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What's New Welcome to our web! Here you will find links to our medical services, directories to save Info Center you time, and resources to heath information Medical on the Internet. Our medical center's mission Service is to improve the health of the people in our communities by providing and Home assuring access to affordable and high quality care. About Our Clinic Hours Medical Staff List Services Directory Community Gifford Randolph

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G I F F O R D M E D I C A L C E N T E R PO Box 2000 Randolph Vermont 05060 (802) 728-4441 FAX (802) 728-4245 www.giffordmed.org

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This page address: http://12.11.138.14/index.htm Last Edited: December 20, 1999

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Gifford News This year has been one of many Gifford significant accomplishments for Gifford News as we move forward preparing Phone List ourselves for health care in the next century. Directories

HealthStyles We finally received the "green As we plan for the renovations Calendar (pdf light" from the State which is that will be necessary to 150k) allowing us to plan for the move accommodate this major addition GMC of Gifford Elder Care from its to our current facility, we have On-Line current location to our main realized that we will be faced with campus. other structural changes to better Library serve our patients; such as Directory of This move will establish an relocating the Birthing Center to in-hospital, long-term care center VT Hospitals the in patient wing of the hospital that will offer all the services and moving all of the Same Day typically provided by a nursing Surgery Program to the third home. We are excited about this floor. With the State firmly as it will now give us a cohesive committed to supporting us as we community elder care program move forward with our strategic and will set the stage for new plan, we are now well on our way partnerships for the hospital the to providing a comprehensive community. continuum of care for every Gifford patient.

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G I F F O R D M E D I C A L C E N T E R PO Box 2000 Randolph Vermont 05060 (802) 728-4441 FAX (802) 728-4245 www.giffordmed.org

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Copyright © 1999 Gifford Medical Center All rights reserved. This page address: http://12.11.138.14/Infocenter/news.htm Last Edited: December 16, 1999 Phone List A quick list of our phone numbers (Area Code 802) Gifford News Phone List To search use Ctrl-F Directories GIFFORD MEDICAL CENTER Randolph, VT 05060 728-4441 HealthStyles Calendar (pdf GIFFORD FAMILY HEALTH CENTER 150k) Bethel, VT 05032 2349913 GMC CHELSEA FAMILY HEALTH CENTER On-Line Chelsea, VT 05038 685-4400 Library GIFFORD VALLEY HEALTH CENTER Directory of Rochester, VT 05767 767-3704 VT Hospitals SOUTH ROYALTON HEALTH CENTER South Royalton, VT 05068 763-7575

Patient Accounts 728-2336 Patient Relations 728-2433 Emergency Room 728-2206 For your health care questions and physician referral: HEALTH CONNECTIONS 728-2323

ANESTHESIOLOGY Dennis Henzig, M.D. 728-4441 Renee Francisco, C.R.N.A. 728-4441 CARDIOLOGY Douglas James, M.D. 728-2454 John Jayne, M.D. 728-2454 COMPLEMENTARY MEDICINE Acupuncture 728-2384 Massage Therapy 728-2360 FAMILY MEDICINE Kenneth Borie, D.O. 728-2445 Martha Bressett, P.A.-C. 728-2428 Terry Cantlin, D.O. 234-9913 Marcus Coxon, M.D. 728-2445 Jonna Goulding, M.D. 728-2445 Sally Lanpher, F.N.P. 234-9913 Maria Puglisi, F.N.P. 728-2445 Mark Seymour, D.O. 234-9913 Starr Strong, P.A.-C. 685-4400 George Terwilliger, M.D. 685-4400 GASTROENTEROLOGY Peter Moses 728-2430 INTERNAL MEDICINE Milton Fowler, M.D. 728-2428 Mark Jewett, M.D. 728-2428 David Pattison, M.D., M.P.H. 763-7575 Jerald Ward, M.D. 234-9913 Lucy Wollaeger, M.D. 728-2428 NEUROLOGY Daniel Sax, M.D. 728-4441 Thomas Ward, M.D. 728-2454 OBSTETRICS/GYNECOLOGY Brent Burgee, M.D. 728-2401 William Ellis, M.D. 728-2401 Anne Stohrer, M.D. 728-2401 OBSTETRICS/GYNECOLOGY NURSE-MIDWIFERY Ellen McAndrew, C.N.M. 763-7575 Anita Onofrio, C.N.M 728-2401 Annie Richardson, C.N.M. 763-7575 ONCOLOGY Marc Pipas, M.D. 728-2454 OPHTHALMOLOGY Jack Singer, M.D. 728-2460 Christopher Soares, M.D. 728-2460 OPTOMETRY James Begun, O.D. 728-2460 ORTHOPEDICS William Minsinger, M.D. 728-2455 OTOLARYNGOLOGY Benoit Gosselin, M.D. 728-2454 PATHOLOGY Michael Belding, M.D. 728-4441 Brian Travis, M.D. 728-4441 PEDIATRICS AND ADOLESCENT MEDICINE Louis DiNicola, M.D. 728-2420 Rebecca Foulk, M.D. 763-7575 Elizabeth Jewett, M.D. 728-2420 Frank Lamson, P.N.P. 763-7575 David Pattison, M.D., M.P.H. 763-7575 PODIATRY Kevin McNamara, D.P.M. 728-2490 PSYCHIATRY John Delaney, Ed.D. 728-5633 John Porter, M.D. 728-2312 Maryann Smith, M.A., R.N., C.S. 728-2330 RADIOLOGY Royal Bartum Jr., M.D. 728-2282 James Chandler, M.D. 728-2282 Robert Johnson, M.D. 728-2282 Robert Naylor, M.D. 728-2282 REHABILITATIVE SERVICES Audiology 728-2383 Occupational & Physical Therapy 728-2229 Speech Therapy 728-2382 SURGERY LeRoy Hodges, M.D. 728-2430 UROLOGY Carter Agee, M.D. 728-2430

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G I F F O R D M E D I C A L C E N T E R PO Box 2000 Randolph Vermont 05060 (802) 728-4441 FAX (802) 728-4245 www.giffordmed.org

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This page address: http://12.11.138.14/Infocenter/phonelist.htm Last Edited: December 20, 1999 Directories Find answers to your WHO? WHAT? WHERE? type questions. Gifford News

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Directory of How to Schedule an Appointment VT Hospitals To schedule appointments or reach the following providers please call: Gifford Primary Care, In Philip D. Levesque Medical Office Building, Maple St., Randolph VT (Directions to Gifford) Family Practice Internal Medicine (802) 728-2445 Pediatrics (802) 728-2428 Kennet Borie, DO (802) 728-2420 Mark Jewett, MD Marcus Coxon, MD Louis DiNicola, MD Milton Fowler, MD Jonna Goulding, MD Elizabeth Jewett, MD Lucy Wollaeger, MD Maria Puglisi, NP

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G I F F O R D M E D I C A L C E N T E R PO Box 2000 Randolph Vermont 05060 (802) 728-4441 FAX (802) 728-4245 www.giffordmed.org

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This page address: http://12.11.138.14/Infocenter/directory.htm Last Edited: December 20, 1999 Spring 1999 HEALTHSTYLE Programs in health and wellness at Gifford Medical Center

A Matter of Life n the communities served by the request of his wife, Iris. “I already “You matter because you are you. Gifford Medical Center, efforts to had a spiritual foundation but the You matter to the last moment of improve care for the terminally training exposed me to a new way of your life. We will do all we can, ill and the dying have never thinking that has helped me be more not only to help you die been more alive and well. accepting.” peacefully, but also to help you ISince 1980, the Randolph Area Ed is part of a core group of 20 live until you die.” Hospice, a group of specially trained Hospice volunteers in Gifford’s service Dr. Cicely Saunders, Founder volunteers, have helped patients and area who commit to an average St. Christopher’s Hospice families through the experience of assignment of four hours per week London, England dying, death, and grief. when they agree to work with a In 1990, Randolph’s local Hospice patient. He looks forward to the ince 1967, when Dr. Cicely chapter started working with the “hours here and there” that he takes Saunders founded St. Visiting Nurse Alliance to combine away from his business to provide SChristopher’s Hospice in community volunteer efforts with the respite care for family members of London, the “modern day” Hospice agency’s clinical services. Now, terminally ill patients. movement has spread throughout through the fully-integrated Hospice Ed comfortably recalled one of his the world. In 1971, the first US VNH, a network that serves patients patient’s end-of-life experience. “I was Hospice opened in New Haven, and families in 71 Vermont and New holding his hand and rubbing his Connecticut, paving the way for a Hampshire towns, Hospice patient shoulder when he died,” said Ed. “I greater willingness in this country to care in the Randoph area is delivered had been talking to him and, even consider the realities of dying and by an organized support team under though he could not respond, I felt death as inevitable, normal parts of the direction of the patient’s physician. that he chose that time to let go.” the life cycle. Vermont was the The Hospice teams include: nurs- “These are very special people who fourth state to offer Hospice services es, home health aides, physicians, can come into a stranger’s home with statewide through a network of non- social workers, hospital discharge such love and affection for everyone profit home health-care agencies. planners as well as other hospital there,” says Mickey Morehouse, who The roots of today’s Hospice phi- support staff and therapists, clergy, has been on the receiving end of the losophy, which is by no means a bereavement coordinators, volunteer Hospice experience. new idea, can be traced to the Latin coordinators, and volunteers. The Mickey’s husband of 51 years, word, hospes, meaning both guest Randolph Area Hospice committee Paul, was diagnosed with cancer in and host. We know that during the plays an important role in coordinat- June 1997. With the help of visiting Crusades, Christian monks and ing Hospice services. nurses, home health aides, and nuns maintained Hospices through- Hospice volunteers, Mickey was able out Europe as havens for sick and Hospice Volunteers to care for her husband in their Bethel dying travelers. Ed King, owner of the King & I Gift home during the final eight months of Hospitality has always been the Shop in downtown Randolph, has his life. heart of Hospice. In the words of worked with four Hospice patients “I could not have kept Paul home Henri Nouwen, spiritual writer and since completing the volunteer train- without their support,” recalls Mickey. author of Reaching Out, “Hospitality ing program in 1996. “They were so gentle with Paul and he is not to change people, but to offer “I think that I came away from loved each one of them.” them space where change can take that training as a different person,” Hospice has continued to play a place.” said Ed who attended the session at continued on page 2 HEALTHSTYLE

supporting role during this year of In June 1996, following a year of room for the family. bereavement for Mickey. Roberta planning by surviving family members Seed money for the renovation pro- Dean, one of the Hospice volunteers of Hospice patients and hospital per- ject was provided by the Philip D. who came to be with Paul, continues to sonnel, Gifford opened its Garden Levesque Memorial Fund at the request stop in for regular visits with Mickey, Room, a private suite in the Howell of the late hospital president’s family. calls frequently, and has left an open Pavilion medical-surgical unit for termi- Additional gifts were made by the invitation for Mickey to “pick up the nally ill patients and their families. Gifford Hospital Auxiliary and in mem- phone and call anytime you want.” The Garden Room was designed ory of long-time hospital auxiliarian, from the patient’s point of view as inter- Gwendolyn Webster, and Gifford volun- Gifford’s Garden Room preted by surviving family members of teer, Richard Monell. As good as Hospice is at addressing the terminally ill and nursing staff rep- Consideration for the patient’s needs the physical, social, emotional, and resentatives who were especially inter- went beyond the Garden Room walls, spiritual needs of a dying person, when ested in end-of-life patient care. through French doors and into a walk- terminal illness advances to its final There were no architectural draw- lined garden filled with a profusion of stages the goals of comfort and quality ings. Two adjacent hospital rooms were perennial plants and shrubs - the of life are sometimes better met in a torn down, rebuilt, and furnished to Healing Garden. hospital environment. achieve comfort and safety with mini- As a result of Gifford’s recent facili- The staff at Gifford recognizes that mal intervention. Adjacent to the ties expansion, the Garden Room has dying is much more than a medical patient’s private room and specially been relocated on Howell Pavilion. The event. equipped bath, is a combination kitch- adjacent garden, which has been enette, dining area and furnished living redesigned for a 66’x68’ hospital courtyard space, will be planted this spring. “The staff loves what we can do for The Time to Learn Costs patients in the Garden Room,” says About Hospice is Hospice counts on voluntary Jane Hayward, Vice President of Patient Before Illness Strikes donations and community support Care Services. Most people think of to make services available. Costs are “We have helped stage family Hospice only when they or reimbursed through Medicare, reunions and birthday parties there. someone close to them is dying. Medicaid, CHAMPUS, or private The patient’s children and grandchil- But learning about Hospice insurance programs, For most ser- dren, as well as their pets, wander in before you need Hospice services, there is little or no direct cost through the French doors at any time of vices can alleviate much of the to the patient or family. the day or night. Sometimes we provide stress related to dealing with a respite care stay to give the patient’s end-of-life issues and choices. Who to Call family a rest. Or, the nurses will help If you do face a life-threatening Young or old, preparing for the family members to gain the confidence illness, involving Hospice at the future or experiencing serious illness to provide direct care for their loved one time of diagnosis - even while today, interested in becoming a during the hospital stay.” you are continuing treatment Hospice Volunteer, do you want A multi-disciplinary team of medical with a hope for cure - can offer more information about Hospice pro- professionals, clergy, and family mem- you more options, control, and grams in your area? bers is assembled to create a care plan peace of mind. For general information, to for every patient admitted to the inquire about Hospice care and Garden Room. In the case of a bereavement services, and to learn Hospice patient, the two teams are inte- Eligibility and Referral when and where support groups are grated to provide continuity of care. The Garden Room is also supported Hospice care services in the home meeting, call 1-800-745-9108. by an active group of volunteers, espe- are available to anyone with a life- For information on becoming a cially trained by the hospital staff to threatening illness, and to family Hospice volunteer and/or volunteer provide a range of services - everything and friends. Services may be training schedules, call 1-800-575- from making arrangements for the requested by a patient, family mem- 5162. patient’s pet to offering grief support. ber, friend, visiting nurse, or physi- To talk to an active Hospice cian. A physician must make the Volunteer member of the Randolph formal referral and will direct care Area Hospice, call Agnes Pietryka in based on close communication with Randolph at 728-9237 or Roberta Hospice team members and with the Dean in Bethel at 234-9441. patient and family. All patients have a personal physician of their choice.

2 HEALTHSTYLE

I DON’T KNOW WHAT TO SAY: TALKING ABOUT ILLNESS AND DEATH Monday, April 12, 7:00 - 8:30 pm

GMC Conference Room East, Director of Hospice VNH and modera- Janine experienced a range of FREE, panel discussion. For indi- tor for this panel discussion. “How sad encounters and emotions during her viduals with cancer and other seri- that is, not only for the person dealing son’s illness and after her loss, which ous illnesses, a difficult side- with illness but for all who can- she is willing to share in the hope of effect is often the loss of not share their love and con- helping others. friends who can not deal with cern.” Dr. David Pattison is a mem- their condition. “Not know- Following a presentation by ber of Gifford’s medical staff, with an ing what to say” or “being the moderator, the panel and the office practice in adult internal medi- afraid of doing the wrong audience will consider comfort- cine and pediatrics at the South thing” prevents many of us able and effective ways to lend Royalton Health Center. Dr. Pattison HOSPICE VNH from being the support we support when faced with the diffi- has a special interest in hospice and want to be for family and friends as cult subjects of death and dying. is experienced in working with griev- they deal with illness and death. ing parents. We see a friend with cancer and About the Panel: Susan Cliff, an educator and cross the street to avoid greeting her. Marie Kirn, M.A. was a founder board member of the Randolph Area We tell the child whose grandfather in 1978 of Monadnock Hospice, Hospice, has found a way to inte- has died only that grandpa has Peterborough, NH, and Director of New grate her long-time interest in serious “gone away.” We allow ourselves to Hampshire Hospice Organization. She illnesses and end-of-life experiences think of treatment in terms of cure is currently Executive Director of with community service as a Hospice alone rather than comfort. And Hospice VNH, a program of the Visiting volunteer. when we are dying, or losing some- Nurse Alliance, which provides a broad Jody Harvey, M. Ed., a former one we love, we believe we should range of hospice services for residents school counselor, is Director of not talk about it, should not cry, of 71 towns in Vermont and New Healing Through Grief, a program should not burden others with our Hampshire, including the Randolph sponsored by Hospice VNH to help grief. area. adults communicate with children “While these are all understand- Janine Luttrell of Bethel lost her regarding the issues of loss, grief, and able human reactions, too often it is 18 year old son, Matthew, to cancer in death and to provide training in con- our own fears that keep us from July 1995, seven months after his diag- structive methods of helping children expressing our concerns or reaching nosis. As her son’s primary caretaker, deal with grief. out,” says Marie Kirn, Executive

LIVING WITH GRIEF: stresses associated with different types LIVING WITH OUR WHEN ILLNESS IS of diseases, dealing with grief after the MORTALITY PROLONGED death, and caring for the caregiver. Friday, April 30, 9:00 - 4:00 pm Tuesday, April 20, 7:00 - 8:30 pm The program will offer humane and practical suggestion for individuals who GMC Conference Room West, Cost: GMC Conference Room East, FREE. are now or who have in the past experi- $25.00 (scholarships available). This In the first hour of this program partici- enced grief, as well as for those assisting one-day workshop offers an opportunity pants will watch an edited version of grieving persons and for organizations for participants to explore their own the Hospice Foundation of America’s who may have those struggling with ill- experience, attitudes, and feelings 1997 National Bereavement ness and loss in their midst. The pro- about living with the awareness of ill- Teleconference on “Living With Grief: gram is intended for professionals and ness and death, and to consider options When Illness Is Prolonged.” With lay people. and choices available as persons face Cokie Roberts, ABC and NPR Following the taped presentation, the end of life. The topic is an impor- Correspondent, as moderator, a distin- Marie Kirn, Executive Director of tant one for everyone. Health care per- guished panel of health professionals Hospice VNH, will facilitate a 30 sonnel or volunteers, educators, emer- will discuss dealing with loss during minute discussion among those present. gency personnel, and clergy will find it prolonged illness, recognizing particular particularly useful in their professional as well as personal lives. (Living With Our Mortality is also the first experience

