Starr Strong blazed a new role for 21 years at Chelsea Health Center
Starr with a baby
Physician assistant Starr Strong retires on May 1 after 21 years at the Chelsea Health Center. Robin Palmer, a former journalist who now does marketing at Gifford, sat down with Strong this week to get her reflections on her career and two decades of commitment to the Chelsea community.
CHELSEA – Starr Strong took a meandering path to health care.
Raised in Connecticut, she studied eastern religion at Beloit College in Wisconsin and went on to travel in India and Nepal and work a variety of jobs, including for a childhood lead prevention program in Massachusetts and counseling troubled teens.
A self-described hippie, wherever she went she found a cabin in the woods to live with her dog, usually with no electricity. She “played pioneer,” she said.
She contemplated a career in social work, but after traveling found herself drawn to a relatively new career – that of a physician assistant.
Despite a complete lack of experience in medicine, as a white person traveling in India and Nepal she was often called upon by villagers to help with illness, she said. “They bring you their wounds. They bring you their sickness. I found that I loved it.”
Duke University had started the first physician assistant program following the Vietnam War for returning medics looking to put their skills to work, Strong recalled. Wake Forest University in North Carolina was one of the schools to follow. Strong entered physician assistant school at Wake Forest in 1979.
Coming home to Vermont
Starr with a patient in 1996
She came to Vermont in 1981 while in physician assistant school to do what the industry calls a clinical rotation – like an internship – with local ob/gyn Dr. Thurmond Knight and midwife Karen O’Dato. It was not her first experience in Vermont, however.
Strong calls growing up in Connecticut “a mistake.” “I knew that I was so supposed to be here,” she said.
Strong’s family came from Brookfield. As a child they would visit the family homestead several times a year. Strong recalls her mother telling at her the end of one trip when she was 5 or 6 that is time to go home. “But I am home” was Strong’s reply.
Strong is the sixth generation to own that Brookfield property, where she still lives with husband John Button and one of her two children, Dylan, 28. Twenty-four-year-old daughter Maylee lives in Chelsea.
When she first came home to that old farmhouse with no running water, Strong envisioned a job at Gifford in Randolph, but long-time hospital Chief Executive Officer Phil Levesque told her no, repeatedly.
“I knocked on Gifford’s door every year,” said Strong. She repeatedly heard that the Medical Staff just wasn’t ready for a physician assistant, and might never be.
The hospital had just one private practice nurse practitioner affiliated with it at the time. The concept of a physician assistant – now commonplace in the industry – was completely new.
Starr in 1996
Strong went to work for Planned Parenthood for a dozen years. She worked mostly in Barre doing gynecological exams and talking about birth control. But still she knocked on the door.
The door to Gifford edges open
In early 1993, the door creaked ajar. The hospital agreed to trial Strong in Chelsea a day and a half a week alongside new physician Dr. George Terwilliger, who had replaced retiring physician Dr. Brewster Martin.
Strong was Gifford’s first physician assistant and the first female health care provider at the Chelsea Health Center.
Martin made sure Strong stuck.
“He was incredible,” she recalled. He introduced her around time, advocated for her and he came during many a lunch hour to the Route 110 health center to chat.
The duo formed a mentor-mentee relationship and a strong friendship. They’d save up stories and thoughts to share. They talked about suffering and loss, life and death, and whatever they found funny.
“He was the wisest person I’ve known in my life. It was quite a blessing and I don’t use that word very often,” said Strong.
What she remembers most was that he would ask her thoughts on a subject.
“He gave me confidence,” she said. “I had so much respect for him that him asking me what I thought was enormous.”
Starr in 2008
Soon Strong was working at other Gifford health centers, including in Bethel, at the student health center at Vermont Technical College, in Randolph and recently in Berlin. Chelsea, however, has been a constant.
She promised Martin she would stay in Chelsea for 20 years. This year marks 21.
Just the right fit in Chelsea
Strong found a home at the Chelsea Health Center.
“Chelsea’s an old time family community and people are fiercely independent and have a lot of pride. If they don’t have anything, it doesn’t matter. It’s down to earth,” Strong said.
For a woman loath to “lipstick and high heels,” it was just perfect.
