For a 14th consecutive year, Gifford Medical Center in Randolph has completed its fiscal year “in the black” and on budget.
Gifford Administrator Joseph Woodin made the announcement to staff on Friday following a detailed auditor’s review of the hospital’s 2013 fiscal year finances. The fiscal year ended Oct. 31.
Specifically, the medical center achieved both its state-approved budget and operating margin. An operating margin is the money the medical center makes above expenses – usually by 2 to 3 percent – to reinvest in programs, staff and facilities.
Achieving the operating margin can be an indicator of an organization’s success. “No margin, no mission” is a saying often used within non-profits. Gifford has made both its budget and margin each of the last 14 years – a major feat among Vermont hospitals. Continue reading →
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.
In between birth and death there is a dash. You know: the diminutive line on a tombstone or obituary indicating all those years of life between birth and death.
Linda Morse made “The Dash” famous in a poem by the name that challenges us to reflect on how we live our dash.
On Dec. 5, Gifford Medical Center picks up the discussion with “The Dash: Quality of Life Matters.”
The free discussion open to all is a continuation of last winter’s popular education series on death and dying and reopens a new series expected to last into the spring, explains organizer Cory Gould, a mental health practitioner and member of Gifford’s Advanced Illness Care Team.
The talk will include interviews with pre-selected participants on their quality of life. For example, Dr. Daniel Stadler, assistant professor of medicine and an internist with special interests in geriatrics and palliative care at Dartmouth-Hitchcock Medical Center, will interview a woman in her 90s about her life experiences.
Other discussion points during the 5-6:30 p.m. event will focus on:
What do we mean by “quality of life?”
How do you measure it?
Is your quality of life different than someone else’s quality of life?
Does quality of life change over time?
How does one’s quality of life relate to the quality of one’s death?
“There’s a truism that’s been repeated over and over again and that is that people die as they lived,” says Gould. “We want to involve participants in a discussion of the question: ‘What gives life meaning for you?’”
Following this free talk, other talks are planned on advance directives; what dying looks like; a “death café” or open discussion about death; and a discussion on death with dignity versus assisted suicide.
Speakers will explore the concepts but there will be ample opportunity for group discussion and sharing.
Last year, the popular series included sessions on starting the conversation of end of life and preparing for death, such as through Advance Directives; what is a “good” death; and various aspects of grief.
Prior attendance at discussions is not required and all are welcome.
No registration is required for this free educational discussion. Gould can be reached at (802) 728-7713 to answer questions.
The talk will be held in the Gifford Conference Center. The Conference Center is on the first floor of the hospital and marked with a green awning from the patient parking area. For handicapped access, take the elevator from the main lobby to the first floor. For directions to the medical center and more, visit www.giffordmed.org.
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 →
Gifford ranks first in Vermont for energy efficiency among hospitals
Gifford electricians Stu Standish and Frank Landry, part of the Randolph hospital’s facilities team, replace 250-watt metal halide parking lot lights with 78-watt LEDs. Gifford is the most energy efficient hospital in Vermont and is striving to do even better by becoming the first Vermont hospital to earn the “Energy Star” label. (Provided: Robin Palmer)
Already the most energy efficient hospital in the state, Gifford Medical Center is striving to become the first hospital in Vermont to earn a national “Energy Star” rating by the end of 2014.
The Energy Star label is a program by the U.S. Environmental Protection Agency that benchmarks energy use. For hospitals that means looking at energy use per square foot and then taking into account factors such as number of hospital beds, number of employees and climates. Hospitals are then ranked nationwide.
No Vermont hospital has achieved the 75th percentile ranking required for the Energy Star rating. Gifford is currently at 65 percent and as such, the most energy efficient hospital in Vermont.
The Randolph medical center would have to reduce its energy usage by 6 percent to reach the 75th percentile. Despite Gifford’s record of energy efficiency, Tim Perrin at Efficiency Vermont and Gifford’s Director of Facilities Tyson Moulton say further reduction is attainable.
In fact, energy efficiency projects are already under way.
Last month, electricians at Gifford changed out parking lot lights from 250-watt metal halide bulbs to more efficient 78-watt LEDs.
