Rochester appears to be on the verge of dramatic growth if state officials are receptive to Mayo Clinic's pitch for Destination Medical Center, a $5 billion economic development initiative to position the clinic as a global medical destination. Exactly what changes that means for Rochester are still a bit sketchy, but the interesting component for those of us in the outlying areas is what kind of change it means for southeastern Minnesota as a whole.

Rochester has already shown dramatic growth in past 30 years, with the population about doubling since the 1980s. Our relationship to the city has also changed dramatically over that time.

Several decades ago, Rochester was seen more as a competitor to small towns, with the then-new big box stores moving in, taking away sales from established merchants on the main streets of small towns in the area. Our towns were much more self-sufficient then, as even in the towns closer to the regional center, only about a fifth of the people commuted out of town to work.

Over the years, our retail environment has been decimated, much to the gain of Rochester, with only businesses that offer unique products and/or exceptional service remaining. That is not an isolated trend, as small towns throughout the country have been forced to adjust to a new retail environment.

On the other hand, Rochester has been a massive job creator and that has trickled down to the surrounding communities. Commuter buses now pick up workers from Chatfield, Grand Meadow, Fountain, Preston, Racine and Spring Valley. Most of those communities have buses picking up at three different times in the morning.

Cars heading to Rochester from the south also line Highway 63 and 52 each morning. The majority of them are headed to Mayo Clinic, which employs roughly 32,000 people.

Those jobs have transformed our towns, making many of them closer to bedroom communities than self-sufficient rural communities. On the plus side, our rural communities have remained stronger than similar sized towns that are more isolated. On the other hand, residents' connections to the communities aren't quite as strong as they were decades ago, although they are definitely much stronger than suburban or true bedroom communities.

Our view of Rochester has also changed over the years. Rather than being seen as a competitor, in some ways, the city is seen as a partner in our success. For example, sharing the proceeds from the city sales tax with Chatfield and Spring Valley, even though a forced move by the Legislature, showed that Rochester officials had trust in the small towns to use it as they felt needed rather than Rochester dictating its use.

Chatfield City Clerk Joel Young noted that the sales tax process highlights the "symbiotic relationship" between all the communities in the region. While the job opportunities in the regional center contribute to the health and vitality of these communities, Rochester also needs vibrant communities to provide a strong, quality workforce.

The relationship, which has been developing over the past few decades, is going on a fast track, though, if the Destination Medical Center initiative comes to fruition.

Under the plan, Mayo Clinic has pledged to spend $3.5 billion over the next 20 years to expand its operations in Rochester, and it will leverage another $2 billion in private investments on retail businesses, hotels, entertainment facilities and other amenities. In return, it is seeking $585 million in public money to be spent on infrastructure improvements to support the project, paid in part by the new taxes generated by the development.

Funds generated through the legislation will not go to Mayo Clinic. More importantly, the model proposed is built on the proof, not promise, of growth as public investment will be made over time based on a proven level of growth by the private sector.

For those reasons, it appears likely state officials will approve the funding. After all, the plan would keep Mayo's headquarters in the state and add tens of thousands of jobs over the next two decades. It is already the state's largest private employer in an industry that will always have customers.

It isn't just the several thousand jobs that Mayo Clinic would add as there is a ripple effect. Studies show that every job created, particularly high-skilled jobs, results in anywhere from 2.5 to 4.3 additional jobs throughout the area.

The dramatic growth in Rochester will also have a ripple effect on the surrounding communities, perhaps as far away as 40 to 50 miles.

So far, our small towns have adapted to the changes in our regional center, although not without some bumps in the road. If Destination Medical Center becomes a reality, communities in Destination Bluff Country need to prepare.

Although it will take some time to sort out what Destination Medical Center will mean - for Mayo Clinic, Rochester and the entire region - there is no doubt that it is going to mean changes, big changes and rapid changes.

The question facing our communities is what kind of changes will it mean for our future. There will likely be perceived pluses with increased job growth and perceived minuses with threats to our heritage and quality of life.

The important thing is that we soon need to be talking about these changes. We can merely react to them, as many of us have done over the past couple decades, or our communities can become partners in, manage and prepare for the coming changes.

After all, like it or not, we are in a symbiotic, or interdependent, relationship with Rochester.