And like with Martin, she formed relationships there.
“Medicine is not just a science. Medicine is an art and it’s about relationships and it’s about developing relationships with people,” she said.
Those relationships have come with generations of patients and with co-workers like nurse Judy Alexander, who became the closest of friend.
“She just made me laugh. I could call her at 4 o’clock in the morning and she would be at my house at 4:30, and you don’t get that in life often.”
Starr with friend and patient Judy Alexander in 2012
Alexander is also a patient of Strong’s – a patient who is in the very end stage of terminal cancer. Like so many of her patients, Strong has been at Alexander’s bedside.
“At the beginning of my career, I thought birthing was my ticket and then I took care of a dying person and found that that is really where the juice is,” she said, noting the courage one witnesses in illness and death.
Alexander’s illness and waiting for just the right new providers to join the Chelsea Health Center in her place have in part kept Strong working past that 20 years she promised Martin.
A new chapter
But now she is ready.
Strong is 62, struggles with pain caused from arthritis in her spine and is slowing down. “I don’t have that vitality anymore,” she said.
And she wants to be home. Her husband has been building a new house on that family homestead in Brookfield. “I want to be there to finish it, and have the time to move in.”
She wants to travel and ski and kayak and garden and make stained glass and spend more time with her 95-year-old mom.
She can do all this because of family medicine providers Dr. Amanda Hepler and physician assistant Rebecca Savidge. Like Strong did 21 years ago, they have joined the Chelsea Health Center.
Dr. Hepler comes from Maine and has a passion for rural medicine and Savidge is a Chelsea native. They’re skilled and compassionate and plan on staying for a very long time. Strong couldn’t be happier.
“Once patients meet them, they’re going to love them,” Strong said.
In fact, they’re so great to be around that Strong anticipates a few visits to Chelsea of her own.
“Now I’m going to be the lunchtime girl,” she said, thinking back to those lunches with the retired Martin.
Wish Strong well in her retirement and meet Dr. Hepler and Savidge at a May 1 open house being held from 4-6 p.m. at the Chelsea Health Center that is open to all.
The following is an excerpt from our 2013 Annual Report: A Recipe for Success.
Cindy Legacy and dietitian Stacy Pelletier
For six months leading up to her bariatric surgery, Cindy Legacy of Randolph met with registered dietitian Stacy Pelletier and has kept in touch in person and via e-mail since. Cindy lost 30 pounds before her surgery and another 80 pounds since, for a total 110 pounds of weight loss. More importantly, she experienced a major improvement in her
health, in part thanks to Stacy’s continued help.
“She is a wonderful, wonderful , wonderful support person. I wanted to succeed. She wanted me to succeed. She listened to what I had to say and made me feel like she really cared about what I was trying to do. There was no judgment. She’s like a security blanket. I can go and say, ‘What do I do?’”
~ Cindy Legacy
The following is an excerpt from our 2013 Annual Report: A Recipe for Success.
When Donna Shephard of Rochester came with her husband, Dick, for an appointment at Gifford primary care on her 72nd birthday in April, nurse Dorothy Jamieson had cake, cupcakes, a crown and lei waiting as a surprise. Donna, who has Parkison’s and regularly visits Gifford, was appreciative of the birthday surprise but more so of the care that Dot
“I love her. She’s the best nurse that you (could) ever see. You don’t get them like that. She’s so gentle and nice and friendly. She puts a smile on anyone’s face.”
~ Donna Shepard
Nurse Dorothy Jamieson with Dick and Donna Shepard
Members of Gifford’s breast care team pose in this file photo. They are, from left, certified breast sonographer Terri Hodgdon, certified mammogram technologist Cheryl Jewkes, board certified radiologist Dr. Scott Smith, certified breast sonographer Kim Nelson and patient care navigator Brittany Kelton.
Gifford Medical Center’s mammography and nuclear medicine departments have both been awarded three-year reaccreditations by the American College of Radiology.
The American College of Radiology calls their recognition the “gold seal of accreditation” and notes it represents the highest level of image quality and patient safety.
