The following was published in our 2012 Annual Report.
Reflections on the past remind us of our roots and of how health care has changed in the past decades. Chief among those is the increasing role mid-level providers, such as nurse-midwives, nurse practitioners, and physician assistants, play in health care. Today, we have diverse physician-led health care teams in every area of medicine to encourage and support wellness.
Mid-level providers are extremely instrumental at birth, during hospital stays, in the primary care setting, specialty clinics, and even for our surgical patients. This team approach to care improves provider access and quality of care.
At Gifford, we are transitioning with great success to a team-based approach and are taking steps to ensure continued access to high-quality health care.
In 2012, some of those steps included new radiology services and technology, such as more interventional offerings, an upgraded 64-slice CT scanner, and a fluoroscopy room.
The midwifery team has expanded to the Twin River Health Center in White River Junction. Gifford’s approach to obstetrics and gynecology has grown to include more complicated cases.
The Blueprint Community Health Team has expanded and behavioral health is increasingly a part of Gifford’s offerings. Thanks to a generous gift from the Auxiliary, new CarePoint EKG transmission technology is available between our Emergency Department and ambulance services to identify heart attacks in the field and determine the best and fastest course of treatment.
Urology offerings have also grown and the Cancer Committee continues to expand. The Sharon Health Center sports medicine team has welcomed a nurse practitioner and second chiropractor.
These improvements are examples of the changes and quality upgrades we, as part of the health care team, can affect in an institution of the size and mindset of Gifford for the betterment of the community. Meld these improvements with Gifford’s foundation of patient care and advocacy, and we have a formula for success for decades to come.
Ovleto Ciccarelli, MD, Surgery Division
Martin Johns, MD, Hospital Division
Joshua Plavin, MD, MPH, Medicine Division
Rebecca Savidge grew up in Chelsea, attended the local school and is now the latest health care provider at the Chelsea Health Center.
From her years at the Chelsea Public School, Savidge went on to the University of Vermont where she majored in biology with a chemistry minor. After graduating magna cum laude in 2009, she was part of the inaugural class of the physician assistant master’s degree program at Franklin Pierce University in New Hampshire.
During her schooling, she completed training rotations at medical centers throughout Vermont and New Hampshire, including Gifford, the South Royalton Health Center, Androscoggin Valley Hospital in Berlin, N.H., Central Vermont Medical Center, Cheshire Medical Center in Keene, Little Rivers Health Care in Wells River, The Health Center in Plainfield, and Dartmouth-Hitchcock Medical Center.
Since graduating nearly two years ago, Savidge has worked at The Health Center in Plainfield providing family medicine. She loved the job, but not the drive from Chelsea, where she lives.
A job at Gifford meant not only work close to home, but work at a hospital she respects and in a community she knows well.
“I love that Gifford is a community-based hospital with a range of ancillary patient services and it still feels accessible,” says Savidge, calling the rural medical center both well thought of in the community and among other hospitals.
“Chelsea is a special community because people choose to give back,” she adds. “A huge attraction of working at the Chelsea Health Center is taking care of people you understand and feel connected to.”
Savidge is certified by the National Commission on Certification of Physician Assistants. She has special clinical interest in preventative care, women’s health, chronic care, small procedures and urgent care.
In addition to work in Chelsea, Savidge will work half a day a week in Randolph in the primary care office’s urgent care clinic.
Patients should expect a partner and collaborator in Savidge.
“I like to use shared, informed decision making within a patient-provider team model. Patients active in their care leads to better outcomes.”
In a small community where neighbors are friends, Savidge puts a large emphasis on respecting patients’ privacy.
Savidge is currently building a house in Chelsea with her husband. In her free time she enjoys the outdoors, including cross country skiing, snowshoeing, and pick-up soccer games in town, as well as gardening and reading.
Call Savidge at Chelsea Health Center at 685-4400. The health center, a modern new facility offering family care as well as pharmacy services and mental health, is off Route 110 just north of the village.
Starr Strong was born in Brookfield and still lives there today. Married to John Button of Chelsea, the couple has two grown children. In her free time, Starr enjoys gardening, skiing, kayaking, and hiking.
