you and I were talking about that was really eye-opening for me: we were talking about ER waits versus going and seeing what I call a "doc-in-a-box", most people call an urgent care. I moved here when I was in my late 30s. I probably hadn't spent a lot of time in my adult life going to the doctor, so I wasn't really that familiar with urgent cares.

I had the Kaiser medical system in California, so I would call a number and be told where to go based on what was wrong with me. But here, you go to an urgent care. I didn't know that.

You end up at the ER for things that you don't need to be at the ER for. You need to really figure out how your healthcare system works and how it's different from where you're from so that you can access healthcare. Here, if you have something minor, you would go to an urgent care.

You would do this for almost everything, unless you actually feel like you are so sick that you need to see a doctor right away because you're in danger. This way, you are not spending time in the ER, and it keeps the ERs less crowded.

Our ER, I took my daughter there when she was a baby. You see, that's what you do when you have a baby; you think they're very precious. But it wasn't insane.

It was not, back then, an insane wait. I don't see, some ERs are like days long. It's a triage, and it's an absolutely horrifying experience.

When I was there, it was unpleasant, obviously, and I did wait, but it wasn't as intense as the ERs that I've seen. I see a lot of people complain online, and I try to go in gently but firmly to tell them that you're causing your own problem. If you go into the ER because you think you have the flu, there's a difference between "I'm sick, I can't go to work"

and "I can't breathe." If you can't breathe, go to the ER. Now, I'm not a doctor; don't take any medical advice from me.

But I see these people complain online about how long the wait is, and it's like, "Well, you're not a serious enough risk for the hospital." To your point, they have to triage the people that have gunshots or fell off a ladder or can't truly breathe. They're getting the beds.

You're going to have to wait until there's availability, versus if you went and saw an urgent care, you might wait for 30 minutes, an hour, or an hour and a half if it's flu season, but you're going to get seen. You're going to get meds. You're going to get to go home.

I think people are, to your point, if they're moving here from somewhere else, their expectation is different than what the local area provides.

The other thing is you can reserve a spot with the urgent care. You can go online, see how many people are ahead of you, and then you show up. It's very convenient, and they're really helpful.

I didn't know that. I was wasting a lot of time. I always joke, and it's true, I hadn't seen a doctor with their name on the door for 10 years between 30 and 40.

Once I hit 40, I had to start seeing a real doctor and getting a medical history built and start working on various things. But until then, for 10 years, it was like, if I was sick, I went and saw somebody. If I wasn't, I didn't.

That's what people do. If you're a hypochondriac, you might be like, "I'm 25 and I have to go see my doctor." I guess you could.

When you're in these more urban and suburban areas, you have access to those. Across the country, we had a really bad flu season, and my family got hit four times. One kid got it twice; she got A and B.

We were in and out of these urgent cares fairly frequently to see doctors and try and get those antiviral meds early on to speed up the recovery. In some cases, they closed early on Friday. Knowing where you can go in advance is also a huge advantage.

If you're moving here, I would recommend looking into the urgent care, seeing where they are based on what part of town you're moving to, so you have a plan of attack should you, a child, or a parent get ill.

South Huntsville is extremely convenient. There's one right over off Cecil Ashburn, and they're open Sundays, every day of the week. The closer you are into the city, the longer they're open, the more days they're open.

As you get out into suburbia, you start running into the ones that close at five or six, aren't open on the weekends, or only open one weekend a month. That's just the way it is around here. The more urban, the more access.

But also, when we talk about urban areas, a lot of times a rural area will not be that far away from an urban area. The South in general is more populous than the West. If you're in Idaho or Montana and you're in the country, you're very much in the country.

If you don't have access there, you're talking several hours. There are places around here that are several hours from healthcare, but for the most part, you can find the closest stuff and it might not be too far.

If you're going to be within 5 to 10 minutes of a hospital or 15, even 20, you're going to pay a premium for being in a more urban, dense city versus being out 30 to 45 minutes or an hour away. If you go out well past Athens or well past Huntsville to the east, you are going to hit areas where you're an hour away from true healthcare. If you had an emergency, an ambulance can only get to you so fast, and they can only get you to a hospital so fast.

But if you're closer in, you get to more types of healthcare, hospitals, more doctors, more dentists, more specialists, so you're going to pay a premium for being in those urban centers.

We have a for-profit healthcare system in this country. That means they're going to place that healthcare in places where they can make the most money, and that is not a rural environment. You have a push and pull.