3 HEALTHSTYLE in training to be a Hospice volunteer.) how to start your own exercise program. find that these learned responses This is an experiential workshop that Examples of class topics include: emo- become habitual within three weeks.) invites participants to find new aware- tional eating, behavior modification, Liz will also lead participants ness and perspectives. Its overriding label reading, healthy snacks, dining through an in-depth conscious eating goal is to help participants achieve out and low fat exercise. Workshop participants are greater comfort in communication with cooking ideas asked to bring a problem food - that is, family and friends who are dealing with and recipes. a food they typically overeat or one that life-threatening illness, the final stage of Participants makes them feel out of control when life, or bereavement. are taught the they eat it. Facilitator: Marie Kirn, M.A., American Heart Association food plan Presenter: Liz Barron is a licensed Executive Director of Hospice VNH by qualified instructor, Sue Johansen, independent clinical social work with R.D. Personal calorie needs are over 25 years experience working with assessed and goals are set. Participants individuals, couples, and families. For GRIEVING THE “weigh-in” each week and report on the past 15 years, she has specialized in LOST DREAM experiences. Since exercise is an essen- the treatment of eating disorders, Thursday, May 6, 7:00 - 9:00 pm tial component of a healthy lifestyle, a including anorexia, bulimia, compulsive personal exercise program is developed eating, and chronic dieting. Liz divides GMC Conference Room West. and tips are given on how to succeed her time between private practices in FREE. Couples who have faced infertil- with exercise. Randolph, VT, and Gloucester, MA. ity and pregnancy loss suffer with feel- Instructor: Sue Johansen, R.D., CDE, ings of chronic sorrow, devastated graduated from the University of New expectations and damaged self-esteem. Hampshire and completed a dietetic JIN SHIN JYUTSU: Men and women often struggle with internship at the University of SELF-HELP these overwhelming events in isolation Wisconsin at Madison. She is a Tuesday, May 4, 7:00 - 8:30 pm from family and friends, and they may Registered Dietitian as well as a find it difficult to articulate why their Certified Diabetes Educator. Sue has GMC Conference Room East, Cost: lives feel so profoundly changed. This enjoyed over 30 years of working in $5.00. Jin Shin Jyutsu, an ancient art of presentation and discussion offered by health care as a clinical dietitian in hos- harmonizing the body’s life energy, sur- the founders of Family Solutions, a psy- pital settings and as a Nutrition vived as an oral tradition until the early chotherapy practice with offices in Educator with school food service staff 1900’s when it reemerged from relative Brattleboro and Lebanon, will outline and teachers. She also provides nutri- obscurity in Japan. It is practiced by and define infertility and pregnancy loss tion counseling and workshops for placing the fingertips (over clothing) on as life crises. Presenters will offer sug- groups in the Central Vermont area designated energy pathways in the gestions for how couples can take care through her consulting practice, Green body, to restore physical, mental, and of themselves during these crises so Mountain Nutrition Associates. spiritual balance. Jin Shin Jyutsu can that a resolution may seem more possi- be applied as self-help or by a trained ble and more manageable. practitioner. It complements conven- MAKING CONSCIOUS tional healing methods by reducing the EATING A REALITY tension and stress that accumulate in SELF... PERSONAL Wednesday, April 15, daily living. This workshop will empha- EALTH AND 7:00 - 8:30 pm size the self-help aspects of Jin Shi H Jyutsu through presentation and hands- DEVELOPMENT GMC Conference Room West, Cost: on participation. $5.00. We know that dieting does not Instructor: Stephanie Suter has stud- work. We also know that it is not ied Jin Shin Jyutsu since 1991. She SLIM FOR LIFE always easy to limit eating to when we began her private practice in Mondays, April 12 - June 21 are physically hungry and to stop eating Brownsville, Vermont in 1993 and (no class on May 31), when we are physically full. opened a second office at Pathways to 7:00 - 8:15 pm This workshop will focus on making Well-Being, Burlington, in 1997. self-loving choices that do work in Stephanie is also a practitioner on the GMC Conference Room East; Cost: developing a healthful relationship with staff of The Healing Arts Clinic at $75.00 for the ten-week course includes food. Eating disorder specialist, Liz Mount Ascutney Hospital in Windsor, an American Heart Association Barron, will teach deep breathing and Vermont. Cookbook. relaxation skills to help change negative Slim For Life is a ten-week weight and habitual eating patterns. (Research management course that teaches the shows that individuals who practice low fat lifestyle recommended by the these simple techniques every day will American Heart Association, as well as

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ANCIENT MOTHER ARTHRITIS/ TAI CHI CHUAN: Thursday, May 13, 7:00 - 9:00 pm FIBROMYALGIA BEGINNER & GMC Conference Room West, Cost: SELF-HELP COURSE INTERMEDIATE LEVELS $5.00. The Goddess and Sacred Mondays, May 3 - June 21 Saturdays, April 3 - May 22, Feminine, revered in all cultures at one (no classes on May 31 & June 7), 8:30 - 10:00 am time, are reawakening in the hearts and 4:00 - 6:30 pm minds of people throughout the world. GMC Conference Room East & West, Different aspects of the original Great GMC Cafeteria, Cost: $25.00, Cost: $40.00 per eight-week session Tai Goddess have survived in various cul- includes workbook. (If you have a Chi is a slow moving exercise for indi- tures and deities. workbook and would like to repeat the viduals who wish to practice a less This evening's workshop will cele- course, you may do so at no additional strenuous exercise program for overall brate the Ancient Mother through visual cost.) health. Beginners will learn deep images, poetry/prose, and music. Arthritis and fibromyalgia, like other breathing, slow relaxed movement, and Awakening to the Sacred Feminine chronic diseases, need to be managed. self-defense techniques. They will touches the mind, body, and spirit of all Your quality of life, and how you are develop basic skills through the study of men and women. affected by the disease, is very much up body movement and conditioning. Presenter: Mari Augustoni has a to you. The key to living a happy, pro- Intermediate students will build on their Ph.D. in clinical psychology and over ductive and more comfortable life is basic skills and complete the three parts 15 years of clinical practice experience learning how to gain this kind of control of Tai Chi Form including push hands with children, adolescents, individuals by using the management style that is and (Quigong) breathing practices. and couples. She specializes in right for you. This six-week course Instructor: Jim Shea, MA Education, women's mental health and has trained includes an overview of various types of has 21 years martial arts experience. and worked at Wellesley College and arthritis, discussion of medications used He trained at Wah Lum Temple in Tai Harvard University. Mari is presently in arthritis management, appropriate Chi Chuan for over 12 years and is a the Personal Counselor at Vermont use of exercise, joint protection strate- student of master Poi Chan. Technical College. She also has a pri- gies and relaxation techniques. vate practice in psychotherapy in For more information or to register, Randolph. call one of the co-facilitators, Ann SUN DO TAOIST YOGA Bowen at 728-3715 and Helen Chase at MEDITATION 728-5594, both of whom are trained Wednesdays, April 7 - May 26, SELF-ESTEEM Arthritis Workshop Facilitators. This 7:00 - 8:15 pm Tuesday, May 25, 7:00 - 8:30 pm workshop is co-sponsored by the Arthritis Foundation’s VT and Northern GMC Conference Rooms East & GMC Conference Room West, Cost NY Chapters. West, Cost: $40.00 for the eight week $5.00. Self-esteem, n. 1 the thinking session. Sun Do is an ancient body- well of oneself. 2 self-respect. Self- mind practice that combines stretching, esteem is available to anyone who is GROUP EXERCISES meditation, and focused breathing to willing to work at it. Participants in this promote deep relaxation and a centered workshop will be given a deeper under- way of being. The practice was perfect- standing of how their self-perceptions TAE-BO ed in Korea where it has been handed effects their actions. They will learn Wednesdays, April 1 - May 13 down over the last 5,000 years. It can ways to reclaim their personal power (no class on April 29), be practiced by anyone, at any fitness and to nourish themselves. Through 5:30 - 6:30 pm level. Participants will be encouraged the use of readings, discussions, and to progress towards health at their own exercises, Karen Hansen, workshop pre- GMC Conference Room West, Cost: pace, gently and slowly, following their senter, will help participants reach their $30.00 for the six week session. Tae- own body’s wisdom. “positive selves” and learn how to Bow, or “Cardio-Karate,” is a low impact Instructor, Jamie Trombly, has stud- increase their feelings of self-esteem. exercise that works all part of the body ied and practiced Sun Do for eight Presenter: Karen Hansen is a Ph.D. to tone muscles and reduce stress. It years. She is also certified as a person- candidate with masters in Psychology incorporates Karate punches and kicks al trainer, group exercise leader, senior and Business Administration. She pro- and includes basic self defense tech- exercise leader, aqua aerobics instructor vides traditional psychotherapy and niques. Beginners are welcome. and an Arthritis Foundation PACE therapeutic workshops for individuals Instructor: Nichole Ainsworth, an instructor. and groups in central Vermont. Athletic Trainer certified by the American Council on Exercise, is a second degree black belt in Tae Bo.

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YOGA FOR PREGNANCY 25 years. She brings to her classes a your condition. Topics covered will Thursdays, April 8 - June 10 blend of several traditions, including include: asthma triggers, medications (no classes on April 29 and Iyengar and Kripalu yoga, mindfulness, (how they work and how to use them), May 27), 5:30 -7:00 pm meditation and guided imagery. handling asthma episodes, relaxation techniques and exercises. Learn how GMC Conference Room East, Cost: CHUN CLASSIC you and your medical provider can $40.00 for the eight week session. Each Saturday, May 22 work in partnership. pre-natal class will begin with a medita- Presenter: Derek van Gulden, tion that focuses on breath and the Montague Golf Respiratory Therapy Manager, Gifford health of mother and baby, followed by Club, Randolph, Cost: Medical Center gentle warm-up stretches and yoga pos- $75.00 per player. tures to release tension and open ener- Now in its sixth year, CYBER - HEALTH: gy in the back, neck, shoulders, pelvis, the Chun Classic is firmly entrenched INTERNET HEALTH and legs. Classes will end with a deep as a Gifford tradition in the greater RESOURCES FOR relaxation. Participants should wear Randolph community. Gifford Medical CONSUMERS loose clothing and bring a blanket or Center established the benefit tourna- April 27, 6:30 - 8:30 pm towel. Previous yoga experience is not ment in memory of Dr. Kwang Ho Chun necessary. - avid golfer, beloved surgeon - who GMC Computer Room in the Instructor: Wendy Farber has prac- died from complica- Conference Center, FREE. “The World ticed yoga since 1972 and has taught tions of leukemia on Wide Web has become a medical-infor- yoga in central Vermont since 1991. July 24, 1992. mation candy store. Patients can learn She earned a B.S. in Human The Chun Classic is what their symptoms might mean, get Development from the University of an 18 hole scramble details on treatments for almost any ill- Vermont and received her yoga teacher tournament with a ness, read about clinical trials testing training from the Kripalu Center in shotgun start, for experimental medications - even find Lenox, Massachusetts. In addition to golfers at all levels of leads on the best specialists. But like her Healthstyle program at Gifford, experience. Due to its anything on the Internet, it can be diffi- Wendy currently teaches beginner, popularity, the Chun cult to sort the gems from the junk. intermediate, senior, and pre-natal Classic now features a Anyone can throw up a Web site and classes in Montpelier. morning and an afternoon flight. claim to have good information.” The Participation is limited to the first 264 Wall Street Journal, December 23, 1998 YOGA FROM THE entries. To receive an informational Not sure how to avoid the clutter INSIDE OUT brochure and entry form, call Gifford and access quality health-related Web Wednesdays, April 14 - June 9 (no Medical Center at 728-2304. sites? As with everything else on the Class on May 12), 5:15-6:30 pm Internet, the medical information highway can be a bewildering maze for con- GMC Conference Rooms East & FYI: HEALTH sumers. Spend an evening with health West, Cost: $40.00 per eight-week ses- EDUCATION resources educator, Robert Swartz, who sion This class combines basic yoga will lead you to reliable Web sites for postures and breathing techniques with good and basic information. other forms of exercise to create an inte- TEENS WITH ASTHMA: Presenter: Robert Swartz, Education grated body-mind-spirit approach to LIVING A NORMAL LIFE Resource Coordinator for The yoga. Starting with breath awareness, Northeastern Vermont Area Health Wednesdays, April 7, 14, 28 & participants learn to stretch safely and Education Center (AHEC). The educa- May 5 build strength where tion center was established in 1997, needed. Each ses- through an alliance with the University Randolph Union High School, FREE. sion ends with a of Vermont, as an independent, non- As a teenager with asthma, you proba- guided meditation. profit organization to serve the health bly wonder whether your condition will Instructor: Susan care needs of rural communities of affect your daily schedule - your ability Mills, MS northeastern Vermont. AHEC serves as to participate in gym class and sports, Counseling, MA a bridge between the University of to be involved in after-school activities Education, has Vermont and rural health care providers that you like, or to work part-time. been and their communities. teaching Perhaps you are interested in learning and prac- how to control your asthma so that a ticing yoga sudden episode can be prevented. and medita- This four-part series will provide you tion for over with information you need to manage

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AARP - 55 ALIVE intended for lay people who act as first Learn how to make your own non-toxic Wednesday, June 2 & Thursday, responders and whose job requires a cleaning products - furniture polish, June 3, 9:00 am - 1:00 pm written evaluation and a course com- sink cleaner, air freshener, and moth- pletion card. The objectives of away sachets for your dresser drawers. GMC Conference Rooms East & Heartsaver Plus are: West, Cost: $13.00, includes lunch. BEAUTY WITHIN: This nationally recog- • To provide information about heart HERBAL FACIALS nized program is disease, risk factors, signals and Wednesday, May 5, 6:30 - 8:30 pm designed to refresh dri- actions for survival, prudent heart ving habits, review living, and heart and lung function. GMC Cafeteria, Cost: $20.00 state regulations, and ($5.00/registration and $15.00/materials explore driving limita- • To instruct learners in one-rescue fee.) Rejuvenate yourself with an herbal tions that result with CPR, management of foreign-body facial that will leave you feeling relaxed aging. Developed by AARP in 1979, 55 airway obstruction, and the use of and refreshed. Learn how to make your Alive was the first and is now the barrier devices for ventilation. own facial products and then indulge largest, comprehensive classroom yourself with a one-hour facial. refresher course available in the country Participants must demonstrate skills Decadent desserts provided. to motorists age 50 and older. and pass a written test with a minimum (Participants are Participants will receive a copy of 84% score to earn their completion asked to bring a Vermont’s driving manual, an AARP-55 card. towel, a face- Alive workbook, and a certificate upon The course will be taught by quali- sized bowl, and completion. No test required. fied instructors from Gifford’s CPR something to tie Instructor: Robert Ammel, AARP Training Center. their hair back.) volunteer and trained 55 Alive instruc- Register early; tor, White River Junction. PEDIATRIC CPR this popular pro- Tuesdays, June 22 & 29, gram is limited to BABY-SITTING BASICS 6:00 - 8:00 pm 12 participants. Saturday, June 5, Instructor: Julie Manchester, 10:00 am - 4:00 pm GMC Conference Rooms East & Woodsong Herbal, Randolph West, Cost: $15.00. The Pediatric Basic GMC Conference Rooms East & Life Support Plus Course is intended for THE UPPER CRUST West, Cost: $5.00 (scholarships avail- lay people whose job requires a written Tuesday, May 18, 6:30 - 8:30 pm able). For boys and girls ages 11 and evaluation and course completion card. up. Learn about planning for a baby- It is also available to young adults over GMC Conference Room West, Cost: sitting job, knowing what to expect of 12 years of age who have signed $20.00, includes tastings and recipe children, selecting toys and games, parental permission to take the course. hand-outs. Have you had difficulty supervising children, preventing acci- Successful completion of the course making a pie crust, ending up with a dents, giving basic First Aid, caring for requires a satisfactory score on the writ- patchwork crust or a crumbly mess? infants and children, and solving prob- ten evaluation, as well as demonstra- Have you been frustrated enough in lems. (Participants should bring a bag tion of the skills in CPR and relief of your attempts to work with phyllo lunch; beverages foreign body airway obstruction. dough to pass up new recipes that call provided.) The course will be taught by quali- for it? Here is an opportunity to build Instructor: fied instructors from Gifford’s CPR your baking confidence with Ginny Melissa Carpenter, Training Center. Callan, founder of the Horn of the R.N. is a maternal- Moon Cafe in Montpelier and author of child health nurse SPRING CLEANING - popular vegetarian cookbooks, “Horn of with the Visiting WITHOUT PETRO- the Moon Cookbook,” and “Beyond the Nurse Association CHEMICALS Moon Cookbook.” at Ayers Brook Tuesday, April 6, 6:30 - 8:00 pm In this workshop, Ginny will lead Center. participants through the preparation of GMC Conference Rooms West, Cost: basic pie crust, Greek Walnut Pie made ADULT CPR: $20.00 ($5.00/registration and with phyllo dough, Sweet Potato Strudel HEARTSAVER PLUS $15.00/materials fee.) Be kind to your- using puff pastry dough, and Mushroom Tuesdays, June 8 & 15, self; be kind to the planet. Prepare for Leek Turnovers with blue cheese. 6:00 - 8:00 pm the end-to-winter chore of spring clean- Participants are encouraged to eat ing in the most earth-friendly way with lightly before class. Registration is lim- GMC Conference Rooms East & Julie Manchester, Randolph herbalist ited to the first 25 to allow for individ- West, Cost: $15.00. This course is and owner of Woodsong Herbals. ual hands-on experience.