Starr has been a physician assistant for 31 years, including 19 years at the Chelsea Health Center as well as at Gifford’s Randolph and Bethel practices and Vermont Technical College’s student health center.
Her greatest love, professionally, is the Chelsea Health Center and the long-term relationships she has forged with generations of families there. At a rural practice, she says, people matter and she is able to spend time with her patients. “It is a privilege in life to make a place your own, to grow a life that is bigger than just yourself,” she says.
Below is her story as told in her own words, as featured in our 2012 Annual Report.
“When I was young, it took me a long time to sort out what I wanted to do with my life. Through traveling and experiments with lifestyles, I discovered a new profession – physician assistant – that appealed to me. It fit my personality (rebellious) and, I hoped, my potential. In 1979 I told my potential educators that I wanted to be a family practitioner in a rural health center. Three decades later, that vision has evolved into a challenging and fulfilling life.
Top left: Strong examines a curious Xabian Bring in 2009. Bottom: A 1996 portrait of Strong reviewing a patient chart with a co-worker.
My family’s ancestral home is a humble hill farm in Brookfield. I’ve known all my life that it is my true home. In 1981 when I was completing physician assistant (PA) school, I met with Phil Levesque, Gifford’s president at the time. He told me that Gifford didn’t have a place for me and he doubted that the Medical Staff would accept a PA in the years to come. I kept knocking on the door, and nearly 20 years ago I got an opportunity to “try it” in Chelsea. I was the first PA at Gifford, the first non-physician provider in Chelsea, and the only woman to practice there.
“The door” in Chelsea was opened to me largely by the gracious support of Dr. Brewster Martin who became my teacher, mentor, advisor, very dear friend, and, eventually, my patient. Brewster was the wisest person I have known and his influence on my life is immeasurable. I promised him that I would practice in Chelsea for 20 years and I am nearly there. During our lunchtime chats we shared the deepest thoughts and concerns in our hearts, and we shared funny stories. It was a privilege to be his friend and I miss him every day.
Family medicine is at least as much about relationships as it is about science. The depth of that trust can be built through years of commitment and listening. I am fascinated by the richness of families and individual’s lives, their dignity and fears, joys and sorrows. I am humbled by the courage I witness, and am grateful for the privilege of such trust.
Just like with Brewster, some of my fondest and most challenging experiences are with those I know best. I especially treasure my relationship with Judy Alexander, a woman who is my patient, friend, and co-worker. She has taught me a lot about humor and the joy of sarcasm, and she strengthens my love of play. Her courage in facing the battle of her life keeps me grounded, humble, and ever so appreciative of the fullness of life. I treasure that we will walk this road together as far as it takes us.
I love this place.”
~ Starr Strong, PA-C
Chelsea Health Center physician assistant
Friends and co-workers Judy Alexander and provider Starr Strong share smiles and laughter.
This article appeared in our Fall 2013 Update Community Newsletter.
Pediatrician Dr. Pam Udomprasert with a young patient
Family health center now meeting even more of community’s needs for care
Pediatrician Dr. Pam Udomprasert joins the family medicine team at the Gifford Health Center at Berlin beginning this October.
“Dr. Pam,” as patients affectionately know her, is a graduate of SUNY Downstate College of Medicine in Brooklyn and completed her three-year residency at the University of Connecticut School of Medicine and Connecticut Children’s Medical Center in Hartford.
She worked in Connecticut before joining Gifford and moving with her family to Randolph in 2011.
Board certified by the American Board of Pediatrics and the National Board of Medical Examiners, she is a member of the American Academy of Pediatrics and the Academy of Breastfeeding Medicine. She has a special interest in lactation support as well as asthma and allergies.
Personable and responsive, Dr. Pam continues to see patients in Randolph part of the week. In Berlin, she joins family nurse practitioners Sheri Brown and Tara Meyer as well as internal medicine physician/infection control practitioner Dr. Jim Currie.
The diverse team is available to care for all of your primary care needs, from birth through end-of-life.
The clinic is also home to Gifford’s remarkable team of certified nurse-midwives providing prenatal and well-woman care, neurologist Dr. Robin Schwartz, orthopedist Dr. Stephanie Landvater and podiatrist Dr. Kevin McNamara.
