Free Talk: “Everything You Need to Know about Medicare”

free Medicare talkl

Gifford Medical Center is offering a free talk on Medicare insurance on Friday, June 29 from 2-3:30 p.m. in the hospital Conference Center.

Titled “Everything you need to know about Medicare,” the talk is for anyone who is currently on Medicare, who soon will be, or who has a parent or spouse going on Medicare.

Topics include why understanding one’s insurance is important, why participating in Medicare Part B is beneficial, and what one’s choices are under Medicare Part D.

“When making health care decisions, understanding your health insurance is vital. Medicare, which many of us have as health insurance or soon will, can be complicated to understand,” said Gail Bourassa, director of patient access and financial services at Gifford. “We’re hoping to help our patients make informed decisions by sharing what Medicare, and its various parts, covers.”

Bourassa, along with Gifford Patient Financial Services staff members Deborah Kendall, Melinda Mercier, and Michele Packard, of Health Connections, will lead the free discussion.
No registration is required. Call Gifford Patient Financial Services at (802) 728-2200 to learn more.

The Gifford Conference Center is at the medical center in Randolph at 44 S. Main St. (Route 12). Use the stairway under the green awning marked “Conference Center” or take the elevator from the main lobby/registration to the first floor.

Health Focus: Understanding Palliative Care

‘It’s not a death sentence.’ It’s patient-centered care.

Gifford's palliative care physician Dr. Cristine Maloney with a palliative care patient

Gifford’s palliative care physician Dr. Cristine Maloney with a palliative care patient

With three outpatient palliative care physicians, Gifford Medical Center is already offering palliative care to outpatients early in their illness. To understand the discussion, however, you must understand the meaning of palliative care.

Gifford internal medicine provider Dr. Cristine Maloney of Randolph completed a year-long palliative medicine fellowship at Dartmouth-Hitchcock Medical Center in Lebanon, N.H. In the article below from Gifford, she explains the difference between palliative medicine and hospice medicine and why more of us may benefit from palliative care than we think.

One day last fall, David Wark of West Topsham awoke barely able to breath. “I thought I was going to die. I got up and I couldn’t catch my breath.”

Besides emergency care for a truck accident in the mid-’90s, the 58-year-old hadn’t been to a doctor in well over 20 years. But after that 2011 incident, and at the urging of his ex-wife and good friend, he called for an appointment.

Gifford's palliative care physician Dr. Cristine Maloney with a palliative care patient

Gifford’s palliative care physician Dr. Cristine Maloney with a palliative care patient

A construction worker, Wark was helping with the remodel of Randolph’s Cumberland Farms, so he called nearby Gifford Medical Center.

He got in right away, undergoing pulmonary function testing, X-rays and blood work and then sitting down with internal medicine physician Dr. Cristine Maloney.

“‘Don’t bull#@*# me. Just tell me the truth,’” Wark remembers telling the doctor.

The truth was worse than he expected. Wark, who had struggled with shortness of breath for years, suffered from tuberculosis as a child, experienced asbestos exposure and smoked since his teens, had late stage emphysema, or chronic obstructive pulmonary disease (COPD).

He didn’t know it at the time, but the diagnosis meant Wark was now a palliative care patient.

“Palliative medicine is designed for anyone who has a serious illness,” says Dr. Maloney. She lists cancer, dementia, heart failure, COPD, liver disease, renal failure, stroke, cystic fibrosis, congenital malformations and extreme prematurity as examples. “It’s any illness that has the potential to shorten your life.”

For those patients, palliative medicine focuses on providing relief from symptoms, pain and

Gifford's palliative care physician Dr. Cristine Maloney with a palliative care patient

Gifford’s palliative care physician Dr. Cristine Maloney with a palliative care patient

the stress associated with having a serious illness. It involves listening to patients so their treatment is aligned with what is important to them. It works to enhance the patient’s, as well as their family’s or caregiver’s, quality of life through symptom management. And it includes an interdisciplinary team of caregivers helping to care for the patient’s diverse needs, not just treating his or her disease.

Palliative care is often confused with hospice care.

Hospice medicine is subset of palliative medicine, but is for patients nearing the end of life. Medicare defines hospice care as for a patient who two doctors have determined has six months or less to live and who understands that care going forward will be palliative, not curative, Dr. Maloney explains. Most private insurers have similar definitions, although sometimes allow patients to pursue both symptom management and life prolonging treatments.

Palliative care is offered early and throughout an illness. It doesn’t mean foregoing curative treatments. And it doesn’t mean giving up your primary care provider to meet with a palliative care physician like Dr. Maloney.