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with information regarding the natural GIFFORD BIRTHING MATERNAL AND process of labor and delivery, including CENTER CHILD HEALTH the emotional and physical changes that may take place. You will learn and Need a practitioner referral? Need practice exercises, relaxation, and nat- advice about breast feeding? Need CHILDBIRTH ural breathing to effectively work with reassurance about your newborn during PREPARATION SERIES your body during the lonely hours of the night? Gifford labor and deliv- Birthing Center’s toll-free line, 1-800-3- ery. Through BABY-33 or 728-2257 for local calls, is Tuesdays, May 4 - June 1, the use of a staffed by the center’s specially trained 7:00-9:00 pm work book, obstetrical nurses and available to Wednesdays, July 7- August 4, labor callers anywhere in Vermont, 24 hours 7:00 - 9:00 pm rehearsals, every day. videos, GMC Conference Rooms East or and group BREAST PUMP West, Cost: $60.00 per five-week ses- discus- RENTAL PROGRAM sion. This course provides instruction sion, you and opportunities for discussion regard- will be well- ing labor and birth, including video pre- Gifford Birthing Center is a rental equipped to depot for Medela Lactina electric breast sentations, breathing exercise, Cesarean participate in birth preparation, guided imagery, care pumps and breast feeding products. your birthing deci- Breast pumps are particularly helpful and feeding of newborns, and transition sions. For pre-registration, contact to parenthood. For information and for mothers returning to work who want Kimberly Goodling, AAHCCM to continue breast feeding. They are pre-registration, contact Childbirth Provisional Bradley Natural Childbirth Educators: Corky Burton, R.N., at 728- often used to maintain the established Educator, at 276-3207. For further milk supply of mothers who encounter 9829 or Faythe Hawley, P.T. at 728- information from the National 9671. breast feeding difficulties. Headquarters, call 1-800-4-A-BIRTH, For more information, to check www.bradleybirth.com. pump availability or to schedule a con- Instructor: Kim Goodling, AAHCC, sultation appointment, call 1-800-3- has undergone an intensive training BABY-33 or 728-2257 for local calls. program developed by the American Academy of Husband-Coached Childbirth to become a certified instructor of natural childbirth utilizing the DAFFODIL DAYS Bradley Method. She also has a March 22-26 Masters Degree in Education. Kim is currently home-schooling her three chil- Sponsored by BlueFirst, the dren, who were born at Gifford Birthing managed care program of Center with the assistance of the Vermont BlueCross/BlueShield, Bradley Method of natural childbirth. and the American Cancer Society New England Division. THE BRADLEY METHOD Volunteers will reach out to the OF NATURAL CHILDBIRTH YOGA FOR PREGNANCY communities in the White River Valley with a message of caring Tuesdays, April 6 & 13, and Thursdays, April 8 - June 10 and support, delivering daffodils Mondays, April 19 - June 7, (no classes on April 29 and to home-bound residents in the 7:00 - 9:00 pm May 27), 5:30 -7:00 pm Randolph area on March 22. To order a bouquet of daffodils GMC Conference Room East, Cost: GMC Conference Room East, Cost: for someone you love and to learn $120.00 per ten-week session (fee $40.00 for the eight week session. (See more about Gifford’s community includes workbook). The Bradley GROUP EXERCISES, page 5 for the outreach programs for women and Method encourages couples to strive for description.) families, call 728-2472. natural, unmedicated births, while emphasizing excellent nutrition and active participation of the partner as labor coach. You will enter labor armed

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GIFFORD MEDICAL SPECIAL LUNCHEONS MOTHERS, CENTER AUXILIARY FOR HIGH SCHOOL DAUGHTERS, SPRING LUNCHEON STUDENTS AND ISTERS (followed by an open house and tour of May 1 - 31 S The Howard and Gladys Menig Extended Care Unit; 2:30 -3:30 pm) Hosted by Ladies First and Gifford, MOTHERS, DAUGHTERS, special luncheons will be held at area AND SISTERS Tuesday, May 18, 12:30 pm high schools for students to learn and talk about growing up female today. Too many women die each year from In celebration of Mother’s Day and Students will be encouraged to bring cancer. spring, Gifford’s Auxiliary will hold its their mothers, grandmothers, aunts or There are no guarantees... annual spring luncheon at Gifford special friends. We can not change the winds, but we Medical Center. All women in the com- If your school is interested in hosting can adjust our sails munity who are interested in learning a luncheon, please call Gifford’s With early detection and regular more about the Auxiliary and its pro- Community Outreach Office at 728- screenings. grams are invited to attend. Eileen 2472. Murphy, Family Nurse Practitioner from SELF DEFENSE AND Gifford’s Bethel and Rochester Clinics, will speak on women’s health issues. PERSONAL SAFETY SUPPORT GROUPS FOR WOMEN Reservations are requested; there is no charge for the luncheon. Please call 728-2472. Tuesday, May 4, 6:00-8:00 p.m.

Rotta’s Black Belt Academy, 53 OPEN HOUSE & TOUR South Main Street, Randolph. Bring The Howard and Gladys Menig along a friend and learn more about the Extended Care Unit, importance of self defense and personal Tuesday, May 18, 2:30-3:30 safety for women. Registration fees (donations accepted) from this special On December 29th, the residents class will go to Gifford’s Woman to from Gifford Elder Care on Randolph Woman Fund which supports Gifford’s The following list represents a sampling, Avenue moved into their spacious new breast cancer awareness and prevention but not all, of the support groups offered home on the Gifford Medical Center programs. in the communities served by Gifford. campus. The Menig Extended Care To register for this class, call 728- Unit is named for Howard and Gladys 2323. Menig of Braintree, whose generosity ALZHEIMER’S SUPPORT contributed substantially to the success GROUP WOMEN’S HEALTH CLINIC of this project. Following the auxiliary Second and fourth Wednesday of luncheon, uided tours of the facility will every month, 3:00 pm Saturday, May 15, be offered; the new Clifford Courtyard 8:00 a.m.-2:00 p.m. Garden will be on view. Home of John and Edie Palmer, 26 Women’s Health Center of Elm Street, Randolph. Co-facilitated by Randolph; Dr. William Ellis and Dr. Polly Frankenburg and John Palmer; Dr. RANDOLPH GARDEN Ken Borie is medical liaison. Caregivers Anne Stohrer, 41 S. Main Street. CLUB ANNUAL PLANT Schedule an appointment for yourself of Alzheimer patients are encouraged to and a friend for an annual breast exam, SALE attend. For more information or assis- Pap test, and mammogram. No physi- Saturday, May 22, tance, call John Palmer at 728-3614. cian referral is necessary. Appointments 9:00 am - 1:00 pm are limited. Screenings will be free of charge for those with no insurance. At the home of Phyllis Hawley, Peth Insurance will be billed, when appropri- Road, Randolph. Gifford volunteers ate. will be on hand with information about Call 728-2323 to schedule your free programs that will pay for breast appointment. and cervical cancer screenings. A free plant will be given to each woman who enrolls in Ladies First or Gifford’s Woman to Woman program.

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ARTHRITIS SUPPORT DIABETES SUPPORT PARENT SUPPORT GROUP GROUP GROUPS First Thursday of every month, Fourth Tuesday of every month, 4:00-6:00 pm 3:30 - 4:30 pm Teens/Young Parents Group: Meets twice each month, 3:00 - GMC Cafeteria. A peer-directed sup- GMC Conference Room West. A 5:00 pm, Ayers Brook Center, Lash port group co-facilitated by Ann Bowen peer-directed support group that Road, Randolph. For information, (728-3715) and Helen Chase (728- includes discussion and guest speakers. call Nancy Chase at 728-6155. 5594). Facilitator: Janet Young, RN, CDE, Diabetic Educator. (728-2210). Parents For Parents Group: Meets the first and third Fridays of the CHILDREN’S PLAY month, 6:30 - 8:00 pm, Ayers Brook GROUPS Center. For information, call Amy DO YOU KNOW Bingham at 728-2097. These play groups are sponsored by ABOUT DIABETES? the Ayers Brook Center in Randolph. New Parents Group: Beginning January 7, will meet for six With the exception of one group, they • An estimated 28,000 weeks on Thursdays, 10:00 am - are open to children, birth to five years Vermonters suffer from dia- 12:00 pm, Ayers Brook Center. old, and their parent or caregiver. The betes, though about one-third To register or for more information, 9:00 - 11:00 am group that meets on of those have not yet been call Nancy Clark at 728-6155. Mondays at the Ayers Brook Center in diagnosed. Randolph is open to children, birth to Parents of Twins: Interested in three years old. For more information • Diabetes is the seventh leading forming a support group? Call call Amanda Duncan at 728-6155. cause of death in Vermont. Nancy Clark at 728-6155. The rate of diabetes-related Bethel deaths in the state, for the peri- Tuesdays, 9:00 - 11:00 am, od 1992-1996, was 44 deaths White River Credit Union Building per 100,000 people. GIFFORD CLINICS Randolph • Diabetes is the major cause of Mondays, 9:00 - 11:00 am, lower limb amputation, blind- ANTICOAGULATION Ayers Brook Center, Lash Road, ness, and kidney disease. It is OUTPATIENT CLINIC Randolph also a major contributor to high Tuesdays & Thursdays, blood pressure, heart disease, 8;30 am - 2:30 pm Fridays, 9:00 - 11:00 am, stroke, and infection. Ayers Brook Center This clinic is for physician-referred • Diabetes results in about $37 patients who are being treated with Rochester million in hospital charges per coumadin (blood thinner) following Thursdays, 9:00 - 11:00 am, year in Vermont. total joint replacement surgery as well Early Education Building, as for conditions such as atrial fibrilla- Peavine Drive tion, pulmonary embolism, and deep vein thrombosis. Debbie Gorton, RN, South Royalton WOMAN TO WOMAN : will help patients manage their antico- Wednesdays, 9:00 - 11:00 am, A CANCER SUPPORT agulation treatment by providing con- United Church on the Green GROUP sultation and education, monitoring of Wednesdays, 6:00 pm blood levels, and coordination with Tunbridge their primary care physicians. For infor- Mondays, 9:00 - 11:00 am, Gifford Medical Center. Women mation, or to make an appointment, Tunbridge Elementary School coping with any kind of cancer are call Debbie at 728-2207. encouraged to join this group which offers support and education. The DIABETES group meets weekly at the hospital with OUT-PATIENT CLINIC a facilitator and occasional guest speak- Tuesdays, 8:00 am - 4:00 pm ers, followed by the regular support group meeting. For more information, At Gifford Medical Center the man- call 728-2472. agement of diabetes is a team effort that includes the patient, family members,

10 HEALTHSTYLE the patient’s health care provider, a clin- ers travel to the job site to test for WOMAN TO WOMAN ical nurse specialist, the hospital dietit- weight, smoking habits, blood pressure, ian and other health care professionals cholesterol, and blood sugar levels. To Through a special fund supported by with special training and skills. schedule a Healthbreak for your the Gifford Medical Center Auxiliary Under the direction of Janet Young, employees, call 728-2472. and the Susan G. Komen Breast Cancer R.N., CDE, the out-patient clinic pro- Foundation, Gifford will pay for the vides diabetes education, blood glucose annual screenings of women who are monitoring, nutrition and exercise coun- HEALTHBREAKS not eligible for “Ladies First,” but who seling, medication and prevention SCREENING FOR do fall within specific guidelines of the advice, as well as assistance with spe- SELF- EMPLOYED HAIR Woman to Woman program. For more cial patient needs. STYLISTS AND BARBERS information, call 728-2472. For information, or to make an appointment, call 728-2210, Monday- Monday, May 10, Friday, 7:00 am - 3:30 pm. 9:00 a.m.-12:00 p.m. PATIENT NAVIGATOR PROGRAM Gifford’s Community Outreach ONCOLOGY CLINIC Office, 9 Maple Street, Randolph. In partnership with the American Mondays - Fridays, HealthBreaks is a federally-funded Cancer Society, NW Region of New 9:00 am - 4:00 pm program which offers free preven- England, Gifford Medical Center has tive health screenings for business- established a new volunteer program to The out-patient clinic, located in the es that do not offer health insur- provide one-on-one assistance for Howell Pavilion of Gifford Memorial ance. Screenings will be done for women undergoing cancer screening Hospital, provides services locally for weight, cholesterol, diabetes, and and treatment. The purpose of the pro- cancer patients who often require fre- blood pressure. gram is to diminish and/or eliminate the quent and on-going treatment. The Call 728-2472 to schedule an financial, medical, social, communica- clinic is staffed by specially trained appointment or to request more tion, and transportation barriers that oncology nurses, who see and treat information regarding a Health- may exist for women accessing the patients by appointment. Arrangements Breaks team visit at your business. health care system. To learn more can also be made for oncology care that about becoming a Navigator volunteer, is needed on the weekend. For infor- call 728-2472. mation and/or an appointment, call RANDOLPH AREA 728-2322. VOLUNTEER EXCHANGE (RAVE) COMMUNITY HEALTH RESOURCE CENTER GIFFORD CAN HELP RAVE matches members of the greater Randolph community who are Gifford has received a grant from the interested in volunteering their time Northeastern Vermont Area Health Education Center to develop a commu- HEALTH CONNECTIONS with non-profit organizations that have requested volunteer assistance. For nity health resource center. The center, more information, call 728-2472. which will run in conjunction with Health Connections and Gifford’s Gifford’s other outreach programs, will Community Outreach Office provide the be located in the Community Outreach link to a wide range of health care ser- “LADIES FIRST: EVERY Department adjacent to the main hospi- vices at Gifford and in the community. WOMAN MATTERS” tal building. These include Vermont’s Health Access Staff will be available to help Plan (VHAP) and Gifford’s Affordable Ladies First is a free service to pre- patients and community members Care. For more information, please call access information from Gifford’s updat- 728-2323. vent breast and cervical cancer. It is available to Vermont women, ages 40+, ed web site, www.giffordmed.org with limited incomes. If you are eligi- and to check out books, videotapes and other health-related information HEALTHBREAKS ble, Ladies First will pay for annual Pap tests, clinical breast exams, and mam- from the new library. A steering com- mograms. For more information call mittee of community consumers, practi- Healthbreaks is a federally-funded 728-2370. tioners, and hospital representatives will program which offers free on-site pre- help guide the development of the ventive health screenings for employees Resource Center. of businesses that do not offer health For more information, call 728-2336. insurance. A team of health care work-

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Registration Form Advance registration and prepayment are required for all programs. Photocopies are welcome.

Name Address Telephone (day) (evening) Please register me for the following class(es):

Total Amount Payment method: ❏ MasterCard ❏ Visa ❏ Check Enclosed, payable to Gifford Medical Center Card # Expiration Date Signature

Mail to: Healthstyle, PO Box 2000, Randolph, VT 05060 • Fax to: Healthstyle, (802) 728-4245

OW O EGISTER us, you are confirmed in the program(s) of H T R Refunds and Cancellations your choice. We look forward to seeing you. If you must cancel, please do so at least By Mail seven days before the class or workshop to For Inquiries The Healthstyle staff and presenters want receive a credit toward future Healthstyle For further information, call Renée to meet your expectations. programs or a full refund. Pedersen at the Healthstyle Information Your advance registration for classes Line, 728-2250. Gifford’s Healthstyle Office helps make that possible. Confirmation is staffed Monday – Friday, from 7:30 am – Please return the completed registration We do not send individual confirmation 4:00 pm. When calling at other times, form at least one week in advance. Mail to: notices for Healthstyle classes, workshops, please leave a message and your call will be Healthstyle, PO Box 2000, Randolph, VT and support groups. Unless you hear from returned as soon as possible. 05060. If you are unable to meet this request, please call the Healthstyle Information Line at 728-2250, to make other arrangements. Non-Profit Organization By Fax U.S. Postage Fax Visa or MasterCard information on PAID the completed registration form to (802) Gifford Medical Center Permit #2 728-4245. P.O. Box 2000 East Barre, VT Payment Randolph, VT 05060 Payment in full for classes and workshops that require a fee must accompany your registration. We accept credit cards (Visa & MasterCard) and personal checks. Please make checks payable to Gifford Medical Center.

Scholarships Gifford Medical Center is committed to helping all members of the community attend Healthstyle classes and workshops. Scholarships are available; call Healthstyle Information, 728-2250.

12 GMC On-line Document Library You Need Acrobat to View These You can download the free document viewer software that allows you to view, Gifford Documents . . . navigate, and search the documents on this News page. Phone List Directories HealthStyles Community Business Grants Planning Calendar (pdf 150k) GMC Community Related Business Related On-Line Library Healthstyles Financial Reports Directory of Gifford Annual Report 1997 VT Hospitals ar1997.pdf (517k)

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This page address: http://12.11.138.14/Infocenter/docindex.htm Last Edited: December 16, 1999 Directory of Vermont Hospitals # OF LICENSED # OF LICENSED Gifford HOSPITAL BEDS HOSPITAL BEDS News 61 Brattleboro Memorial Hospital 80 North Country Hospital Phone List Brian Mitteer, President Sidney Toll, President Directories 9 Belmont Avenue Prouty Drive HealthStyles Brattleboro, VT 05301 Newport, VT 05855 Calendar (pdf (802) 257-0341 (802) 334-7331 150k) GMC On-Line 149 Brattleboro Retreat 100 Northeastern VT Regional Hospital Library Richard Palmisano, CEO Paul Bengtson, Administrator Directory of 75 Linden St., PO Box 803 P.O. Box 905 VT Hospitals Brattleboro, VT 05301 St. Johnsbury, VT 05819 (802) 257-7785 (802) 748-8141 http://www.bratretreat.org

122 Central Vermont Medical Center 70 Northwestern Medical Center Philo Hall, President Peter Hofstetter, CEO P.O. Box 547 P.O. Box 1370 Barre, VT 05641 St. Albans, VT 05478 (802) 229-9121 (802) 524-5911

http://www.together.com/~jmsnmc/nmchome.htm

53 Copley Hospital 45 Porter Medical Center Carolyn Roberts, President James Daily, President RD 3, Box 760, Washington Highway South Street Morrisville, VT 05661 Middlebury, VT 05753 (802) 888-4231 (802) 388-4701

615 Fletcher Allen Health Care 188 Rutland Regional Medical Ctr. John Frymoyer, M.D., CEO Tom Heubner, President 111 Colchester Avenue 160 Allen Street Burlington, VT 05401 Rutland, VT 05701 (802) 656-2345 (802) 775-7111) http://www.fahc.org

53 Gifford Medical Center 140 Southwestern VT Med. Center David Gregg, President Harvey Yorke, President P.O. Box 2000 100 Hosp. Drive East Randolph, VT 05060 Bennington, VT 05201 (802) 728-4441 (802) 442-6361

19 Grace Cottage Hospital 69 Springfield Hospital Albert LaRochelle, Admiminstrator Glenn Cordner, CEO Route 35, P.O. Box 216 25 Ridgewood Rd., PO Box 2003 Townshend, VT 05353-0216 Springfield, VT 05156 (802) 365-7357 (802) 885-2151

33 Mt. Ascutney Hospital & Health Ctr. 175 Vermont State Hospital Richard Slusky, Administrator Bertold Francke, MD, Admin. County Road, RR 1, Box 6 103 S. Main Street Windsor, VT 05089 Waterbury, VT 05676 (802) 674-6711 (802) 241-1000 http://www.hitchcock.org/pages/tha/mahhc.html

*120 Veterans Administration Center * Beds Not Licensed by State Gary De Gasta, Director N. Hartland Road White River Jct., VT 05001 (802) 295-9363

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This page address: http://12.11.138.14/Infocenter/vthospitals.htm Last Edited: December 16, 1999 Gifford Medical Center ... is the focus of central Vermont's community-based health system and a member of a Regional Network of Health Care Providers.

