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Education

Doctors in Residence

Dr. Lauren Wagener

Dr. Lauren Wagener says she discovered roller derby before she enrolled in medical school, and continued to play while earning that degree.

She told BusinessWest she started playing in a league, taking shifts as both a ‘jammer’ and a ‘blocker,’ terms most Baby Boomers might remember — that’s might — from when they watched the sport on TV back in the ’70s.

Things are different now, said Wagener, noting that today’s game features less violence and fewer of the pro-wrestling-like antics that Boomers might remember.

“Roller derby has revamped into more of a fully realized team sport with rules and regulations and safety — we’re not allowed to trip, no punching, no hitting,” said Wagener, who did some extensive research on the scene well before she moved here and identified two leagues she might play in locally.

But she has a few problems.

The first is a completely torn anterior cruciate ligament in her knee, an injury suffered while playing the sport; she is scheduled to have surgery soon. The second is that she just started her residency at Baystate Medical Center.

“No one likes working on the computer, on the notes; it’s the patient care everyone enjoys. This is what internal medicine offers, and I wanted to be a part of that.”

And while residents don’t have the crazy schedules they did until a decade or so ago, they still put in 80 hours a week over six days, the equivalent of two full-time jobs. That won’t leave much time for roller derby, although Wagener is determined to make some — after the knee is healed, of course.

In the meantime, she plans to take some of the lessons she’s learned from roller derby about teamwork into her daily duties at Baystate’s Mason Square Neighborhood Health Center and myriad other settings she finds herself in. And there are many such lessons, as she will explain later.

Wagener is one of 90 new residents and fellows to arrive at Baystate this summer to begin the next chapter in their healthcare education. Each one has a different and compelling story.

Dr. Zoha Kahn is from Pakistan. But she was already quite familiar with Baystate and Western Mass. before starting her residency a few weeks ago because her sister is a cardiology fellow at the hospital, and her brother-in-law is a pulmonary and critical-care fellow.

Kahn is an internal-medicine resident who hasn’t quite figured out what she wants to a specialize in, and plans to spent at least the next year narrowing her focus.

“Internal medicine is very broad — you deal with everything,” she explained. “This gives you the opportunity to look at the full spectrum of diseases before choosing what you want to do; I get to find out what I truly like.”

Dr. Zoha Kahn

Dr. Tiago Martins, meanwhile, is from Ludlow. While attending Ludlow High School, he took part in a job-shadowing program that brought him to Baystate Medical Center, an experience that inspired him to choose healthcare as a career. Later, he did rotations at Baystate while attending the University of New England College of Osteopathic Medicine in Maine and was actually on a trauma-surgery rotation at the hospital when he learned he had matched there.

Today, he’s essentially starting his professional career there with the stated goal of becoming a hospitalist, a specialist who, as that name implies, cares for individuals while they are hospitalized.

“It provides a different type of challenge,” he said of the hospitalist role. “You see patients not on a long scale, like a primary-care physician does, but you deal with more healthcare needs, and you also get to work with them more on a social level; I really enjoy it.”

For this issue and its focus on education, BusinessWest talked with these residents and some of their supervisors about these intense experiences and how they help these newly minted doctors prepare for the careers in front of them.

Learning Curves

Kahn told BusinessWest there is certainly no shortage of poverty in Pakistan. She cared for that population while attending medical school in that country, and she said she’s generally aware of the myriad challenges that those living in poverty — there and here — face as they struggle to survive day to day.

But none of this prepared her for what’s known as ‘poverty simulation,’ an experience that seemingly every participant describes with the same adjective — eye-opening.

Kahn is no exception. She played the role of a young, single mother in this exercise, and over the course of the fast-moving, four-hour simulation, she learned first-hand all that life can throw at you — and take from you — when you’re living at a certain income level.

Dr. Tiago Martins

“When you’re in that place, it is so difficult,” she recalled. “I was a single mother with two kids, and I was going to school. The first week, I couldn’t pay my rent, my kid was taken away … it was really crazy. You don’t know how to handle all your expenses along with taking care of kids; it’s really eye-opening and gives you a better perspective on how to deal with the kind of patients you’re going to see.”

The poverty simulation is part of the orientation process for all new residents at Baystate, she explained, and, as she said, it’s designed to help ease residents into the community they’re going to serve and give them perspective into one of the larger populations they will serve.

Kahn said she knew more than a little about Springfield from visits to see her sister and brother-in-law, both of whom also did their residencies at Baystate. This familiarity, not to mention a host of positive reviews, put the hospital at or near the top of her wish list when it came to the matching process for her internal-medicine residency.

“When I came for the interview, it felt right,” she said, adding that feel is all-important when one is considering where to spend their next three years on their career journey.

In addition to the array of options it presents, she said she chose internal medicine for the high level of patient interaction.

“You get these long-term relationships — you’re following that one patient for a while, and you build a relationship with that patient, which is very important to me,” she said. “No one likes working on the computer, on the notes; it’s the patient care everyone enjoys. This is what internal medicine offers, and I wanted to be a part of that.”

“Some rotations are harder than others, so we try to pick the schedules carefully so the rotations are balanced in terms of the intensity of the number of hours they do.”

Since starting her residency, Kahn has been working mostly on the ‘floors,’ or wards within the hospital. The cardiac ward is coming up soon on the schedule, and she expects to be working with her sister. She described life so far as “crazy,” in part because she’s learning a new system.

“The way medicine is practiced in Pakistan is different from the way it’s practiced here,” she explained. “It’s a steep learning curve, even with something like the electronic system of documentation.”

Kahn said she’s managing to navigate all this change thanks to a solid support system, a sentiment echoed by all the residents we spoke with.

“Everyone is super helpful,” she explained, adding that it certainly helps to have family in the area — and at the same hospital. “I feel more confident in my ability to deal with patients, and things have gotten better with time, but in the first few days it was really tough; what’s helped has been all the support.”

Support System

Dr. Reham Shaaban is a big part of that support system that Kahn mentioned.

She’s program director of Internal Medicine Residency at Baystate and an academic hospitalist there. She also did her own residency at Baystate.

Each year, she told BusinessWest, a class of 18 new residents arrives at the Baystate system. The doctors come from across the region and around the world, she noted, adding that the class of 2019 is quite typical.

“They all have different backgrounds, different experiences, and different expectations,” she explained. “And knowing that, we start with a blank slate and put together a six-week orientation period for them to get them familiar with all of our resources, all of the help, to get to know them a little better, and ease them into understanding our system and what’s expected of them.

“And introduce them to our community,” she went on, adding that there is quite a bit that goes into that part of the equation.

Part of it involves work at Baystate’s various neighborhood clinics, like the one in Mason Square, she said, adding that the six-week orientation also involves rotations in various wards at the hospital. There are also shadowing programs with nurses and other healthcare professionals, and so-called boot camps, simulation-lab cases conducted with supervisors and chief residents to focus on some of what Shaaban called the “bread-and-butter medicine aspects we see in internal medicine to help them hit the ground running.”

The poverty-simulation program is another big part.

“This is the third year we’ve been doing it, and it’s a very powerful experience for our residents to understand our community and have a different perspective going into medicine,” she explained. “And we do it purposefully before they start seeing their first patients.”

When they do start seeing patients, they do so with large amounts of supervision and support from senior residents, who are two years ahead of them in training, she went on, adding that guidance is provided in everything from patient diagnosis and treatment to use of the computer system.

And the schedule is carefully choregraphed, she went on.