Gifford's palliative care physician Dr. Cristine Maloney with a palliative care patient

Gifford’s palliative care physician Dr. Cristine Maloney with a palliative care patient

Instead it is an extra layer of care, where a doctor spends time with patients to determine their wishes, help them understand their options and navigate the health care system, and answer their questions so they have better control over their disease and their care.

Long-time internal medicine physician Dr. Milt Fowler has referred patients to Dr. Maloney and Gifford’s other palliative care physicians. “My referrals to Dr. Maloney are to have her join forces with me in caring for patients with serious illnesses that would be helped by a team approach,” Dr. Fowler said.

“The palliative care specialty is young, but very useful. Patients who I have referred have felt our team approach has offered them more options and more availability. We have used this team approach both in office consults as well as with a number of home visits, which we often make together,” he said.

Research also backs what Gifford physicians have found anecdotally to be true.
“Many, many guidelines say this is the way to go. If you get patients onboard sooner, they do better,” Dr. Maloney says, citing studies from Massachusetts General Hospital and Dartmouth-Hitchcock Medical Center that found cancer patients undergoing palliative care had a better quality of life and improved mood, and, in the case of the Mass General study of metastatic lung cancer patients, slightly longer lives with less aggressive care.

This type of care also often produces less confusion and conflict with family or friends about a patient’s treatment goals, says Dr. Maloney.

Gifford's palliative care physician Dr. Cristine Maloney with a palliative care patient

Gifford’s palliative care physician Dr. Cristine Maloney with a palliative care patient

Over a longer appointment than the average doctor’s visit or over several appointments if the patient isn’t yet ready to discuss certain topics, Dr. Maloney determines a patient’s wishes by asking questions – without judgment – about treatment wishes; their home and financial resources, including family support and worries or concerns about their illness; their spiritual beliefs; if they want to know more about their prognosis; and their wishes should they be unable to speak for themselves.

“No one asks people what they want. They make the assumption they want the most care possible, which may not be the best care possible,” says Dr. Maloney, who often hears “I want to be home,” “I don’t want to travel to get treatment,” “I want to play with my grandkids” or even “I want to putter in my woodshed.”

Based on a patient’s wishes, Dr. Maloney then provides help achieving the patient’s goals to the best extent possible. That help might include referrals to a massage or music therapist, a visit with a chaplain or social worker, or help completing an Advance Directive and expressing wishes to family.

Gifford's palliative care physician Dr. Cristine Maloney with a palliative care patient

Gifford’s palliative care physician Dr. Cristine Maloney with a palliative care patient

In Wark’s case, Dr. Maloney prescribed breathing medications and recommended both that he quit smoking and participate in the medical center’s pulmonary rehabilitation program. He’s chosen not to pursue pulmonary rehabilitation yet, but has cut back on his smoking and says the medications have greatly improved his life.

“It’s a lifesaver. I can walk up my hill now,” says Wark, who is staying active with yard work and walking his Siberian husky dogs.

He knows “there’s going to come a time eventually that I’ll have to have oxygen.”

He’s OK with that. But he has also discussed that he doesn’t want the kind of aggressive care his own mother, for example, received for cancer. “I’d rather live a shorter life, but be more comfortable than receive very aggressive medications. I don’t like it. I don’t want it,” says Wark, who has signed a “do not resuscitate” order, which he’s shared with his ex-wife and keeps on his fridge.

And he remains upbeat about this illness.

“I’m not going to sit around and feel sorry for myself,” says Wark, who should have years to live. “It’s not a death sentence. You just have to deal with it and let the doctor help you.”

In addition to Dr. Maloney, Gifford’s palliative care physicians who can help are Drs. David Pattison, an internal medicine provider and pediatrician, and Jonna Goulding, a family physician. All three palliative care physicians serve on Gifford’s multidisciplinary Advanced Illness Care Team, which aims to promote and provide patient-focused palliative and hospice care both in the outpatient and inpatient settings.

Help Wanted!

We have two fantastic job opportunities right now at Gifford Medical Center in beautiful central Vermont:

Physical Therapy

help wantedGifford Medical Center in beautiful Randolph, Vermont, is seeking a Physical Therapist to work in our Advanced Physical Therapy practice in Wilder, Vermont. This is a unique opportunity to work in a spectacular setting at a rural, financially stable, non-profit hospital with a progressive philosophy, supportive administrative team, and advanced technology.

Your teammates include several PTs and OTs, with a variety of experience levels and many with specialized areas of interest. Work for a strong rehabilitation department but in an established, personalized satellite clinic with another therapist. Opportunities include working in our aquatics program. We encourage those who wish to pursue a current discipline of interest, or develop specific skills in conjunction with the needs of the department.