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Information Center We offer many services and we invite you learn more about what we offer... Gifford News Phone List Directories HealthStyles Calendar (pdf The partnership that exists between a rural hospital and its medical staff is 150k) key to meeting the expectations and needs of the community. At Gifford, GMC that partnership has been forged with a medical staff of 65 primary care On-Line providers and specialists to create a rural health care system that works! Library Medical Clinic Hours Medical Clinic Services Directory of Medical Service Descriptions Gifford Medical Services Staff VT Hospitals Phone Listing for Clinics Directions to Gifford

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This page address: http://12.11.138.14/Infocenter/index.htm Last Edited: December 20, 1999 Gifford Medical Center Web Site

● Gifford Medical Center News ❍ GMC Document Library ❍ Directory of Vermont Hospitals ● Gifford Information Center ❍ Gifford Medical Clinic Services ❍ Gifford Medical Center: driving directions ● Gifford Medical Services ● Gifford Medical Service Descriptions ● Directory: Who, What, & Where ● Gifford and the Community ❍ Community Resources on the Internet ❍ Healthstyles Calendar ● The Hitchcock Alliance ● Our Community ● Education and Resources ❍ Consumer Health ❍ Biomedical & Clinical Sites ❍ Using Internet Search Engines ❍ Free MEDLINE and more. ❍ Knowledge-based information ● Education and Resources ❍ Internet basics and tutorials ❍ Evidence-Based Medicine & Clinical Practice Guidelines ❍ Health Administration Resources On the Internet ❍ Medical/Health Related News Sites ❍ Nursing Resources on the Internet ❍ Electronic Medical Journals on the Internet ❍ Anatomy of the Lung ❍ Material Safety Data Sheets ❍ Health Agencies, Professional Health Societies, Non-Profit Consumer Health Organizations ● GMC Medical Clinic Hours ● Gifford Medical Services Staff ● Gifford Information Center Phone Listings

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Gifford News Phone List Directories HealthStyles Calendar (pdf 150k) GMC On-Line Our web site is divided into four sections Library Education Community Medical Services Info Center Resources Directory of about our hospital about our services directories links for patients VT Hospitals and providers

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This page address: http://12.11.138.14/_private/help.htm Last Edited: December 16, 1999 Gifford and Our Community We are more than a medical center. We are doctors, nurses, medical professionals, Our and volunteers - and we are a complex and sophisticated organization that employs Community more than 400 people from our region. But The we are first, and always, a member of our Hitchcock community. Alliance

Community Gifford Medical Center's Mission Resources As a community-based health system and a member of a regional network on the of health care providers, Gifford Medical Center's mission is to improve the Internet health of the people in the communities that it serves by providing and assuring access to affordable and high quality care and by promoting the Travel health and well being of everyone in its area. Directions ● Giffords Healthstyles Calendar ● Fun things to do around our to Gifford of classes, seminars, and community services ● Directory of Vermont's ● Local events of our town of Hospitals Randolph,Vermont

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This page address: http://12.11.138.14/Community/index.htm Last Edited: December 20, 1999 The Randolph Community

We are more than a medical center. We are doctors, nurses, medical Our professionals, and volunteers - and we are a complex and sophisticated Community organization that employs more than 400 people from our region. But we are first, and always, a member of our community. The Hitchcock The Randolph Chamber of Commerce has links to many area business and Alliance activities. Community Info Center Medical Services Phone Directory Resources Send Comments Index Home on the Internet G I F F O R D M E D I C A L C E N T E R Travel PO Box 2000 Randolph Vermont 05060 Directions (802) 728-4441 FAX (802) 728-4245 to Gifford www.giffordmed.org

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This page address: http://12.11.138.14/Community/randolph.htm Last Edited: December 16, 1999 The Hitchcock Alliance

Our Community The Hitchcock Alliance Gifford Medical Center is a member of The Hitchcock Alliance, a Community collaborative health care system providing northern New England's premier Resources integrated health care. on the Info Center Medical Services Phone Directory Internet Travel Send Comments Index Home Directions to Gifford G I F F O R D M E D I C A L C E N T E R PO Box 2000 Randolph Vermont 05060 (802) 728-4441 FAX (802) 728-4245 www.giffordmed.org

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This page address: http://12.11.138.14/Community/THAlliance.htm Last Edited: December 16, 1999 Education & Resources

GMC Community Education & Resources Community Resources Health Promotion | First Aid | Textbooks Consumer | Consumer Health Organizations | Health Search the Internet Biomedical & Clinical Sites Community Resources on the Internet Health Promotion Using Internet Search Engines Alcohol Abuse Prevention National Institute on Alcohol Abuse and Alcoholism - Alcoholism | National MEDLINE Institute on Alcohol Abuse and Alcoholism - Cut Down on Drinking | U.S. Navy PREVLINE | American Academy of Family Physicians | American Psychiatric Association | Columbia Complete Home Medical Guide | Mayo Clinic

Anthrax Anthrax Vaccination Program Back Injury and Musculoskeletal Injury Prevention AHCPR | American Academy of Orthopaedic Surgeons - Low Back Pain | American Academy of Orthopaedic Surgeons - Exercises to Prevent Back Pain | American Academy of Orthopaedic Surgeons - Lift It Safe | American College of Emergency Physicians | American Academy of Family Physicians | American College of Rheumatology | Columbia Complete Home Medical Guide | Mayo Clinic - Back Care | Mayo Clinic - Back Pain

Chewing Tobacco Cessation American Academy of Otolaryngology | Mayo Clinic | National Jewish Center for Immunology and Respiratory Medicine

Cholesterol National Institutes of Health | American Academy of Family Physicians | Columbia Complete Home Medical Guide

Domestic Violence American Academy of Family Physicians | Columbia Complete Home Medical Guide | Mayo Clinic

Family Planning American Academy of Family Physicians - Birth Control | American Academy of Family Physicians - Vasectomy | Columbia Complete Home Medical Guide | Planned Parenthood

Hearing Protection American Academy of Otolaryngology | American Speech and Hearing Association | Columbia Complete Home Medical Guide | Mayo Clinic

Heat Stress Prevention Mayo Clinic | Virtual Hospital

HIV / AIDS Awareness National Institute of Allergy and Infectious Disease | American Academy of Family Physicians | Columbia Complete Home Medical Guide | Planned Parenthood

Personal Hygiene Mayo Clinic

Stress Management American Academy of Family Physicians | American Psychological Association | Mayo Clinic | Virtual Hospital

Suicide Prevention Columbia Complete Home Medical Guide | Mayo Clinic

Weight Control National Institute of Diabetes and Digestive and Kidney Diseases | American Academy of Family Physicians | Mayo Clinic

First Aid / Eight Basic War Wounds

Basic First Aid and First Aid Principles Columbia Complete Home Medical Guide

Amputated Hand Columbia Complete Home Medical Guide

Burns Home Medical Guide Electrical Shock Columbia Complete Home Medical Guide

Smoke Inhalation Columbia Complete Home Medical Guide

Textbooks

● AHCPR Patient Guidelines ● HealthFinder ● LifeLines4QOL ● National Cancer Institute PDQ Clinical Cancer Information ● NIH Health Information Index ● Telegenetics ● US Government Consumer Health Information ● American Academy of Family Physicians Patient Information ● American Academy of Otolaryngology Ear Nose and Throat Information Center ● American Academy of Pediatrics ● American Cancer Society Cancer Resource Center ● American Heart Association Heart & Stroke A-Z Guide ● CDC Disease Fact Sheets ● Columbia University College of Physicians and Surgeons Complete Home Medical Guide ● Dr Koop's Community ● IntelliHealth ● Iowa Health Book ● KidsHealth.Org ● Mayo Health Oasis ● MEDLINE Plus ● Merck Manual of Medical Information - Home Edition ● Oncolink ● PDR's Getting Well Network ● Peer Reviewed World-Wide Web Sites on Common Medical Problems ● Science Panel on Interactive Communication and Health - How to Evaluate Medical Websites ● Thrive ● US Pharmacopeia from HealthAnswers ● US Pharmacopeia from Intellihealth ● Virtual Hospital ● Virtual Children's Hospital

Consumer Health Organizations

Peer Reviewed World-Wide Web Sites on Common Medical Problems

Search the Internet

Health Sciences Search Engines MedHunt | Medical World Search | OMNI

Image Search Engines AltaVista Photo Finder | ArribaVista | Scour.Net

Health Promotion | First Aid | Textbooks | Consumer Health Organizations | Search the Internet

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This page address: http://12.11.138.14/Education/resources/patients.htm Last Edited: December 16, 1999 GMC Community Education & Resources GMC On-Line Answers to Frequently Asked Questions Community Welcome It is our vision that our Education & patients and care providers be Resources able to access knowledge-based Consumer information and perform routine Health information-gathering activities with equal ease from their Biomedical & workstations in our hospital, Clinical Sites offices, or homes. Community ● Internet basics and tutorials Resources on ● Using Internet Search Engines the Internet Using Internet Resources for Providers Resources for Patients Search Engines Biomedical & Clinical Sites Anatomy of the Lung MEDLINE Evidence-Based Medicine & Clinical Consumer Health Practice Guidelines Material Safety Data Sheets Health Administration Resources On the Internet Free MEDLINE and more.

Medical-Health Related News Sites Community Resources on the Internet Nursing Resources on the Internet Health Agencies, Professional Health Electronic Medical Journals on the Societies, Non-Profit Consumer Internet Health Organizations

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This page address: http://12.11.138.14/Education/resources.htm Last Edited: December 20, 1999 Education & Resources

GMC Community Education & Resources Consumer Consumer Health Health Biomedical & Clinical Sites Community Resources on the Internet CHID Online (Combined Health Information Database) Information on health promotion, patient education material, and program descriptions Using Internet from several U.S. government health-related agencies. Search Engines MEDLINE Healthfinder U.S. Government site for selected online publications, databases, agencies, non-profit organizations, and self-help groups.

HealthWeb: Consumer Health (University of Illinois at Chicago) helpful commentary on educational sites on diseases or health issues.

Iowa Health Book (The Virtual Hospital - University of Iowa) searchable information on men's, women's, and children's health for the general public. Advanced directives and DNR orders included.

Look It Up at Pathfinder's Thrive@Health search and retrieve fact sheets and article summaries on disease conditions, drugs, and surgical procedures. Sources include MDX Health Digest, Harvard Heart Letter, and Consumer Reports.

MedicineNet (Information Network, Inc.) consumer health information written by Board Certified Specialists.

NetWellness (University of Cincinnati Medical Center) an electronic consumer health library with accurate, up-to-date information.

NIH Word on Health (formerly HEALTHWise) practical health news based on research conducted by NIH scientists or grantees at universites and medical schools around the country.

NOAH (New York Online Access to Health) full-text health information for consumers.

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This page address: http://12.11.138.14/Education/resources/consumer.htm Last Edited: December 16, 1999 Education & Resources

GMC Community Education & Resources Biomedical & Clinical Consumer Sites Health Biomedical & Clinical Sites Community Resources on the Internet AHCPR Clinical Practice Guidelines (Agency of Health Care Policy and Research) Using Internet Search Engines Alternative Medicine Homepage (Falk Library, University of Pittsburgh) MEDLINE CenterWatch Clinical Trials Listing Service provides links to a variety of information related to clinical trials. Designed for both research professionals and patients.

Finding Information on Medical Topics (National Library of Medicine) provides access to valuable medical information in databases such as: DIRLINE (organizations, research resources, projects, etc.), HSTAT (clinical practice guidelines from AHCPR), HIV/AIDS Resources Grateful Med, NIH Clinical Alerts, and consumer health information.

OncoLink (The University of Pennsylvania Cancer Center Resource)

The Virtual Hospital (University of Iowa College of Medicine) a digital health science library providing patient care support and distance learning for healthcare providers.

Virtual Medical Center - Martindale's Health Science Guide (Jim Martindale, author) tutorials, textbooks, and cases by subject; world news, language dictionaries, travel warnings and immunizations in International Services; journals, abstracts, newsletters in Reference Desk under Medicine; Internet/computer info in Technical Support.

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This page address: http://12.11.138.14/Education/resources/biomed.htm Last Edited: December 16, 1999 Education & Resources

Subject Directories Yahoo | Argus Clearinghouse | Magellan Internet Guide

Subject directories covering health related topics CliniWeb | Hardin MD | Medical Matrix

Searching the Web using Subject Directories & Search Engines Subject Directories provide links to Internet sites that are arranged within subject categories and subcategories. Subject directories offer a collection of subject related links that provide a good place to begin a search, especially if you are interested in an overview or broad coverage of a topic. Subject directories are usually organized by a group or individual with some subject knowledge or expertise. Some subject directories evaluate and rate the linked sites. Subject directories are easy to use, but because the focus is on "arrangement by subject", coverage of a topic may be more limited than what is contained in a search engine database.

Subject directories, covering a vast array of subjects: Yahoo, Argus Clearinghouse, Magellan Internet Guide Subject directories, covering health related topics: CliniWeb: From Oregon Health Sciences University. Provides table of contents of diseases and anatomy indexed by Medical Subject Heading (MeSH).

Hardin MD:Hardin Meta Directory of Internet Health Sources: From Hardin Library, University of Iowa. A comprehensive listing of resources in biomedical fields, including nursing, pharmacy and allied health care.

Medical Matrix - Guide to Internet Clinical Medicine Resources: From Healthtel Corporation. Annotated sites in clinical medicine and continuing education are continuously updated, peer-reviewed and ranked by an editorial board drawn from the American Medical Informatics Association's Internet Working Group.

Search Engines permit the searching of very large portions of the Internet. Search engine databases are created by "robots" or spiders" that are programmed to search the Internet. Search engines vary greatly in their searching features and in the number of Internet sites that are searched. Search engines are useful for searching the unique or unusual question or for searching a specific word or phrase. Unlike subject directories, search engine databases are usually not arranged in subject order. The meaning or context in which you search a word or phrase may not be interpreted correctly, retrieving seemingly hundreds of irrelevant sites. Using the advanced/power search features available with most search engines should improve search results.

Search engines that we like: Alta Vista, Ask Jeeves, Excite, HotBot, Northern Light

Some search engines search specifically health related sites: MedBot: From Stanford University. Search by keyword and select up to four of eight general search engines and other medical indices. Requires Netscape 2.0 or higher with Java enabled.

MedHunt: From the Health on the Net Foundation. Locates medical and hospital related sites.

Medical Word Search: Recognizes terms used in the National Library of Medicine's Unified Medical Language System, which includes MeSH, ICD, CPT and SNOMED.

Some search engines will search other search engines, several at the same time. Search engines like Metacrawler, SavvySearch, Dogpile, will apply your search question to several search engines simultaneously.

For more information on How to Search the Web: How to Search the Web - A Guide to Search Tools (Palomar College Library) Introduction to Search Engines (Kansas City Public Library) The Spider's Apprentice - How to Use Search Engines (Monash Information Services) Info Center Medical Services Phone Directory

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This page address: http://12.11.138.14/Education/resources/websrch.htm Last Edited: December 16, 1999 GMC Community Education & Resources PaperChase is an online information service that helps you search the National Library of Medicine's MEDLINE, HealthSTAR, and AIDSLINE Consumer databases and the National Cancer Institute's CANCERLIT database. Health Biomedical & Free" MEDLINE Clinical Sites There is much current interest in the availability of "free" MEDLINE on the Internet. Not all of the "free" MEDLINES available via the Internet are Community created equally. The quality of search interfaces, types of search Resources on methodology used and the currency and completeness of the databases the Internet may vary greatly from site to site. Several considerations should be ongoing when using a web based MEDLINE service, especially when the information Using Internet obtained is to be used in clinical decision making. The following sites Search Engines provides some practical suggestions for evaluating the "free" MEDLINES: MEDLINE ● MEDLINE on the Web: Ten Questions to Ask When Evaluating a Web-Based Service

● MEDLINE FAQ ● Free MEDLINE on the Web: A Practical View

Interested in reviewing some of web based "free" MEDLINES? Try: ● National Library of Medicine's PubMED ● PubMED Free MEDLINE LOWDOWN for evaluative information. ● Dr. Felix's Free MEDLINE Page provides links to where MEDLINE may be searched for "free". Also includes a variety of links discussing issues relating to the quality of "free" MEDLINES.

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This page address: http://12.11.138.14/Education/resources/paperchase.htm Last Edited: December 16, 1999 Directions to Gifford Medical Center Randolph is in the exact center (heart) of Vermont.

Gifford By Car: By Rail: News Phone List Interstate 89 - Amtrak's Vermonter gives you easy service connects us Directories access to directly to the whole HealthStyles Randolph (EXIT Northeast corridor, from Calendar (pdf 4), from there Montreal to Washington, 150k) you head west on D.C. with many stops in Rt 66 and south Here for a detailed between. GMC on Rt 12 through On-Line the town of map of the Randolph area By Air: Library Randolph. Gifford Air connections at is one mile further Here For a detailed Lebanon, N.H. (30 mins. Directory of on the left. drive), Burlington, VT. VT Hospitals (international airport - map of the medical center 60 mins. drive), and Barre-Montpelier, VT. (30 mins. drive) Note: Barre-Montpelier does not service commercial airlines.