“Some rotations are harder than others, so we try to pick the schedules carefully so the rotations are balanced in terms of the intensity of the number of hours they do,” she explained. “We try to put easier rotations between harder rotations to give them some breathing room.”

Describing the sum of all this, both Shaaban and Marie Housey, administrator of the internal-medicine program, said it extremely rewarding work — and it’s a lot like parenting.

“It’s the best job I ever had,” said Shaaban, who devotes much of June and July to the new residents before shifting back to the second-and third-year doctors. “It’s like being a parent and seeing your kids go through and learn new things and grow each day until you let them out to real life.”

Housey agreed. She said she starts corresponding with residents soon after match day and continues to do so on a weekly basis, dealing with subjects ranging from the location of housing to how and when they get paid.

“It’s like having a lot of children and nurturing them and watching and helping them grow,” she said. “It’s a lot of work, but it’s very, very rewarding.”

At Home with the Idea

Flashing back to the job-shadowing experience nearly a decade ago, Martins said he was able to shadow a wide variety of professionals, including Emergency Department staffers, radiologists, physician assistants, nurses, and a variety of doctors.

The experience, as noted earlier, put his career path into focus.

“From that point, I knew that I wanted to go into medicine,” he told BusinessWest. “And, ideally, I knew that I wanted to work at Baystate.”

And today he is, with a badge that declares that he is a doctor of Osteopathic Medicine.

Martins said he has a number of connections to Baystate, and collectively they make the hospital feel like home.

Listing more of them, he said his mother works there as a housekeeper; he now rides to work with her most days. Also, he became familiar with the hospitalist and that unique role while visiting — and translating for — grandparents and parents when they were in the hospital.

“Coming from a first-generation family, I always had to interpret for my parents and grandparents,” he explained. “And I found myself always connecting very well with the hospitalist team that took care of them, one of them being my current advisor; she took care of my grandfather when he was here with cancer four years ago.”

This explains the wide range of emotions when he received the e-mail on match day informing him that he would be doing his residency at Baystate.

“It’s hard to describe,” he said. “It was a happy, emotional type of experience, but at the same time it was kind of surreal; I was very excited.”

When he spoke to BusinessWest, Martins was on rotation at the Cardiac Intensive Care Unit (CICU) at the hospital, but, like Wagener, he’s also doing work in the clinics as well, specifically the one on High Street, another facility that serves a generally low-income population.

“We see a wide variety of conditions, and we also deal with some complex social backgrounds that are not unique to Springfield but are very common here,” he explained. “In a sense, we’re helping them with the social determinants of healthcare; many of these patients can’t afford some of their medications and have to make decisions about what they can afford and can’t afford.”

The clinic setting contrasts sharply with the CICU, he said, adding that those working in the latter setting are far less focused on social concerns than the immediate medical necessities; going from one world to the other is part of the residency experience.

“There are high points of stress and low points of stress,” he said, referring initially to the CICU, but also the clinic setting as well.

Like Kahn, he said the poverty simulation brought home the challenges facing many of his patients in a very powerful way.

“Even though we all knew it was a game,” he recalled, adding that he played the father and head of a household in his simulation, “it became very real.”

Rolling with the Punches

Wagener told BusinessWest she had heart surgery as an infant and has vivid memories of some of the follow-up visits to the hospital.

She recalls having a temper tantrum upon being informed that she couldn’t keep an X-ray taken of her.

Overall, she said science and medicine are in her blood, and that’s why she took the healthcare fork along the career path. “I took an anatomy class in junior or senior year of high school, and that got me full into it,” she said, adding that further inspiration was provided by listening to the stories of some classmates diagnosed with cancer.

Dr. Lauren Wagener, seen here in her other uniform, will struggle to fit roller derby into her life — even after knee surgery.
Photo by Phantom Photographics

A native of the Pittsburgh area, she preferred to stay somewhat close to home for her residency, but she also read — and actually called up the quote on her phone to verify — that Baystate “has the happiest residents in the country.”

On match day, she got a text informing her that she would be one of them.

As noted, her residency is in what’s known as ‘med-peds,’ a combination of internal medicine and pediatrics, which means she has many career options to consider as her residency plays out over the next three years, both general and very specialized.

Early into her residency, she has spent considerable time at the clinic in Mason Square, where she’s taking care of patients and getting a first-hand look at the challenges facing a population that is, for the most part, living at or below the poverty line.

“At Mason Square, we have a very underserved population of patients,” she explained. “These are people not only with complicated medical issues, but also people who might struggle to get the resources that would help with their treatment. In the clinic, it’s not only learning the medicine, it’s also learning how to navigate the resources that we have for patients and helping them get what they need, not only medicine-wise, but with things in the home as well.”

Overall, it’s work that is in many ways different from medical school.

“It feels different when the decisions are yours and you’re not just recording for someone else,” she said, adding that she is new to such duties as ordering tests and prescribing medications. “There is a lot of responsibility that comes with that, and you want to do well by your patients.”

As for roller derby, she said it’s like medicine in a lot of ways, especially when it comes to teamwork.

“You have to have a good team and a strong sense of teamwork and collaboration,” she said, referring to both the roller-derby rink and a hospital or clinic. “Communication is the name of the game.

“You’ve got to put yourself out there,” she continued while expanding the analogy to her current work in residency. “In roller derby, one of the first things they teach us is falling and how to fall safely; they teach you how to fall so hopefully you can fall less in the future. If you make a mistake by falling, you know to get back up again and jump back into it — it’s in the same in this setting. And there’s a lot of encouragement as well; we pick each other up.”

Study in Determination

Wagener told BusinessWest she’s going to be very careful and patient when it comes to roller derby, and she wasn’t just talking about her knee.

“It’s a sport that can easily take over your life,” she said, while quickly noting that she’s already had her life taken over by something else — her med-peds residency.

It’s a three-year journey and a critical step in one’s career in healthcare. It’s a learning experience, but also a life-changing experience, as these residents, only a few weeks into the process, already know.

George O’Brien can be reached at [email protected]

Features

Transition Game

Photo by Sandra Costello

As the founding director of the Family Business Center of the Pioneer Valley, Ira Bryck has spent countless hours talking about the importance of succession planning and how to execute it properly. When it came time for his agency to transition, he — and his board — followed his own advice.

Ira Bryck knew it was time — as in time to put a succession plan in place — when he attended a gathering of family business center directors just over a year ago, took a quick look around the room, and concluded that he was the only first-generation leader still on the job roughly a quarter-century after this “movement,” as he called it, began.

“They were all second- and third-generation administrators,” he said of the other 39 people in the room. “I was the elder statesman, and that was a wake-up call.”
He laughed as he recalled this — it was one of those Baby-Boomer-realizing-he’s getting-on-in-years laugh — but there was considerable seriousness in his voice as he talked about the subjects of succession and succession planning.

As leader of the Family Business Center of the Pioneer Valley Inc., and as a fourth-generation member of a family business himself, he knows that far too many companies, large and small, don’t have succession plans, or don’t have them until it’s too late.

For this reason, the transition in leadership at the FBC, as it’s called, from Bryck, whose name is pretty much synonymous with that agency, to Jessi Kirley became not just a succession, but what amounted to an exercise in successful succession planning.

And, no, these two are certainly not shy about using that phraseology this early on — just as Kirley is about to officially take the reins at the FBC’s 25th anniversary gala next month at the Log Cabin. They really believe that this is how it should be done.

