Up in a high-rise lab on the western edge of the University of Nebraska Medical Center campus, Dr. Howard Fox and his research team are studying the combined effects that HIV infection and aging have on brain cells.
It's no small enterprise. Funded by $4 million in annual outside grant awards, 16 investigators, technicians, graduate students and others work daily in the lab, exploring on a molecular level how cells protect themselves from infection.
Fox's team believes its research holds the power to one day prevent HIV and other degenerative disorders. But more than that, such research is helping make the medical center one of the most powerful players in the region's economy.
Fueled in recent years by explosive growth in research and in many areas of clinical care, the med center has surpassed Offutt Air Force Base as the Omaha metro's largest employer.
Nearly 11,000 doctors, nurses, medical aides, researchers, educators, administrators and support staff are working at the med center's mid-Omaha academic and research campus, the attached hospital and related facilities. That's up nearly 2,700 since 2001.
Over that same period, the UNMC campus has been reshaped by some $1.1 billion in new construction, with a new academic, research or clinical building or a major renovation completed nearly every year. That has offered jobs for thousands in the construction trades — about 900 in 2012 alone.
Clearly, the med center is contributing not only to Omaha's health but its wealth, too, packing an annual economic impact in Nebraska estimated at $3.2 billion.
And now the influential midtown institution is poised to launch its most ambitious — and perhaps transformative — project of all. Demolition work began this month toward construction of UNMC's $370 million cancer treatment and research center, the largest building project ever on campus.
Beyond the additional 1,200 good-paying jobs that med center officials estimate the cancer center will create, the project is expected to spark a private housing and retail redevelopment on the edge of campus that could approach the scale of urban renewal projects such as Midtown Crossing or Aksarben Village.
The med center's growing economic impact has not come about by happenstance. Med center officials say that right along with advancing science, improving health and saving lives, they believe their campus has a role to play in the growth and vitality of its neighborhood, city and state.
“We've been here 100 years, and we're going to be here for the next 100,'' said Don Leuenberger, UNMC's vice chancellor for business and finance. “We have a strong interest in the quality of life in the community.''
Others have taken notice of the med center's growing economic clout.
“It's a jobs juggernaut, with high-paying jobs that have huge economic impact and neighborhood impact,'' said David Brown, CEO of the Greater Omaha Chamber of Commerce.
Omaha real estate agent Deb Cizek said med center employees have a positive impact at all levels of the Omaha housing market. But it's particularly noticeable at the upper end when the med center recruits new researchers or doctors from outside Nebraska.
“Let's face it, most of the jobs there are nice jobs,'' she said. “It has worked out very well.''
Terry Moore, CEO of the Omaha Federation of Labor, said local craftsmen are especially looking forward to the kickoff of cancer center work and the related private development.
“The cancer center,'' Moore said, “is going to be huge.''
Metro Credit Union, across Saddle Creek Road from the campus, counts med center employees as its primary customers. Fueled by campus growth, the credit union over the past 25 years has seen its workforce grow from 15 to 115 and its assets climb from $25 million to $225 million.
“The medical center (leaders) are very good business people,'' said Mike McDermott, the credit union's president. “They're not like typical government bureaucrats. They're good at making positive things happen in the community.''
Nebraska's state-run medical center is indeed a unique institution within the state.
While collectively known both around Omaha and on campus as “the med center,'' it's made up of two separate legal entities: the University of Nebraska Medical Center, which is the academic health professions and research side; and the Nebraska Medical Center, which operates the teaching hospital and provides health care.
While legally distinct and with their own leadership, their mazes of offices and buildings are completely intertwined and linked on the midtown campus. Ninety percent of the hospital's physicians are on the UNMC payroll. One institution could not exist without the other. And when it comes to economic impact, it's a singular force.
So just what is fueling all the med center's growth?
Much of it appears to be a function of the growth in all of health care.
Triggered by the move of baby boomers into old age, health care employment grew nationally throughout the Great Recession even as millions of jobs in other fields disappeared. Health care jobs grew about 27 percent nationally between 2001 and 2012 and by roughly the same amount in the Omaha metro.
But the med center's job growth appears to have topped even that. It grew nearly 33 percent over that same period, from 8,216 in 2001 to 10,901 in 2012.
Some 10,605 of those employees work in the Omaha metro area. At some point in recent years, med center employment surpassed that of Offutt — the longtime metro jobs leader — which currently employs some 9,980 workers.
Underscoring the growing importance of health care in the Omaha economy, Alegent Creighton Health, which operates 10 hospitals and other medical facilities in the region, now ranks right behind Offutt, with 9,729 metro workers. About 800 of those came on last year when Alegent added Creighton University's teaching hospital to its network.
Employers on such a scale also spin off thousands of other jobs in the community. A recent economic impact study estimated the med center's payroll and other spending create 8,400 other jobs in Nebraska in retail, government and other fields.
The med center affects the economy in other ways, too. It educates some 3,700 students a year, producing about half the state's health care professionals. And it annually draws a half-million patients, including a substantial number from out of state.
The chamber's Brown and others say Harold Maurer, the med center's soon-to-be-retiring chancellor, deserves much of the credit for the med center's rise.