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Clinic Hours We offer many Clinic services and we invite you learn more about Services what we offer... About Our Services Clinic Hours Medical Staff How to Schedule an Appointment Clinic Services Medical Service Staff Phone Medical Staff List Descriptions Directions to Gifford Phone List

As few as five years ago, gall bladder surgery at Gifford meant four to six days in the hospital and a six-week recovery.Today the typical patient goes home the same day and is back to full activity within a week. Most benefits of minimally invasive surgery go to the patient: shorter stays, less pain, faster recovery, less risk and often less overall cost. The surgical revolution depends on narrow scopes and tiny tools. It is often called minimally invasive surgery because it needs only very small incisions through which these instruments are inserted and manipulated. "This type of surgery involves the whole breadth of specialties here," said surgeon LeRoy Hodges. Minimally invasive surgery at Gifford includes knee, gynecological and abdominal surgery, along with the eye work of ophthalmologist Jack Singer, whose cataract operations now need a single stitch-less incision only 1/16 inch wide. About half of Gifford surgeries are now performed using endoscopes, high-tech tubes that place a tiny video camera and bright fiber-optic lighting inside the patient. Procedures that use these scopes have various names—arthroscopy for the knee, hysteroscopy for the uterus, laparoscopy for the midsection. They are the key technology in same-day surgery, which accounts for "at least 80 percent of our volume now," said Susan Nicholls, R.N., OR coordinator. Info Center Medical Services Phone Directory

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This page address: http://12.11.138.14/MedServices/index.htm Last Edited: December 20, 1999 GMC Medical Clinic Hours We offer many services at our clinics and we invite you to learn more about our services, just click here.. Clinic Hours Clinic Services About Our Services To Schedule an Appointment Click Here Medical Phone List of Medical Staff Staff CLINIC PHYSICIAN PHYSICIAN DAY CLINIC Staff Phone HOURS HOURS List Kenneth Borie, Gifford Primary 9:00-12:00, Monday 8:00-5:00 D.O. Care 1:00-5:00 Gifford Primary 9:00-12:00, Tuesday 8:00-5:00 Care 1:00-5:00 Gifford Primary Wednesday 8:00-5:00 Off Care Gifford Primary 9:00-12:00, Thursday 8:00-5:00 Care 1:00-5:00 Gifford Primary 9:00-12:00, Friday 8:00-5:00 Care 1:00-5:00

Marti Bressett, Gifford Primary Monday 8:00-5:00 1:00-5:00 P.A. Care Gifford Primary Tuesday 8:00-5:00 9:00-5:00 Care Gifford Valley Wednesday 9:00-4:00 9:30-3:30 Health Gifford Primary Thursday 8:00-5:00 9:00-5:00 Care Gifford Primary Friday 8:00-5:00 9:00-5:00 Care

G. Brent Burgee, Monday Gifford Ob/Gyn 8:30-5:00 8:30-5:00 M.D. Tuesday Gifford Ob/Gyn 8:30-5:00 8:30-5:00 Wednesday Gifford Ob/Gyn 8:30-5:00 8:30-5:00 Thursday Gifford Ob/Gyn 8:30-5:00 alternating Friday Gifford Ob/Gyn 8:30-5:00 alternating

Terry Cantlin, Gifford Family Monday 8:00-6:00 9:00-5:00 D.O. Health Gifford Family Tuesday 8:00-6:00 10:00-6:00 Health Gifford Family Wednesday 8:00-5:00 9:00-5:00 Health Gifford Family Thursday 8:00-6:00 OFF Health Gifford Family Friday 8:00-4:00 9:00-4:00 Health

Marcus Coxon, Gifford Primary Monday 8:00-5:00 9:00-12:00 M.D. Care Gifford Primary Tuesday 8:00-5:00 OFF Care Gifford Primary 9:00-12:00, Wednesday 8:00-5:00 Care 1:00-5:00 Gifford Primary 9:00-12:00, Thursday 8:00-5:00 Care 1:00-5:00 Gifford Primary Friday 8:00-5:00 9:30-12:00 Care

Louis DiNicola, Gifford Primary Monday 8:00-5:00 9:00-5:00 M.D. Care Gifford Primary Tuesday 8:00-7:00 9:00-7:00 Care Gifford Primary Wednesday 8:00-5:00 OFF Care Gifford Primary Thursday 8:00-5:00 9:00-5:00 Care Gifford Primary Friday 8:00-5:00 9:00-5:00 Care

William Ellis, Monday Gifford Ob/Gyn 8:30-5:00 8:30-5:00 M.D. Tuesday Gifford Ob/Gyn 8:30-5:00 OFF Wednesday Gifford Ob/Gyn 8:30-5:00 8:30-5:00 Thursday Gifford Ob/Gyn 8:30-5:00 OFF Friday Gifford Ob/Gyn 8:30-5:00 OFF

Rebecca Foulk, So. Royalton 9:00-12:30, 8:00-5:00, M.D. Monday Family Health School 5:00-8:00 Center 12:30-2:30 So. Royalton Tuesday Family Health 8:00-5:00 9:00-5:00 Center So. Royalton Wednesday Family Health 8:00-5:00 OFF Center So. Royalton 9:00-12:30, 8:00-5:00, Thursday Family Health 6:00-9:00, School 5:00-8:00 Center 12:30-2:30 So. Royalton Friday Family Health 8:00-5:00 8:00-5:00 Center

Milton Fowler, Gifford Primary Monday 8:00-5:00 9:00-5:00 M.D. Care Gifford Primary Tuesday 8:00-5:00 9:00-5:00 Care Gifford Primary Wednesday 8:00-5:00 OFF Care Gifford Primary Thursday 8:00-5:00 9:00-5:00 Care Gifford Valley Friday 9:00-5:00 10:00-4:00 Health

Jonna Goulding, Gifford Primary 9:00-12:00, Monday 8:00-5:00 M.D. Care 1:00-5:00 Gifford Primary Tuesday 8:00-5:00 OFF Care Gifford Primary Wednesday 8:00-5:00 9:00-12:00 Care Gifford Primary Thursday 8:00-5:00 9:30-12:00 Care Gifford Primary Friday 8:00-5:00 9:30-12:00 Care

Leroy Hodges Gifford Surgical Monday 8:30-4:30 8:30-4:30 M.D. Associates Gifford Surgical Tuesday 8:30-4:30 8:30-4:30 Associates Gifford Surgical Wednesday 8:30-4:30 8:30-4:30 Associates Gifford Surgical Thursday 8:30-4:30 OFF Associates Gifford Surgical Friday 8:30-4:30 8:30-4:30 Associates

Elizabeth Jewett, Gifford Primary Monday 8:00-5:00 9:00-12:00 M.D. Care Gifford Primary Tuesday 8:00-5:00 9:00-12:00 Care Gifford Primary Wednesday 8:00-5:00 9:00-5:00 Care Gifford Primary Thursday 8:00-5:00 OFF Care Gifford Primary Friday 8:00-5:00 9:00-4:00 Care

Mark Jewett, Gifford Primary Monday 8:00-5:00 9:00-5:00 M.D. Care 2:00-5:00, Gifford Primary Tuesday 8:00-5:00 Rochester Care 9:30-1:00 Gifford Primary Wednesday 8:00-5:00 9:00-5:00 Care Gifford Primary Thursday 8:00-5:00 OFF Care Gifford Primary Friday 8:00-5:00 9:00-5:00 Care

Frank Lampson, So. Royalton 8:00-5:00, P.N.P. Monday Family Health 1:00-9:00 5:00-8:00 Center So. Royalton Tuesday Family Health 8:00-5:00 1:00-3:00 School Center So. Royalton 9:00-11:30, Wednesday Family Health 8:00-5:00 2:00-5:00, School Center 12:00-1:30 So. Royalton 8:00-5:00, Thursday Family Health 1:00-5:00 5:00-8:00 Center So. Royalton Friday Family Health 8:00-5:00 1:00-3:00 Center

Sally Lanpher, Gifford Family Monday 8:00-6:00 8:00-4:00 F.N.P Health Gifford Family Tuesday 8:00-6:00 8:00-4:00 Health Gifford Family 8:00-10:30, 10:30 Wednesday 8:00-5:00 Health Employee Health Gifford Valley Thursday 8:00-6:00 8:30-4:00 Health Gifford Family Friday 8:00-4:00 OFF Health

Kevin McNamara, Gifford Surgical Monday 8:30-5:00 9:00-5:00 D.P.M. Associates Gifford Surgical Tuesday 8:30-5:00 9:00-5:00 Associates Wednesday Barre Office 8:30-5:00 8:30-5:00 Gifford Surgical Thursday 8:30-5:00 OFF Associates Gifford Surgical Friday 8:30-5:00 9:00-5:00 Associates

Anita Onofrio, Monday Gifford Ob/Gyn 8:30-5:00 OFF C.N.M. Tuesday Gifford Ob/Gyn 8:30-5:00 8:30-5:00 Wednesday Gifford Ob/Gyn 8:30-5:00 8:30-5:00 Thursday Gifford Ob/Gyn 8:30-5:00 8:30-5:00 Friday Gifford Ob/Gyn 8:30-5:00 OFF

David Pattison, So. Royalton M.D. Monday Family Health 8:00-6:00 9:00-5:00 Center So. Royalton Tuesday Family Health 8:00-6:00 OFF Center So. Royalton Wednesday Family Health 8:00-5:00 9:00-5:00 Center So. Royalton Thursday Family Health 8:00-6:00 9:00-5:00 Center So. Royalton Friday Family Health 8:00-4:00 9:00-5:00 Center

Maria Puglisi, Gifford Primary Wednesday 8:00-5:00 9:30-12:00 F.N.P. Care

Annie So. Royalton 8:00-5:00, Richardson, Monday Family Health OFF 5:00-8:00 C.N.M Center So. Royalton Tuesday Family Health 8:00-5:00 9:30-4:00 Center So. Royalton Wednesday Family Health 8:00-5:00 OFF Center So. Royalton 8:00-5:00, Thursday Family Health 10:00-6:00 5:00-8:00 Center Friday Gifford Ob/Gyn 8:00-5:00 1:00-5:00

Mark Seymour, 9:00-12:00 Gifford Family D.O. Monday 8:00-6:00 Rochester, Health 1:00-4:00 Gifford Family Tuesday 8:00-6:00 9:00-5:00 Health Gifford Family Wednesday 8:00-5:00 OFF Health Gifford Family Thursday 8:00-6:00 10:00-6:00 Health Gifford Family Friday 8:00-4:00 9:00-4:00 Health

Anne Stohrer, Tuesday Gifford Ob/Gyn 8:30-5:00 8:30-4:00 M.D. 8:30-4:00 Thursday Gifford Ob/Gyn 8:30-5:00 alternating 8:30-4:00 Friday Gifford Ob/Gyn 8:30-4:30 alternating

Starr Strong, Chelsea Health Monday 9:00-4:00 9:00-4:00 P.A. Center Chelsea Health Tuesday 9:00-4:00 OFF Center Gifford Family Wednesday 8:00-5:00 9:00-4:00 Health Chelsea Health Thursday 9:00-4:00 9:00-4:00 Center Gifford Family Friday 8:00-4:00 9:00-4:00 Health

George Chelsea Health Monday 9:00-4:00 9:00-4:00 Terwilliger, M.D. Center Chelsea Health Tuesday 9:00-4:00 9:00-4:00 Center Chelsea Health Wednesday 1:00-7:00 1:00-7:00 Center Chelsea Health Thursday 9:00-4:00 OFF Center Chelsea Health Friday 9:00-4:00 9:00-4:00 Center

Jerry Ward, M.D. Gifford Family 8:00-4:00 Gifford Monday 8:00-6:00 Health Medical Center Gifford Family Tuesday 8:00-6:00 11:00-6:00 Health Gifford Family Wednesday 8:00-5:00 Health Gifford Family Thursday 8:00-6:00 10:30-5:00 Health Gifford Family Friday 8:00-4:00 OFF Health

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This page address: http://12.11.138.14/MedServices/GMCClinichrs.htm Last Edited: December 20, 1999 GMC Medical Center Clinics We offer many services and we invite you to click a link below to learn more about what we offer... Clinic Hours

Clinic Services Diabetes Lactation Clinic Oncology Clinic

About Our Pain Gifford Day Care Gifford Elder Care Services Management Clinic

Medical Gifford Medical Gifford Outreach Staff Center Volunteer Healthbreaks Centers Staff Phone Services List Cardio Vascular Audiology Services

Diabetes Under the direction of a diabetic nurse educator, the out-patient clinic provides diabetes education, blood glucose monitoring, nutrition and exercise counseling, medication and prevention advice, as well as help with special patient needs. For more information, call 728-2210.

Lactation Clinic A certified lactation consultant is available for pre-natal and post partum breast feeding consultation. For more information, call 728-2257.

Oncology Clinic Provides service locally for cancer patients who require frequent and on-going treatment. For more information, call 728-2322.

Pain Management Clinic Specially trained registered nurses help patients understand and manage pain related to a variety of conditions such as rheumatoid and osteorthritic diseases, carpal tunnels syndrome, migraine headaches, lower back pain, fibromyalgia. For more information, call 728-2295.

Gifford Day Care Offers care for children six weeks to six years. Holds a license for 26 children. (8 infants, 8 toddlers, and 10 pre-schoolers). Provides a learn through play environment with a daily schedule.

Gifford Elder Care Provides round the clock nursing coverage with a ratio of one nurse for every 7 patients. An activity schedule for every day of the week is maintained.

Gifford Medical Center Volunteer Services A volunteer support and fund-raising organization, raises funds primarily with the Hospital Thrift Shop. The Gifford Hospital Auxiliary brings together over 150 community members who donate their to greet visitors, visit patients, and provide assistance in various hospital service areas.

Gifford Outreach Centers Gifford operates four outreach centers that provide primary care, specialty services and some diagnostic procedures for the entire family in convenient rural locations:

● Gifford Family Health Center, Bethel

● Gifford Valley Health Center, Rochester

● Chelsea Family Health Center, Chelsea

● So. Royalton Family Health Center, So. Royalton

Healthbreaks Gifford’s outreach program for small and mid-sized companies, that do not offer health insurance, provides on-site health screening for their employees. For more information, call 728-4546 or 433-6063.

Audiology Audiology services provides hearing evaluations for adults and children of all ages. For more information, call 728-2393.

Cardio Vascular Services A range of standard diagnostic cardiovascular procedures available at Gifford, 24 hour Holter monitoring, cardiac stress tests, echocardiography, and vascular imaging, electroencephalograms and evoked potential testing. For more information, call 728-2259.

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This page address: http://12.11.138.14/MedServices/GMCClinics.htm Last Edited: December 16, 1999 Gifford Medical Center Services We offer many services and we invite you learn more about what we offer...

Clinic Hours The Birthing Center Clinic Single room maternity care and much more... In 1977, Gifford took on the Services leadership role when it opened the state’s first birthing center as an alternative to the traditional delivery room. Minimal intervention continues About Our to draw expectant mothers from across the state and around the region. Services For more information, call toll free at 1-800-3-BABY-33. Medical The Complementary Medicine Center Staff Accessible alternative therapies... Gifford’s first step towards Complementary Medicine more accessible to the community was in 1996. Staff Phone Out-patient center accepts self-referrals, as well as physician referred List clients for acupuncture and massage therapy. For acupuncture, call 728-2384, and for massage therapy, call 728-2360.

The Garden Room and Healing Garden A private suite on the hospital’s medical surgical unit reserved for terminally ill patients and their families. Offers a physically and emotionally accessible home-like environment that stretches outside the hospital walls to a patio surrounded by a walk lined garden of perennial plants and shrubs.

The Gifford Community Outreach Center This centralized information and referral services acts as a clearing house for various health related programs offered by Gifford to serve the needs of the community.

Health Connections Health connections provides access to representatives who can assist community members with a diverse range of health care needs, including low cost health care, financial support, physician referrals, support group information and transportation needs. For more information, call 728-3744.

Healthstyle Information and Registration A support service for Gifford’s three (Winter, Spring, and Fall) program series in health education and wellness that are offered each year to encourage lifestyle enhancement for members of the community. Healthstyle programs stress holistic, preventative approach to god health, including alternative approaches to wellness behaviors. For more information, call 728-2250.

RAVE Randolph Area Volunteer Exchange links members of the greater Randolph community who are interested in volunteering their time with non-profit organizations that have requested volunteer assistance. For more information, call 728-2347.

Ladies First A free cancer screening service for women 50 and older with limited income. For more information, call 728-2370.

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This page address: http://12.11.138.14/MedServices/GMCServices.htm Last Edited: December 16, 1999 Gifford Medical Center Staff “The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet, Clinic Hours and in the cause and prevention of disease.” Clinic Services About Our Services Medical Agee, L. Carter, M.D. Urology Staff Bartrum, Royal, M.D. Radiology Staff Phone Belding, R. Michael, M.D. Pathology List Black, William, D.D.S. Honorary Borie, Kenneth, D.O. Family Medicine Bressett, Marty, P.A. Family Medicine Burgee, G. Brent, M.D. Obstetrics/Gynecology Cantlin, Terry, D.O. Family Medicine Chandler, James, M.D. Radiology Coxon, Marcus, M.D. Family Medicine Delaney, John, Ed.D. Psychology DiNicola, Louis, M.D. Pediatrics Ellis, William, M.D. Obstetrics/Gynecology Foulk, Rebecca, M.D. Pediatrics Fowler, Milton, M.D. Internal Medicine Francisco, Renee, C.R.N.A. Anesthesiology Gadway, Ronald, D.O. Honorary Gates, Kit, C.N.M. Obstetrics/Gynecology Gosselin, Benoit, M.D. Otolaryngology Goulding, Jonna, M.D. Family Medicine Henzig, Dennis, M.D. Anesthesiology Hodges, LeRoy, M.D. General Surgery James, Douglas, M.D. Cardiology Jewett, Elizabeth, M.D. Pediatrics/Adolescent Medicine Jewett, Mark, M.D. Internal Medicine Johnson, Robert, M.D. Radiology Jonas, Howard, D.O. Family Medicine Lamson, Frank, P.N.P. Pediatrics Lanpher, Sally, F.N.P. Family Medicine Leopold, Kenneth, M.D. Oncology McAndrew, Ellen, C.N.M. Obstetrics/Gynecology McNamara, Kevin, D.P.M. Podiatry Minsinger, William, M.D. Orthopedics Onofrio, Anita, C.N.M. Obstetrics/Gynecology Pattison, David, M.D. Internal Medicine/ Pediatrics Pipas, J. Marc, M.D. Oncology Porter, John, M.D. Psychiatry Puglisi, Maria, F.N.P. Family Medicine Richardson, Annie, C.N.M. Obstetrics/Gynecology Sax, Daniel, M.D. Neurology Seymour, Mark, D.O. Family Medicine Singer, Jack, M.D. Ophthalmology Smith, MaryAnn, M.A., R.N., C.S. Psychiatry Soares, Christopher, M.D. Ophthalmology Stohrer, Anne, M.D. Obstetrics/Gynecology Strong, Starr, P.A.-C Family Medicine Terwiliger, George, M.D. Family Medicine Thadani, Vijay, M.D. Neurology Travis, Brian, M.D. Pathology Ward, Jerald, M.D. Internal Medicine Ward, Thomas, M.D. Neurology Wollaeger, Lucy, M.D. Internal Medicine Zagroba, John, M.D. Honorary

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This page address: http://12.11.138.14/MedServices/staff.htm Last Edited: December 20, 1999 Education & Resources Welcome to the Gifford Medical GMC Center's Education and Resources Homepage! Community Education & It is our vision that our patients and Resources care providers be able to access Consumer knowledge-based information and Health perform routine information-gathering activities with equal ease from their workstations in our hospital, Biomedical & offices, or homes. Clinical Sites Community MISSION STATEMENT The mission of the Gifford Medical Center web site is to provide current, Resources on authoritative, and easily accessible knowledge-based information in support the Internet of patient care, education, management decision-making, and research Using Internet needs of the Gifford Medical Center System community. Search Engines GOALS MEDLINE Provide access to external knowledge-based information in the biomedical and health sciences.

Support and promote effective use of knowledge-based information and information technology.

Participate in and contribute to innovative, technologically advanced, and cost-effective resource-sharing efforts in improving access to knowledge-based information.

Our Community is invited to visit our Community Health Resource Center for: ● Computers with health information set up for consumer use ● Resource coordinator to help you find and print out information you want ● Health videos and VCR

Multimedia Workstation: Gifford provides a multimedia computer and a series of interactive CD-ROM materials. CD-ROM materials currently available include ADAM 2.3 and BodyWorks (human anatomy), and a selection of self-learning tutorials for Microsoft Windows, PowerPoint, Word, Excel and Access. Info Center Medical Services Phone Directory

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This page address: http://12.11.138.14/Education/index.htm Last Edited: December 20, 1999 Comments

To serve you better Gifford has created this Internet site to make it easier for our community to use learn about, and use our services.