“The family business, as a topic, has a lot to do with succession, and I have coached a lot of other people how to go through succession, and I did see it with my own family,” said Bryck, who will remain with the FBC on a very part-time basis working on special projects and coaching. “I believe what we’ve done here is a good model to follow.”

Kirley concurred, and noted that this transition has been different from most she’s observed in the way that the process used has enabled her to establish relationships and trust with the board and the FBC’s members before her tenure officially began, helping to ensure a smooth passing of the baton.
“Ira’s been talking about this transition for a long time,” she explained, “giving the members time to absorb it, to ask questions, to share concerns, and being really available.”

Elaborating, the two said the board of the FBC, which currently boasts nearly 60 members, was involved in not only making sure Kirley was a proper fit — she and Bryck both took a battery of personality tests — but that the transition was given the time, resources, and blueprint to help ensure success.
By time, they meant nearly 10 months of the two working together at the FBC, and by resources, they meant the payroll flexibility to have them both on the clock for that extended period.

And by blueprint, they meant a plan of action whereby Bryck would hire a program manager who then would be assessed to determine if he or she had what it took to become the FBC’s second executive director. And for this assessment, the chosen candidate (Kirley) would quickly start making key decisions and assuming a leadership role.

“One of the first things I said to her was, ‘I’m throwing you in the deep end of the pool and making sure you don’t drown,’” said Bryck, adding that this strategy paid off. “Right away, she took ownership.”

Kirley agreed, and described this succession as a “slow, conscientious hand-off.”
For this issue, BusinessWest takes an in-depth look at this handoff to detail both this important change at the FBC at its 25th anniversary, and also the manner in which this became what Bryck and Kirley both believe could be a model transition.

Following the Script

Bryck called it a “rainy-day fund.”

That’s what the FBC, like many businesses, agencies, municipalities, and states, calls money put aside for emergencies and unforeseen expenses.
It was this account that was tapped to enable Bryck and Kirley to be on the payroll for several months together — budget flexibility that they readily acknowledged that many businesses and nonprofits don’t have.

The FBC didn’t officially rename the fund, but Kirley did unofficially, suggesting that it might be called the ‘growth and sustainability fund.’
Such thinking helps explain the mindset that all those involved in this transition — Bryck, Kirley, the FBC’s board, and its membership — took with this exercise.

“One of the first things I said to her was, ‘I’m throwing you in the deep end of the pool and making sure you don’t drown.”

Photo by Sandra Costello

It was, indeed, a slow, conscientious handoff, one designed to secure perhaps another 25 years for this agency, devoted, as the name suggests, to providing education and insight to those involved in family businesses — however they are defined, and there are several working definitions.

And while this story officially began with Bryck walking into that conference meeting room, it started to gather steam when he got back. Not long after, he talked with his board and conveyed the need to start the process of succession.

“I knew I needed to find someone who did what I did, but would do it differently if they really wanted to increase the capacity,” said Bryck, “and do the second quarter-century the right way.”

This was a huge moment in the FBC’s history, because Bryck had been there from the beginning and was (and still is) quite popular with members — and for many reasons.
They include his innovative methods — right down to writing and then performing plays about various aspects of being in business with family members — as well as a hands-on approach and first-hand experience with being in a family business, specifically a children’s clothing store.
So it was important not only to pick the right successor but orchestrate a smooth transition that would not only retain members, but create momentum and enthusiasm for the next 25 years.

The process started with finding the right person. Kirley was recommended to Bryck by a mutual friend who, Bryck recalled, kicked things to a higher level with the comment, ‘why haven’t you hired Jessi Kirley yet?’

Jessi Kirley says the deliberate, well-orchestrated passing of the baton at the FBC helped her build confidence before officially taking the helm.
Photo by Sandra Costello

After several interviews with Kirley, who was looking for a new challenge after working in administrative positions for a succession of healthcare-related businesses, Bryck decided she had the requisite skills and potential. And she decided that was where she wanted that search for a new challenge to end.
“It was clear that there was a growth-oriented mindset built into the fabric of what Ira has created over 25 years,” she recalled. “I felt like I was home, that I was around people who want to learn and love and care for their business; it’s what I had always been looking for.”
Thus began a lengthy process of making sure she was the right fit for the executive director’s position, one that included several personality assessments, for both Kirley and Bryck.

“They wanted to make sure that she had the leadership style, the ability to gather a community together, and the ability to tap into what a lot of people have in common,” Bryck explained. “They also wanted to determine if she was coachable and if she could scale this over the next 25 years.”

Bryck originally thought this process of evaluation and eventual succession would take roughly two years. But in practice, it has gone much more quickly, roughly 10 months, in part because of that decision to throw Kirley into the deep end of the pool.

“He let me try things,” she recalled. “Within my first month, he let me book a speaker, which was a big risk for him. He’s let me try to throw on new systems that ask him to do things differently. He could have said, ‘we’re going to do things this way, and then when you have full reins, you can do what you want,’ but he didn’t.

“There’s something to be said for taking risks with a safety net,” she went on. “Having Ira there and being able to test ideas and try things little by little … I don’t know if enough rising leaders get to do that. And it built my confidence quicker, as well as my credibility, and it allowed us to know sooner that this was going to go well.”

“There’s something to be said for taking risks with a safety net.”

Bryck and Kirley acknowledged that certainly not all businesses and nonprofits can transition in this manner. Many simply wouldn’t have the payroll flexibility or an environment that would allow responsibilities to be shared in such a manner. But when possible, they said, the slow, conscientious handoff could help ensure a successful succession.

Bottom Line

Several weeks ago, both Bryck and Kirley both went to the 2019 edition of the gathering that triggered this succession process.
Still the elder statesman in the room, Bryck felt much more comfortable this time, because he no longer had to be concerned about succession; he and his board had found a successor.

Not only that, they provided to their members a real-life demonstration of how to put a plan in place and then execute it.
And that’s something else to celebrate as this important resource for the region’s business community celebrates a critical milestone and moves on to what’s next.

George O’Brien can be reached at [email protected]

Healthcare Heroes

This Public Health Leader Is a Visionary and Innovator

Frank Robinson, Ph.D.

“Dr. Frank Robinson is a true visionary. He sees partnerships and systems that most other people don’t see. He doesn’t stop there … and he doesn’t allow other people’s short-sightedness or lack of imagination to get in his way. He persists because he loves to see other people, particularly young people, grow and thrive and achieve their dreams.”

Over the next few pages, you’ll read quite a bit of material that will help explain why Robinson, currently vice president of Public Health for Baystate Health, is one of two Healthcare Heroes in the Lifetime Achievement category for 2019. But none of the words to come can do that more effectively that those at the top.

They’re from the nomination form submitted by Jessica Collins, executive director of the Public Health Institute of Western Mass., a job Robinson once held himself, when the agency was known as Partners for a Healthier Community.

And Greater Springfield has, indeed, become a healthier community because of Robinson, who, over the past 35 years or so, has conceived or been closely involved with initiatives in realms ranging from children’s oral health to asthma; from food insecurity to sexual health; from health education to overall population health.

And who really knows if he would have been involved in any of that had it not been for … Hurricane Agnes.

The storm barreled into Elmira, N.Y. in late June, 1972, flooding the recently opened Elmira Psychiatric Center, where Robinson was working as a psychiatric social worker. That’s was, because the storm put him out of work.

He found new work essentially counseling youths displaced by the hurricane and relocated to nearby Elmira College.

“Dr. Frank Robinson is a true visionary. He sees partnerships and systems that most other people don’t see. He doesn’t stop there … and he doesn’t allow other people’s short-sightedness or lack of imagination to get in his way.”

