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
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 story appeared in our Fall 2013 Update Community Newsletter.
Lorraine “Lori” Sedor has a myriad of health problems and a healthy fear of the water. So when certified diabetes educator Jennifer Stratton invited Lori to attend a water aerobics class Gifford was offering at the Vermont Technical College pool, Lori thought “no way.”
A retired school driver, 67-year-old Lori of Braintree has diabetes, an enlarged heart, rheumatoid arthritis, injuries from an accident, and uses a walker to get around. She also nearly drowned at age 16 and hadn’t swum since.
But Lori told Jennifer she’d try it, if only to prove her wrong.
“She told me that I could do it and I told her I couldn’t, and she was right, as much as I hate to admit it,” says a good-natured Lori.
The class started back in January and lasted six weeks. She was slow at first, but soon she was doing jumping jacks, twisting, bending, touching her knees, “and I swam.”
“I loved it. I was able to exercise whereas on land it’s harder to exercise. My body felt better. It’s just fantastic.”
After the class, Lori’s daughter bought her a year’s pass to the pool and for a couple months, Lori and a friend went two or three times a week. Health problems have prevented Lori from swimming since, but she expects to soon be back in the pool.
“I can’t wait to go back,” Lori says. “I’d recommend it for anyone who needs to exercise.”
Another water aerobics class is taking place now. If you have a chronic condition, call Jennifer Stratton at 728-7100, ext. 4 to learn about future classes.
Dawn Blodgett is happily back to riding horses, dairy farming, and more following a Tenex prodedure at Gifford.
This story appeared in our Fall 2013 Update Community Newsletter.
Dairy farmer Dawn Blodgett has struggled with foot pain her whole life. But when a lump formed on the bottom of her left foot last summer, what was a daily ache turned into sharper pain.
“I felt like I was stepping on a marble,” says 33-year-old Dawn of Brookfield.
Gifford podiatrist Dr. Robert Rinaldi diagnosed the nodule as plantar fibromatosis. Dawn tried orthotic shoe inserts and wearing sneakers instead of barn boots, but still the pain persisted. Dr. Rinaldi offered another possible solution. On the day before Thanksgiving, he performed a new procedure – a Tenex Health TX.
The procedure is aimed at relieving tendon pain – a problem for millions of Americans. Tendon pain is often the result of damage or overuse injuries. The body attempts to heal itself, causing scar tissue. Scar tissue can be painful because it doesn’t stretch and function as a tendon should, explains Dr. Rinaldi.
The Tenex procedure removes and breaks up the scar tissue, or in Dawn’s case the nodule. It is a procedure that doesn’t require general anesthesia or even a single stitch. Patients are given local anesthesia, or an injection. The doctor then makes a very small incision and inserts a device the size of a needle. The device is used to make holes in the scar tissue and delivers ultrasound energy designed to break down and remove damaged tissue. Saline solution helps keep tissues cool during the procedure.
The procedure takes about 20 minutes.
For Dawn, the relief was immediate.
“As soon as the procedure was done, there was an immediate difference,” she says. “I cooked Thanksgiving dinner the next day.”
Today, Dawn is back to milking cows, mucking stalls, doing fieldwork and putting up fencing with much less pain. She’s spending more time with her horses, chasing her kids, and running for exercise.
In fact, she’s 20 pounds lighter than she was before the procedure, which she recommends to others suffering from tendon pain.
The Tenex procedure is new and available for use in orthopedics, sports medicine and podiatry. Gifford is the first hospital in Vermont to offer the technology.
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.
RANDOLPH – Emergency medicine physician Dr. A. Nicole Thran has joined Gifford Medical Center full-time, providing care in the Randolph hospital’s 24-hour Emergency Department.
A native of New York City, Dr. Than attended Tufts University in Medford, Mass., earning her bachelor’s degree in biology. She went on to medical school at Vanderbilt University in Nashville. Her internship and residency in emergency medicine were at the University of Massachusetts in Worcester.
Dr. Thran has worked in emergency medicine since 1991 at hospitals in Connecticut, Virginia, Rhode Island, Oklahoma and, since 2012, in Vermont at Rutland Regional Medical Center and Brattleboro Memorial Hospital. There she was what is known as a locums tenens physician. Continue reading →
Cardiac rehabilitation nurse Annette Petrucelli shares a smile with patient Janet Kittredge. Besides getting stronger, one of Janet’s favorite parts of cardiac rehabilitation was the good times she had with staff. “I love those ladies,” says Janet. “They became friends and I couldn’t wait to get back to see them.”
This story appeared in our
Fall 2013 Update Community Newsletter.
Janet Kittredge of Hancock struggled to breathe for two years before miserably failing a cardiac stress test and being diagnosed with a 90 percent blockage of one of the arteries in her heart.
In April, she had a stent placed in the blocked artery at Fletcher Allen Health Care. Part of her follow-up care plan was cardiac rehabilitation at her home hospital, Gifford.
Janet remembers the day she started cardiac rehabilitation vividly. She was nervous. “It had been so long since I had been able to do anything,” she says.
For Janet, a walk out to the garage meant sitting and resting before returning to the house. Carrying in groceries meant pausing between trips. “I completely stopped walking. I just stayed in and pretty much all I did was watch TV.”
So faced with the treadmills, recumbent bike and arm ergometer that make up the cardiac rehabilitation gym, Janet was worried.
A welcoming staff and consistent monitoring of her pulse and heart rate put Janet more at ease and quickly she discovered that not only could she do some exercise, the more she came, the more she could do.
“I just got so excited. It made me feel so good. I walked taller. I felt younger. I just wanted to do more and more and get stronger,” says Janet, who found herself raising the difficulty level on her workouts before even being prompted by staff.
Janet finished her program in August. The 67-year-old Stanley Tool retiree is now back to the active life she once enjoyed. She is walking a mile and a half or more a day, shopping with her granddaughters and impressing her friends with the bounce in her step.
“I have totally gotten my life back. I feel 100 percent better. I have energy. I feel like doing things.”
“I can’t say it enough how much this changed my life. If I hadn’t had this rehab, I never would have gotten myself to this point.”
Cardiac rehabilitation is a 12-week outpatient exercise, education and nutrition program for people with coronary heart disease, angina, recovering from a heart attack or heart surgery, stent placement or other heart conditions. It is offered in a special gym space at Gifford and overseen by specially trained registered nurses. To learn more, call 728-2222 or ask your health care provider for a referral.
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.