Other projects planned include replacing a large kitchen stove hood with one that runs on demand using heat sensors rather than running more constantly. In addition to electricity savings, the hood would remove less air that has already been heated or cooled. Heating and ventilation systems in parts of the building are also being rebalanced to run more efficiently.
The projects, noted Moulton, are part of an ongoing energy efficiency plan at the hospital and relatively small in scale because of work that has already taken place.
“We have a history of energy efficiency,” Moulton said.
Moulton gives a couple of examples. A project in the 1980s focused on recapturing some exhaust heat from the medical center’s inpatient unit to reclaim energy. The building’s pumping system has been simplified to replace many smaller pumps added over time with fewer larger pumps, and domestic hot water and chilled water for coolant systems have also been converted to demand-based systems.
Gifford Director of Facilities Tyson Moulton, right, poses with his predecessor, Theron Manning, on the rooftop of the Randolph medical center. In the background are heating, ventilation and air conditioning units. Over decades of work, Manning set the stage for Gifford to become the state’s most energy efficient hospital. Working with Efficiency Vermont, Moulton is carrying on the tradition as Gifford now strives to earn an “Energy Star” rating. (Provided: Robin Palmer)
Moulton credits former facilities head Theron Manning with the decades-long work that has led to Gifford’s top energy efficiency rating.
The ranking, however, does not include buildings outside of the main medical center, namely older homes that have been converted into office space surrounding the medical center and Gifford’s eight outlying community health centers.
The benchmarking of Vermont hospitals is by Efficiency Vermont, which has been reaching out to medical centers to reduce energy usage. Efficiency Vermont helped Gifford audit and identify lower cost ways to reduce energy consumption last year when the medical center and other large Vermont employers participated in a voluntary “Energy Leadership Challenge.”
Gifford is also part of the national Healthier Hospitals Initiative. Vermont is the first state in the nation to have all hospitals join the initiative, which includes energy reduction.
Efficiency Vermont, Vermont hospitals and the Vermont Association of Hospitals and Health Systems worked collaboratively on the Healthier Hospitals Initiative.
“We have been very impressed with the work that Gifford has done to manage energy usage and promote sustainability,” Richard Donnelly of Efficiency Vermont said in announcing that all Vermont hospitals had signed on to the initiative.
“Energy efficiency is always part of projects,” Moulton said. “When we replace fixtures and equipment, we look at what we can do to be energy efficient.”
That look toward energy efficiency is done both from a costs’ perspective to save the non-profit, patient-focused medical center money and to reduce its impact on the environment, particularly when it comes to non-renewable energy.
“Both electricity and oil are very expensive,” said Moulton. “Most of Vermont’s electricity, however, is from a hydroelectric, which is renewable. Oil is a limited resource.”
Dr. Mark Jewett has been an internal medicine physician at Gifford Medical Center for his entire 36-year career. Originally from Pennsylvania, Dr. Jewett came to Randolph in 1976, where he has lived since with his wife, Gifford pediatrician Dr. Elizabeth Jewett. Together they have three grown children and one grandchild. In his free time, Dr. Jewett maintains a healthy lifestyle – hiking, biking, running, skiing, and sailing.
Except for a nine-month sailing trip in 2005, Dr. Jewett has worked at the Rochester Health Center. From 1976-2005, he also saw patients in Randolph.
Outpatient medicine is a passion for Dr. Jewett because it provides him an opportunity to interact with and help others. Sometimes that help comes in a cure. Sometimes it is with coping. Sometimes it is just to be understanding.
Below is his story as told in his own words, as featured in our 2012 Annual Report.
“Mitt Fowler and I were in residency together in Massachusetts when Gifford advertised for an internal medicine physician in the underserved Rochester area. We had come to Vermont to ski and liked the rural lifestyle. In fact, my role model as a child was an uncle who was a doctor in a town of 5,000 people, much like Randolph. That is what I envisioned for my life. So we convinced then hospital administrator Phil Levesque that it wasn’t one internal medicine physician that he needed, but two.
Milt and I opened the Rochester Health Center in 1976 and soon Dr. Lou DiNicola joined us. We were all fresh out of our residencies. A federal grant helped support the launch of the health center – called the Green Valley Health Center at that time – and its first three years of operations. While we “worked” for Gifford, as was the standard at the time, Milt, Lou, and I and the health center were a private practice. It wasn’t until about two decades later that we became employees of the medical center.