Coming soon are:

● Schedules for Programs in health and wellness at Gifford Medical Center ● Descriptions of Services available at Gifford Medical Center and answers to your most frequently asked questions

● Physician biographies We appreciate your feedback regarding this site, and our and services. We invite you to share your comments, questions and suggestions with us at your convenience.

Send Us Your Comments Just click on this button to send us email.

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This page address: http://12.11.138.14/_private/comments.htm Last Edited: December 16, 1999 Gifford Medical Center ... is the focus of central Vermont's community-based health system and a member of a Regional Network of Health Care Providers.

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Community Resources GMC Medical Services

Healthcare Education The Hitchcock Alliance Info Center Medical Services Phone Directory

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Healthstyles Calendar

Stay tuned for the the latest Healthstyles calendar - Coming Soon!! Gifford News Phone List Info Center Medical Services Phone Directory

Directories Send Comments Index Home HealthStyles Calendar (pdf G I F F O R D M E D I C A L C E N T E R 150k) PO Box 2000 Randolph Vermont 05060 GMC (802) 728-4441 FAX (802) 728-4245 On-Line www.giffordmed.org Library Send comments and suggestions to Directory of [email protected] VT Hospitals Copyright © 1999 Gifford Medical Center All rights reserved.

This page address: http://12.11.138.14/Infocenter/Healthstyles.htm Last Edited: December 16, 1999

Knowledge-based information Knowledge-based information, according to JCAHO, is: A collection of stored facts, models, and information that can be used for designing and redesigning precesses and for problem-solving. In the context of the JCAHO Accreditation Manual of Healthcare Organizations, knowledge-based information is found in the clinical and management literature. Education & Resources

GMC Community Education & Resources Internet basics and Consumer tutorials Health Biomedical & Clinical Sites Community Resources on the Internet ILC Glossary of Internet Terms (Internet Literacy Consultants) Using Internet The Net: User Guidelines and Netiquette (Arlene H. Rinaldi) Search Engines MEDLINE ABC of Medical Computing (by Nicholas Lee and Andrew Millman) Finding Information on the Internet - A Tutorial (U. of California at Berkeley)

Guide for Citing Electronic Information (William Paterson College of New Jersey) general rules and numerous examples for citing journals and individual works from CD-ROM databases and the internet.

How to Cite the Internet Page (Michael Nyerges, Canandaigua Academy Virtual Library) numerous examples of citations to Internet resources, such a WWW, gopher, e-mail, newsgroups, telnet, ftp, etc.

MLA-Style Citations of Electronic Resources (University of Florida) guidelines for citing Internet resources, endorsed by the Alliance for Computers & Writing.

Web Extension to American Psychological Association Style (WEAPAS) proposed standards for referencing online documents in scientific publications.

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GMC Community Education & Evidence-Based Medicine Resources Consumer & Clinical Practice Health Guidelines Biomedical & Clinical Sites Community Resources on the Internet Evidence-Based Medicine is the process of systematically finding, appraising and using contemporaneous research findings as the basis for Using Internet clinical decisions. Evidence-Based Medicine asks questions, finds and Search Engines harnesses that information for everyday clinical practice. MEDLINE Evidence-based medicine follows four steps: 1. formulate a clear clinical question from a patient's problem. 2. search the literature for relevant clinical articles. 3. evaluate (critically appraise) the evidence for its validity and usefulness. 4. implement useful findings in clinical practice. Scope Note. Medical Subject Headings (MeSH), U.S. National Library of Medicine, 1997.

A Selection of Evidence-Based Medicine Internet Resources:

Evidence-Based Medicine (Evidence-Based Medicine Informatics Project, McMaster University, Hamilton, Ontario, Canada.) Presents an excellent overview: Evidence-Based Medicine - A New Approach to Teaching the Practice of Medicine. Also available at this site are a series of user guides, including the Users Guide to the Medical Literature. Links to additional Internet resources.

Center for Evidence-Based Medicine (Oxford, England) support materials and analytical tools for Evidence-Based Medicine.

ACP Journal Club (American College of Physicians) "select from the biomedical literature those articles reporting studies and reviews that warrant immediate attention by physicians attempting to keep pace with important advances in internal medicine."

Evidence-Based Medicine (American College of Physicians) "alerts clinicians to important advances in medicine by summarizing and providing commentary on significant evidence-based articles".

POEMs: Patient Oriented Evidence that Matters (Journal of Family Practice) Each month eighty journals are reviewed to identify eight articles with "patient oriented outcomes that have the greatest potential to change the way primary care clinicians practice".

Bandolier (An online journal produced monthly in Oxford for the NHS R&D Directorate) contains "bullet points" of evidence-based medicine.

The Cochrane Collaboration An international network of health care professionals working to prepare, maintain and disseminate the systematic reviews of the effects of health care.

The work of Cochrane Collaboration, as disseminated through the Cochrane Library can assist practitioners in their practice of Evidence-Based Medicine. The Cochrane Library site contains information concerning the Cochrane Database of Systematic Reviews.

Medical Matrix - Decision Making Links Check here for some interesting information about Evidence-Based Medicine and the Cochrane Collaboration, discussion forums, full text journals and a variety of relevant Internet resources.

Clinical Practice Guidelines

Evidence-Based Medicine recognizes the use of Clinical Practice Guidelines.

Practice Guidelines are defined as: Directions or principles presenting current or future rules of policy for the health care practitioner to assist in patient care decisions regarding diagnosis, therapy or related clinical characteristics. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or the covering of expert panels. The guidelines form a basis for evaluation of all aspects of health care and delivery.

Scope Note Medical Subject Headings (MeSH), U.S. National Library of Medicine, 1993.

A Selection of Clinical Practice Guideline Resources:

AHCPR Clinical Practice Guidelines (Agency for Healthcare Policy and Research) Full text of guidelines are searchable. The full collection of the AHCPR Clinical Practice Guidelines may also be found in the Aaron Library's collection. NIH Consensus Development Program Consensus statements on a variety of issues in medicine of importance to health care providers, patients and the general public.

NIH Clinical Alerts expedite the release of findings from NIH funded clinical trials where such information could significantly affect morbidity and mortality.

HSTAT (Health Services Technology Assessment Text) Includes the full text of a variety of guideline related publications.

Center for Disease Control (CDC) Prevention Guidelines Database A comprehensive compendium of all the official guidelines and recommendations published by the CDC for the prevention of diseases, injuries and disability.

Medical Matrix - Practice Guidelines Links interesting links concerning various Clinical Practice Guidelines.

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GMC Community Education & Resources Health Consumer Administration Resources Health On the Internet Biomedical & Clinical Sites Community Resources on the Internet Hospital Web USA Using Internet Joint Commission on Accreditation of Health Care Organizations Search Engines (JCAHO) MEDLINE The Foundation Center a clearinghouse on foundations, corporate giving, and related subjects for grantseekers, researchers, and policymakers. Search the Grantmaker Information Directory to more than 190 Web sites of public, private, corporate, and community foundations.

Foundation Directories Online a service of the Northern California Community Foundation, Inc. Mediqual System, Inc. the largest collection of qualitative healthcare information can be found in: Health Trends 1993-96. It provides a national overview of hospital costs, LOS, case volume, mortality, blood usage, and more in 16 major disease areas. Best Outcomes Benchmarks with graphs and charts of performance measurement requirements which meets JCAHO approval. Heart Attack Report Cards showing local market views which compare the performance of hospitals in 50 major metro areas in the treatment of Medicare patients suffering from heart attacks. See Buffalo General Hospital compared to other area hospitals in the Buffalo-Niagara region under Hospital Perspective(s)

Welcome to GrantsNet (Department of Health and Human Services)

Health Hippo Provides over 3000 links to internet health policy and regulatory information. Includes news sources, links to discussion groups, search engines and a variety of regulatory sites. Healthcare Association of New York (HANYS)

American Hospital Association includes the AHA Resource Center's Health Administration Links to information on health administration and related topics. Search the AHA Resource Center Catalog for books and historic documents on healthcare administration.

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GMC Community Education & Resources Medical/Health Related Consumer News Sites Health Biomedical & Clinical Sites Community Resources on the Internet This listing includes selected sites which provide references to the medical, scientific and health literature as quoted in the popular press. Very often, Using Internet newspapers and television reports do not include important details Search Engines regarding these articles. The sites described below are useful when you MEDLINE need to quickly locate information on topics that regularly appear in newspapers, radio or television reports.

American Medical Association's ● American Medical News: Published weekly, intended to serve as "an impartial source of information affecting physicians and their practices". Provides links to current and past issues of the AMA journals, including some full text articles. ● Science News Press Releases: News from JAMA and the AMA Archive journals; updates are made available to the public on a weekly basis. AHA News: covers the latest health-policy news from Washington as well as national and state health care news.

Medical News - Dr's Guide to the Internet: Contains selected conference communiques. Often quoted in the press prior to publication in the clinical literature, these communiques, as found here, may be searched by key word or browsed by general subject.

Biomedicine and Health in the News: Provides summaries of articles in the New York Times, including relevant referenced journal articles. Produced by the Lyman Stowe Library, University of Connecticut Health Center. Included are announcements of research findings and unpublished research reported at professional meetings.

Health and Medicine in the News: University of Minnesota Medical Library, includes newspaper article summaries, source and journal article citations. New entries are added regularly and grouped by month. Key word searching is available.

Medical Breakthroughs: From Ivanhoe Broadcast News, Inc. Contains current medical news from the "world's leading medical centers and research labs". Ivanhoe Broadcast News, Inc., is a large television news gathering organization covering medical breakthroughs and other health issues. Over two hundred television affiliates throughout the U.S. broadcast Ivanhoe's medical reports.

Media News Releases: The American Heart Association's news releases. Contains references to articles found in association journals. Also provides a link to the Reuters Health News Heath Information Service for both the health care professional and the consumer.

Television News Archive: Produced by Vanderbilt University. Indexes and abstracts national television newscasts dating from 1968. May be searched by keyword. This database is a guide to the Vanderbilt University collection of network television news programs.

FDA News: News from the U.S. Food and Drug Administration. Includes press releases, fact sheets, FDA Bulletins and current and archived speeches by FDA officials.

Other news related sites may be located via Yahoo:Health:News and Media

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GMC Community Education & Resources Nursing Resources on the Consumer Internet Health Biomedical & Clinical Sites Community Resources on the Internet Nursing - HealthWeb (U. of Michigan) electronic listservs, discussion forums, and full-text journals. Using Internet Search Engines Nursing Sites on the World Wide Web (SUNY at Buffalo) nursing MEDLINE education, research, and administration. SpringNet (Springhouse Corp.) Continuing education, career information. Resources for nurse managers, practitioners, and students.

Association Information American Nurses Association organizational information with membership listings by state. National League of Nursing testing services, catalogs, educational and career opportunities.

New York State Nurses Association membership information, position statements, Nursing Practice Alerts, job listings and CE programs.

Nursing Listservs/Discussion Lists Participation in Internet Listservs or Discussion Lists allow for the exchange of professional ideas and advice.

Sites offering a list of nursing related listservs: Nursing - Health Web - Nursing Communication NURSENET - Nursing Discussion Forums

You may search for Nursing lists by keyword or subject categories using: ● Liszt ● The Directory of Scholarly & Professional E-Conferences ● Tilenet ● Catalist Nursing Continuing Education CE WEB (American Health Consultants) Billed as "The Nurse's One Stop Resource for CE on the Web". SpringNet CE Connection (Springhouse Corp.) "Providing nurses with continuing education opportunities online".

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GMC Community Education & Resources Electronic Medical Consumer Journals on the Internet Health Biomedical & Clinical Sites Community Resources on the Internet Journals of the AMA Using Internet ● JAMA - full text of selected articles in current issue. Search Engines ● ARCHIVES of ... - full text of articles for entire year's issues. MEDLINE ● American Medical News - full text of medical news reports. Archival from 1995. ● MSJAMA - Medical Student JAMA ● JAMA Information Center - peer-reviewed collections of resources on specific conditions. Annals of Internal Medicine Archival from January 1, 1996, with limited number of featured articles from 1995 issues. Other publications from American College of Physicians Online..

BMJ Archival from March 18, 1995.

CA: A Cancer Journal for Clinicians Fulltext from January 1996.

Canadian Medical Association Journal Online Searchable. Archival from January 1, 1996. Other CMJ publications.

The Lancet Registration required. Archival from June 1, 1996.

New England Journal of Medicine On-line Current issue is available every week beginning Thursday morning. Abstracts of major articles contain Medline links. Full-text collections on asthma, breast cancer, and molecular medicine. Archival from January 1995.

The Journal of the American College of Cardiology published by Elsevier Science, Inc. Archival to vol. 27. JAMA - The Journal of the American Medical Association Archival from July 5, 1995.

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GMC Community Education & Resources Consumer Anatomy of the Lung Health Biomedical & Clinical Sites Community Resources on the Internet Using Internet Search Engines MEDLINE

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GMC Community Education & Resources Material Safety Data Consumer Sheets Health Biomedical & Clinical Sites Community Resources on the Internet ECDIN (Environmental Chemicals Data and Information Network) Physical-Chemical properties, Production and Use, Legislation and Rules, Using Internet Occupational Health and Safety, Toxicity, Concentrations and Fate in the Search Engines Environment, Detection Methods, and Hazards/Emergency information by MEDLINE CAS Number, ECDIN Number, Name - Synonym, or molecular formula.

Enviro-Net (University of Utah) select from an alphabetical list of chemicals.

Vermont SIRI MSDS Collection search by company, product name, or CAS; links to new MSDS provided directly by manufactures.

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GMC Community Health Agencies, Education & Resources Professional Health Consumer Societies, Non-Profit Health Consumer Health Biomedical & Organizations Clinical Sites Community Resources on the Internet National and International Health Agencies ● Using Internet Armed Forces Institute of Pathology Search Engines ● Centers for Disease Control MEDLINE ● Department of Health and Human Services ● Food and Drug Administration ● National Cancer Institute ● National Center for Infectious Diseases ● National Eye Institute ● National Heart. Lung, and Blood Institute ● National Institute on Aging ● National Institute on Alcohol Abuse and Alcoholism ● National Institute of Allergy and Infectious Diseases ● National Institute of Arthritis and Musculoskeletal and Skin Diseases ● National Institute of Child Health and Human Development ● National Institute of Diabetes and Digestive and Kidney Diseases ● National Institute on Drug Abuse ● National Institute of Mental Health ● National Institute of Neurological Disorders and Stroke ● National Institutes of Health ● National Library of Medicine ● National Sports Medicine Institute of the United Kingdom ● OSHA ● World Health Organization

Professional Healthcare Societies ● Ambulatory Pediatric Association ● American Academy of Allergy Asthma & Immunology ● American Academy of Child & Adolescent Psychiatry ● American Academy of Dermatology ● American Academy of Family Physicians ● American Academy of Neurology ● American Academy of Ophthalmology ● American Academy of Orthopaedic Surgeons ● American Academy of Otolaryngology-Head and Neck Surgery ● American Academy of Pediatrics ● American Academy of Physical Medicine & Rehabilitation ● American Association of Clinical Endocrinologists ● American Association for the Study of Liver Diseases ● American Association for the Surgery of Trauma ● American Association of Neurological Surgeons ● American Association of Orthodontists ● American College of Allergy, Asthma & Immunology ● American College of Cardiology ● American College of Chest Physicians ● American College of Emergency Physicians ● American College of Obstetricians and Gynecologists ● American College of Physicians ● American College of Radiology ● American College of Rheumatology ● American College of Surgeons ● American Dental Association ● American Dietetic Association ● American Gastroenterological Association ● American Geriatrics Society ● American Medical Association ● American Orthopaedic Foot and Ankle Society ● American Orthopaedic Society for Sports Medicine ● American Psychiatric Association ● American Psychological Association ● American Roentgen Ray Society ● American Society of Anesthesiologists ● American Society for Dermatologic Surgery ● American Society for Gastrointestinal Endoscopy ● American Society for Mohs Surgery ● American Society for Therapeutic Radiology and Oncology ● American Society of Addiction Medicine ● American Society of Cataract and Refractive Surgery ● American Society of Ophthalmic Plastic and Reconstructive Surgery ● American Society of Plastic and Reconstructive Surgeons ● American Speech and Hearing Association ● American Thoracic Society ● College of American Pathologists ● The Endocrine Society ● Radiological Society of North America ● Society for Pediatric Radiology ● Society of American Gastrointestinal Endoscopic Surgeons ● Society of Cardiovascular & Interventional Radiology ● Society of Critical Care Medicine ● Society of Laparoendoscopic Surgeons ● Society of Nuclear Medicine ● Society of Thoracic Radiology ● Society of Thoracic Surgeons

Non-Profit Consumer Health Organizations ● American Association of Kidney Patients ● American Brain Tumor Association ● American Cancer Society ● American Diabetes Association ● American Heart Association ● American Liver Foundation ● American Lung Association ● American Red Cross ● Arthritis Foundation ● The Australian Lung Foundation ● International Myeloma Foundation ● Juvenile Diabetes Foundation International ● La Leche League International ● Lupus Foundation of America ● National Arthritis Foundation ● National Neurofibromatosis Foundation ● National Osteoporosis Foundation ● National Psoriasis Foundation

Health Sciences Institutions ● Mayo Clinic Health O@sis ● National Jewish Center for Immunology and Respiratory Medicine ● University of Iowa Virtual Hospital ● University of Pennsylvania Cancer Center, OncoLink

