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New doctors, renovations for AVH

Construction Manager Chris Allain, and doctors Ron King and Daniel Van Buren look over the plans for the renovations at Androscoggin Valley Hospital. Kayti Burt. (click for larger version)
August 18, 2010
BERLIN — Androscoggin Valley Hospital (AVH) undergoing some major developments with the expansion of their cardiology department and the creation of pulmonology and sleep practices. Though construction on an enhancement to the actual space of the hospital has been ongoing for months, the recent arrival of cardiologist Dr. Dan Van Buren, the first of three new doctors set to join AVH's staff in the coming months, is beginning to make AVH's plans of expansions a firm reality.

Dr. Van Buren is originally from upstate New York, and earned his Doctor of Medicine degree in 2003 from Ross University School of Medicine in Wisconsin where he finished first in his class. Dr. Van Buren's clinical training was completed in New York where he interned in Internal Medicine at the Maimonides Medical Center, a high-volume cardiac center in Brooklyn. He was named "Intern of the Year." Dr. Van Buren completed his fellowship at Maimonides in cardiovascular disease, receiving Level 2 training on nuclear stress testing and exercise stress testing. He is married and has a two-year-old daughter.

Though the transition from a city like New York to a Berlin may be jarring, Dr. Van Buren seems to be taking it well within stride. He spent the previous week in Manchester at the New England Heart Institute of the Catholic Medical Center (CMC), the hospital that has worked with AVH for the past eleven years to provide cardiological services to the region, to get to know the staff there before coming to Berlin.

"I can say coming from a high-volume tertiary center in New York City that they have everything," said Dr. Van Buren, excluding transplants from that list — a goal the medical center is working towards.

Dr. Van Buren began his first official day at AVH last Monday, and he says the transitions thus far is smooth, in no small part to the welcoming staff.

"I don't have the vocabulary to describe how supportive they've been," praised Dr. Van Buren.

As for the physical changes to the building, construction is going "full-speed ahead," said Cardio-Pulmonary Director Dr. Ron King. "Renovations are being done as we speak."

Chris Allain of Portland-based Langford and Low General Contractors, and his crew of 15 men have gutted what used to be the mental health department and are turning the 5,700-square-foot space into what will be the new department of medicine wing, complete with six exam rooms, an echo testing room, a cardio testing room, a waiting room, and offices for the physicians. The project, which planning started on only 2 or 3 years ago, is set to be finished by October 25.

The decision to expand the cardiology department came after it became clear that the community's need was no longer being met by the part-time services previously offered, said Dr. King. Over the past five or six years, AVH, in conjunction with CMC, has offered two days a week of cardiology physician services. The hospital serves an area of roughly 20,000 people and, though the health of the region did not worsen, marketing and cardiac disease awareness saw the demand for services grow. Over the past four years, there has been a 25-30 percent growth in patients for cardiac management.

"The two days per week lead to a persistent wait time for the patients of our service area which needed to be addressed," said Dr. King. Through the continued collaboration with CMC, AVH was able to provide a cardiology midlevel provider to work alongside the cardiologists a couple days a month. This enabled AVH to provide cardiological services to Upper Connecticut Valley Hospital in Colebrook, a rural health care region where service is particularly hard to come by. Despite these changes, it became apparent that an expansion was still necessary if AVH was to provide service without expecting patients to have a significant wait time. Dr. King said that the hospital prides itself on providing care that respects the patients time, which means keeping departments within close proximity to each other so additional tests can be run on the same day, versus making the patient come back on another day.

"We wanted to keep that same model, but just expand it," explained Dr. King.

One of the spaces that has already been fully renovated is the new cardiac rehabilitation area, moved from the first floor to the second where the Home Health space used to reside before moving off-site. It can now accommodate 8 patients at a time, versus four. Cardiac rehab area is part of AVH's Phase II program for patients recovering from cardiac problems. Phase I is the period in the hospital when a patient has very recently undergone surgery, a service not offered at AVH. Phase II focuses on rebuilding a patient's strength, as well as educating them about their disease. During the months following surgery, a patient is at high-risk for a second incident and Phase II programs have proven to decrease the risk of a relapse. AVH's cardiac rehab space is stocked with exercise machines and equipment where staff, including a recently hired second Cardiac Rehab Nurse, can monitor a patient's EKG rhythm while they exercise.

An extremely important aspect of the cardiac rehab program is the patient education, which Dr. Van Buren said is greater than anything he encountered at his last hospital in New York City.

"We pride ourselves on the variety of education," said Dr. King, listing hands-on activities including group presentations, one-on-one meetings with nutritionists, and a very well-attended presentation during which AVH staff prepare a healthy yet tasty meal for patients to demonstrate what kinds of things they should be eating. The nutrition department, cardiologists, and former patients have even put together a Cardiac Rehab Cookbook, which will be given to patients who complete the Phase II program.

AVH has no Phase III program, when an exercise program is developed for the patient to ensure continued health.

"We don't have the ability to maintain that capacity right now," said Dr. King, explaining it is a matter of space, as well as staff. However, with the ongoing expansion, he hopes to offer a Phase III program by the end of the year. The hospital has already started talking to former patients and developing plans and policies for the program, said Dr. King.

In addition to Dr. Van Buren, pulmonologist Dr. Phillip Maioraio will be arriving at the hospital September 20 and sleep physician Dr. Joseph DellaVella will be arriving in November.

Sleep practice will probably start in November or December, expanding from the service AVH has now in conjunction with physicians from Dartmouth.

"This will enable us to do more in-house," said James Patry of AVH Public Relations. With the addition of sleep rooms, individuals can be tested on-site. "It's amazing the number of people who are having sleep exams done. The growth in that industry is amazing."

"It's very exciting for us to be part of this expansion," said Dr. Van Buren in closing. "From my understanding, it's a service that is desperately needed here — not just at AVH, but in the North Country."

"This full time recruitment will allow us to provide cardiac and vascular services to the North Country citizens that has been needed for many years," added Dr. King.

Martin Lord Osman
Varney Smith
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