To schedule an appointment with Dr. Pam or another member of the Berlin team, call 229-2325.
Beginning Jan. 1, federal law requires all Americans to have health insurance or face a tax penalty. Gifford has specially-trained staff called “navigators” available to help you sign-up for a health plan.
This information appeared in our Fall 2013 Update Community Newsletter.
Beginning on Jan. 1, federal law requires all Americans to have health insurance or face a tax penalty.
In the Green Mountain State, Vermont Health Connect is the new online marketplace where individuals, families and businesses with 50 or fewer employees can shop for, compare and purchase insurance plans.
Open enrollment for these plans began this October. Vermonters can determine their eligibility and enroll online. For those without computer access or needing in-person support, Gifford has resources to help.
Across the state, “navigators” have been trained and taken rigorous exams to provide one-on-one assistance with the Vermont Health Connect marketplace.
Gifford has three navigators through its Health Connections office, a part of the Vermont Coalition of Clinics for the Uninsured, as well as the medical center’s Blueprint for Health team.
A Vermonter without health insurance,
A Vermonter who currently purchases insurance yourself,
A Vermonter with Medicaid or Dr. Dynasaur,
A Vermonter with Catamount or the Vermont Health Access Program,
A Vermonter with “unaffordable” coverage provided by your employer, or
A small business with 50 or fewer people
and you need help understanding the exchange, get help by calling Gifford Health Connections at 728-2323.
Individuals who are fully enrolled by Dec. 16 will have health coverage starting Jan. 1.
Under Vermont Health Connect, an employer-sponsored plan is considered “unaffordable” if your premium for yourself is more than 9.5 percent of your household income. To learn more, call (855) 899-9600 or visit www.healthconnect.vermont.gov.
Dr. Mark Jewett has been an internal medicine physician at Gifford Medical Center for his entire 36-year career. Originally from Pennsylvania, Dr. Jewett came to Randolph in 1976, where he has lived since with his wife, Gifford pediatrician Dr. Elizabeth Jewett. Together they have three grown children and one grandchild. In his free time, Dr. Jewett maintains a healthy lifestyle – hiking, biking, running, skiing, and sailing.
Except for a nine-month sailing trip in 2005, Dr. Jewett has worked at the Rochester Health Center. From 1976-2005, he also saw patients in Randolph.
Outpatient medicine is a passion for Dr. Jewett because it provides him an opportunity to interact with and help others. Sometimes that help comes in a cure. Sometimes it is with coping. Sometimes it is just to be understanding.
Below is his story as told in his own words, as featured in our 2012 Annual Report.
“Mitt Fowler and I were in residency together in Massachusetts when Gifford advertised for an internal medicine physician in the underserved Rochester area. We had come to Vermont to ski and liked the rural lifestyle. In fact, my role model as a child was an uncle who was a doctor in a town of 5,000 people, much like Randolph. That is what I envisioned for my life. So we convinced then hospital administrator Phil Levesque that it wasn’t one internal medicine physician that he needed, but two.
Milt and I opened the Rochester Health Center in 1976 and soon Dr. Lou DiNicola joined us. We were all fresh out of our residencies. A federal grant helped support the launch of the health center – called the Green Valley Health Center at that time – and its first three years of operations. While we “worked” for Gifford, as was the standard at the time, Milt, Lou, and I and the health center were a private practice. It wasn’t until about two decades later that we became employees of the medical center.
Drs. Mark Jewett, Lou DiNicola, and Milt Fowler in the early years shortly after coming to the Randolph area. The three physicians have spent the entirety of their careers providing medical care to the rural communities in central Vermont.
Initially I spent two days a week in Rochester, working in Randolph as well. In addition to Milt and Lou, other providers, including physician assistant Sue Burgos and family medicine provider Dr. Mark Seymour, rotated through Rochester throughout the years. But except for the nine months I took off in 2005 for my other passion – sailing – my trip from home in Randolph, over the mountain to Rochester, has been a constant for 36 years.