Patient Advocacy Groups ● Planned Parenthood

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ANNUAL REPORT  hen I joined the Board of Trustees eight years ago, Gifford was known as a Dr. William Minsinger, Whospital. Today we are a President of the Medical Staff Executive Committee (seated community-based medical left); James Shinn, Chairman center. We are changing the of the Board of Trustees (seated services we provide, for right); David Gregg, President and CEO (standing). three basic reasons: to meet the needs of our community, to meet the challenges of today’s health care system, and to remain financially viable. Our continuing he medical staff continues focus is on maintaining a to work closely with small-town medical center Gifford’s Board, the where we know the people TMedical Center adminis- we serve—and our neigh- tration, and specialists at bors know Gifford is here The Hitchcock Clinic to for them. make sure that we improve In the last two years, through The —not just treat—the Hitchcock Alliance, we have formal- health of our community. ized our relationship with one of the New England’s best As a forward-looking organization, we are constantly evaluat- tertiary care facilities, Dartmouth-Hitchcock Medical ing innovative ways of both providing and financing health Center. The Alliance helps us find ways to keep meeting our care. It is important that we do this, not only because finan- community’s needs, while Dartmouth-Hitchcock provides us cial pressures continue to increase, but because today’s health access to a broad range of health-care professionals and facili- care environment makes it vital that we work together and ties, and brings us major savings through combined purchas- think creatively. ing and contracting. We face financial realities every day. Last year Gifford As we look at more regional health care planning efforts provided nearly $377,000 in charity care, and $2.96 million through The Hitchcock Alliance, we are also focusing on in unreimbursed care. Reimbursement rates for many proce- bringing health care services out into the communities we dures continue to tighten. We cannot spend money unneces- serve. This includes our two school-based clinics in South sarily, and we must provide the care that our community Royalton and Strafford, our Health Connections and needs, within a realistic budget. The good news is that we HealthBreaks programs that bring affordable care to all are meeting these challenges. members of our community, and our HealthStyles program- We have the advantage of trust. Our patients know we ming, focusing on wellness, prevention and lifestyle issues. are providing the best possible care at the lowest possible Gifford strongly believes that providing access to basic cost. We do not spend our energies on competition, we work health care services for all members of our communities is together. The medical staff has taken an increasingly active one of our major responsibilities and the driving force role in this process. This is just what we should be doing. behind our mission statement. James D. Shinn William Minsinger, M.D. Chairman, Board of Trustees President, Medical Staff Executive Committee n 1997, we continued our planning and development for the future. Gifford adopted an information system plan, I which will allow us to enhance patient care and meet the challenges

of managed care, including a new New surgical care Community Care billing system to be implemented in July 1998. We resolved our differences with the State of Vermont over the nursing home and created an approach to elder care services which will include an institutional component, in combination with the develop- Cataract Care Workplace Care ment of home and community-based programs. We began the process of looking at women’s health needs, and through a dialogue with our communities, we will be able to determine what Gifford should be doing

to better meet these needs. Long-Term Care Preventive Care Gifford is committed to its role of providing a full continuum of health care services, from birth through long-term care for the elderly. Our $4.3 million capital improvement project will create a new approach to the institutional component of elder Oncology Care Auxiliary care services, and allow for the opportunity to redistribute resources for other services for our aging pop- ulation. The project will also consol- idate and modernize inpatient and outpatient services, including our birthing center and same-day surgery center. As we move forward with the Affordable Care Volunteers most significant project in our 95- year history, your continuing involvement and support are critical to our success. David H. Gregg, Jr. President and CEO

Access to Care HIGH-TECH TOOLS, LOW-IMPACT OPERATIONS

s few as five years ago, gall bladder surgery at Most benefits of minimally invasive surgery go to the Gifford meant four to six days in the hospi- patient: shorter stays, less pain, faster recovery, less risk and tal and a six-week recovery. Today the typi- often less overall cost. Because they rely on high-tech equip- cal patient goes home the same day and is ment, these surgeries can be more expensive to do, but back to full activity within a week. much shorter hospital stays and simpler follow-up needs A Hysterectomy patients previously needed can reduce total costs. 20-30 stitches and recovered for six weeks. Instead of bending over an open cut or an older-style Today most hysterectomies require only two tube, today’s surgeons often watch a monitor’s close-up or three stitches. “Patients are feeling good image while they manipulate instruments that can stretch, in two weeks,” said gynecological surgeon cut and remove tissue—all from the ends of tubes. William Ellis, M.D., who practices at Gifford “You actually get a much better view for a lot of what with his wife and fellow OB-GYN, Anne you’re doing,” Dr. Ellis said. Stohrer, M.D. “The wave of the future is more minimally invasive This surgical revolution depends on nar- surgery,” Susan Nicholls said. “We are staying on top of the row scopes and tiny tools. It is often called latest technology to evaluate what are reasonable procedures minimally invasive surgery because it needs to perform here.” only very small incisions through which these instruments are inserted and manipulated. “This type of surgery involves the whole breadth of specialties here,” said surgeon LeRoy Hodges. Minimally invasive surgery at Gifford includes knee, gynecological and abdominal surgery, along with the eye work of ophthalmologist Jack Singer, whose cataract operations now need a single stitch- less incision only 1/16 inch wide. About half of Gifford surgeries are now performed using endoscopes, high-tech tubes that place a tiny video camera and bright fiber-optic lighting inside the patient. Procedures that use these scopes have various names—arthroscopy for the knee, hysteroscopy for the uterus, laparoscopy for the midsection. They are the key technology in same-day surgery, which accounts for “at least 80 percent of our volume now,” said Susan Nicholls, R.N., OR coordinator. To embrace this change and improve the efficiency of all surgeries, Gifford will open a new, larger same-day surgery unit, integrating the operating room and the minor procedure/endoscopy suite. The new unit will serve a growing Dr. Anne Stohrer need: 944 same-day surgeries were done during fiscal 1997, 44 percent more than the year before.

2 DR. SINGER’S PIONEERING VISION

School and a member of The Hitchcock Clinic in Randolph, was the first to provide cataract sufferers with a painless surgery that uses no needles, heals without stitches, leaves no visible scars, and opens new vision almost instantly. Dr. Singer makes a tiny, self-sealing cut in the eye’s clear outer dome, or cornea, then uses an ultrasound probe to break up and remove the cataract. Through the incision he injects a thin, rolled-up silicone lens implant, which unrolls to cover the lens. “I didn’t hold out much hope that it was going to work,” Letitia said. Yet within minutes of emerging from surgery, she was stunned to see the hands of a clock on the wall. “It was really a big surprise,” she said. “Everything was so clean-looking! I found out Cremora is white. I thought it was beige.” “The operation was a breeze,” she said. And now she has 20/20 vision, without glasses. Unlike most cataract surgeons, Dr. Singer adds a simple procedure that corrects astigmatism (uneven focusing in the cornea), along with Dr. Jack Singer near- and farsightedness. He has also begun offering newly developed multiple-focus lens implants, which eliminate the need for distance or reading glasses. or Letitia Rydjeski of Randolph, seeing “Now people say, ‘You’ve got contacts,’” Letitia said. through cataracts was like looking through “I say no—I had cataracts!” wax paper. Everything was a muddy brown- Last year Dr. Singer received new honors from the ish-gray. She had given up driving at night, American Academy of Ophthalmology and the American when headlights looked like exploding fire- Society of Cataract and Refractive Surgery for his teaching F works. The glasses she had worn since and innovations. He continues to give lectures and ninth grade in 1946, to correct nearsighted- surgery demonstrations, sharing his advances with eye sur- ness and astigmatism, could not compen- geons around the world. But he stays here, and lives in sate any more. Randolph, because he has chosen to. Her optometrist recommended Jack “I like the lifestyle,” he said. “I like the environment Singer, M.D., the Gifford ophthalmologist for my family. And people who live in rural areas deserve who has earned world renown and many the best possible health care.” honors for his continuing innovations in cataract surgery. Dr. Singer, who is also an assistant professor at Dartmouth Medical

3 LONG-TERM CARE: CREATING A NEW SYSTEM

he number of people over 65 years old in able for long-term care. Gifford will soon launch a capital Gifford’s service area is expected to grow campaign to make the expansion possible; the existing by 37 percent over the next 17 years. Yet Gifford Elder Care facility will continue operating during a society cannot afford to keep adding new 12-month transition period. nursing-home beds. “We will be able to accomodate all our existing resi- T From that reality comes an effort at dents—either in our own, new facility or in appropriate levels Gifford to find a broader solution for of care within our community,” said Jane Hayward, R.N., long-term care. Gifford and other administrator of Gifford Elder Care and vice president of providers are collaborating to develop a patient care services for the Medical Center. “When new peo- new, coordinated system in which in- ple come to us, we will help them find the appropriate place patient care will be one piece in a range for their care.” of services and options—most of which Overall, long-term care in this area will rely on coordinat- will center on supporting care in private ing a number of key services: homes and assisted-living facilities. • In-patient care, including the new swing beds, which can be more flexibly used than nursing-home beds—for example, providing respite care for families. • Other residential options, such as assisted-living facilities like those at Joslyn House in Randolph and Park House in Rochester. • Adult day programs that offer social and medical resources to help families meet long-term care needs. • Support services for at-home care. “Developing a coordinated team is really important,” Davis said. To make all parts of the new system mesh, case management is critical. “We’ve got to make sure that people “Long-term care is at a critical point. We’ve got to mobi- with complex health problems don’t get lost in the system,” lize and find the resources to care for people more actively in Davis said. “And if we’re going to expect families to take on our communities,” said Betsy Davis, the Gifford trustee who more responsibility for long-term care, we’ve got to make sure is CEO of the Visiting Nurse Alliance of Vermont and New we have in place the support systems they will need.” Hampshire. Gifford is working closely with VNA to develop “These changes really will fall into place,” Jane Hayward the new system as part of the Connecticut Valley Health and added, “if we can be patient and a bit flexible in how we Human Services Network. think about long-term care, and how we plan for the future. Gifford will create a key piece of the system in 1998, now It will be different—but I think in the end, people will feel that almost three years of negotiations have won State that the system we put in place will support the needs of our approval to add 20 in-hospital “swing” beds that will be avail- community.”

4 “WHY WE DO WHAT WE DO”

oping with a frightening diagnosis like cancer can be easier when you’re among people who know you. People like Sheila Metcalf and Pam Fournier. Registered nurses who received special C training last year in oncology care, Sheila and Pam are key players in Gifford’s team approach to providing comprehensive cancer care. Thanks in part to growing awareness of Gifford’s personal, community-style oncology services, last year many more cancer patients chose to receive their treatment here. Visits to Gifford for cancer treatment totaled 249 in fiscal 1997, compared with 151 the year before. One former patient who knows Gifford’s oncology staff well is Carolyn Donnet of Rochester. In 1996, having “It was very comforting to have the same two nurses already undergone a lumpectomy at Gifford for a breast when I went for my treatment every week, in a familiar malignancy, Carolyn fell ill with colon cancer and began a place,” Carolyn remembers—“and the rest of the team near- yearlong chemotherapy series here. by, if we needed to consult with them.” Working with Gifford physicians, the team includes the oncology nurses and the staff dietician, pharmacist, social services coordinator, and others as needed. Oncology services also include counseling and a breast-cancer support group, and Gifford has begun recommending massage therapy to ease patients’ discomfort. Today Carolyn is in remission. Asked about the friend- ship they developed with her, the nurses smile. “Carolyn used to get me to bring in pictures of my son, because she says he looks like her grandson,” Sheila said. “Really getting to know our patients helps them to be more at ease. I think that helps in their overall recovery.” “GLAD to SAY/that I’m OKAY,” began a rap-style poem that Carolyn wrote for her nurses about her “chemo.” Gifford’s HealthStyle newsletter published it last June. “She’s why we do what we do,” Pam Fournier says.

5 CONNECTING PEOPLE TO AFFORDABLE CARE

ike an estimated one in 10 people within Gifford’s “It has just been a big help to us so far,” Paul said. “I service area, Paul and Ruth Kennedy couldn’t ask for better people to work with. Michelle Graci cannot afford private health insurance even called me from her home, after hours. These people right now. It is too expensive and their really care about people that are having problems.” family has too many bills, some of them Formerly Gifford’s volunteer coordinator, Michelle now L for health problems. Last year, a hospital runs Health Connections—and interest in the program is bill led Paul to Health Connections, soaring. Gifford’s new program that helps people “We’ve seen over 400 people since we started,” Michelle with limited incomes find affordable said—“and the volume has tripled in the last two months health care solutions. of the year.” She estimates that in 1997 the program saved Gifford substantially in uncollectable bills by linking people up with coverage, often after they have received care. Most coverage comes through the Vermont Health Assistance Program (VHAP), which provides health insurance at very low cost to Vermonters whose income falls within guidelines set New by the State. Health Connections also solutions links people with Gifford Affordable for Care, which provides free and discounted community care; Dr. Dynasaur, a State program of needs free medical and dental care for children and expectant and new mothers; and Ladies First, which offers mammograms and pap smears for women over 50. Those programs also carry income limits. Health Connections emphasizes prevention, provides information, and links people with a wide range of health services. Gifford has always provided free care to those who need it—but the effort here is to connect with people who do not seek care because they do not think they can afford it. There are many more people to reach. If you are one of them, call Health Connections at 728-3744. “They’re doing real well,” Paul Kennedy said.

6 HEALTHBREAKS TRAVELS TO THE WORKPLACE

e have quite a few people who have no blood pressure, cholesterol, diabetes, and other health insurance, but need health services,” said issues. Women are offered appointments for pap tests and Elizabeth Dean, controller of Vermont mammograms. Sports Apparel, which employs about “We do a lot of follow-up calls, to find out if they’ve fol- 100 people in Randolph. lowed up,” said Anita Rye, an information and intake spe- W The company’s problem is common cialist. “If they haven’t, we do a lot of urging.” among today’s smaller businesses and the The program has served grocery stores, building contrac- self-employed all over Gifford’s service tors, restaurants, small manufacturers, auto body shops, and area. Many working people are not earn- more. To find other small businesses that need the service, ing enough to afford private insurance coordinator Beth Warrell visits town clerks and general —and many employers cannot afford to stores. provide it. “I go out and knock on doors,” she said. “Going business To help fill that gap, last February, to business is what works best.” with the help of a three-year federal grant, the Neighborhood Health Clinic launched HealthBreaks to provide workplace health screenings, information and referrals for care and low-cost coverage. The program is the only one of its kind in Vermont—and by the end of 1997, HealthBreaks had served 40 businesses and more than 200 people. “They came in and screened everybody,” said Dean of Vermont Sports Apparel. “Some people they found would qualify for different programs, either through the State or through Gifford.” That’s the purpose of HealthBreaks: to make it easy for working people to connect with coverage through the Vermont Health Assistance Program (VHAP), or with services through Gifford Affordable Care. Concentra- ting on preventive care and information, the HealthBreaks team of a nurse, a lab technician, and an information specialist screens for weight,

7 REACHING OUT FOR PREVENTION

n a snowy night late in 1997, four tables pulled together in the library of Strafford’s Newton School were filled with community residents and area health-care providers. They were hashing out details O for the new school-based health clinic. With only a few weeks to go before Newton School, Strafford. the clinic’s planned opening in January 1998, the local volunteers—already at work for a year and a half—had many School & more meetings still ahead. Gifford is the community sponsoring agency for the clinic, which is clinics learning much from the pioneering work of the South Royalton School Clinic that In Strafford, a town without local health services, the aim opened with Gifford’s collaboration in is to meet a range of students’ needs, from physical exams to 1995, the first of its kind in Vermont. disease prevention, treatment and follow-up, from dental screenings to mental health consultation and referrals. “Gifford has been really, really supportive of this project,” Nurse Practitioner Sally Lanpher at work in Rochester. said school nurse Alison Riley-Clark. “In both Strafford and South Royalton, people want this to work for their kids, and for their community—and they’ve worked very hard to make that happen,” said Sara Simpson, coordinator of the State program that has used Robert Wood Johnson Foundation grant money to fund both clinics. In South Royalton, about two-thirds of the local school children are enrolled in the clinic, with more coming in all the time. Gifford’s four community health centers—in Bethel, Chelsea, Rochester and South Royalton—received a total of 25,628 patient visits during fiscal year 1997. A familiar presence in the Bethel and Rochester clinics is Sally Lanpher, F.N.P. Sally has served in Bethel since 1974 and also works one day each week in Rochester, Sally’s home town, where Gifford is constructing a new clinic, to be opened in the spring. All the community health centers offer convenience, Sally noted—and practitioners are working steadily to encourage the regular visits that can prevent disease. “It takes a lot of coaching sometimes, and convincing,” she said. But when a mammogram, pap smear, or other check catches a disease in time, she added, “that makes it all worthwhile.”

8 QUITTING FOR YOURSELF

fter 20 years of smoking, Phil Hyde, a 37-year-old technician at the Vermont Castings foundry in Randolph, was up to two and a half packs of Marlboro 100s a day. He had tried to quit once, on his own, A without success, when he signed up for a Gifford “Freedom from Smoking” program at Vermont Castings last fall. “I work with White River Valley Ambulance Service, so I’ve seen what it can do,” he said. “And I just wanted to quit. I probably could have done it on my own, but this was more helpful to me.” For several years, respiratory therapist Derek vanGulden has offered the workshop to the community through Gifford’s Healthstyle program. This was the first time he took it to a workplace, as part of Gifford’s growing focus on industrial health. “The Castings folks were a great bunch, because they work together,” said vanGulden. “They would bounce ideas off each other.” The company paid for half of the workshop; employees paid the rest, but were reimbursed if they stayed clean for three months. Through the first two weeks, 18 participants kept track of their smoking. For week three, they set a quit date. Then they kept it. That first morning, driving to work from East Randolph, Phil had cravings. Since then, he said, not much. “I had my mind made up that I was going to quit. They showed you how to relax, how to think of other things. And everybody was there to support everybody. If I had an urge for a cigarette, I’d say no—I quit.” Quitting smoking is not easy. But at year’s end, three “Freedom from Smoking” participants were still clean. Phil Hyde is one. Quitters on the job: (from the left) Phil Hyde, Jim Foley, Phil Neff, His advice for others? and Derek vanGulden, Gifford’s respiratory therapist. “You don’t quit for anyone else,” he said. “You’ve got to quit for yourself.”

9 CONNECTING KIDS WITH SMOKING FACTS

n Bethel and Chelsea, a test of an innovative smoking- prevention program called HealthQuest has elementary school students phoning and e-mailing local doctors to ask such questions as, “Why do tobacco companies I sell something that’s dangerous?” “To make money,” George Terwilliger, M.D., told his young questioner in Chelsea. HealthQuest has been developed and directed by Jim Sargent, M.D., a pedia- trician at the Children’s Hospital at The program, which is being field-tested in the Chelsea Dartmouth-Hitchcock. and South Royalton school systems, combines up-to-date information and education resources with young people’s natural curiosity. The aim is to help students see more clearly the high-stakes battle that swirls around them— with tobacco marketers on one side and people who care about their health on the other. School classes are each researching a smoking-related topic, developing a presentation for a year-end competition. Among the resources available to them are local doctors David Pattison, M.D., of the South Royalton Health Center, and Terwilliger, of the Chelsea Family Health Center. “My third graders’ problem is to address and debunk a smoking myth,” Dr. Pattison said. “I went to visit them. It was a blast. They had all kinds of questions.” Dr. Terwilliger told one of his questioners that, while the overall number of American smokers is declining, smoking is on the increase among young people. Nearly 30% of Vermont 12th graders say they smoke. “I think advertising is the main influence,” he reflected. “Teenagers recognize the risk, but they think they’ll be different—they won’t get addicted. Yet at that age, you can become addicted on less than a pack of cigarettes.” Thanks to HealthQuest, Dr. Terwilliger said, “We’re able to talk with kids directly about questions they have. It’s so informal. We get the question, and we give a prompt

Dr. George Terwilliger answer.”