“A call came out for help because these youngsters were running wild in the dorms unsupervised,” Robinson recalled, adding that he and a friend were dispatched to the scene because they were staff at a facility called the Elmira Neighborhood House — Robinson taught boxing there and knew most of the teens.

In some ways, Hurricane Agnes blew Robinson onto a different, more community-focused career path that, early on, featured extensive work with young people. And, by and large, he has stayed on that path.

Fast-forwarding through his résumé, he worked locally for the Mass. Department of Mental Health (at the same time as the other Lifetime Achievement hero for 2019, Katherine Wilson; see story on page 22); the W.W. Johnson Life Mental Health Center in Springfield; the Springfield Community Substance Abuse Partnership and Prevention Alliance, part of the Springfield Department of Health and Human Services; Partners for Community Health; and Baystate Health, first as director of Community Health Planning and now as vice president of Public Health.

At each stop, he has been a visionary and an innovator, leading initiatives ranging from the BEST Oral Health program to Baystate Academy Charter School to the Baystate Springfield Educational Partnership.

“Over the years, I have worked in positions that have advanced my specific interest in creating a healthier community and preventing health problems from occurring by giving people what they need,” he said while summing up his life’s work in a simple yet effective way, adding quickly that, while progress has been made, there is still a great deal of work to be done.

And he’s still doing it.

Indeed, Robinson, who turns 70 this month, acknowledged that he is working past what would be considered retirement age. He attributes this to both a passion for his work and the simple fact that he has some projects he’s still working on that he wants to see to conclusion.

These include something called 413 Cares, an online community-resource database that provides resource and referral information to residents as well as healthcare and social-service agencies across the region, and also works to make Baystate an “anchor network” within the region.

Explaining the latter, he said that, by adjusting and refocusing some of its spending — in such areas as goods and services, hiring, and real-estate facilities — an institution like Baystate can have an even more profound impact on the communities it serves.

“Simply by changing our business practices in terms of how we spend money — spending it deliberately, intentionally, to benefit communities where there’s been substantial disinvestment or there are substantial disparities — we can change those community conditions,” he noted. “That’s the healthcare anchor institution mission and vision.”

A lifelong desire to change community conditions for the better explains not only why Robinson is still working — and still innovating — but also why he’s a Healthcare Hero. Again.

Background — Check

Indeed, this will be Robinson’s second trip to the podium at the Healthcare Heroes gala.

He was one of a large contingent on hand to accept the award in 2017 in the category called Collaboration in Healthcare. The name on the envelope, if you will, was the Healthy Hill Initiative, or HHI, a broad effort to change the health landscape in the Old Hill neighborhood of Springfield.

Robinson, one of nearly a dozen players involved in the initiative who were gathered around a conference-room table at Way Finders to talk about it, described it as a program that existed at “the dynamic intersection of two social determinants of health — public safety and access to physical activity.”

And he should certainly know. In many respects, he has spent his whole career working to address the many social determinants of health, including poverty, food insecurity, inadequate housing, lack of transportation, domestic abuse, and the stress that results from all of the above.

Retracing his career steps, Robinson said there have been some pivots — such as the one forced by Hurricane Agnes — along the way, and also some pivotal moments.

One of the latter was the consent decrees that eventually closed Northampton State Hospital and Belchertown State School and the creation of community-based programs to serve the residents of those facilities.

Frank Robinson has been called a true visionary by those who have worked with him over the years, and a long list of accomplishments bears this out.

Robinson was involved in this work during his time with the Department of Mental Health, and he remembers it leaving him inspired in many ways.

“Both of those institutions were closed by forward-thinking insiders who worked with progressive outsiders, or advocates, and formed this sort of perfect union around change,” he told BusinessWest. “That was a pivotal event; I knew I could create large-scale community change if you got the formula right and if you got in front of problems, prevented problems, and worked to change the lives of individuals.”

And over the past 40 years or so, he has repeatedly demonstrated his ability to create community change by getting in front of problems and using teamwork to address them.

This has been the formula at each career stop, including a brief stint as deputy commissioner and superintendent of the Northeast Ohio Development Center in Cleveland in the early ’80s before returning to this area and working at the W.W. Johnson Life Mental Health Center, the community substance-abuse partnership, and especially at Partners for a Healthier Community, where Robinson spent nearly 20 years at the helm.

During his tenure there, his ability to convene, create partnerships, and stare down difficult problems resulted in several new initiatives to improve the overall health of the Greater Springfield community.

One such effort is the BEST Oral Health program, blueprinted to address the alarming problem that children with MassHealth had very limited access to oral-health preventive and comprehensive treatment services. Robinson secured state funding to launch a demonstration project in Springfield that became the BEST program; it created a local system of education, screening, and treatment for preschoolers to decrease oral-health disease.

Another example of coalition building during his tenure at PFC is the Pioneer Valley Asthma Coalition, which strives to improve asthma management and indoor air quality in Springfield and other area communities where substandard housing contributes to this ongoing health problem.

The Big Picture

Looking back over his career, Robinson said one of the goals — and one of the big challenges — has been to create change and generate solutions that would have an impact much longer than the typical three-year grant cycle.

“What you really need are initiatives with lasting impact where you can see change occur at a level where you improve the conditions of a whole population — where you can say, ‘we’ve changed community conditions,’” he explained.

With that thought in mind, he said there are two programs that “rise to the top,” as he put it, when he talks about career accomplishments.

One is the Baystate/Springfield Educational Partnership, an initiative that brings hundreds of students into the Baystate system to learn about careers in healthcare and places many of them in internships.

“Over the past 20 years, there have been substantial gains from our ability to work together across sectors and across organizations. And that’s new; there’s that essential element of trust across organizations that didn’t exist 15 years ago or 20 years ago, to be sure. And in spite of the competitive nature of social-service organizations in healthcare, there tends to be more agreement today that there is a public space where we can all come together and make a difference.”

These internships often lead to careers in healthcare, he went on, adding that, over the first 10 years of the program, there are many examples of this.

“Some of them are physicians, some of them are nurses — it’s across the whole spectrum,” he explained. “I know there are youngsters who are now physicians because of this program.”

The other program is the Baystate Academy Charter School, a 6-12 grade school based in Springfield and focused on healthcare careers.

The school graduated its first class of students, 45 of them, in June, said Robinson, adding that there was a 100% graduation rate and each graduating student was accepted at a two- or four-year college.

“The social determinant of health solution there is education,” Robinson explained. “The idea is that, if you graduate from Baystate Academy Charter School, you are college-ready.

“These two programs will be around long after I’m gone, producing change on a large scale and at a population level for our community,” he went on. “I’m very proud of both of them.”

Looking at the proverbial big picture from his unique vantage point, Robinson told BusinessWest there have been significant gains in many areas and many respects, especially when it comes to agencies and providers of healthcare working collaboratively, but significant challenges remain.

“Over the past 20 years, there have been substantial gains from our ability to work together across sectors and across organizations,” he explained. “And that’s new; there’s that essential element of trust across organizations that didn’t exist 15 years ago or 20 years ago, to be sure. And in spite of the competitive nature of social-service organizations in healthcare, there tends to be more agreement today that there is a public space where we can all come together and make a difference.

“This is especially true with matters of equity,” he went on. “We understand that there are significant challenges for large segments of our community, and the only way you’re to change those conditions is if people work together collaboratively and pool resources. There’s a clear recognition that this is the way to go.”

Elaborating, Robinson said there have always been coalitions, but today there is greater strength and “sophistication” to such partnerships, which has generated progress in a number of areas.

