Podiatry care when you need it most

Emily Wheeler certainly didn’t want an injury so late in her pregnancy but was glad for the care she received

This article was published in Gifford’s Fall 2014 Update Community Newsletter.

Dr. Samantha HarrisEight months into her pregnancy, Emily Wheeler of Corinth didn’t expect to need a podiatrist.

But the unlikely happened. The day after her baby shower on a routine walk out her front door, she fell down her steps. Her first concern was for her baby and she rushed to Gifford’s Birthing Center for monitoring. Only after determining that her baby was fine did she go upstairs to the Emergency Department to have what she suspected was a broken ankle X-rayed.

She followed up with Gifford podiatrist Dr. Samantha Harris of the Gifford Health Center at Berlin. Dr. Harris confirmed Emily’s worry. Her ankle was fractured. She spent the last weeks of her pregnancy in an air cast and wheelchair.

Emily had never heard of Dr. Harris before. She is new to Gifford, but Emily was familiar with the Berlin health center. She was already going there for her prenatal care with Gifford’s midwives. Now she had another reason to go.

“She was really quick with the diagnosis and quick to give treatment,” says Emily, praising her new podiatrist. “The office there has been really great and Dr. Harris has been available.”

Emily delivered a healthy, 10-pound baby boy in August. Days later she headed back to Gifford Health Center at Berlin to get back on her feet once again and – now for a third reason – to have Owen’s first check-up.

About the health center
The Gifford Health Center at Berlin, located off Airport Road, offers a full spectrum of care, including family and internal medicine, help with infectious diseases, midwifery, neurology, orthopedics, urology, and podiatry.

About Dr. Harris
Dr. Harris joined Gifford in July from a practice in her native Tennessee. She got her start in medicine as a physical therapist and went on to attend Ohio College of Podiatric Medicine in Independence, Ohio. Her residency in podiatric medicine and surgery at Mercy St. Vincent Medical Center in Toledo followed.

A desire to start farming and produce maple syrup brought her to Vermont, and she found the right fit at Gifford, which is home to four podiatric surgeons working out of Gifford clinics in Randolph, Sharon, and Berlin.

Dr. Lou DiNicola Honored By the Vermont Medical Society

Dr. Lou DiNicola

Dr. Lou DiNicola with award and scroll

Randolph pediatrician and former president of the American Academy of Pediatrics Vermont Chapter, Louis DiNicola, M.D., received the Green Mountain Pediatrician Award on Friday, November 14 at the chapter’s annual meeting in Montpelier.

Surrounded by approximately 50 of his Vermont colleagues, Dr. DiNicola was acknowledged for over 38 years of service as a Gifford pediatrician. The award is given annually to an outstanding pediatrician for their dedication and contribution to children’s health in the state.

“I was very surprised,” Dr. DiNicola said. “It humbles me when I am recognized. I do what I love; this is what makes me tick.”

The award was presented by long-time friend and colleague, Dr. Kim Aakre of Springfield. In addition to a plaque, she presented a 7-foot handwritten scroll, describing what makes Dr. DiNicola special. The scroll added even more emotion to the event.

DiNicola shared, “I lost a longtime neighbor and friend earlier in the day. This handmade gift has helped fill that hole in my heart; the timing was perfect.”

Gifford’s Record of Success Continues for 15th Straight Year

Randolph hospital ‘makes’ budget, operating margin

Gifford 2014 budget

President Joseph Woodin and CFO Jeff Hebert announce via video that Gifford closed the books with a 3.2% margin for the 2014 fiscal year.

In a feat that has not been replicated by any other hospital in Vermont, Gifford Medical Center announced that it has achieved its state-approved operating margin for the 15th straight year, by managing its expenses and the budget process.

In a “reality TV” video announcement sent to staff on Monday, November 3, President Joseph Woodin and CFO Jeff Hebert announced what auditors have confirmed – Gifford closed the books with a 3.2% margin for the 2014 fiscal year.

“This is all thanks to the hard work and dedication of our staff,” said Woodin. “Without their diligent focus, always trying to manage quality and costs, we would not be able to have accomplished this.”