The accreditation is awarded only to facilities meeting American College of Radiology practice guidelines and technical standards after a peer-review evaluation by board certified physicians and medical physicists who are experts in the field. Assessed are image quality from actual patient images taken (without sharing patient names), personnel qualifications, facility equipment, quality control procedures and quality assurance programs.
Quality control procedures include daily, weekly and monthly checks of machines to determine they are functioning optimally.
Gifford submitted its records for review for reaccreditation for both mammography and nuclear medicine in January and heard back on March 26.
The recognition, says Nuclear Medicine Manager Tera Benson, tells patients “we’re dedicated to providing the best quality image.”
In addition, it ensures that Gifford is following not just what it deems the best standards for care, but national standards for care.
“We are fortunate to receive a lot of positive feedback from patients regarding the courtesy of our staff or the speed with which we complete exams like mammograms. This accreditation is a recognition of all the work that occurs behind the scenes to ensure patients not only have a great experience, but the highest quality imaging as well,” said Director of Ancillary Services Pam Caron, who praised her team’s hard work.
According to the American College of Radiology’s Web site, Gifford is one of seven Vermont facilities with an accredited nuclear medicine program. The closest other programs are larger hospitals in Burlington and Rutland, as well as Dartmouth-Hitchcock Medical Center in New Hampshire. A greater number of mammography programs are accredited.
Pennsylvania native Amanda Hepler knew from a young age that she would become a doctor.
“Pretty much from when I was very little, I wanted to be a doctor,” says Hepler, whose mother was a radiology technologist and often the go-to person for medical questions.
At Grove City College in Pennsylvania, Hepler studied molecular biology. Medical school at Jefferson Medical College of Thomas Jefferson University in Philadelphia followed. Her residency in family medicine was at Latrobe Family Medicine Residency, also in Pennsylvania.
When it came time to start work, Dr. Hepler looked for a rural practice and found it at Rangeley Family Medicine in a community of 1,200 in Maine. There for four years, Dr. Hepler was the lone physician, caring for all ages, doing home visits and addressing emergencies as they arose.
From Maine, Dr. Hepler went to work at Cheshire Medical Center, part of Dartmouth-Hitchcock Keene, in New Hampshire. The role meant working in a multi-physician practice, overseeing nurse practitioners and physician assistants, caring for patients in a skilled nursing facility and working to meet quality goals as part of an Accountable Care Organization. It lacked one thing, however: rural roots.
It’s Dr. Hepler’s passion to care for whole families.
“I always pictured myself working in a rural area,” Dr. Hepler said. “Family medicine is called family medicine because you’re supposed to be taking care of a whole family. You can learn a lot more about a person from first-hand experience with a family. You have a true family history.”
Dr. Hepler is now rediscovering her passion for rural medicine as the latest member of the Chelsea Health Center team.
The rural clinic is part of Gifford Health Care and was recently named a Federally Qualified Health Center by the Health Resources and Services Administration, part of the U.S. Department of Health and Human Services.
“It just felt right,” says Dr. Hepler of joining the Chelsea team, which includes physician assistant and Chelsea native Rebecca Savidge and physician assistant Starr Strong, a veteran Chelsea caregiver who will soon retire.
Dr. Hepler is board certified by the American Board of Family Medicine and a member of the American Medical Association and the American Academy of Family Physicians.
A kind and compassionate caregiver who quickly creates a relaxing environment, Dr. Hepler works hard to listen to patients, get to know them and help them make the best decisions to improve their health. She has special clinical interests in caring for whole families, women’s health, diabetes management and caring for children.
Dr. Hepler is currently living in Randolph while she searches for a home for her and her dog, Cosmo, closer to Chelsea. (She notes patients have already been helpful and welcoming as they call with leads on rentals.) In her free time she enjoys snowshoeing and hiking with her dog, kayaking, and flower and vegetable gardening.
Dr. Hepler is now seeing new patients. Call her at the Chelsea Health Center at (802) 685-4400.
The following is an excerpt from our 2013 Annual Report: A Recipe for Success.
Arnie Williams, nurse Cindy Loomis and medical secretary Carol Young
Arnie Williams of Tunbridge had a hernia that needed a quick fix. His primary care doctor sent him straight upstairs to the general surgery office without an appointment. He was seen that day, a Wednesday, and was in surgery Friday morning. Medical secretary Carol Young got him in and nurse Cindy Loomis was by his side.