Drs. Mark Jewett, Lou DiNicola, and Milt Fowler in the early years shortly after coming to the Randolph area. The three physicians have spent the entirety of their careers providing medical care to the rural communities in central Vermont.
Initially I spent two days a week in Rochester, working in Randolph as well. In addition to Milt and Lou, other providers, including physician assistant Sue Burgos and family medicine provider Dr. Mark Seymour, rotated through Rochester throughout the years. But except for the nine months I took off in 2005 for my other passion – sailing – my trip from home in Randolph, over the mountain to Rochester, has been a constant for 36 years.
The road has changed over that time. In the early years when the top was a narrow dirt lane, I left a few mufflers behind. Since then it has been modernized, as has medicine. Initially as rural doctors, we took care of everything. There were far fewer specialists for referrals, we didn’t yet have CT scans or MRIs, and a radiologist’s availability to read X-rays was much more sporadic.
While I know today we’re taking better care of people thanks to these advances, I miss being able to do it all. I believe in the primary care medicine model where doctors know everything about their patients and coordinate all aspects of their care.
What’s nice about being in a community for 36 years is you get to see people over time. You see how people grow up in a community. You see how people grow old in a community. You see how people sometimes die in a community.
As an internal medicine physician, I see only adults. But even without youngsters in the mix, I still take care of up to four generations of the same family over time. To lose a patient – especially after decades of care – is painful for me as a doctor. It’s painful because of the relationships formed. Those relationships are what allow me to help families because I too am feeling the loss.
In a couple more years I will retire. While I won’t be driving over the mountain four days a week as I do now, I won’t stop caring – for the people of the Rochester area who have entrusted me with their care for so many years or for people in need of health care. While this area will always be with me in spirit, it’s my goal, if I’m still able, to sail my sailboat to the Caribbean and work in another underserved area, such as Haiti, providing care to new generations in need.”
~ Mark Jewett, M.D.
Rochester Health Center Internal Medicine Physician
Above left: Madison Fuller and Kristi Fuller of Granville and Carol McLoughlin of Rochester “examine” Dr. Mark Jewett. Dr. Jewett has been providing care at the Rochester Health Center for 36 years and cares for generations of area residents, including this fun-loving grandmother, mother, and daughter trio. Dr. Jewett also cared for Carol’s late mother, Lilla Clancy. Carol shares that her mother used to bring Dr. Jewett cookies in the early days because she thought he was too skinny. Above right: Dr. Jewett in 1979 a few years after joining Gifford.
A Randolph Center resident, husband, and father, Dr. Christopher Soares joined the Gifford Medical Staff in 1993, spending his entire career to date in Randolph. Initially a Dartmouth-Hitchcock Medical Center provider, Dr. Soares opened his own practice, Soares Ocular Surgery, in 2007. In addition to caring for adults, he is also a pediatric ophthalmologist.
An avid cyclist, he has biked more than 40,000 miles, including from Canada to both the Grand Canyon and Mexico along the Pacific Coast Highway. Dr. Soares also enjoys kayaking, water skiing, boogie boarding, cross country and downhill skiing, ice skating, and more. He is originally from Massachusetts.
Below is his story as told in his own words, as featured in our 2012 Annual Report.
Raising a family of three children has tremendous rewards. After 20 years my last child is finishing college and preparing to enter an exciting new phase in her life. My two boys are finished with college and have started careers. All three have expressed their gratitude for the opportunities they were given while growing up. All three realize my wife and I love them unconditionally and we gave our all raising them the best way we knew how.
Working as an ophthalmologist in Randolph for nearly 20 years has similar rewards. In the early years, just like parenting, you are learning and developing your skills. People are glad that you are in town and they do not have to travel a great distance to get eye care. You develop a friendship with the patients. This friendship grows with the years. As the years go by, your skill sets expand and more patients come for care. All the while, friendships continue to grow. As a doctor’s experience and confidence grows, so do the positive outcomes. Challenging cares are taken on and the outcomes are even more rewarding.
At left – Dr. Soares, dressed in scrubs, is often seen riding his bicycle through Randolph. Right – an updated portrait of Dr. Soares.