But when asked if Springfield is a much healthier community than it was 20 or 30 years ago, Robinson paused for several seconds and said ‘no.’

He based that answer on standard health measures and still-apparent gaps, or disparities, in overall care as viewed through what he called a “racial-equity lens.”

“If I compare poor people to the average, and black or brown people to the average, there are huge health-disparity gaps,” he noted. “The infant-mortality rate is still three times higher for black women than it is for white women; although the rate for black women has improved over time, the gap still exists.

“We find that same gap in issues such as low birth rate,” he went on. “These are measures not necessarily of the quality of healthcare, but measures of the conditions under which people live. Those gaps still exist, and so this city is still not healthy.

“We’re great as a community, and as a health system, when it comes to dealing with stuff that occurs inside the skin,” he continued, referring to the care provided at Baystate and other area facilities. “But if you think of health as things outside the skin that actually determine one’s health, we haven’t really improved there; poor people are sicker.”

These problems are not unique to Springfield, obviously, said Robinson, adding that most large urban centers continue to have these inequities in overall health based on income and opportunity. Progress has come, slowly, and the hope is that, by continuing to build coalitions and get in front of problems, more progress can be achieved.

This is what Robinson has spent a career doing, and he shows no signs of slowing down.

View to the Future

“Dr. Frank Robinson has worked tirelessly over the past 30 years to address public health and health inequities in our city and beyond. He is a recognized leader and a visionary in creating systems that make it easier for people to access needed healthcare services and creating systems in our neighborhoods that make it easier for people to make the healthier choice.”

There’s that word ‘visionary’ again. This time, it was put to use by Springfield Mayor Domenic Sarno, in that same nomination submission, as he went on about trying to put Robinson’s career, and his contributions, in perspective.

And visionary certainly fits. He’s been able to look at the community he serves, identify needs, and most importantly, create solutions for meeting those needs.

He’s spent a lifetime doing that, and that’s why he’s a Healthcare Hero.

George O’Brien can be reached at [email protected]

Healthcare Heroes

While She Manages People and Programs, Her Job Is About Changing Lives

Katherine Wilson

It’s probably fair to say that the discussions had at the dining room table when Katherine Wilson was in high school were not like those going on in most households in the mid’-60s.

Indeed, Wilson’s father was a physician, specializing in family medicine. Beyond the work at his practice, he was one of the pioneers of a sort when it came to the broad subject of healthcare management.

“From having a solo private practice, he got into the development of systems of delivery of healthcare,” she recalled. “He started an HMO, he was the first medical director of Community Health Center … my father was a big part of the systems that are now in place.

“We had discussions around the kitchen table about healthcare,” she went on. “His interest was in healthcare management, and he was progressive in his thinking at a time when they didn’t have community health centers and they didn’t have HMOs; he did a lot of work with the community physicians and community hospitals.”

One might say that Wilson, certainly inspired by not only those dinnertime talks, but later work at her father’s practice and in one of the first community health centers, has a made a career — a long and very successful career — of working innovatively and in partnership with others to find new and better ways to manage healthcare, and especially mental and behavioral healthcare, in this region and across the Commonwealth.

She’s done this in a variety of settings, most notably, for the past 30 years, as president and CEO of Behavioral Health Network Inc.

Created in 1992 through the merger of four entities — the Child Guidance Clinic of Springfield, Agawam Counseling Center, Community Care Mental Health Center, and the Hampden District Mental Health Clinic — BHN now serves more than 40,000 individuals annually in a service area that stretches across the four western counties.

There are 40 locations in all and more than 2,000 employees. Together, they provide and manage services that come in a variety of forms, from detox centers and ‘step-down’ facilities to a wide variety of counseling services for adults, youth, children, couples, and families; from a 24-hour crisis-intervention service to a host of developmental and intellectual disability services.

“In a society where, even today, stigma may still surround mental illness and those it affects, Kathy not only keenly understands, but goes to every length to help others understand as well. Kathy Wilson has changed innumerable lives for the better, and she’d be the first to say her work is far from finished.”

Wilson has spent the past three decades building and shaping BHN into a $115 million network that continues to expand and find new ways to provide care and a support network to those in need. In recent years, she has been at the forefront of efforts to better integrate general healthcare with behavioral healthcare, particularly in the Medicaid population, with the goal of driving down the ballooning cost of care nationally (more on that later).

And certainly this work to build and manage BHN goes a long way toward explaining why Wilson was chosen as a Healthcare Hero for 2019 in the Lifetime Achievement category. Actually, she is one of two who tied for the high score. The other winner is Frank Robinson, vice president of Public Health at Baystate Health (see story, page 19). Suffice it to say, these two won’t have to introduce themselves when they meet at the Healthcare Heroes gala on Oct. 17. They both worked for the Department of Mental Health in the late ’70s, and both worked to create community programs for residents of Northampton State Hospital and Belchertown State School after those institutions were ordered closed. And they’ve been working in concert on many initiatives ever since.

But there is more to this honor than the vast portfolio of programs and initiatives that is today’s BHN. Indeed, it’s also about a lifetime spent advocating for those with mental illness, substance-abuse issues, or developmental disabilities, anticipating and then meeting their needs, and then asking the difficult but necessary question, ‘what else can be done?’

It’s a philosophy, or mindset, perhaps best summed up with these words from her nomination form, submitted by her daughter, Amy Greeley, formerly a nurse manager at BHN:

“Kathy exemplifies a unique combination of innate compassion and fervent determination that’s led to the helm of a regionally renowned institution. It’s from a position from which she never stops working for greater, more advanced, and even more accessible services for all who need them.”

“In a society where, even today, stigma may still surround mental illness and those it affects, Kathy not only keenly understands, but goes to every length to help others understand as well. Kathy Wilson has changed innumerable lives for the better, and she’d be the first to say her work is far from finished.”

Care Package

It’s called the ‘Living Room.’

As that name suggests, this is a warm, home-like place where anyone age 18 or older can come to “regroup and get help,” said Wilson.

Elaborating, she said the facility, one of many that BHN has carved out of old, mostly unused or underutilized manufacturing buildings in the Liberty Street area, is one of the latest additions to the agency’s portfolio. It was designed for people in a developing crisis, a current crisis, or a post-crisis situation, and is a place where people “can find help from others who have had similar experiences and who can provide support, encouragement, and guidance,” according to a brochure on the facility.

The Living Room, as noted, is just one of dozens of facilities under the BHN umbrella, and its creation speaks to Wilson’s ongoing work — and mission — to continually find new and different ways to meet unmet needs and build support networks for those who desperately need them.

And, as mentioned, this has been her career’s work — going all the way back, in some ways, to those discussions at the dining-room table.

Retracing her route to the corner office at BHN, Wilson said that, after working at her father’s practice and other health settings while in high school and college, she eventually decided that psychology, not healthcare, would be her chosen field; she earned a bachelor’s degree in that field at Denison University and a master’s in clinical psychology at SUNY Plattsburgh.

After a very short stint as a psychotherapist, she applied for a job with the Department of Mental Health, and was hired as a planner during that critical time when Northampton State Hospital and Belchertown State School were ordered to close.

“It was my responsibility to identify individuals from both institutions, look at what their needs were, and see what we could create in the community,” she recalled, adding that she worked to develop some of the group homes that are in use today. “I also worked with agencies that began to adopt the agenda of creating community programs to support people, such as the Community Care Mental Health Center in Springfield, which created day programs so individuals could get some of their rehabilitation in a clinical setting.”