An operating margin is the money the medical center makes above expenses – needed to reinvest in programs, staff and facilities. Sixteen years ago, Gifford ended the fiscal year with a negative 16% margin ($2.9 million loss), after having lost money 4 out of 5 years. At that time, the future of the hospital was uncertain, with some state officials even asking if the hospital should be closed.

Today, Gifford is known as one of the most successful and innovative hospital and health care organizations in New England. They are designated a CAH (Critical Access Hospital), as well as an FQHC (Federally Qualified Health Center); one of only three in the nation to carry that dual designation. They also operate a nursing home (Menig) that is rated one of the top 1% in U.S., and are currently constructing the first phase of a five-phase senior living community in Randolph Center, VT.

Consistently achieving the operating margin can be an indicator of an organization’s success. Despite record shortfalls in revenue for Vermont hospitals, including Gifford, Woodin noted the medical center was able to make up for revenue shortfalls through managing expenses and due to support from federal programs like 340B, a drug pricing program that in part generates revenue when Gifford patients fill non-generic, non-narcotic prescriptions at participating pharmacies.

“This news is exciting for Gifford and for the community,” said Woodin. “It is an indicator of Gifford’s health as a medical center, community organization, and employer. Primarily it means we’re stable, and we’re able to provide consistent care and services without facing cuts and uncertainty.”

The achievement is especially remarkable within the current economic climate and amid so many changes in health care, hospital officials also noted.

Ob/gyn team provides comprehensive care — and now total laparoscopic hysterectomies

This article was published in Gifford’s Fall 2014 Update Community Newsletter.

Gifford ob/gyn teamGifford’s women’s health team has grown to include two new ob/gyns.

Dr. Sean Tubens and Dr. Melissa Scalera have joined gynecologist Dr. Ellamarie Russo-DeMara, as well as Gifford’s certified nurse-midwife team, in caring for women.

Dr. Sean Tubens
Dr. Tubens is a native of Baltimore who joined the U.S. Marines out of high school. He went on to work in his father’s trade – as a hairdresser – before illness took his parents’ lives just months apart. Dr. Tubens found himself wanting to do more and pursued a career in medicine.

He attended Towson University in Baltimore, graduating magna cum laude in just three years while working full-time. He went on to Ross University School of Medicine in Dominica in the West Indies and New Jersey and completed his ob/gyn residency at Bayfront Medical Center in St. Petersburg, Fla. During his residency, he worked exclusively on high risk pregnancies and performing gynecologic
surgeries.

His work at Bayfront earned him recognitions for excellence in laparoscopic surgery, excellence in reproductive endocrinology and as outstanding resident teacher of the year.

When it came time to look for a job, Dr. Tubens looked for a warm and friendly community where he and his wife could settle with their two huskies.

He has found that in Vermont and at Gifford.

“People are so welcoming. They smile. That’s very attractive,” said Dr. Tubens. “We hope we can spend the rest of our lives here.”

Dr. Melissa Scalera
A native of New Jersey, Dr. Scalera was the first person in her immediate family to go to college. She earned her bachelor’s degree in psychology from Williams College located just three miles south of Vermont in Williamstown, Mass. She worked at a direct marketing company that made and sold leather books before deciding that she wanted a change.

“I want to be a doctor,” she decided, quit her job, and moved in with her parents. With no science classes to her credit, she did two years of post-baccalaureate studies in the pre-medical curriculum at nearby Seton Hall University in South Orange, N.J., before attending the New Jersey School of Medicine at the University of Medicine and Dentistry in Newark. She went on to residency at Albany Medical Center in nearby New York.

Since then she has worked for 13 years as an ob/gyn physician in Washington, Texas, Oregon, Pennsylvania, New Zealand, and North Carolina. A love of snow and skiing has brought her and her family to Vermont, and to Gifford.

“Gifford,” she says, is “a really fantastic match for me.”

A new team
Dr. Scalera brings a love of all things ob/gyn to the practice. Dr. Tubens is a new resource in high-risk pregnancies, gynecologic surgery as well as office procedures. Specifically, Dr. Tubens offers urogynecology procedures for uterine prolapse, bladder and rectal prolapse, and urinary incontinence. He also performs total laparoscopic hysterectomies – something not previously offered at Gifford.