The successful candidate will have strong time management skills, be a member of a team, and demonstrate critical thinking and strong patient care values. We offer a flexible schedule to fit the candidate and clinic’s needs. Current PT licensure by the State of Vermont required. EOE

Speech Therapy

Gifford Medical Center in beautiful Randolph, Vermont, is seeking a Speech/Language Pathologist to work in our multidisciplinary Rehab Services Department. This is a unique opportunity to work in a spectacular setting at a rural, financially stable, non-profit hospital with a progressive philosophy, supportive administrative team and advanced technology.

The Speech/Language Pathologist will be responsible for providing direct patient care services to the following patient populations: inpatients/outpatients/long-term care; developmentally delayed; laryngectomy; left and right hemisphere CVA; maxillofacial surgery; patients with congenital neurological impairment; patients with neurogenic degenerative diseases; temporary non-speaking patients; and those with specific language impairments.

This position provides assessment and treatment for: Aphasia; Augmentative Communications; Cognitive Rehabilitation; Developmental Language Impairment; Reading and Writing Disorders; Speech Disorders; Swallowing Disorders; and Voice Disorders. Actively participate in a team-oriented approach to care of the patient, while communicating in a positive and professional manner.

The successful applicant will be certified by American Speech-Language-Hearing Association, or in the process of obtaining certification. Requirements include eligible for state licensure, graduate from accredited program, and have completed CCC’s. Master’s level SLP training, expertise in voice, swallowing, early intervention, AAC preferred. EOE

For more information or to apply, contact Janice Davis,
Human Resources Supervisor,
 (802) 728-2634.

Gifford Holding First Antique and Artisan’s Fair

Event brings back Gifford yard sale, in part, plus much more

Gifford antique and artisan fairRANDOLPH – Gifford Medical Center will open its new park space up to the public on Saturday, July 21 with a 1st Annual Randolph Antique and Artisan’s Fair.

To be held from 8 a.m. to 3 p.m. rain or shine, the fair is open to individuals or businesses selling antiques, architectural salvage, collectibles, crafts, unique items, vintage clothing and more.

Up to five food vendors will be welcomed. And Gifford will be selling some used office items, such as desks and printers. A consignment area will also be available for those with only a few items to sell.

“This is an opportunity to welcome the community to our new park space and to celebrate our unique artisan and historical cultures,” said organizer Amanda Wheeler of Gifford. “Even though health care is our focus, if you take a walk around Gifford, you’ll see history, art and community are all central to our local hospital.”

Organizers at the hospital hope to make the fair an annual event.

“We already have great interest from vendors and crafters and are expecting more over the coming weeks,” said Wheeler.

Lot sizes are 15-feet by 15-feet with up to three lots available per person/business. Lots are $20 each and space is limited. Call Wheeler at 728-2238 or e-mail awheeler@giffordmed.org by July 13 to reserve a space while they last.

Not accepted are animals, cars, junk or merchandise from distributors such as Pampered Chef, Avon, Snap-on tools, etc.

Vendors must supply their own tents, should they want them. Some tables are available for a nominal fee.

Contributing to the Economy as an Employer

Kingwood Health Center

The renovated Kingwood Health Center on Route 66 in Randolph is now home to Gifford’s Diabetes Clinic and outpatient rehabilitation services.

The following is an excerpt from our 2011 Annual Report.

There are a variety of ways to define the health of a community. Gifford often defines it in  terms of physical wellness. But a hospital as a local employer also impacts a region’s economic health.

“The economic health of our community is tied to the stability and health of its institutions  as well as its individuals. Gifford provides both health services for area residents and a broad range of employment opportunities in our community,” notes Julie Iffland, executive director of the Randolph Area Community Development Corp.

The U.S. Department of Labor ranks Gifford 29th in the state among the 50 largest  employers. A second ranking by Vermont Business Magazine places Gifford at 42nd in Vermont for number of full-time employees. (The difference between the two rankings is that U.S. Department of Labor data does not tally businesses with multiple sites, like Shaw’s supermarkets. Instead locations are counted separately affecting overall employee
numbers.)

Of Gifford’s total 589 full and part-time employees, 98 percent live in Vermont, including 71 percent who live in what the hospital deems its primary service area, where they are likely paying taxes, using services and shopping.

Drive by Gifford at lunchtime and the economic impact is evident. Employees regularly trek into town to run errands and to shop.

Gifford's impact on Randolph

Many Gifford employees walk downtown on their lunch break to run errands and shop.