The road has changed over that time. In the early years when the top was a narrow dirt lane, I left a few mufflers behind. Since then it has been modernized, as has medicine. Initially as rural doctors, we took care of everything. There were far fewer specialists for referrals, we didn’t yet have CT scans or MRIs, and a radiologist’s availability to read X-rays was much more sporadic.
While I know today we’re taking better care of people thanks to these advances, I miss being able to do it all. I believe in the primary care medicine model where doctors know everything about their patients and coordinate all aspects of their care.
What’s nice about being in a community for 36 years is you get to see people over time. You see how people grow up in a community. You see how people grow old in a community. You see how people sometimes die in a community.
As an internal medicine physician, I see only adults. But even without youngsters in the mix, I still take care of up to four generations of the same family over time. To lose a patient – especially after decades of care – is painful for me as a doctor. It’s painful because of the relationships formed. Those relationships are what allow me to help families because I too am feeling the loss.
In a couple more years I will retire. While I won’t be driving over the mountain four days a week as I do now, I won’t stop caring – for the people of the Rochester area who have entrusted me with their care for so many years or for people in need of health care. While this area will always be with me in spirit, it’s my goal, if I’m still able, to sail my sailboat to the Caribbean and work in another underserved area, such as Haiti, providing care to new generations in need.”
~ Mark Jewett, M.D.
Rochester Health Center Internal Medicine Physician
Above left: Madison Fuller and Kristi Fuller of Granville and Carol McLoughlin of Rochester “examine” Dr. Mark Jewett. Dr. Jewett has been providing care at the Rochester Health Center for 36 years and cares for generations of area residents, including this fun-loving grandmother, mother, and daughter trio. Dr. Jewett also cared for Carol’s late mother, Lilla Clancy. Carol shares that her mother used to bring Dr. Jewett cookies in the early days because she thought he was too skinny. Above right: Dr. Jewett in 1979 a few years after joining Gifford.
A Randolph Center resident, husband, and father, Dr. Christopher Soares joined the Gifford Medical Staff in 1993, spending his entire career to date in Randolph. Initially a Dartmouth-Hitchcock Medical Center provider, Dr. Soares opened his own practice, Soares Ocular Surgery, in 2007. In addition to caring for adults, he is also a pediatric ophthalmologist.
An avid cyclist, he has biked more than 40,000 miles, including from Canada to both the Grand Canyon and Mexico along the Pacific Coast Highway. Dr. Soares also enjoys kayaking, water skiing, boogie boarding, cross country and downhill skiing, ice skating, and more. He is originally from Massachusetts.
Below is his story as told in his own words, as featured in our 2012 Annual Report.
Raising a family of three children has tremendous rewards. After 20 years my last child is finishing college and preparing to enter an exciting new phase in her life. My two boys are finished with college and have started careers. All three have expressed their gratitude for the opportunities they were given while growing up. All three realize my wife and I love them unconditionally and we gave our all raising them the best way we knew how.
Working as an ophthalmologist in Randolph for nearly 20 years has similar rewards. In the early years, just like parenting, you are learning and developing your skills. People are glad that you are in town and they do not have to travel a great distance to get eye care. You develop a friendship with the patients. This friendship grows with the years. As the years go by, your skill sets expand and more patients come for care. All the while, friendships continue to grow. As a doctor’s experience and confidence grows, so do the positive outcomes. Challenging cares are taken on and the outcomes are even more rewarding.
At left – Dr. Soares, dressed in scrubs, is often seen riding his bicycle through Randolph. Right – an updated portrait of Dr. Soares.
That is certainly true in the case of Nathan Wheeler.
Nathan is a young man who last year tripped, fell, and hit his head on a piece of furniture, severely injuring his left eye. He had torn an essential eye muscle in half. Nathan had already been seen by two ophthalmologists and an oculoplastic specialist after an emergency room visit, and was finally referred to my practice three days after the injury. I explained to him and his family the seriousness of the injury and that several surgeries might be required. The first surgery was performed that very night in a Gifford operating room. It lasted four hours. I’ll spare you the details, but I was able to locate the muscle stumps and sew them back together.