Dr. Tubens and Dr. Scalera are currently working exclusively in Randolph. Their skills meld nicely with Dr. Russo-DeMara, who focuses on gynecologic and menopause care. Dr. Russo-DeMara works out of Gifford’s Bethel and White River Junction practices. Joining them are Gifford’s midwifery team, which focus on prenatal care and births as well as well-woman care in Randolph and Berlin.

“This new team is providing comprehensive women’s health medical and surgical services, from contraception to menopause management and everything in between,” explained Alison White, Gifford vice president of patient care services.

Family Nurse Practitioner Joins Gifford Health Center at Berlin

Jeff Lourie

Jeff Lourie

Family nurse practitioner Jeff Lourie has brought his passion for primary care to the Gifford Health Center at Berlin.

A Cape Elizabeth, Maine, native, Lourie attended The Evergreen State College in Olympia, Wash., earning his bachelor’s degree in organic chemistry. He went on to work in a research lab studying organic chemical synthesis before discovering that what he really wanted to do was help people – hands on.

He became a certified nursing assistant in his native Maine, and then went on to pursue his family nurse practitioner degree at the University of Southern Maine in Portland.

From there he was certain of his career path: rural, primary care.

“It’s where you can really make a difference,” he says of primary care, noting that difference comes in the bonds formed with whole families. “When you see two, three, four generations of families, you really get to understand why things happen.”

Lourie worked for three years at a rural family practice in Wilton, Maine, before moving with his wife, Emily, to her native Vermont in 2013. The couple moved to Barre and Lourie went to work at Berlin Family Practice as a practitioner for Fletcher Allen Health Care.

This month he joined the Gifford Health Center at Berlin, part of Gifford Health Care in Randolph.

In Berlin, Lourie works with family nurse practitioner Tara Meyer in providing primary care at the multi-specialty health center located just off Airport Road.

Board certified by the American Academy of Nurse Practitioners, Lourie is a member of the American Nurses Association, the American Association of Nurse Practitioners, and is on the board of The Vermont Nurse Practitioners Association.

He brings clinical interests in diabetes management, weight loss, preventative care, and pediatrics to the health center. He is also a certified medical examiner for those seeking a commercial driver’s license.

As a primary care provider, Lourie sees his role in part as a motivator and in part as an advocate for patient goals.

“My goal is to partner with patients,” he says. “I want to work on the issues that they want to work on.”

Lourie is seeing new patients of all ages. Call him at the Gifford Health Center at Berlin at (802) 229-2325.

Family Nurse Practitioner with Doctorate Degree Joins Gifford

Christina Harlow

Christina Harlow

A nurse practitioner with advanced degrees and diverse experience has joined Gifford Health Care’s family practice in Randolph.

Family nurse practitioner Christina Harlow holds a bachelor’s degree in nursing from Colorado Mesa University, a master’s degree in nursing from the University of Arizona College of Nursing in Tucson and a doctor of nursing practice degree from the same institution.

She is board certified by the American Nurses Credentialing Center, a member of the American Nurses Association, and has experience in emergency medicine, psychiatrics and more.

A native of Wisconsin, Harlow’s first career was as a mountain bike guide and a river guide in Utah and West Virginia. During that time, however, Harlow lost a brother to mental illness. Looking to her future, she knew she needed a more stable career. The loss of her brother struck an interest in better understanding depression and anxiety.

She went to nursing school and worked internationally as a volunteer in Honduras and Northern India and in the United States as a psychiatric registered nurse, then in specialty and inpatient care and finally in an emergency room. “I wanted to be more well-rounded, because psych is everywhere,” she says of her diverse experience.

She went on to nurse practitioner school and then took the extra step to earn her doctorate in the field.

She worked as an emergency department nurse practitioner in Colorado and as an adjunct professor at Adam’s State University, before deciding to move to Vermont with her family.

Her husband, Dr. Nathaniel Harlow, grew up in Vermont and wanted to be closer to family here.

The couple both joined Gifford – him as a sports medicine provider at the Sharon Health Center and her as a family medicine nurse practitioner in Randolph, where she is looking forward to getting to know her patients and providing well-rounded care.

“I wanted more than just a passing relationship with my patients,” she notes of her emergency department work. “I am really interested in continuity of care.”

In Harlow, patients will find a highly-educated, compassionate caregiver and open communicator.