“I couldn’t have been treated better, physically and emotionally. Everyone has been so good to me… When you have something wrong with you and you’re in good hands, you feel very secure. You can just relax and let them do their job. It makes everything better.”
~ Arnie Williams
Cindy Legacy poses with Gifford registered dietitian Stacy Pelletier. Legacy of Randolph lost 110 pounds and is now starting a weight loss support group at Gifford to help maintain her own weight loss and help others on their journey to becoming healthy.
After losing 110 pounds, Cindy Legacy of Randolph is launching a weight loss support group at her workplace – Gifford Medical Center – to help keep the weight off and help others on their weight loss journeys.
The first meeting, which is free and open to all, will be Wednesday, April 9 from 6:30-7:30 p.m. in the Gifford Conference Center.
Legacy has some goals for the group, including providing educational resources, occasional speakers, discussion, support, walking and activities. There won’t be weigh-ins, or judgment, however.
“I don’t care what you weigh. It’s none of my business,” says Legacy, who rather wants to help anyone, at any stage in his or her effort to lose weight and have a healthier lifestyle.
But she is also interested in finding what participants want and what meeting times work best. That will be part of the first meeting. She’s envisioning weekly, evening meetings to follow.
Joseph Woodin, Gifford’s administrator, speaks at Saturday’s Annual Meeting of the medical center’s corporators. Woodin outlined a year of success.
If there was any doubt that Randolph’s local hospital – Gifford – stands above when it comes to commitment to community and financial stability, it was wholly erased Saturday as the medical center held its 108th Annual Meeting of its corporators.
The evening gathering at Gifford featured an overview of the hospital’s successful past year, news of spectacular community outreach efforts, a video detailing employees’ commitment to caring for their neighbors and a ringing endorsement from Al Gobeille, chairman of the Green Mountain Care Board and the evening’s guest speaker.
Diane and William Brigham, corporators, arrive at Gifford’s 108th Annual Meeting.
For Gifford, 2013 brought a 14th consecutive year “making” budget and operating margin, new providers, expanded services including urology and wound care, expanded facilities in Sharon and Randolph, a designation as a Federally Qualified Health Center and all permits needed to move forward on the construction of a senior living community in Randolph Center and private inpatient rooms at Gifford.
The Randolph medical center also collected a ranking as the state’s most energy efficient hospital, an award for pediatrician Dr. Lou DiNicola, national recognition for Outstanding Senior Volunteer Major Melvin McLaughlin of Randolph and, noted Board Chairman Gus Meyer, continued national accolades for the Menig Extended Care Facility nursing home.
Al Gobeille, chairman of the Green Mountain Care Board, speaks at Gifford’s 108th annual corporators meeting on Saturday evening at the Randolph hospital.
“In the meantime, we’re faced with an ever-changing health care landscape,” said Meyer, listing accountable care organizations, payment reform initiatives and a burgeoning number of small hospitals forming relationships with the region’s two large tertiary care centers.
For some small hospitals, these shifts cause “angst.” “We like to think it brings us possibility,” said Meyer. “As both a Critical Access Hospital and now a Federally Qualified Health Center, Gifford is particularly well positioned to sustain our health as an organization and continue to fulfill our vital role in enhancing the health of the communities we serve.”
Joan Granter, left, and Irene Schaefer, corporators, arrive at Gifford’s 108th Annual Meeting.
The FQHC designation brings an increased emphasis on preventative care and will allow Gifford to invest in needed dental and mental health care in the community, Administrator Joseph Woodin said.
Gifford is but one of only three hospitals in the country to now be both a Critical Access Hospital and Federally Qualified Health Center.
“Congratulations! You’re a visionary,” said Gobeille in addressing Gifford’s new FQHC status. “It’s a brilliant move. It’s a great way to do the right thing.”
And Gifford is doing the right thing.
Gobeille was clear in his praise for Gifford’s management team and its commitment to stable budgets, without layoffs or compromising patient care.
Marjorie and Dick Drysdale, corporators, arrive at Gifford’s 108th Annual Meeting.
