Generations of Caring in Rochester – Dr. Mark Jewett

Dr. Mark Jewett

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.

Dr. Mark Jewett

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

generations of caring in Rochester

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.

For the Love of Patients, Families, and the Community – Dr. Lou DiNicola

Dr. Lou DiNicolaBorn in New Jersey, Dr. Lou DiNicola moved to Randolph in June of 1976 to become a local pediatrician. Passing up job offers in much larger areas then and since, he chose to stay in Randolph because he’s been able to able to practice medicine as he always envisioned. He has been able to affect change on a state level; create unique, trend-setting models of health care; and demonstrate his love of the community through his work.

Married to his wife Joann for 43 years, the couple has two grown children, two grandchildren, and a third on the way. Dr. DiNicola is an outdoor enthusiast, enjoying hiking, snowshoeing, walking, and gardening. He’s also a photographer and works with his artist wife, framing her paintings. 

Dr. DiNicola has spent his entire career in Randolph while also working in Rochester from 1977-1992 with internal medicine physicians Drs. Mark Jewett and Milt Fowler. 

Below is his story as told in his own words, as featured in our 2012 Annual Report.

Thirty-six years ago I was fresh out of residency and looking for job opportunities when I saw an ad in a magazine for a pediatrician in rural Vermont. Vermont was where I wanted to work, so I sent in my curriculum vitae, the medical equivalent of a resume, but never heard a word back. I called but the response was less than enthusiastic. I was basically told “thanks, but no thanks.”

I had three job offers in Pittsburgh and was literally sitting down to take a job at Children’s Hospital of Pittsburgh where I’d just completed my internship and residency when my pager went off. It was Gifford President Phil Levesque’s secretary, wondering if I could come up in a couple of weeks for an interview. “I’ll come this weekend, or I’m not coming at all” was my response. The secretary covered the phone, relaying my message to Phil. “Hell, let him come” was his reply.

Needless to say, I came, and stayed.

More than three decades later I hope I have made a positive impact on the community and my patients, and know they have made a remarkable impact on me – teaching me how to communicate care, respect, and love.

It’s amazing how much you can love your patients. Also amazing is the window being a pediatrician gives you to see the love between a parent and a child. No more clearly is that demonstrated than in the unconditional love between a parent and a special needs child. More than once, parents of special needs children have amazed me and inspired me, as have the children themselves. I’ve seen parents of special needs children go on to adopt more children with special needs. Those are the moments that touch you most; those, and loss.

Dr. Lou DiNicola

Dr. DiNicola thumb wrestles with patient Troy Daniels.

There is no greater loss than the loss of a child. Throughout my career, there have been car accidents, disease, malignancies, and newborn deaths. I think of two patients I lost to cancer, both of whom I visited at their bedsides at home as they were dying. As I reflect on my career, I think of them not with tears but fondness because of the relationships I have had with their families.

At Gifford, we are small enough to have that closeness with our patients and courageous enough to get up the next day and reflect on what we did or didn’t do, what we could have done differently, and how we can improve care. This ability to affect change is one of the things that has kept me practicing – happily – in this community and state for so many years.

One of the biggest changes Gifford has been able to enact in health care is around childbirth. When I first came to Gifford, I kept hearing about this guy Thurmond Knight, a local physician who was delivering babies in people’s homes. I met Thurmond at a Medical Staff meeting. He was knitting. I asked him what it would take for him to deliver babies at the hospital. He answered “a Birthing Center”. We opened the Birthing Center (the first in the state of Vermont) 35 years ago in 1977.

I’ve also been fortunate to be part of and help form organizations that were decades ahead of their time, in many ways laying the foundation for today’s medical home and Vermont Blueprint for Health models as well as utilizing computers for communication at the advent of the computer revolution. Additionally, Vermont has provided me with the opportunity to work on important legislation, such as child abuse laws, outlawing corporal punishment in schools, mandatory kindergarten, and the recent immunization law. These opportunities along with the privilege of making a difference in kids’ and families’ lives keep me going.

One of the things I find incredibly rewarding is living and working in the same town. I don’t mind if I run into someone downtown and they ask me a question. And I feel it’s so important that we recognize and talk to kids. One way I have been able to successfully converse and care for kids for so long is through humor. I try to infuse that in my appointments with children and often am treated – sometimes at unexpected moments – to humor in return.

One such humorous moment came from a 5-year-old. I try to end all my appointments by asking if patients have any questions for me. This 5-year-old’s question: “Why do frogs jump so high?” Should I ever write a book, I think this will be the title.