The consent decrees that shuttered the institutions in Northampton and Belchertown coincided with national initiatives imbedded within the Community Mental Health Act, established by President John F. Kennedy. It made federal funds available to create more community systems of care, said Wilson, adding that, locally, a consortium of agencies was created to administer this flow of federal money.

“We got together and said, ‘survival means you have to get bigger, you need to have a stronger base at the bottom to support what we do, and this will give us a platform for growth.”

Called the Springfield Community Mental Health Consortium, it administered a number of initiatives, including hospital supports, group-living environments, outpatient systems of care, emergency services, and more, said Wilson, who transitioned from working for the state to being employed with the consortium as a planner.

“It was my responsibility to help establish the Community Mental Health Center range of services,” she explained. “Now that we had more people in the community living with mental illness, we needed to create the system of healthcare support.”

When the Reagan administration closed the tap on federal money for these services, with funding to be secured through state-administered block grants instead, the agencies that were part of the consortium broke apart and continued to do their own work, said Wilson, who then went to work with Child Guidance Clinic of Springfield, first as Business and Finance director and then executive director of the Child Guidance Clinic of Springfield.

As funding for mental-health programs became more scarce, Wilson said, she and the directors of three other agencies — Agawam Counseling Center, Community Care Mental Health Center, and the Hampden District Mental Health Clinic — decided that the best strategy was to merge those entities into one corporation.

“We got together and said, ‘survival means you have to get bigger, you need to have a stronger base at the bottom to support what we do, and this will give us a platform for growth,’” she recalled, adding that this new entity would become BHN.

And over the years, it would continue to get bigger and widen that base of support, as those administrators knew it had to, through additional mergers and the addition of many new programs.

Room to Grow

As president and CEO of BHN, Wilson wears a number of hats and logs tens of thousands of miles each year traveling back and forth to Boston for meetings on a range of topics and with a host of groups and individuals.

As for those hats, Wilson said she is the face of BHN and, for many, a first point of contact. She also considers herself a problem solver and a “convener,” a strategist, a mentor for many, and even an interior designer.

“I’m often the one that picks the colors for the walls,” she said, referring to the seemingly constant work to open and renovate new facilities, not only at what has become a ‘BHN campus’ off Liberty Street in Springfield, but across the region, while also noting that much goes into to picking those colors.

All those skills have been put to use over the past 30 years, an intriguing time of growth and evolution for BHN as it responds to emerging needs within the community, said Wilson, who cited, as one example, profound expansion into addiction services.

“One of the areas we identified maybe 10 years ago is that we were seeing many more of the parents of the children we were seeing at the Child Guidance Clinic, and many more adults coming in to adult outpatient clinics having mental-health issues co-occurring with substance use,” she explained. “And we said, ‘we can’t just treat mental-health problems without acknowledging the fact that there is a substance-use disorder concurrently, and that we really need to think about building a system of care that serves that population.’”

As a result, BHN collaborated with Baystate Health, which had a community-based system of care that included a detox and some community group-living environments for post-detox care, said Wilson, adding that Baystate asked BHN to manage those facilities and eventually transfer them into its system of care.

“We inherited Baystate’s system of community services for those with addiction,” she said. “And once we did that, we got established with the Department of Public Health and its Bureau of Substance Abuse Services, and we became known as an agency that could handle co-occurring treatments as well as individuals whose primary diagnosis was addiction, and from there, they helped us grow a system of treatment for people with substance-abuse disorder, and that really took off because the state was making significant investments in that world.”

That system now includes two detox operations, two step-down facilities, and a number of beds in what are called ‘residential recovery,’ or group-living facilities, she told BusinessWest, adding that this is just one example of how BHN continues to grow and evolve.

And it’s also just one example of how Wilson has led efforts to improve access to a wide array of care at a time when more people need access. The creation of the Northern Hope Center and Recovery Services in Greenfield, blueprinted in response to needs created by the opioid crisis in Franklin County, is still another case in point.

And these initiatives provide ample evidence of the additional emphasis placed on integrated healthcare and behavioral healthcare with the twin goals of improving population health and bringing down the cost of care, said Wilson, adding that BHN has been at the forefront of these efforts.

“This is what the federal government wants its funding to support, particularly for the Medicaid population,” she explained. “This is the population whose behavioral health — addictions or mental health — really interfere with their managing health.

“You have this small group of people that is driving high costs to Medicaid and both commercial and private insurance,” she went on. “So the move these days is for physicians and healthcare systems to work with behavioral-health systems of care and provide wrap-around services for individuals to see if you can manage the behavioral health, because that will help bring the cost of healthcare down.”

BHN adopted this rather profound operational shift several years ago, said Wilson, adding that, overall, it is part of her job description to keep the agency on the cutting edge of trends and developments in healthcare, while also making sure it remains viable and able to function properly in the years to decades to come.

That means continuing to find more ways to grow the network (the ‘N’ in BHN), building upon its base of support, and developing new methods for providing all-important access to care.

When asked about her most significant accomplishment, she quickly changed the subject of that question to ‘we,’ meaning BHN, but in doing so still managed to sum up her career’s work.

“I think we’ve created excellent, value-based, top-of-the-line service delivery for people who need access, sometimes very quickly, to good treatment,” she noted. “I have excellent medical leadership on both the addiction and behavioral healthcare side, and we hire really good, skilled, competent people. So I think people who are not used to getting good access to care now get it.

“Also, we’ve hired so many people that we have helped come from an addiction to sobriety, reunification, and now they’re BHN employees,” she went on. “To me, that warms my heart to know that people have been able to turn their lives around with the help of BHN.”

Change Agent

Which brings us back to that passage from Wilson’s nomination form. There are a number of key phrases within it that explain why she will be at the podium on Oct. 17 to receive her Lifetime Achievement award.

There’s the part about battling the stigma attached to mental illness, something she’s been doing for more than four decades. There’s also that point about how she would be the first to acknowledge that her work isn’t finished — because it never is.

But perhaps the words to remember most are those concerning ‘changing thousands of lives for the better.’

Indeed, while Wilson manages people, programs, and facilities for BHN, changing lives is what she does for a living.

And that’s why she’s a Healthcare Hero.

George O’Brien can be reached at [email protected]

Healthcare Heroes

This Leader Is Focused on Dismantling the Barriers That Limit One’s Ability to Thrive

Cristina Huebner Torres, Ph.D.

Dr. Cristina Huebner Torres was moving into a new home a little while back, and during the unpacking process happened to come across the essay she wrote while applying for entry to New York University for her master’s degree.

Re-reading it gave her the feeling that, career-wise, she really was doing exactly what she knew she always wanted to do. Well, sort of.

“I have always had a goal of creating a multi-cultural wellness center where people explore their health, bodies, creativity, minds and their holistic self through integrating movement, art, nutrition and other forms of … biomedical and traditional medicine,” she said, quoting from the essay, adding that at the time her work was largely focused on women and women’s reproductive health.

As things worked out, as vice president of Research & Population Health for the Caring Health Center (CHC) in Springfield, she’s working with a much larger constituency — and a much broader range of health matters. And rather than just ‘having a career’ at this facility, she has assumed a pivotal leadership role in efforts to not only study the many and persistent social determinants of health — such things as poverty, food insecurity, inadequate housing, crime, lack of transportation, and more — but doing something about them.

Her ongoing work has earned her the 2019 Healthcare Heroes award in the highly competitive category called ‘Innovation in Healthcare and Wellness.’

