The following is an excerpt from our 2013 Annual Report: A Recipe for Success.
This has been another successful year for Gifford, and it is due to our continued ability to take care of so many different patients, from so many different communities. Ultimately that is our mission and focus, and for me constitutes our Recipe for Success. We continue to offer treatment and services over a wide geography, and “how” we do that is as important as “what” we do. We strive to bring personal attention into the clinical delivery system through relationships and flexibility. Sometimes we do these things very well, and sometimes we learn and grow from our experiences and shortcomings. In all instances we are indebted to the many communities and friends who utilize us and give us feedback and support.
A Gallon of Leadership
This has also been a year marked with stress over health care reform and the roll-out of both a national and state-wide insurance product (i.e. Vermont Health Connect). Although the state has done a better job than the federal government in implementing the insurance exchange, there is still much uncertainly about these new programs, with people looking for answers and assurance that this is the “right direction.” That uncertainty, however, does not find its way into our planning for the future. Gifford has always relied upon a simple understanding that if we focus on patient care, quality and insuring access to everyone, regardless of their ability to pay, we will be successful. Maybe it’s that three-ingredient recipe that has helped sustain us over these past 110 years (since our founding in 1903). While others are employing sophisticated forecasting techniques and prediction models, we are just trying our best to be your medical home and guide.
I hope you enjoy this report, and the many stories that highlight our efforts this past year. We are grateful for the legacy we have inherited, and continue to build upon that
success each and every year.
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.
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 →