You want this rural lifestyle, but you also want this world-class healthcare; you're going to have to maybe make some compromises. That's important because I have people that chose not to move here because they couldn't find what they wanted within an acceptable distance from a hospital. You do have to set that right expectation.

I would get on Zillow or our website, look at the houses that you're interested in, pull up Google Maps, and say, "How far is that from the hospital?" before you even start making too many plans. If you can't find what you want within your budget and within an acceptable distance from a hospital, then it may just not be the right place for you.

There's a lot of data out there, and we'll be sharing that on our website, so please use the tools that we provide.

That brings up something else: there's a way to future-proof yourself to a certain degree. Because Huntsville is growing so much and we're expanding in different areas, there are a lot of things coming down the pike. Huntsville Hospital has made two big announcements recently about where they're going to put, I like to call them outposts, but they have an official title and that'll be on the page too.

One's going to be in Northwest Huntsville, and there are even rumors of one going in near Hampton Cove. Hampton Cove already has really good access because it has ambulance service and you would use Huntsville Hospital; it's just right over the hill. But having its own access means it's going to be even more convenient.

Hampton Cove is a great area. If you were coming out of Hampton Cove, you're maybe two to three red lights from the hospital. People don't realize that when you look at it on a map, that is a straight-line, 65-mile-per-hour trip over the hill.

It's a straight-line shot into the medical district and everything you want. But if you needed something faster, something more local, there's a lot more building going out there. I closed on a house in McMullen Cove last Friday, and I spend as much time in Owens Crossroads as I spend anywhere these days.

As you have more people, you need more access to those services.

I always want to say this on our podcast: if you're looking for that area, it's in Gurley, not Owens Crossroads. If you want to find all of Owens Crossroads, you have to look in Gurley, too, because some of it is technically in Gurley. The search criteria on any website isn't fuzzy math; it doesn't look beyond what you tell it.

Half of McMullen Cove is in Gurley, and they're not the only ones that suffer from that. But the one that's going to be in Northwest Huntsville, I'm really excited about that one because they're building a large shopping center there, and they're going to build this hospital in conjunction with that. I was watching the Huntsville Planning Commission videos from the end of May; they're bringing in a massive, single-family townhome/condo-style mixed-use development, and they're going to start with a 55-plus community there.

We need more of those. It's the same developer that does all the Del Webb-style communities throughout the Southeast and Southwest. So they've already got like 16 of these communities across that geography, and we'll be number 17.

The amount of people who have commented on our videos, emailed me, texted me, and called me asking if we have a Del Webb-style community, that demand is built up over the years. It's going to be really cool to see that come in.

It's going to be massive. I don't want to throw a number out there because I don't remember the exact figure, but they start with the 55-plus buildout until they feel like they've satisfied that part of the market, and then they expand into other parts of the neighborhood that would then be non-55-plus, more traditional. Even if they put a date on it, they wouldn't hit it, but they were approved, so it's coming.

If you're moving here and you do need more access, or maybe you're three years from moving here, maybe you're thinking about retiring here, or your job will transfer you in the future, or you're waiting on a kid to get out of school, you do want to be close to medical care. By the time you're ready, that will be there. I had this conversation with a client who's looking about 10 minutes from there; that was one of the big things for them.

They think they're going to have an appreciation in value because they're going to have access to these things that aren't there now. I think there's going to be a huge appreciation of value out there. Big corporations think so too; that's why they're building out there.

You look at the massive amount of investment from the city and the state with building the Northern Bypass, and kind of like Owens Crossroads, I feel like I'm up in Meridianville and New Market constantly. It's an area where right now Meridianville kind of feels like tract homes, and I actually take people out there when they want to see all the builders because they're all right next to each other. It can feel kind of corporate, but I think eventually it will take on a more lived-in feel.

I find New Market to have definitely a more organic feel than Meridianville.

We've talked about the rural areas where you may or may not have much access depending on what your needs are, and we've got some resources for people there. We talked about more urban areas where there's a higher cost to live, but you have almost immediate access and even more coming. And then we talked about future-proofing yourself if you're looking for something a couple of years down the road or you want to get there in advance to take advantage of the equity play.

You've kind of got three different options. The big takeaway is you need to decide how important healthcare is to you right now and how important you think it's going to be to you in the future, and really weigh the pros and cons because there are always trade-offs. Thanks for watching; we'll catch you on the next one.