In fiscal year 2011, Gifford spent more than $5.5 million with vendors in 99 Vermont  towns, including more than $1.1 million spent in Randolph alone.

The Vermont Association of Hospitals and Health Systems estimates that its member hospitals directly provide more than 15,000 jobs in Vermont, injecting more than $309 million into state government programs (through tax payments and the like) and generating more than $1.79 billion in total economic impact in Vermont in 2009 dollars.

But Gifford’s impact goes beyond simple buying and spending, notes Ben Merrill, Randolph Area Chamber of Commerce executive director. “Gifford is not only a great employer, but a great neighbor,” says Ben. He points to hospital facilities and recent renovation projects, like the Kingwood Health Center on the Route 66 corridor and a house on Highland Avenue in the downtown.

“Everything Gifford touches is better,” Ben says, calling these projects, while fairly small in size, huge in impact. “Improvement projects like these transform entire neighborhoods.”

Gifford is also in many ways a community center. “Gifford has opened its doors to the community. It’s a very warm and welcoming place,” he says, pointing to the active Conference Center and catering service as an example.

Having a strong medical center further enhances the area overall, causing a multiplier effect in the community.

“When people look to relocate to an area, to have a medical center, an all-inclusive medical center, that’s a big draw,” Ben says. “Employers like Gifford attract people who will come and stay and make their own investment in the community.”

Gifford Medical Center

Gifford bought and renovated this apartment house on Highland Avenue, shown before and after improvements were made. The home is used as temporary housing for new Medical Staff moving to the area.

SAVE THE DATE – The 2012 Last Mile Ride

2012 Last Mile RideThe 7th annual Last Mile Ride will be held on August 18, 2012, at Gifford Medical Center in beautiful Randolph, Vt.

Staging begins at 8:30 a.m. and motorcyclists depart at 10 a.m. for a 100-mile ride through some of Vermont’s most beautiful countryside. The guided ride includes some spectacular landscape and a mid-way break for riders to stretch their legs. The ride ends at Gifford Medical Center, where it will have begun, with a barbecue lunch, live music and prize giveaways.

The cost is $50 for one rider and $75 for two riders (on one bike). Riders need not pay the money themselves. They can fundraise the fee by asking friends and family for donations.

For their effort, riders get free commemorative pins, T-shirts if they register early, an escorted ride, a very fun day and the opportunity to support an outstanding cause. The ride raises money for services for terminally ill patients at Gifford, or those in the last mile of life. Visit www.giffordmed.org for more information.

Photographer Bruce Small Coming to the Gifford Gallery

Vermont photographyRANDOLPH – West Brookfield photographer Bruce Small returns to the Gifford Medical Center art gallery on May 30 after a five-year hiatus, bringing his mix of the natural beauty and national history.

Known locally for his stunning photographs, Small’s works include lighthouses, hot air balloons, covered bridges, scenic areas and historic monuments.

Small first began taking pictures just out of high school while serving in the U.S. Navy, including on shore patrol in Naples, Italy. He returned to his native West Brookfield and began a career in the construction trades. His work required commuting around the state. He started keeping a camera beside him so he could capture the beautiful scenes he saw along the way. Then it was family vacations across North America that had him clicking away.

At first, the photos were just for him as he strove to bring the beautiful images he saw in his travels home with him to Vermont.

Chandler’s Local Artist Show first inspired Small to show his work. He has since shown his work in Northfield, Waterbury and at Gifford with resounding success. His photos have also hung in area banks and he currently has a collection at Eaton’s Sugarhouse in Royalton.

His favorite showing was a rotating display for his father when he resided at Mayo nursing home in Northfield. The show, he says, was an opportunity to share his travels with those no longer able to travel.

This has always been his focus – to capture the scene before him so he could share it with others.

His latest collection contains photos of Vermont as well as from Pennsylvania, New Mexico, Utah, Texas, Maine, Nevada and Arizona.

“What I’m trying to do is put out a show that people enjoy,” Small says. “That (viewers enjoyment) is the greatest thing for me. That’s what makes it worthwhile.”

Small’s show runs through Aug. 1. The Gifford Gallery is just inside the main lobby of the hospital at 44 S. Main St. (Route 12) in Randolph. Call Volunteer Coordinator Julie Fischer at (802) 728-2324 or visit www.giffordmed.org to learn more. The show is free and open to the public.

Pulling Together in the Face of Natural Disaster: Rochester

Gifford Medical Center

Rochester Office Manager Dawn Beriau crosses a first-generation
footbridge connecting Route 73 to Route 100. For weeks she and many others “on the island” had to carry supplies, like gas and groceries, over the bridge and then a sturdier second-generation bridge, along a winding path and through a muddy field to their cars.