That is certainly true in the case of Nathan Wheeler.
Nathan is a young man who last year tripped, fell, and hit his head on a piece of furniture, severely injuring his left eye. He had torn an essential eye muscle in half. Nathan had already been seen by two ophthalmologists and an oculoplastic specialist after an emergency room visit, and was finally referred to my practice three days after the injury. I explained to him and his family the seriousness of the injury and that several surgeries might be required. The first surgery was performed that very night in a Gifford operating room. It lasted four hours. I’ll spare you the details, but I was able to locate the muscle stumps and sew them back together.
A month later, Nathan was seeing well but required one more surgery to align his vision when looking down. This second surgery was also a success. Nathan’s vision was restored and he was able to return to work with no restrictions.
In Vermont fashion, I had done the job before me, to the best of my ability, but when I came home after that first surgery, I was distraught. In fact, I was nearly in tears. I had been in that OR for hours and I wasn’t sure if I had even helped Nathan. At the time, I didn’t know what I had accomplished.
Later, I researched more on the procedure and found that what I had accomplished was rarely, if ever, done by others. My case was so unique that I was asked to present it to a group of pediatric and adult strabismus specialists at the Massachusetts Eye and Ear Hospital. Of the 50 doctors in the room, none had ever attempted to find a ruptured muscle and suture it back to the remaining muscle.
Needless to say, Nathan was thrilled with the results and has sent patients to me ever since, some looking for “miracles”. I can’t perform miracles, but every week I am blessed to receive the gratitude of at least one patient. This appreciation for what I do energizes me and keeps me committed to offering the best eye care possible.
~ Christopher Soares, M.D.
Soares Ocular Surgery ophthalmologist
Dr. Soares examines patient Nathan Wheeler, whose injured eye he restored through a series of tough and rarely attempted surgeries. And a grateful Nathan has been referring patients to Dr. Soares ever since.
The following was published in our 2012 Annual Report.
Above left – Robin Palmer, Tammy Hooker and Ashley Lincoln – the team lucky enough to be charged with coordinating the Last Mile Ride each August, post for a photo. Above right – Jack Cowdrey, Chair of the Development Committee and one of the chase-truck drivers for the Last Mile Ride.
In this year’s Annual Report, we are fortunate to read stories from our long-time providers. Gifford is also fortunate to have many long-term supporters. Many of their names follow, but it is hard not to pull out one group for its remarkably long-standing relationship. That group is the Gifford Medical Center Auxiliary.
In 2012, the now 106-year-old Auxiliary continued its support of Gifford programs and services, including “wish list” items awarded to individual hospital departments looking to improve care through new technology or training materials.
As these “wish list” gifts are distributed, there are often tears of thanks and happiness from the receiving department staff members. This speaks volumes to how much these gifts – and the Gifford Auxiliary – mean to the medical center and its patients.
Other major supporters in 2012 included those who gave to the Last Mile Ride. Now in its seventh year, this charity motorcycle ride raised a record $54,000 for end-of-life care and services. This year’s event brought a new run/walk and thus many new participants. Top among them was Todd Winslow and Lu Beaudry who raised more than $5,000 in memory of Todd’s mother, Joyce (read more about the Winslow family in our Donor Profile). The event was our largest individual fund-raiser to date.
The motorcycle ride is just one way to support Gifford. Many offer their community medical center financial support each year through an annual gift to the hospital or a special purpose fund. Others include Gifford in their will or trust, while still others choose a charitable gift annuity where they receive a predictable return on their investment.
Increasingly, community members are also expressing tremendous interest in our planned senior living community. That interest and enthusiasm has come in the form of financial support as well as interested residents. This project shows so much promise, and it is our utmost honor to be working to provide a solution to a serious problem in our region – a lack of local housing alternatives for those wanting to age in place, in their communities, rather than having to travel great distances.
As always, the Development Department is available by calling 728-2380 to discuss the many ways to support Gifford. Your investment truly makes a difference and the impact is far-reaching. Please don’t hesitate to ask us your questions or visit our website, www.giffordmed.org, to discover ways you can leave your legacy. New this year, we have included an option for online giving opportunities.
On behalf of Gifford, thank you. We appreciate your friendship.