Longwood Medical Area: Boston's Teaching Hospitals

The Longwood Medical and Academic Area occupies a compact stretch of Boston near the Fenway, and it contains a concentration of teaching hospitals, research institutes and medical education that few places in the world can match.

What is there

The area includes major teaching hospitals, research institutes focused on cancer and other specialities, a children's hospital, and Harvard Medical School itself. Several nearby colleges and schools of public health and pharmacy round it out.

The important structural fact is that these are teaching hospitals: they treat patients, train physicians, and run research simultaneously, and those three functions are interleaved rather than separated. A patient in a teaching hospital may be seen by attending physicians, fellows and residents, and may be offered participation in a clinical trial.

Why the density matters

Medical research moves faster when the people doing it are physically close to the people treating patients. A finding in a laboratory reaches a clinician who can evaluate it, and a clinical observation reaches a researcher who can investigate it, without either of them getting on a plane.

Combined with the biotech cluster across the river in Cambridge, this gives the Boston region an unusual position in the pipeline from basic science through clinical trials to commercial treatment.

The employment consequence is substantial. Health care and research are among the region's largest employment sectors, and the institutions in this area are among the largest employers in the city.

Getting there

Longwood is served by the Green Line E branch, which runs along Huntington Avenue, and by a network of buses. The area also runs shuttle services between institutions.

Driving is the option to avoid if you have any alternative. Parking is limited and expensive, the street layout is not forgiving, and the area absorbs an enormous number of daily commuters into a small footprint. If you have an appointment, plan the transit route rather than the parking.

If you are a patient

Confirm which institution your appointment is at. This sounds trivial, and it is the most common navigational error in the area, because several large hospitals sit within a few blocks of each other and their names are not always distinctive to someone unfamiliar with them.

Confirm the building and the floor as well. These are large campuses with multiple connected buildings, and "the hospital" is not an address.

Allow more time than you think for the last stretch of the journey. The distance from a transit stop to a specific department inside a large hospital complex can be substantial.

The wider picture

Concentrations like this create their own pressures. The area draws tens of thousands of daily commuters into neighbourhoods that were not designed for it, competes for land in a housing-constrained city, and like the universities operates substantially outside the property tax base.

Those tensions are the subject of continuing negotiation between the institutions and the city, and they are the reason that a discussion about a new medical building in Boston is never only about the building.