The following is an excerpt from our 2011 Annual Report.

The storm knocked out the bridge connecting Route 73 to Route 100 in Rochester. Isolated on the other side of the bridge, away from the Rochester clinic, was Office Manager Dawn Beriau.

When she finally arrived at the Rochester clinic, she found Dr. Mark Jewett and Stu Standish installing Gifford’s generator.

“I can’t tell you what a feeling it was to have the townspeople erect a footbridge and make my way into town to find Stu and Dr. Jewett at the health center setting up the operation,” Dawn says, “and how safe it made the townspeople feel to know there was a doctor in town. I have talked to people who say they slept better knowing Dr. Jewett was here.”

Ob/Gyn Dr. Anne Galante Joins Gifford

Dr. Anne Galante

Dr. Anne Galante

RANDOLPH – Anne Galante never planned to be a physician.

Born in Brooklyn and raised in Upstate New York, Galante graduated from Cornell University and worked in insurance in Los Angeles and then New York City for a decade. While in New York, she began volunteering in the Emergency Department in Long Island College Hospital in Brooklyn. “It was very easy to be helpful,” Galante recalls. She cleaned rooms. She held children while they got stitches. She hugged patients newly diagnosed with cancer.

Then she started doing ride-alongs with an ambulance crew, going into to some of the city’s worst neighborhoods.

The experiences gave her stories to tell her friends until one evening during a gathering with those same friends, Galante was suddenly aware that her interest in medicine was more than idle curiosity. “God’s finger thumped my head. I had a calling. I said, ‘I think I’m going to try to go to medical school.’”

“I might as well have said I was going to fly without a plane.”

But soon she found her plane.

She enrolled in medical school at the University of Vermont in 1994, graduating in 1998 and going on to a four-year obstetrics/gynecology internship and residency at Albany Medical Center Hospital in New York.

She initially thought emergency medicine was her calling, but the very first clinical rotation she worked in medical school was in gynecology, and it stuck. “I just loved it, and I loved surgery,” says Dr. Galante, who was intrigued with women’s health.

She went on to work for four years at Porter Medical Center in Middlebury and then worked for an additional four years as a travelling physician filling in where needed. (The industry calls this a locum tenens.) She worked as the “house” ob/gyn on the Rosebud (Lakota Sioux) reservation in South Dakota, at Copley Hospital in Morrisville, at Springfield Hospital and at Gifford Medical Center in Randolph.

She has filled in at Gifford since 2009, but when the opportunity to transition to a full-time, employed provider presented itself this year, Dr. Galante was enthusiastic.

“I’m very happy. I feel like I came home. It’s wonderful to walk into a place where people already know you. They’re confident in you,” she says.

Gifford is renowned for its Birthing Center and midwifery and obstetrics team. In addition to collaborative birth support, Dr. Galante also provides a wide range of well-woman care, including adolescents’ gynecology, care for abnormal pap smears, colposcopies, sexual dysfunction, standard well-woman visits, and perimenopausal help.

Board certified by the American Board of Obstetrics and Gynecology, she is a fellow with the American College of Obstetricians and Gynecologists and has worked as a volunteer physician with organizations such as Medicine in Action caring for women in Jamaica, Haiti, and Tanzania and at the Open Door Clinic in Middlebury.

A mother of two, Isabelle, 11, and Jackson, 10, Dr. Galante is a New Haven resident, published photographer, sailor, cyclist, and cook.

She sees patients at Gifford Ob/Gyn and Midwifery in Randolph. Call her (802) 728-2401.

A Day of Play at Menig

Menig Day of PlayThe Menig Extended Care Facility in Randolph celebrated a Day of Play on Thursday, May 17 in celebration of Older American’s Month.

The event was held at the urging of Vermont Department of Disabilities, Aging and Independent Living (DAIL) Commissioner Dr. Susan Wehry, who sent two members of her staff, Will Rowe and Mary Woodruff, to join Menig nursing home residents, activities staff, volunteers and seventh-grade Community Connections class “buddies” from Randolph Union High School.

For their Day of Play, the Menig residents and visitors participated in a “scavenger hunt” that had them hugging trees, balancing things on their heads, wearing newspaper hats, forming a conga line by cars, posing by a flagpole and much more. The seventh graders then hung out with their Menig pals before heading back to class.

Conga line

Conga line forms

Menig resident Galen Barnard in paper hat

Menig resident Zelma Kehle and buddy Amelia Rose

Menig resident Zelma Kehle and buddy Amelia Rose