After taking over on campus in 1998, Maurer worked hard to increase the med center's research profile. He particularly worked to recruit and retain researchers capable of pulling in the large federal and private foundation grants that fund much of the discoveries in medicine today. Such researchers also tend to attract top-notch graduate students and help raise a university's profile.
But the campus at the time had little to offer in the way of modern research facilities. Most campus labs had been built decades before scientists had broken down the genetic code, an advancement that sparked a medical science revolution.
“When we started this, there was not a lab on campus that met current standards, and there were no vacant labs to recruit anyone into,'' Leuenberger said.
To get the effort off the ground, Maurer effectively tapped into Omaha's philanthropic sector, securing donations of nearly $400 million for construction, including more than $150 million to build state-of-the-art research facilities.
Now towering over the west end of campus, just above Saddle Creek Road, Durham Research 1 and Durham Research 2 stand as visual symbols of the medical center's rise. In all, about 1,000 investigators and other staff now work in the buildings' 214 labs.
Not all the researchers in the towers are new to the med center, some having moved from older labs on campus. But Leuenberger said that in most cases, as those old labs were vacated, they too were modernized toward the goal of luring still more research. Outside research awards to the med center have grown from $31 million to $89 million since 1999.
Fox said labs that rank with the best in the country were a definite draw when he was recruited to Omaha in 2008 from the prestigious Scripps Research Institute in La Jolla, Calif. But he said the upward trajectory he saw on campus was also a major lure.
“Every (medical center) will tell you they are growing,'' Fox said. “This place has a plan.''
Fox brought two assistants and some outside grant funding with him. Since then he has attracted millions in additional grant dollars and expanded both the scope of his lab's work and its staff.
“And all the people in these labs buy homes, pay taxes, send their kids to school, shop and buy cars here,'' Fox said.
The med center also recruited Fox's wife, Nora Sarvetnick, a top investigator in the field of transplant immunology. For the past two years she has served as director of the med center's program in regenerative medicine — one of the hottest areas of medical research. Scientists in the field are exploring new medical therapies that may one day enable the body to repair or restore damaged cells, tissues and organs.
Besides leading her own research in a lab of 15 and overseeing a program that employs 15 others, Sarvetnick is working to hire five additional lead researchers. By the time she's done, that should translate into 60 more jobs.
Better yet, she said, would be if discoveries in the labs can ultimately be turned into new private-sector commercial ventures.
A new No. 1 in Omaha metro area's largest employers
No. 1: University of Nebraska Medical Center and hospital, 10,605 employees
No. 2: Offutt Air Force Base, 9,980
No. 3: Alegent Creighton Health, 9,729
No. 4: Omaha Public Schools, 7,926
No. 5: Methodist Health System, 5,697
Source: Greater Omaha Chamber of Commerce and these employers
UNMC two decades ago founded UneMed, a for-profit corporation with exclusive rights to patent, license and commercialize biomedical innovations coming out of UNMC research.
The university has yet to really cash in on any mega-breakthroughs. But since 2005, the number of annual patents coming out of UNMC has grown sixfold.
“I think there's going to be spinoff stuff from here,'' Sarvetnick said of regenerative medicine. “We are going to be at the cutting edge.''
Sarvetnick, Fox and other med center officials say contributing to the growth of Omaha and the state is now part of UNMC's mission. Several years ago, economic growth was added to the institution's mission statement, right along with health care, education, research, community health and building “a world-renowned health sciences center.''
The massive cancer center complex now being launched will include another research tower, inpatient rooms and an outpatient treatment center. When completed by 2016, UNMC officials say, the center will be a magnet for top cancer investigators. And by 2020, they estimate it will add 1,200 jobs —100 physicians, 50 researchers, 650 clinical staff and 400 research staff.
Then there's the private growth the project could spur.
Somewhat lost in the controversy over the tobacco tax the City of Omaha created to help pay for the cancer center is the major private redevelopment UNMC has said the project could spark on the west side of Saddle Creek Road, including a hotel, housing, retail, restaurants and private medical offices.
Most academic medical centers around the country are in older neighborhoods, making them powerful forces of urban renewal. With the cancer center project, UNMC appears to have turned a corner in its ability to attract private investment in its neighborhood, Leuenberger said.
The project also could revive the long-dormant discussions of realigning Saddle Creek Road to create a sort of flood control waterway and recreational green space.
The cancer center is hardly likely to mark the end of UNMC growth. Campus leaders are already developing their vision for what the institution will look like in 2020 and beyond. With the new cancer center employees and continued growth in other programs at current rates, campus employment by the end of the decade could approach 14,000.
In the longer term, UNMC officials foresee development of a “medical corridor'' south of Leavenworth Street that would link the medical center, Douglas County Health Center and the proposed new VA Medical Center at 42nd Street and Woolworth Avenue. With the acquisition of four properties south of Leavenworth around 40th Street in the past two years, only about one city block now separates UNMC land and those other facilities.
UNMC has no immediate plans for the land south of Leavenworth beyond parking. But history has shown that parking lots at UNMC often ultimately give way to the next big project.
“There will be other things,'' Leuenberger predicted. “I think we are really at a tipping point in terms of our impact on this community.''
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