If downtown Tampa's Center for Advanced Medical Learning and Simulation, or CAMLS, seems a bit long-winded and aloof, a super-high-tech dummy named MATT helps bring it all home.
MATT is a combat-injured dummy who's dressed in khaki fatigues, moans in pain, bleeds and displays two gruesome legs severed below the knee. Computers monitor him head to toe, so when a physician-in-training applies too much pressure, for example, MATT (short for Multiple Amputation Trauma Trainer) will show rising or falling vital signs.
This kind of technology is dazzling Tampa-area leaders with the potential to lure thousands of physicians to South Franklin Street to learn how to use the latest medical devices and robots.
Nearby restaurants and hotels might boom. Upon its opening in March this year, Tampa Mayor Bob Buckhorn called CAMLS a "game changer for downtown."
But first, CAMLS actually has to make money.
CAMLS technically is a nonprofit organization that supports the University of South Florida, but the university wants it to be self-sustaining and expand the concept to other countries. It has lost about $4.5 million in the past year and is operating at only 30 percent capacity.
It's hard to judge it too harshly, though, because many business startups lose money initially, and CAMLS has some impressive talent and technology to tap into.
But it also faces some major hurdles. Although local dignitaries rave about its novelty, other universities and hospital chains are developing their own competing robotics and simulation centers, including one just 70 miles away in Celebration.
"The transformation of health care, which really is what CAMLS represents, is going to be very competitive going forward," said Rick Homans, who leads Hillsborough County's main economic development agency and is a CAMLS believer. "We're at the ground floor of some huge change."
Last week, CAMLS executives opened up their books and their doors to give the Tribune a peek into their virtual operating rooms and their business strategy.
Among its components are:
Some of the world's leading medical device companies have donated or provided cutting-edge equipment to CAMLS at reduced prices so the facility will serve as a showroom for their pricey offerings. Many will fly teams of physicians into Tampa to train on their equipment, such as the medical manufacturer Stryker.
All told, CAMLS has 35 surgical learning stations where physicians and residents can learn the latest techniques. That may be the most surgical stations in the world, CAMLS marketing chief Paul Ayres said.
Instructors will watch.
"Did they listen to the patient?" Ayres said. "Did they touch the patient?"
For now, though, this part of CAMLS' strategy has been slow to take off, said Deborah Sutherland, the center's chief executive officer.
CAMLS is USF Health's attempt to lead in the growing field of robot-assisted and simulated surgery, using high-tech dummies instead of learning the craft exclusively on live humans. The school considered other sites, including near USF's Fowler Avenue campus and the Tampa Heights area, but downtown gave it the best access to hotels and other amenities.
In all, USF spent $38 million developing CAMLS, and there are huge hopes for it inside the university and out.
USF already is hoping to license the CAMLS concept to other countries and has had discussions with Panama and Jordan. CAMLS' potential partly enticed the Trammel Crow development firm to plan a 20-story office tower and hotel across the street.
For all the lofty plans, though, CAMLS needs to make its way out of the red.
Documents provided by USF Health show CAMLS had revenues and other support of about $16.2 million in the year ending June 30, but expenses of $20.7 million, although $2 million of those expenses were non-cash depreciation expenses. CAMLS' controller said the center also had significant expenses before officially opening in March.
CAMLS is a new animal — perhaps the largest medical training and surgical simulation center in the world at 90,000 square feet — and Sutherland and her team are trying to figure out exactly who potential customers are, how to target them and how to use CAMLS to make money.
They're calling on nearly every medical, dental and even veterinary association or society in the country trying to get CAMLS on their radar screens. Come to Tampa for your next conference or training seminar, they're telling them.
It's starting to pay off, but most medical societies book conventions a few years out, so it may be 2016 before their labors completely pay off, Ayres said.
Meanwhile, CAMLS is making some tough calls.
It has allowed dozens of chambers of commerce, banks and law firms to use its facilities for meetings, all free of charge. But that will have to change as the center gets busier, Sutherland said. The center also is considering charging USF students a special lab fee for using its facilities, but some USF deans are pushing back.
Finally, Sutherland has gone into lobbying mode, joining a small group of people nationwide arguing that physicians and residents should be required to do some simulated surgery, such as that done at CAMLS on high-fidelity dummies.
For now, medical residents learn the ropes of surgery by operating on real patients in real hospitals, under the watchful eyes of licensed physicians. But pilots use flight simulators to practice, she said, so why shouldn't physicians start training on simulators instead of on live people?
"The model we've used in medicine is 'see one, do one, teach one,' ," Sutherland said. "That's fine, but most of us would not like to be that first patient."
Paul Phrampus, a physician affiliated with the University of Pittsburgh and a national leader in the push for surgery simulation, said some medical school programs and physician groups, particularly anesthesiologists, are starting to mandate simulated surgery in training.
Some established physicians quietly are fighting it because they don't want to have to return to a lab every few years to practice on a dummy and have someone looking over their shoulder, Phrampus said.
"Everybody in health care hates change," he said.
One of the biggest challenges CAMLS may face is competition for dollars. Phrampus said the number of universities and hospital groups opening high-tech robotics and surgical simulation centers is expanding "prolifically."
In Celebration, the Florida Hospital chain has opened a new 50,000-square-foot facility called the Nicholson Center. Other centers can be found at Vanderbilt University, the University of Toronto and McGill University in Canada and in Taiwan and Singapore, Phrampus said. Sutherland knows of other competitors in Miami, Chicago and Las Vegas.
One thing CAMLS has going for it is sheer size, Phrampus said. It's bigger than just about every other competitor out there and is the talk of the close-knit surgical simulation world.
Stephen Mitchell is a longtime Tampa lawyer whose firm, Squire Sanders, is helping CAMLS license its concept around the world.
"Other schools have simulation centers, but nothing like this," he said.