A month later, Nathan was seeing well but required one more surgery to align his vision when looking down. This second surgery was also a success. Nathan’s vision was restored and he was able to return to work with no restrictions.
In Vermont fashion, I had done the job before me, to the best of my ability, but when I came home after that first surgery, I was distraught. In fact, I was nearly in tears. I had been in that OR for hours and I wasn’t sure if I had even helped Nathan. At the time, I didn’t know what I had accomplished.
Later, I researched more on the procedure and found that what I had accomplished was rarely, if ever, done by others. My case was so unique that I was asked to present it to a group of pediatric and adult strabismus specialists at the Massachusetts Eye and Ear Hospital. Of the 50 doctors in the room, none had ever attempted to find a ruptured muscle and suture it back to the remaining muscle.
Needless to say, Nathan was thrilled with the results and has sent patients to me ever since, some looking for “miracles”. I can’t perform miracles, but every week I am blessed to receive the gratitude of at least one patient. This appreciation for what I do energizes me and keeps me committed to offering the best eye care possible.
~ Christopher Soares, M.D.
Soares Ocular Surgery ophthalmologist
Dr. Soares examines patient Nathan Wheeler, whose injured eye he restored through a series of tough and rarely attempted surgeries. And a grateful Nathan has been referring patients to Dr. Soares ever since.
Elaine Soule’s relationship with Gifford began at birth, and possibly before. Her mother graduated from the nursing school in 1923 and worked under hospital founder Dr. John P. Gifford. Elaine was born at the Randolph hospital in 1933.
Raised in Randolph Center, she attended local schools and married the summer following high school graduation. His career in the U.S. Air Force took them around the country and beyond. Elaine’s own six children were born on military bases in New York, Oklahoma, New Hampshire, Bermuda, Louisiana, and Maryland.
In 1971, after 20 years of military life, the family returned to Randolph. Before the families’ furniture had even arrived, Elaine had landed a job at Randolph National Bank. She started out typing signature cards and eventually became a branch manager of what was Randolph Savings and Loan, then Vermont Federal and finally Vermont National over her 28-year career.
Along the way, Elaine worked at Gifford on weekends from 1990-1995 in patient registration. After retiring from the bank in 1998, she came to work at Gifford in 2001 as the volunteer services coordinator.
“I have always felt close to Gifford,” says Elaine, who served on the hospital Board of Trustees for nine years in the 1990s.
So when Elaine retired in 2006 after five years as volunteer services coordinator to undergo cancer treatment, she knew she’d be back. “I knew I’d come back to volunteer, because I wanted to be part of this place,” says Elaine. “I just loved the Gift Shop. I’d loved volunteering. I thought it was a way to continue to be involved with Gifford after I retired.”
For months, Elaine came to Gifford as a patient for chemotherapy treatments. “My cancer treatments were wonderful,” Elaine says, calling the staff “so compassionate”. When her treatments ended in early 2007, Elaine continued her trips to Gifford – this time as a volunteer two days a week in the Gift Shop.
“Now I don’t have to be here, but I choose to be here,” she says from her post behind the desk of the boutique. “I think the volunteers at the Gift Shop are great. I hope we serve a purpose. I think we do.”
For Elaine, now 79, it is about staying active and connected in her community and at her community hospital. “I love it because it gets me out of the house to meet people and I feel that I am contributing to Gifford in a small way,” she says.
The following was featured in our 2012 Annual Report.
Our effectiveness as a medical home has grown this year with the expansion of health care teams and our collaboration with the Vermont Blueprint for Health. But at the heart of these teams are Gifford’s long-established primary care practices. In each of our health team locations, we have providers and support staff whose relationships with the community run deep.
Take Starr Strong, for example. For 19 years, Starr has committed herself to the people of Chelsea – first under the mentorship of Dr. Brewster Martin and now as a mentor in her own right.
With humility and compassion, family physician Dr. Ken Borie has cared for the people of Randolph for 32 years. The humanity he brings to medicine is an example for all, including the many medical students who he guides through the family medicine portion of their clinical studies.
And Dr. Lou DiNicola, a local pediatrician for 36 years, has been among the foremost leaders in this state when it comes to children, advocating at every turn for their health, safety, and welfare.