Huebner Torres has helped develop and administer a number of initiatives designed to improve the overall health and well-being of the generally underserved population that comes to the Caring Health Center, including creation of its Wellness Center.

Opened a decade ago — a significant milestone, to be sure — this facility lives up to its name and is a unique, innovative addition to a federally qualified community health center. It includes both a fitness center and a full kitchen, where individuals (generally referred to as patients, but also clients) can learn about general nutrition and how to prepare healthy meals for their families.

“After conducting a year and half of focus groups with community and patients, we found that the community was asking for a place where they could engage in group-based exercise, that was cost-free, culturally tailored, taught by someone who was licensed or trained in the area, and located within primary care,” she said, adding that the Wellness Center was developed to meet these community-identified needs.

“She is steadfast in her belief that services that are respectful of gender and sexual identity, widely accessible, culturally tailored, and based on the individual strengths and interests of the patient stand the best chance of bringing about long-lasting health.”

Huebner Torres said there are many ways to qualify and quantify the impact of the many facets of her work, and especially the wellness center, on the overall health and well-being of those served by the CHC. And she’s currently working to attain grants to help with this measuring process. But she believes there is already ample evidence that the center and other initiatives are helping to support patients actively engaged in their wellness.

And all of this is embodied — figuratively, but also quite literally — in an individual who asked to be identified only as ‘Lamont.’

He started coming to the wellness center the first day it opened, not long after his cancer surgery and when Huebner Torres was leading the fitness classes. Today, he leads several classes himself, helping a wide range of individuals with stretching, cardio exercises, and more.

He said these classes are doing what they did for him back when he first started.

“I had lost quite a bit of weight and wasn’t in very good shape,” he said, referring to the impact of the cancer medication. “I told my doctor, ‘I don’t want to stay home, I don’t want to deteriorate, I want to do everything possible that I can to get healthy.”

Many of those he’s now instructing arrive with a similar attitude, and this is exactly what Huebner Torres had in mind when she conceptualized the facility.

Her work, and her approach to it, is best summed up in this summation in the nomination submitted by CHC’s president and CEO, Tania Barber:

“Cristina’s core values and goals are informed by her belief that people are healthier when they feel safe and respected, eat nutritious foods, have opportunities for regular exercise, are knowledgeable about health and well-being, openly celebrate their cultural traditions, and receive services in their own language,” she wrote. “Her work is focused on dismantling the barriers that limit each person’s ability to thrive, both in the community at large as well as the healthcare setting, increasing access to community and social support, addressing structural bias, and promoting peer-led models are important aspects of her approach. She is steadfast in her belief that services that are respectful of gender and sexual identity, widely accessible, culturally tailored, and based on the individual strengths and interests of the patient stand the best chance of bringing about long-lasting health.”

Stress Test

As she talked about her work at the Caring Health Center, especially in the broad realm of the social determinants of health, Huebner Torres honed in on the subject of stress.

More specifically, she talked about how those who come to the CHC combat what would have to be considered a different, more virulent strain of stress.

“We’re not talking about a morning being stressful because you had some extra traffic on your daily commute,” she explained. “We’re talking about not having sufficient food every day for you and your family, and not having sufficient housing for you and your family, or many of those things co-occurring, and the effects of that over time.”

One might say researching this higher level of stress — resulting from those aforementioned social determinants of health — and doing something about it have become Huebner Torres’s life’s work.

As she noted, it was essentially her life’s ambition and she went on to earn a bachelor’s degree in Medical Anthropology from Mount Holyoke College, while also focusing on modern dance. She earned a master’s degree in somatic studies from New York University, and her doctorate in Epidemiology at the UMass School of Public Health and Health Sciences.

Cristina Huebner Torres stands in the kitchen in the Wellness Center at the CHC, which hosts many popular classes in cooking and nutrition.

Building on her undergraduate and master’s studies, she focused her doctorate in social epidemiology on the social determinants of chronic disease management. Her work considers the role of food insecurity and social stressors on the ability to prevent or manage diseases like diabetes and hypertension within community health center settings. She started her career at the Hispanic Health Council in Hartford, where she also interned while in college.

“This was an applied-research environment in a community-based setting, and it really set the stage for my career,” she told BusinessWest, “because I’ve been a community-based investigator, meaning that I find ways to create and partner in opportunities for conducting research within a public health practice and applied framework.

“It’s research driven by emerging trends within the community,” she went on, “and we use that research to inform opportunities for intervention that are culturally and community informed and making sure those interventions are actionable and integrated and sustainable.”

This explanation sums up her job description at the CHC, which she came to in 2007 as director of Research and Wellness. Since opening in 1995, the CHC has become the preferred health provider in Springfield serving a population that is diverse and challenged in many ways. Indeed, 70% of the more than 21,000 are Medicaid beneficiaries and the majority have one or more chronic illnesses. Nearly half of the patients speak languages other than English, and most live with medically complex conditions, often comprised of two or more chronic diseases, such as diabetes, hypertension, emphysema, heart disease, viral hepatitis, and chronic pain. And many patients also navigate behavioral-health conditions such as bipolar disorder, schizophrenia, depression, anxiety, post-traumatic stress disorder, or engage in opioid, alcohol, or other substance abuse.

The culturally diverse population served by CHC has many strengths as well as complex needs, and in her time at the CHC, Huebner Torres has collaboratively led the development of a number of services and programs to address them. These include an award-winning community health worker program that addresses the social determinants of health, as well as writing the grant to integrate the behavioral-health department with staffing and innovative programming to meet the culturally and linguistically diverse needs of refugee and immigrant individuals and families, and to support patients navigating multiple chronic co-morbidities.

Each of these innovations has been supported by leadership at CHC, she went on, and are sustained by a “tremendous collaborative team of dedicated and talented staff at CHC.”

The Shape of Things to Come

As she led BusinessWest on a tour of the Wellness Center, Huebner Torres started in the Wellness Center teaching kitchen.

There, she said, the center provides both nutrition education and cooking demonstrations, such as the very popular “Ask and Cook with the Dietitian!” sessions staged every Thursday by CHC’s registered dietician Vela Nicasio.

The kitchen-focused programs are designed to support patients as they look to follow primary-care treatment plans and recommendations for dietary improvements. The same is true of the workout facilities, which feature a number of cardio machines, weights, and large spaces for group classes in ‘stretching and restoring,’ cardio fitness, and open wellness (including one for women only).

‘Lamont,’ who first came to the Wellness Center the day it opened as a participant recovering from cancer surgery, is now an instructor.

The foundation of all that takes place in the center is the acronym CLAS, which stands for culturally and linguistically appropriate services, said Huebner Torres.

“It’s in the mission of what we do; it’s the heart of what the Caring Health Center does,” she explained, adding that the underlying goal behind creation of the center was to create a place where everyone could exercise and feel comfortable, including populations that just didn’t have such a space.

As an example, Huebner Torres listed Muslim women.

“They didn’t have a place to go because that place couldn’t include men, and it needed to not include music,” she explained. “And if you walk into any gym environment, there’s men and music. So early on, we created a Muslim-women-only exercise class, and it’s the first and only one in this area that we’re aware of.”

That class eventually became simply a women-only class because the Muslim women decided to open it to all women, she went on, adding that, overall, these classes and other programs are designed to help patients deal with health issues, but also the enormous amounts of stress they face in their lives — and do so in a group setting where they can interface with others facing similar challenges.