“Being a nurse first, I have open communication with my patients. I nurse to my patients,” she says. “I like to focus on health. Your health is your wealth.”

“I also really embrace a holistic perspective,” she says, noting she considers a patient’s emotional and spiritual well-being in addition to more common inquiries about diet and exercise.

Harlow’s specific clinical interests include preventative care, women’s health, holistic care and mental illness. As a family nurse practitioner, she treats all ages as well as both men and women.

In her free time, Harlow – a competitive mountain biker, road cyclist, adventure racer, distance runner and climber – enjoys travel and the outdoors. She and her husband are currently living in Brookfield with their young daughter, Juliana, 1.

Harlow is seeing new patients. Call Gifford’s central scheduling line at 728-2777 to make an appointment with Harlow.

Fellowship-trained Sports Medicine Doctor Joins Sharon Health Center

Dr. Nathaniel HarlowDr. Nathaniel “Nat” Harlow grew up in Vermont, in Underhill, so when it came time to put his newly earned sports medicine fellowship to work, he looked to the Green Mountains of his childhood.

Dr. Harlow has joined Gifford Medical Center’s renowned sports medicine practice in Sharon.

A graduate of Brown University in Providence, R.I., he went on to medical school at the University of New England College of Osteopathic Medicine in Biddeford, Maine.

Interested in rural medicine, he completed a family medicine residency at St. Mary’s Family Medicine Residency in Grand Junction, Colo., and went on to work at a Critical Access Hospital in Del Norte, Colo., as an emergency department physician and director of emergency medicine for three years.

An avid climber, skier and mountain biker, Dr. Harlow had considered a sports medicine fellowship out of residency, but the program wasn’t yet developed.

Through his emergency physician role and through work with ski area clinics, he saw many skiing traumas and acute orthopedic injuries. The interest was sparked once more, and by now the fellowship program was developed.

He completed a primary care sports medicine fellowship at Rocky Mountain Orthopedics through St. Mary’s Family Medicine Residency in Grand Junction, Colo.

Already board certified by the American Board of Family Medicine, he went on to earn an additional Certificate of Added Qualification in sports medicine from the same board.

“I believe strongly in providing health care in rural, underserved areas,” says Dr. Harlow, and “I really wanted to come back to Vermont.”

He found just what he was looking for – rural medicine with a sports medicine focus at the Sharon Health Center.

“I’m very excited to be part of the practice. It’s such a strong team environment. It’s a unique practice setting for sports medicine,” he says.

In Sharon, Dr. Harlow is working alongside podiatrists, chiropractors, another sports medicine doctor, an athletic trainer and physical therapists.

Dr. Harlow practices full-spectrum primary care sports medicine including non-operative orthopedics care, as well as the medical aspects of sports medicine, such as care of concussions, sports pre-screenings for heart health, people with asthma and diabetics. He has strong interests in combining sports and wilderness medicine to care for the mountain athlete, using exercise as medicine for non-athletes to help treat and prevent chronic conditions, and osteopathic manipulation.

Friendly and approachable, Dr. Harlow listens to his patients and works with athletes and non-athletes alike to help them reach or return to fitness goals.

Dr. Harlow is a member of the American Medical Society for Sports Medicine, American Academy of Family Physicians and the Wilderness Medical Society.

Now living in Brookfield with his wife and fellow Gifford health care provider, family nurse practitioner Christina Harlow, and their 1-year-old daughter, Juliana, Dr. Harlow enjoys fly fishing and playing guitar in addition to mountain sports. He is also an avid volunteer, both at home and internationally. In fact, he hopes to reach out to area high schools and colleges to provide expertise in concussion management, for example.

To schedule an appointment or learn more, call him at the Sharon Health Center at 763-8000.

Ob/Gyn Dr. Melissa Scalera Joins Gifford Team

Dr. Melissa Scalera

Dr. Melissa Scalera

On her road to becoming an ob/gyn, Dr. Melissa Scalera flirted with Vermont. First there was her undergraduate studies at Williams College just three miles south of the Vermont border in Massachusetts. She crossed the border for Chinese food, antiques, and skiing. Later her residency was at Albany Medical Center in nearby New York.

Now she and her ski enthusiast family are thrilled to be calling Vermont home.