Gifford’s commitment also extends to the community.
In a major announcement, Woodin shared that thanks to the William and Mary Markle Community Foundation, Gifford will grant a total of $25,000 to schools in 10 area towns to support exercise and healthy eating programs.
Gifford annually at this time of year also hands out a grant and scholarship. The 2014 Philip Levesque grant in the amount of $1,000 was awarded to the Orange County Parent Child Center. The 2014 Richard J. Barrett, M.D., scholarship was awarded to Genia Schumacher, a mother of seven and breast cancer survivor who is in her second year of the radiology program at Champlain College.
The continued use of “Gifford Gift Certificates,” encouraging local spending during the holiday, invested about $40,000 in the regional economy in December. “These small stores appreciate it. It really does make a difference,” noted Woodin, who also detailed Gifford’s buy local approach and many community outreach activities in 2013, including free health fairs and classes.
The community in turn has invested in Gifford. The medical center’s 120 volunteers gave 16,678 hours in 2013, or 2,085 eight-hour workdays. Thrift Shop volunteers gave another 6,489 hours, or 811 workdays. And the Auxiliary, which operates the popular Thrift Shop, has both invested in equipment for various Gifford departments and made a major contribution toward the planned senior living community that will begin construction in May.
Outgoing Gifford board member David Ainsworth arrives with wife Peggy to Saturday’s 108th Annual Meeting of the Corporators.
The night also brought new members to the Gifford family.
Corporators elected two new of their own: Matt Considine of Randolph and Jody Richards of Bethel. Considine, the director of investments for the State of Vermont, was also elected to the Board of Trustees and Lincoln Clark of Royalton was re-elected.
Leaving the board after six years was Sharon Dimmick of Randolph Center, a past chairwoman, and David Ainsworth of South Royalton after nine years.
‘Recipe for Success’
“Recipe for Success” was the night’s theme and built around a fresh-off-the-press 2013 Annual Report sharing patient accounts of Gifford staff members going above and beyond. The report, now available on www.giffordmed.org, credits employees’ strong commitment to patient-care as helping the medical center succeed.
Taking the message one step further, Gifford unveiled a new video with staff members talking about the privilege of providing local care and the medical center’s diverse services, particularly its emphasis on primary care. The video is also on the hospital’s Web site.
Gus Meyer, chairman of Gifford’s board, honors retiring board members David Ainsworth and Sharon Dimmick.
Health care reform
Shifting resources to primary and preventative care is a key to health care reform initiatives, said a personable and humorous Gobeille, who emphasized affordability.
“We all want care. We just have to be able to afford care,” he said. “In the two-and-a-half years I’ve been on the board, I’ve grown an optimism that Vermont could do something profound.”
Gobeille described what he called “two Vermonts” – one where large companies providing their employees more affordable insurance and one where small businesses and individuals struggle to pay high costs. “The Affordable Care Act tries to fix that,” he said.
The role his board is playing in the initiatives in Vermont is one of a regulator over hospital budgets and the certificate of need process, one as innovator of pilot projects aimed at redefining how health care is delivered, and paid for, and as an evaluator of the success of these initiatives as well as the administration and legislators’ efforts to move toward a single-payer system.
Audience members asked questions about when a financing plan for a single-payer system would be forthcoming (after the election, Gobeille said), about how costs can be reduced without personal accountability from individuals for their health (personal accountability absolutely matters, he said) and how small hospitals can keep the doors open.
Gobeille pointed to Gifford’s record of financial success and working for the best interests of patients and communities as keys. “I don’t think Gifford’s future is in peril as long as you have a great management team, and you do,” Gobeille said.
Chiropractor Dr. Michael Chamberland has joined Gifford’s Sharon Health Center, fulfilling a dream to work at a multidisciplinary sports medicine practice.
Originally from Bellows Falls, Dr. Chamberland attended the University of Vermont, studying pre-medicine and nutritional sciences. He went on to Western States Chiropractor College in Portland, Ore., earning his doctor of chiropractic degree.
He credits a back injury with steering him toward chiropractic.