~ Lou DiNicola, M.D.
Gifford pediatrician

Dr. Lou DiNicola

Above left – Dr. DiNicola in 1979. Above right – Dr. DiNicola with Kim Daniels of Berlin and her adopted son Troy. Troy along with his siblings, Maggie, Ben, and Alex, were patients of Dr. DiNicola’s for years. Dr. DiNicola credits Kim, who had a special needs child and then adopted two more, with showing him the true meaning of love and parenting. Troy credits Dr. DiNicola with seeing him as a person.

Clocks and Pecan Pie – Dr. Milt Fowler

Dr. Milt FowlerA Randolph resident, Dr. Milt Fowler had been an internal medicine physician in the region for 36 years. Originally from Indianapolis, Dr. Fowler helped create the Rochester Health Center. He practiced there and in Randolph for 29 years. In 2005, he transitioned to practicing only at Gifford internal medicine in Randolph.

Married with two sons and two grandchildren, Dr. Fowler enjoys traveling and woodworking. It is his relationships with patients that have kept him serving the community where he lives and works for more than three decades.

Below is his story as told in his own words, as featured in our 2012 Annual Report.

“Nearing the end of my medical training and beginning the search for practice opportunities brought my attention to a medical journal ad placed by Phil Levesque, then CEO of Gifford. During the recruitment process, Phil and his wife Sandy’s hospitality and vision for Gifford were all the convincing I needed. That was more than 36 years ago, and we (my family along with the Jewetts and DiNicolas, who all came at the same time) are still here. None of us could have anticipated being here this long, or enjoying the richness of the Gifford family, or the beauty and talent of the people of central Vermont as much as we have.

Dr. Milt Fowler

At top – a 1979 portrait of Dr. Fowler. Bottom – Dr. Fowler with a young patient, also from 1979.

During those years, we have had the rare privilege of being part of the joy and sometimes tragedy of so many lives. All of our lives are connected in some way in this community, and the honor of caring for your neighbors and friends is difficult to fully articulate. It is a privilege. An office visit isn’t just caring for an illness in a stranger. In a small town, you are caring for someone whose family you know and about whose life history you are familiar.

Donald Dustin of Braintree is just one example. A furniture maker, he had donated a beautiful Shaker clock to a local church auction. The craftsmanship was notable and at the end of his next office appointment, I asked him if he would mentor me on woodworking. “Of course I would. When do we start?” was his reply. Then followed months of his tutoring, nudging, and pushing. It was during this time that he developed terminal cancer. We kept working together in his shop, and he often called asking, “Where the heck are you? We’ve got work to do.” We continued our clock project with Donald sitting in his wheelchair, barking orders, cigar smoke swirling around his head. The clock’s face was painted by Bill Olivet, another talented patient. “Our clock” is at my home in my study.

Unforgettable was also Rochester summer resident and professional violist 90-year-old Marguerite Schenkman who fell and sustained a large laceration to her scalp just before a concert at the Park House. At the Rochester clinic, she refused to be sutured before the concert. We wrapped her head in a gauze turban to control the bleeding, attended her concert, then repaired the wound after the Beethoven pieces were complete.

Or how could one forget 90-year-old Priscilla Carpenter walking to her appointment the afternoon of the famous Valentine’s Day snowstorm? She climbed over snow banks to get to her visit with a warm pecan pie in hand, which she slyly placed on my office desk.

It is experiences like these that make the daily stress of practicing so rich. It is what drew us and has kept us here. What a privilege.”

~ Milt Fowler, M.D.
Gifford Internal Medicine Physician

Dr. Mitt Fowler

Above left – Dr. Fowler works in his shop crafting clocks, a skill he learned from patient Donald Dustin. Above right – Patient Priscilla Carpenter greets Dr. Fowler with a pecan pie, which they then share, toasting with a glass of milk.

 

2011 Gifford Admissions and Visits by Top 20 Towns

The following is an excerpt from our 2011 Annual Report.

For those of you interested in statistics, here are Gifford’s admissions and visits from 2011. (We’re reporting only the top 20 towns.)