Those of us enjoying long-standing relationships with Gifford and with our central Vermont community consider ourselves fortunate to know and work with these practitioners and their support teams. Such stability, and depth, builds our medical homes into more effective tools for helping our patients.
~ Marcus Coxon
Medical Staff President & family physician
The following article was published in our 2012 Annual Report.
Above left – One of Gifford’s newer providers, internal medicine physician Dr. Cristine Maloney, lives in Randolph and brings special training in palliative care to Gifford’s already robust advanced illness care program. Here she is pictured with patient David Wark of West Topsham. Above right – Emergency Department physician and clinical director Dr. Saul Nurok joined Gifford in 2010. Here he is shown with patient George Carr of Bethel.
Gifford is fortunate to have many long-serving health care providers, but the medical center would not be successful without the providers who have joined Gifford in more recent years.
Lured in part by the stability and quality provided by the very individuals highlighted in this year’s report, Gifford has welcomed new providers in almost every area of medicine.
For example, joining long-time pediatricians Dr. Lou DiNicola and Dr. Elizabeth Jewett, who have both been at Gifford for 36 years, are Dr. Joe Pelletier, now with Gifford for 10 years, and Dr. Pam Udomprasert, who joined more recently in 2011.
“Joe is now the cornerstone of pediatrics here,” says Dr. DiNicola.
At the Chelsea Health Center, long-time U.S. Navy family physician Dr. Brian Sargent joined physician assistant Starr Strong in practice in 2008. “I am especially appreciative of Brian,” Starr states, “and his commitment to the folks of this valley and the joy he takes in developing relationships in this unique place.”
In Bethel, family nurse practitioner and former emergency department nurse Emily LeVan joined long-time family physicians Dr. Mark Seymour and Dr. Terry Cantlin just this year. “Emily brings her wealth of emergency room experience and a firm commitment to primary care. She also has a strong tie to the area, working with her husband and family running a local farm,” Medicine Division Medical Director Dr. Josh Plavin says.
In the Emergency Department, Drs. Steven Fisher, Josh White, and Saul Nurok have filled the shoes of long-term physicians like Dr. Lucy Wollaeger, who retired from full-time work in 2012 after 21 years at Gifford.
“Often people’s first opinion of the hospital is through the emergency room, and Steve, Saul, and Josh are amazing,” Dr. Ken Borie, a family physician at Gifford for 32 years, says.
Anesthesiologist Dr. Dennis Henzig, a 20-year veteran of Gifford, has been joined by Drs. Jon-Richard Knoff in 2007 and Nazek Shabayek in 2012. Both of Gifford’s orthopedists, Dr. Stephanie Landvater and Dr. Bess Brackett, have come to Gifford within the last decade as Dr. Bill Minsinger prepared to retire.
Hospitalist medicine is a newer specialty. Consequently, it melds newer doctors and mid-level providers with experienced ones who have transitioned from another area of medicine, such as family care. Gifford’s certified nurse-midwifery team additionally melds newer and more experienced members. Ob/gyn physicians Dr. Anne Galante and Dr. Dina Levin have both joined Dr. Brent Burgee, a 27-year veteran of Gifford, and experienced gynecologist Dr. Ellamarie Russo-DeMara.
The most recent addition in the Randolph primary care office is family physician Dr. Barbara Lazar. “Barb brings a wealth of experience, particularly in geriatrics, and is an extremely competent and kind provider. She is an excellent long-term fit for our community-focused practice,” adds Dr. Plavin, who is also among those providers who have committed themselves to the community.
Most of Gifford’s newer providers – of which there are many more – are from the immediate area or have made it their home, raising children here and engrossing themselves in the community in a variety of ways.
Together – even as health care changes and recruitment, particularly of primary care physicians, becomes more and more challenging – they are carrying on the tradition of neighbors helping neighbors and of high-quality, accessible care in our communities.
Above left: Family physician Barbara Lazar joined Gifford in 2012, bringing a background in geriatric care. Above right – Certified nurse midwife Donna Butler, pictured here with a patient and her baby, only joined Gifford in 2010, but this Vermont native has more than 25 years of experience.