Dr. Scalera has joined Gifford Ob/Gyn & Midwifery in Randolph.

Originally from New Jersey, Dr. Scalera was the first person in her immediate family to attend college.

Her mother made a list of “academically acceptable” schools, starting with Harvard, that her daughter would be “allowed” to attend, Dr. Scalera recalls. Williams was on it. Scalera loved the school and everything about learning. Initially she thought that she’d major in Spanish literature or art history. “Choose something else” was her dad’s reply.

She graduated with a degree in psychology in the middle of a recession and applied for any and every job she could find. She took a position with a direct marketing company that made and sold leather bound books.

Hunched over a budget report one night at 10 p.m. at that long-ago job, she had an epiphany.

Unhappy stuck in a cubical all day, she wanted to be more active, look at fewer spreadsheets, see the sun, and talk to people.

About the same time, she had seen an ob/gyn for a routine exam and blood work. The exam went well, but the follow-up appointment to go over the results of the blood work with a different doctor was less than stellar. He was cranky, didn’t listen, and she left thinking “I can do better than that.”

Twenty-one and full of confidence, she called her mom and said, “I want to be a doctor.” She quit her job, moved in with her parents, and did two years of post-baccalaureate studies in the pre-medical curriculum at nearby Seton Hall University in South Orange, N.J.

She went on to the New Jersey School of Medicine at the University of Medicine and Dentistry of New Jersey in Newark, earning her doctor of medicine degree in 1997. A four-year ob/gyn residency followed at Albany Medical Center in New York.

She spent the next 14 years working as an ob/gyn physician in the United States, in Washington, Texas, Oregon, Pennsylvania, and North Carolina, and in New Zealand.

Her work in New Zealand was meant to be a six-month adventure. She liked it so much she stayed seven years. Her role in New Zealand was that of a specialist. Midwives in New Zealand provide complete obstetric care for low-risk births. General practitioners’ offices provide Pap smears and routine gynecologic care. Dr. Scalera consequently handled high-risk maternity cases, colposcopy or abnormal Pap smears, and gynecologic surgeries.

“I basically backed up every mid-wife in town.”

“I think Gifford and Vermont are the closest to New Zealand that I’m going to get and still be in the continental U.S.,” says Dr. Scalera, who returned to the States to be near family but looked north for snow.

Dr. Scalera and her family, including her husband of 20 years, Bob Pressey, son Michael, 11, and daughter Catherine, 5, are living in Randolph, where they are loving the community and the school system. They hope to find an older home to buy within walking distance of Gifford.

“I think people are really, really nice, and already kids are coming over to ask if my son would like to come out and play,” says Dr. Scalera, remembering her own childhood of neighborhood children at play and wanting that for her family.

Dr. Scalera is board certified by the American Board of Obstetrics and Gynecology and The Royal Australian and New Zealand College of Obstetricians and Gynecologists.

She describes her bedside manner as “friendly.” “I like people and I love to talk,” she says. Her clinical interests include general obstetrics and gynecology.

“Gifford,” she says, is “a really fantastic match for me.”

Dr. Scalera is accepting new patients. Call her at Gifford Ob/Gyn & Midwifery at (802) 728-2401.

Randolph Artist Erica Sears Brings Unique Talent to Hometown Hospital

Randolph artist Erica Sears

“Untitled in Blues” is among Randolph artist Erica Sears’ works now in the Gifford gallery.

Three panels stretch from floor to ceiling. A painted image of a woman on sandstone is just inches tall.

Renowned local artist Erica Sears’ works are in the Gifford Gallery in a month-long show that does not disappoint.

Sears is a Randolph native who graduated from Randolph Union High School in 1985. She went on to receive her bachelor’s degree in fine arts from Otis Art Institute of Parsons School of Design in Los Angeles, where she lived for 15 years before returning to Randolph in 2000.

She has previously shown her work in Los Angeles and throughout this region at Chandler, First Light Studios, Gifford years ago, in Bethel and currently at the White River Craft Center. Three panels also hang in the upper Ester Mesh Gallery at Chandler as part of its permanent collection.

Sears, who has had a varied career, including making, selling and teaching art for 25 years, has a studio in her home and works full-time at Gifford in the Food and Nutrition Services Department.