10 HIGHLIGHTS OF 

JANUARY free health screenings to work- Health Clinic was formally The first baby born at Gifford places in Gifford’s 15-town ser- “transplanted” into Gifford. in 1997 was four-pound, seven- vice area. Coordinated by the Through Health Connections ounce Izabel Audrey Earle, Neighborhood Health Clinic, and HealthBreaks, the Clinic daughter of JoHanna and the program is supported by a now devotes itself to helping Glenn Earle, Jr., of Rochester. three-year federal grant. those who have no health insur- The Assembly of the Gifford introduced its new ance, or do not have enough, to Hitchcock Alliance held its Patient Relations Department, connect with affordable, long- first meeting in Lebanon. The designating staff members term health care. new Assembly is composed of Marilyn Sargeant, Denise Harp therapist Christina all the governing trustees from Simpson and Phyllis Jensen, Tourin brought her special each of the Alliance’s members, R.N. to answer questions, clear healing sounds to residents of including Gifford. up confusions, and help resolve Gifford Elder Care, patients at delivered by Gifford’s Gifford podiatrist Kevin any problems that patients and Gifford, and even into the oper- Volunteer Services and McNamara, D.P.M., was families have. Patient Relations ating room during a surgery. employees of BlueFirst, the new named a Fellow in the can be reached at 728-2433. managed care program of Blue American Academy of Podiatric JULY Cross/Blue Shield of Vermont. Sports Medicine. Only one in MARCH Joining Gifford’s OB/GYN pro- 64 American podiatry practi- Gifford and the South gram were Brent Burgee, MAY tioners has achieved this desig- Royalton School-Based M.D., and Anita Onofrio, Members and friends of the nation. Health Clinic were awarded a C.N.M., who had been prac- Women’s Alliance of the Sheila Metcalf, R.N., and $150,000 local partnership ticing in the Randolph commu- Federated Church of Rochester Pamela Fournier, R.N., com- grant by the Vermont Agency of nity as members of The presented 12 quilts they made pleted an intensive training pro- Human Services. Funded by the Hitchcock Clinic. during the winter for babies gram in oncology nursing at Robert Wood Johnson At the Randolph Fourth of born at Gifford’s Birthing Dartmouth-Hitchcock Medical Foundation, the grant will help July Parade, the ever-popular Center. Center (see page 5). support the clinic for three years Gifford Drill Team won Most Bill Markle, a long-time as it works to become self-sus- Humorous honors with a Gifford trustee, was named FEBRUARY taining. Randolph Rotary’s Citizen of At Gifford’s Annual Meeting of After several months of ren- the Year. the Corporators, John ovations, the Primary Care The fourth annual Chun Wennberg, M.D., director of wing of the Levesque Medical Classic Golf Tournament, at the Center for the Evaluative Office Building opened to offer the Montague Golf Club in Clinical Sciences at Dartmouth one-stop, integrated access to Randoph, raised funds for the Medical School, spoke about nine Gifford medical practition- Medical Center. the Center’s ground-breaking ers in family care, pediatrics and research on patient-doctor internal medicine. JUNE shared decision-making. Residents of Gifford Elder Four years after being created to The new HealthBreaks pro- Care and Randolph and Joslyn provide free health care to the gram began this month to bring Houses received free daffodils, uninsured, the Neighborhood

16 dazzling display that featured SEPTEMBER Stallion Inn, raised $600 to Certificate of Need for lawn chairs and a fountain. In a day of community service, support Gifford’s Women’s Gifford’s $4.3 million facilities This summer, Bethel’s 16 students from South Wellness Fund, which provides improvement plan. Ending Project Playground installed Royalton High School pushed free mammograms for women three years of negotiations with bright new playground equip- wheelchair-bound residents of who are between 39 and 49 the State about the future of ment at its recreation field, with Gifford Elder Care around the years old and have limited Gifford Elder Care, the action help from Gifford’s annual Tunbridge World’s Fair, while incomes. paved the way for Gifford to $1,000 Philip Levesque com- “Woman to Woman,” implement its plans for facility munity grant. Gifford’s breast cancer support improvements and services. group, resumed its Wednesday AUGUST evening meetings at the Long-time area physician hospital. Elisabeth Berry passed away. other high-schoolers toured the Gifford’s cancer care pro- After many years practicing in fair with South Royalton third gram, the smallest among 2,300 Randoph, and earlier in South graders. hospitals whose cancer pro- Royalton, Dr. Berry had retired The Vermont Recruitment grams are approved by the With each light given in in 1985, but continued to serve Center awarded Gifford a American College of Surgeons, memory or in honor of a family Gifford in an advisory role and Certificate of Appreciation for was awarded a new three-year member, friend or colleague, as an honorary member of the its support of the non-profit approval by the College’s Gifford’s Lights of Love holi- Medical Staff. center, which works to recruit Commission on Cancer. day tree was illuminated on and retain primary care December 11. Gifford’s providers in Vermont. NOVEMBER Auxiliary again sponsored Gifford CEO David Gregg Thirty-nine Gifford employees Lights of Love, which this year won the annual golf tourna- were honored at the annual benefited the Women’s Wellness ment in Burlington sponsored Awards Banquet for their years Fund. The newly renovated South by the Vermont Association of of service. Top honors went to Gifford received a $4,125 Royalton Health Center, Hospitals and Health Systems, Effie Farnham, Edie Young, grant from the Susan G. Komen which was previously limited to as part of its annual meeting. and Janet Young (30 years), Foundation to provide free pediatrics, expanded its services Barbara Springer (25 years), mammograms for women with the new practice of David OCTOBER Mary Bradley, Martha 39-49 years old with limited G. Pattison, M.D., M.P.H., As head of a Gifford task force Chadwick, and Celia Kennedy incomes. in internal medicine and that is looking at women’s (20 years), and Nancy TIME magazine’s cover pediatrics. health center issues in the Harrington (15 years). story “Why More Americans LeRoy Hodges, M.D., White River Valley, Anne Gifford OB/GYN physician Are Fleeing to Small Towns” received a three-year appoint- Stohrer, M.D., told the Valley Anne Stohrer, M.D., received featured Randolph as one of ment as cancer liaison physician News that, “We as women have her master’s degree in public “10 towns...that were once for Gifford’s cancer program. needs that are not being met by health from Harvard University. struggling. Today...they’re going Dr. Hodges joins a national net- the standard medical communi- strong.” Among Randolph’s DECEMBER work of more than 2,000 physi- ty — and women are voicing attractions, the story lists “con- Elizabeth Costle, Vermont’s cians who provide leadership those needs.” trolled growth, above-average Commissioner of Banking, and support to the American “Making Your Steps schools and hospital, and plenty Insurance, Securities and Health College of Surgeons’ Count,” a volunteer fund-rais- of Ben & Jerry’s.” Commission on Cancer. ing walk at Randolph’s Three Care Administration, issued a

17 ALCOHOLISM

Getting the Facts For many people, the facts about alcoholism are not clear. What is alcoholism, exactly? How does it differ from alcohol abuse? When should a person seek help for a problem related to his or her drinking? The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has prepared this booklet to help individuals and families answer these and other common questions about alcohol problems. The information below will explain alcoholism and alcohol abuse, symptoms of each, when and where to seek help, treatment choices, and additional helpful resources.

A Widespread Problem For most people, alcohol is a pleasant accompaniment to social activities. Moderate alcohol use--up to two drinks per day for men and one drink per day for women and older people (A standard drink is one 12-ounce bottle of beer or wine cooler, one 5-ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits) -- is not harmful for most adults. Nonetheless, a substantial number of people have serious trouble with their drinking. Currently, nearly 14 million Americans--1 in every 13 adults--abuse alcohol or are alcoholic. Several million more adults engage in risky drinking patterns that could lead to alcohol problems. In addition, approximately 53 percent of men and women in the United States report that one or more of their close relatives have a drinking problem. The consequences of alcohol misuse are serious--in many cases, life-threatening. Heavy drinking can increase the risk for certain cancers, especially those of the liver, esophagus, throat, and larynx (voice box). It can also cause liver cirrhosis, immune system problems, brain damage, and harm to the fetus during pregnancy. In addition, drinking increases the risk of death from automobile crashes, recreational accidents, and on-the-job accidents and also increases the likelihood of homicide and suicide. In purely economic terms, alcohol-use problems cost society approximately $100 billion per year. In human terms, the costs are incalculable.

What Is Alcoholism? Alcoholism, which is also known as "alcohol dependence syndrome," is a disease that is characterized by the following elements: ● Craving: A strong need, or compulsion, to drink. ● Loss of control: The frequent inability to stop drinking once a person has begun. ● Physical dependence: The occurrence of withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, when alcohol use is stopped after a period of heavy drinking. These symptoms are usually relieved by drinking alcohol or by taking another sedative drug. ● Tolerance: The need for increasing amounts of alcohol in order to get "high." Alcoholism has little to do with what kind of alcohol one drinks, how long one has been drinking, or even exactly how much alcohol one consumes. But it has a great deal to do with a person's uncontrollable need for alcohol. This description of alcoholism helps us understand why most alcoholics can't just "use a little willpower" to stop drinking. He or she is frequently in the grip of a powerful craving for alcohol, a need that can feel as strong as the need for food or water. While some people are able to recover without help, the majority of alcoholic individuals need outside assistance to recover from their disease. With support and treatment, many individuals are able to stop drinking and rebuild their lives. Many people wonder: Why can some individuals use alcohol without problems, while others are utterly unable to control their drinking? Recent research supported by NIAAA has demonstrated that for many people, a vulnerability to alcoholism is inherited. Yet it is important to recognize that aspects of a person's environment, such as peer influences and the availability of alcohol, also are significant influences. Both inherited and environmental influences are called "risk factors." But risk is not destiny. Just because alcoholism tends to run in families doesn't mean that a child of an alcoholic parent will automatically develop alcoholism.

What Is Alcohol Abuse? Alcohol abuse differs from alcoholism in that it does not include an extremely strong craving for alcohol, loss of control, or physical dependence. In addition, alcohol abuse is less likely than alcoholism to include tolerance (the need for increasing amounts of alcohol to get "high"). Alcohol abuse is defined as a pattern of drinking that is accompanied by one or more of the following situations within a 12-month period: ● Failure to fulfill major work, school, or home responsibilities; ● Drinking in situations that are physically dangerous, such as while driving a car or operating machinery; ● Recurring alcohol-related legal problems, such as being arrested for driving under the influence of alcohol or for physically hurting someone while drunk; ● Continued drinking despite having ongoing relationship problems that are caused or worsened by the effects of alcohol. While alcohol abuse is basically different from alcoholism, it is important to note that many effects of alcohol abuse are also experienced by alcoholics.

What Are the Signs of a Problem? How can you tell whether you, or someone close to you, may have a drinking problem? Answering the following four questions can help you find out. (To help remember these questions, note that the first letter of a key word in each of the four questions spells "CAGE.") ● Have you ever felt you should Cut down on your drinking? ● Have people Annoyed you by criticizing your drinking? ● Have you ever felt bad or Guilty about your drinking? ● Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (Eye opener)? One "yes" response suggests a possible alcohol problem. If you responded "yes" to more than one question, it is highly likely that a problem exists. In either case, it is important that you see your doctor or other health care provider right away to discuss your responses to these questions. He or she can help you determine whether you have a drinking problem and, if so, recommend the best course of action for you. Even if you answered "no" to all of the above questions, if you are encountering drinking-related problems with your job, relationships, health, or with the law, you should still seek professional help. The effects of alcohol abuse can be extremely serious--even fatal--both to you and to others.

The Decision To Get Help Acknowledging that help is needed for an alcohol problem may not be easy. But keep in mind that the sooner a person gets help, the better are his or her chances for a successful recovery. Any reluctance you may feel about discussing your drinking with your health care professional may stem from common misconceptions about alcoholism and alcoholic people. In our society, the myth prevails that an alcohol problem is somehow a sign of moral weakness. As a result, you may feel that to seek help is to admit some type of shameful defect in yourself. In fact, however, alcoholism is a disease that is no more a sign of weakness than is asthma or diabetes. Moreover, taking steps to identify a possible drinking problem has an enormous payoff--a chance for a healthier, more rewarding life. When you visit your health care provider, he or she will ask you a number of questions about your alcohol use to determine whether you are experiencing problems related to your drinking. Try to answer these questions as fully and honestly as you can. You also will be given a physical examination. If your health care professional concludes that you may be dependent on alcohol, he or she may recommend that you see a specalist in diagnosing and treating alcoholism. You should be involved in making referral decisions and have all treatment choices explained to you.

Getting Well Alcoholism Treatment The nature of treatment depends on the severity of an individual's alcoholism and the resources that are available in his or her community. Treatment may include detoxification (the process of safely getting alcohol out of one's system); taking doctor-prescribed medications, such as disulfiram (Antabuse®) or naltrexone (ReViaTM), to help prevent a return to drinking once drinking has stopped; and individual and/or group counseling. There are promising types of counseling that teach recovering alcoholics to identify situations and feelings that trigger the urge to drink and to find new ways to cope that do not include alcohol use. Any of these treatments may be provided in a hospital or residential treatment setting or on an outpatient basis. Because the involvement of family members is important to the recovery process, many programs also offer brief marital counseling and family therapy as part of the treatment process. Some programs also link up individuals with vital community resources, such as legal assistance, job training, child care, and parenting classes. Alcoholics Anonymous Virtually all alcoholism treatment programs also include meetings of Alcoholics Anonymous (AA), which describes itself as a "worldwide fellowship of men and women who help each other to stay sober." While AA is generally recognized as an effective mutual help program for recovering alcoholics, not everyone responds to AA's style and message, and other recovery approaches are available. Even those who are helped by AA usually find that AA works best in combination with other elements of treatment, including counseling and medical care. Can Alcoholism Be Cured? While alcoholism is a treatable disease, a cure is not yet available. That means that even if an alcoholic has been sober for a long while and has regained health, he or she remains susceptible to relapse and must continue to avoid all alcoholic beverages. "Cutting down" on drinking doesn't work; cutting out alcohol is necessary for a successful recovery. However, even individuals who are determined to stay sober may suffer one or several "slips," or relapses, before achieving long-term sobriety. Relapses are very common and do not mean that a person has failed or cannot eventually recover from alcoholism. Keep in mind, too, that every day that a recovering alcoholic has stayed sober prior to a relapse is extremely valuable time, both to the individual and to his or her family. If a relapse occurs, it is very important to try to stop drinking once again and to get whatever additional support is needed to abstain from drinking. Help for Alcohol Abuse If your health care provider determines that you are not alcohol dependent but are nonetheless involved in a pattern of alcohol abuse, he or she can help you: ● Examine the benefits of stopping an unhealthy drinking pattern. ● Set a drinking goal for yourself. Some people choose to abstain from alcohol, while others prefer to limit the amount they drink. ● Examine the situations that trigger your unhealthy drinking patterns, and develop new ways of handling those situations so that you can maintain your drinking goal. Some individuals who have stopped drinking after experiencing alcohol-related problems choose to attend AA meetings for information and support, even though they have not been diagnosed as alcoholic.

New Directions With the support of NIAAA, scientists at medical centers and universities throughout the country are studying alcoholism. The goal of this research is to develop more effective ways of treating and preventing alcohol problems. Today, NIAAA funds approximately 90 percent of all alcoholism research in the United States. Some of the more exciting investigations include: ● Genetic research: Scientists are now studying 3,000 individuals from several hundred families with a history of alcoholism in order to pinpoint the location of genes that influence vulnerability to alcoholism. This new knowledge will help identify individuals at high risk for alcoholism and also will pave the way for the development of new treatments for alcohol-related problems. Other research is investigating the ways in which genetic and environmental factors combine to cause alcoholism. ● Treatment approaches: NIAAA also sponsored a study called Project MATCH, which tested whether treatment outcome could be improved by matching patients to three types of treatment based on particular individual characteristics. This study found that all three types of treatment reduced drinking markedly in the year following treatment. ● New medications: Studies supported by NIAAA have led to the Food and Drug Administration's approval of the medication naltrexone (ReViaTM) for the treatment of alcoholism. When used in combination with counseling, this prescription drug lessens the craving for alcohol in many people and helps prevent a return to heavy drinking. Naltrexone is the first medication approved in 45 years to help alcoholics stay sober after they detoxify from alcohol. In addition to these efforts, NIAAA is sponsoring promising research in other vital areas, such as fetal alcohol syndrome, alcohol's effects on the brain and other organs, aspects of drinkers' environments that may contribute to alcohol abuse and alcoholism, strategies to reduce alcohol-related problems, and new treatment techniques. Together, these investigations will help to prevent alcohol problems; identify alcohol abuse and alcoholism at earlier stages; and make available new, more effective treatment approaches for individuals and families.

Resources For more information on alcohol abuse and alcoholism, contact the following organizations: Al-Anon Family Group Headquarters 1600 Corporate Landing Parkway Virginia Beach, VA 23454-5617 Internet address: http://www.al-anon.alateen.org Makes referrals to local Al-Anon groups, which are support groups for spouses and other significant adults in an alcoholic person's life. Also makes referrals to Alateen groups, which offer support to children of alcoholics. Locations of Al-Anon or Alateen meetings worldwide can be obtained by calling the toll-free numbers Monday through Friday, 8 a.m.-6 p.m. (e.s.t.): U. S.: (800) 344-2666 Canada: (800) 443-4525 Free informational materials can be obtained by calling the toll-free numbers (operating 7 days a week, 24 hours per day): U. S.: (800) 356-9996 Canada: (800) 714-7498 Alcoholics Anonymous (AA) World Services 475 Riverside Drive, 11th Floor New York, NY 10115 (212) 870-3400 Internet address: http://www.alcoholics-anonymous.org Makes referrals to local AA groups and provides informational materials on the AA program. Many cities and towns also have a local AA office listed in the telephone book. National Council on Alcoholism and Drug Dependence (NCADD) 12 West 21st Street New York, NY 10010 (800) NCA-CALL Internet address: http://www.ncadd.org Provides phone numbers of local NCADD affiliates (who can provide information on local treatment resources) and educational materials on alcoholism via the above toll-free number. National Institute on Alcohol Abuse and Alcoholism Scientific Communications Branch 6000 Executive Boulevard, Suite 409 Bethesda, MD 20892-7003 (301) 443-3860 Internet address: http://www.niaaa.nih.gov Makes available free informational materials on all aspects of alcoholism, including the effects of drinking during pregnancy, alcohol use and the elderly, and help for cutting down on drinking. Prepared: November 1996