                                                          Inpatient              Outpatient                  Total
Randolph/Braintree                           562                       21,620                   22,182
Bethel                                                   150                         6,373                      6,523
Royalton                                               119                         5,296                     5,415
Northfield                                             138                         3,661                     3,799
Chelsea                                               111                         3,052                     3,163
Rochester                                              82                         2,461                     2,543
Barre                                                       73                         3,175                     3,248
Tunbridge                                              29                         2,354                      2,383
Brookfi eld                                             55                         2,256                      2,331
Berlin                                                      62                         1,505                      1,567
Sharon                                                   28                         1,495                      1,523
Williamstown                                        60                         1,312                      1,372
Stockbridge                                           23                         1,048                      1,071
Granville                                                25                             754                         779
Hancock                                                19                             657                         676
Pittsfield                                                12                             481                         493
Barnard                                                   6                             483                         489
Washington                                         15                              430                         445
Montpelier                                              9                              333                         342
Woodstock                                             4                             314                          318
Other Vermont towns                       207                          8,973                      9,180
Other states                                         21                          1,673                      1,694
Other countries                                     1                                  1                              2
Grand total                                     1,811                        69,707                   71,518

Gifford admissions

Physician Assistant Kate Clemente Joins Gifford Practices in Randolph, Rochester

physician assistant Kate Clemente

Physician assistant Kate Clemente joins Gifford practices in Randolph, Rochester

RANDOLPH – Kate Clemente didn’t have to look far to find her role model.

The Montpelier native’s mother has been a physician assistant for 35 years, dedicating herself to her profession and her community.

Now Clemente is doing the same. A certified physician assistant, Clemente has joined Gifford Medical Center’s family practice in Randolph and will be seeing patients at the Rochester Health Center in the coming months as well.

A graduate of Vassar College in Poughkeepsie, N.Y., Clemente went on to get her master’s degree in physician assistant studies at Franklin Pierce University in Rindge, N.H.

“I’m so grateful to have been given the opportunity to practice close to home at such a wonderful and supportive hospital,” says Clemente of joining Gifford, which she describes as one of the state’s beloved community hospitals.

The chance to practice in family medicine was also appealing.

“You become part of people’s daily lives. You become integrated with the community. It’s special. It’s from a different era of medicine,” says Clemente, who has a special interest in women’s health, encouraging healthy lifestyles, nutrition, wellness and obesity prevention.
Clemente has previously volunteered for the Central Vermont Battered Women’s Shelter, The People’s Health and Wellness Clinic and Two Rivers Farm.

A warm and empathetic caregiver, Clemente is certified by the National Commission on Certification of Physician Assistants.

She now lives in Middlesex in a straw bale home. She enjoys athletics and the outdoors in her spare time, including mountain biking in the summer as well as skiing and ice climbing in the winter.

Contact Clemente in Randolph at Gifford family practice at (802) 728-2445.

Pulling Together in the Face of Natural Disaster: Rochester

Gifford Medical Center

Rochester Office Manager Dawn Beriau crosses a first-generation
footbridge connecting Route 73 to Route 100. For weeks she and many others “on the island” had to carry supplies, like gas and groceries, over the bridge and then a sturdier second-generation bridge, along a winding path and through a muddy field to their cars.

The following is an excerpt from our 2011 Annual Report.

The storm knocked out the bridge connecting Route 73 to Route 100 in Rochester. Isolated on the other side of the bridge, away from the Rochester clinic, was Office Manager Dawn Beriau.

When she finally arrived at the Rochester clinic, she found Dr. Mark Jewett and Stu Standish installing Gifford’s generator.

“I can’t tell you what a feeling it was to have the townspeople erect a footbridge and make my way into town to find Stu and Dr. Jewett at the health center setting up the operation,” Dawn says, “and how safe it made the townspeople feel to know there was a doctor in town. I have talked to people who say they slept better knowing Dr. Jewett was here.”

“Rural Health is Vermont Strong”

[youtube http://www.youtube.com/watch?v=iFUKXFpddbc]

This video, starring our very own Dr. Jewett & Gail Proctor at the Rochester Health Center, describes how rural health care providers responded to Tropical Storm Irene in 2011. It was released last week during National Public Health Week, April 2-6, 2012.

With many bridges and roadways washed out after tropical storm Irene, it wasn’t just commuters, farmers, and tourists who were cut off. Health care providers as well as patients were cut off from clinics, hospitals, and pharmacies until roads were opened again.

In Rochester, Vermont, rural providers had to use two-way radios, cell phones, and 4-wheelers to get prescriptions filled and delivered to patients in need.

The State Office of Rural Health & Primary Care, a part of the Vermont Department of Health, works with and supports small rural hospitals, clinics and health care providers throughout Vermont to improve access to primary care, dental, and mental health care for all Vermonters, especially the uninsured, underserved and those living far from larger medical centers.