He got hurt playing hockey. Months went by without relief until he visited a chiropractor for the first time in his life. “It was a chiropractic miracle, so to speak,” he says, remembering recovering his full range of motion after his first adjustment and being symptom-free within two weeks. “For me, I just couldn’t believe it. I realized that it was the perfect profession for me.”
After a chiropractic internship at Western States Chiropractic Clinics in Oregon, Dr. Chamberland returned to Vermont. He opened a private practice, Catamount Chiropractic, in Colchester as well as working at Jerome Family Chiropractic in Montpelier and Temple Chiropractic in Bellows Falls.
He maintains his private practice part-time, which shares space with a physical therapy facility, but couldn’t pass up an opportunity to work at the Sharon Health Center. “That was the ideal,” he says of the Sharon sports medicine team that includes podiatry, general sports medicine, physical therapists and an athletic trainer, and fellow chiropractor Dr. Hank Glass. “It (a multidisciplinary sports medicine team) doesn’t exist in Burlington. It generally doesn’t exist on the East Coast.”
The Sharon Health Center is part of Gifford Medical Center. Gifford’s family atmosphere and collaborative, team approach were also attractive, he notes.
Dr. Chamberland is board certified by the National Board of Chiropractic Examiners. His clinical interests include prevention and treatment of sports injuries, sports nutrition, posture assessment, injury risk assessment and advanced imaging.
A resident of Essex, Dr. Chamberland is an athlete in his free time, including playing hockey, kiteboarding, alpine skiing, golf, tennis, cycling, hiking, water skiing and wakeboarding. He worked as an alpine race coach in Vail, Colo., as well as Smugglers’ Notch, for a time. He was even part of a race crew for the 1999 World Alpine Ski Championships in Vail.
Now he is putting his athletic and chiropractic experience to work in Sharon. Call him Mondays, Wednesdays and Thursdays at the Sharon Health Center at (802) 763-8000.
Maggie Gardner was studying sociology at the University of Vermont when a nurse-midwife came to speak during a class on reproduction.
Gardner’s first thought: “I want to be her.”
Today, she is.
After graduating from the University of Vermont in 2001, Gardner went to work for that midwife’s home birth practice, Welcoming Home Family Nurse-Midwifery in Hinesburg. Gardner was the office manager and assistant, both clerically and clinically, including assisting at births.
She went on help start a midwifery practice in her hometown of Vergennes, Tapestry Midwifery, and returned to the University of Vermont, undertaking the master’s entry program in nursing and earning her registered nurse certificate. Next was nurse midwifery school at the Frontier Nursing University in Kentucky – a master’s degree program.
And now, Gardner, a Vermont native, is working at one of the state’s most coveted certified nurse-midwifery practices – Gifford Ob/Gyn and Midwifery.
Board certified by the American Midwifery Certification Board and a member of the American College of Nurse Midwives, Gardner is seeing patients at Gifford’s clinics in Randolph and Berlin.
“I’m excited,” says Gardner, calling Gifford’s practice on the top of the pedestal when it comes to midwifery. “It has a strong reputation in the midwifery community.
“Many people don’t get to choose where they work. I get to choose to work at a place that’s committed to midwives.”
Gifford’s practice, she notes, takes the best of the home and hospital birth experience, and combines them into a natural, hospital-based midwifery birth.
Gardner will do the same in her practice at Gifford as well as focusing on open communication, equal partnerships with patients and families, and individualized care.
Gardner cares for all types of patients, from women needing routine gynecologic care to women expecting a baby, but has special interests in breast feeding support, Pap test follow-up, testing for and educating women on risk factors for sexually transmitted infections, and sexual health.
Those interests in part incorporate Gardner’s other work experience. In addition to her midwifery experience, Gardner has worked in pediatrics, emergency medicine, and infectious disease at Fletcher Allen Health Care in primarily office assistant type roles, and most recently was a manager at Planned Parenthood of Northern New England, where she was responsible for the implementation of a new centralized lab management system for 21 Planned Parenthood health centers in Maine, New Hampshire and Vermont.
Gardner lives in the home in which she grew up in Vergennes. She is married and has two children, a 15-year-old daughter and a 12-year-old.
Call Gardner and the midwifery team at Gifford at 728-2401.