“My art is how I express, celebrate, explain or push through what happens in my life. Many different things inspire me, influence me, call to me. Each piece is a visual page in my journal. Each idea that needs to be expressed has its own medium that tells the story. Some in paint, some in clay, cloth, pastel, ink, metal or rock. “

Her Gifford show includes 10 pieces, including “garlic moon,” which is made of garlic skins, coated in gloss and set upon a painted block of wood. The three long panels took about two years to create. Wax, birch bark, oil pastel, pencil, ink and charcoal make up other works. “Untitled in Blues” and “Untitled in Reds” – acrylics on canvas – are more recent works.

“I am a very tactile artist,” Sears notes. “I love color and texture. I love all mediums. I love watching how the images take shape. I love watching people interact with the pieces. The conversations that happen between the viewer and the piece are amazing.”

Interact with Sears’ work at Gifford now through Sept. 24. The gallery is located just inside the main entrance of the South Main Street medical center.

Ob/gyn Dr. Sean Tubens Joins Gifford in Randolph

Dr. Sean Tubens

Dr. Sean Tubens

Dr. Sean Tubens’ path to becoming an ob/gyn physician was anything but direct.

The Baltimore native joined the U.S. Marines out of high school and spent four years as an aviation electrician working on F18s and serving during Operation Desert Storm.

He returned home to Baltimore unsure what he would do next. The idea of becoming a lawyer or psychologist appealed to him but the years of school seemed daunting. His father was a hairdresser and although his first instinct was “no way,” he took up his father’s trade.

“It ended up being a lot of fun, and I was actually really good at it,” he recalls, noting he worked as a hair stylist for 12 years and even owned his own salon.

And then the unthinkable happened. His parents died. Both of them.

His mother was diagnosed with cancer on Dec. 1, 1996. She died that same month on Dec. 31. His father had a lung transplant that same year. He had pulmonary fibrosis. Despite the transplant, he died on Aug. 31, 1997 – exactly eight months after his spouse.

An only child, Dr. Tubens found himself at a crossroads and asking the question “Am I happy with the direction of my life?”

“I just didn’t feel I was making a contribution to other people in a way I was capable of,” he said.

After years of avoiding school, “I decided maybe I wanted to be a surgeon.”

At age 31, he hired a tutor to get through his college entrance exams. “I had no college experience whatsoever.”

He attended Towson University in his native Baltimore, graduating magna cum laude in just three years while still working full-time at his salon. He was accepted to and attended Ross University School of Medicine in Dominica in the West Indies and New Jersey.

Obstetrics and gynecology wasn’t his first choice when it came to medicine – until he assisted with a birth from beginning to end. “It was from that moment that I realized what an honor and a privilege it is to be involved in this process, and that that was what I wanted to do.”

Dr. Tubens went on to complete his obstetrics and gynecology residency at Bayfront Medical Center in St. Petersburg, Fla., working exclusively on high risk pregnancies and performing gynecologic surgeries. “I love gynecologic surgery, specifically laparoscopic procedures,” he says.

His work at Bayfront earned him recognitions for excellence in laparoscopic surgery, excellence in reproductive endocrinology and as outstanding resident teacher of the year.

When it came time to look for a job, Dr. Tubens looked for a warm and friendly community where he and his wife could settle with their two huskies.

He has found that in Vermont and at Gifford.

“People are so welcoming. They smile. That’s very attractive,” said Dr. Tubens. “We hope we can spend the rest of our lives here.”

He and his wife, physician assistant Susan Post-Tubens, have bought a home in Bethel.

They have three grown children and in their free-time enjoy golf, skiing, snowboarding, hiking, travel and reading.

For the region, Dr. Tubens, a physician with a calming demeanor who collaborates with patients to improve quality of life, is a new resource for more complicated pregnancies and surgery. His clinical interests include high-risk pregnancies, office gynecologic procedures as well as gynecologic surgery, especially laparoscopic surgery.

His greatest priority is patient safety and care, notes the physician who is a member of both the American College of Physicians and the American College of Obstetrics and Gynecologists. “The most important thing is the patient. That is the number one priority.”

Dr. Tubens is working full-time at Gifford Ob/Gyn & Midwifery in Randolph. Call him at (802) 728-2401.