“A huge part of what people said they wanted in a center like this was for it to be group-based, and I think the concept of social support and social engagement, for many patients, becomes the number-one driving factor in why to attend,” she explained. “It’s not about ‘did I lose a pound or 10 pounds in so much time’; instead, it’s about ‘I was able to join in with other people like me and with some leadership that cares. And it was fun, I learned something, and I was engaging with people.’”

In short, the center and its programs are designed to educate and inspire commitment to getting healthy and staying healthy.

Which brings us back to Lamont.

“I started going to the wellness center once or twice a week, and I could really see myself making changes in my health,” he recalled, returning to the days and weeks after his cancer surgery. “I started to regain some strength and stamina, and from there I took it to another level; I started getting out to the park and running three or four miles a day, every other day. And I started working out at the wellness center four times a week.”

As he continued to grow stronger health-wise and become a role model, Lamont was advised by his doctor to become involved with a movement known as MOCHA — Men of Color Health Awareness, a name that goes a long way toward explaining what it is and does.

“Men of color have issues with going to the doctor and talking to the doctor, and that’s why a lot of us are dying today,” he said, adding that, as part of his participation in MOCHA, he gave a speech on this subject on the steps of Springfield City Hall.

He credits the Caring Health Center with saving his life when he had cancer, and now he gives back to the center through his role as a certified group exercise instructor and overall work to help others become actively engaged in their health and wellness.

“When it comes to stress, nutrition, getting off the couch and working out two or three times a week … all these things I learned from here,” he said, referring to the CHC and its wellness center. “I learned how to be proactive in talking to my doctor when things are going on and having a conversation.”

From a big-picture, community-health perspective, this is exactly what Huebner Torres had in mind when she blueprinted the Wellness Center a decade ago based on community and patient input.

Practicing Patience

In nominating Huebner Torres as a Healthcare Hero for innovation, Barber listed a number of attributes, all quite necessary for this kind of work.

For example, “Cristina demonstrates respect, consistency, and graciousness toward everyone she encounters. She listens well, speaks directly and honestly, and displays a quiet, well-timed sense of humor … she is intelligent, patient, and calm under pressure, and widely admired by those around her.”

When asked which of these is perhaps her strongest trait, Huebner Torres didn’t hesitate in saying ‘patience,’ adding that it’s more than a virtue when dealing with the complex issues she addresses every day — it’s a necessity.

“The other key factor — and perhaps most important of all — is partnership,” she said. “All of these initiatives are innovative and successful because of the team at CHC, the community, the patients, partner organizations and investigators, and the funders who have supported our efforts.”

“Nothing happens overnight — you have to be able to stick with it over time,” she went on.

Throughout her career, she has shown an ability to do just that, and the nutrition classes and group workout sessions at the Wellness Center are evidence that, when you do stick with it, you can bring about positive change in the lives of individuals — and in a community.

George O’Brien can be reached at [email protected]

Healthcare Heroes

This Nurse Midwife Gave Birth to an Intriguing Concept in Care

Amy Walker

‘Accountability.’

After pausing to give the matter some thought, this was the word a woman who chose to be identified only by her initials — S.M. — summoned when asked about what the New Beginnings program at Cooley Dickinson Health Care has given her.

There were other things on that list, to be sure, she said, listing camaraderie, friends, ongoing education, and even role models of a sort. But accountability, on many levels, was what was missing most from her life, and New Beginnings, which supports pregnant women with an opioid-use disorder with education, skills development, peer support, and goal setting, helped her develop some at a time when she needed it most.

“I wanted to come even though I was struggling to stay sober,” she said, referring to the regular group meetings attended by mothers facing similar challenges. “I didn’t have to come, but I wanted to; it’s hard to explain, but it was the beginning of me being responsible and accepting the fact that I was pregnant and here with the other women in the same situation.”

These sentiments speak volumes about why Amy Walker, a certified nurse midwife at Cooley Dickinson Hospital (CDH), created the program in 2018, and also about its overall mission.

“We want to empower women to be successful mothers,” said Walker, whose efforts to create New Beginnings have not only filled a critical need within CDH’s broad service area but earned her the Healthcare Heroes award in the ultra-competitive Community Health category.

She said the foundation of the program is a group approach, which is nothing new when it comes to expectant mothers, but it is new when it comes to this specific at-risk population, which makes New Beginnings somewhat unique and innovative.

“I wanted to come even though I was struggling to stay sober. I didn’t have to come, but I wanted to; it’s hard to explain, but it was the beginning of me being responsible and accepting the fact that I was pregnant and here with the other women in the same situation.”

“There are a couple of other places in the country that are doing this,” she explained. “There’s not a lot of studies on this yet, but it made sense, because it works so well in general and has these added benefits of providing community and more education, that it seemed like the way to go.”

While the program is still in its relative infancy (pun intended), it is already providing some rather dramatic, and measurable, results. Indeed, since the initiative was launched, 10 women with substance-abuse disorders who have participated in the program have delivered at the Childbirth Center at CDH, and nine of the 10 babies went home with their mothers. Walker believes that number would have been much lower had it not been for New Beginnings.

To send more mothers suffering from opioid-abuse disorder home with their babies, New Beginnings provides the many things these women need at this critical, and vulnerable, time in their lives. That list includes what amounts to a support network at a time when family and friends may be unable or unwilling to fill that role.

Indeed, S.M. told BusinessWest that, while her mother was quite supportive during her pregnancy and the period to follow, her friends were still using drugs, and thus, she didn’t want to be around them.

Support is provided in the months and weeks prior to delivery, during delivery, and then during the post-partum period, said Walker, adding that, while post-delivery is a challenging time for most all mothers, it is especially so for those suffering from opioid-abuse disorder.

“The riskiest time for relapse is in the post-partum period,” she explained. “We find that many women are able to maintain sobriety during pregnancy, but of course, the stresses of parenting, and sometimes parenting with limited resources, can be a triggering factor when it comes to relapse.”

The program also provides education and help to mothers with babies diagnosed with neonatal abstinence syndrome (NAS), the incidence of which is growing as the opioid crisis continues, said Walker.

Such babies are fussy, cry a lot, and are hard to soothe, she went on, adding that many remain in the hospital for several weeks. New Beginnings addresses these needs through something called the ‘eat/sleep/console’ method of evaluating and treating newborns with NAS, an initiative that results in shorter hospital stays and less opioid use for the newborn.

Above all else, New Beginnings provides a judgment-free zone that offers both compassion and quality care, said Walker, adding that all three ingredients are needed to properly provide for both mother and baby.

Pregnant Pause

Flashing back to her first New Beginnings group session roughly 16 months ago, S.M. remembers feeling relatively calm, but also a little uneasy about what she was getting herself into.

“I think was kind of numb and a little nervous,” she recalled, adding that she was struggling with sobriety at that time, when she was on methadone. “But at the same time, it felt comforting knowing what it was for; it was for women with addiction problems who were having babies. It was exactly what I needed at that time.”

S.M. said she was referred to New Beginnings several weeks earlier, about three months into her pregnancy and while she was still using heroin, which she described as her “drug of choice.” She said she was experiencing a number of emotions, but mostly anger — directed at herself.

“I was going through a really tough time accepting that I was pregnant,” she told BusinessWest while sitting in the same small room where the group sessions are held. “I couldn’t face the fact that I was using while I was pregnant, because I was really mad at myself. I came here because I wanted to do everything I could to try to do my best and get my life in order.”

Amy Walker says the New Beginnings program provides a critical judgment-free zone for pregnant women and new mothers battling opioid addiction.

In most every case, these emotions, these sentiments, and this particular drug of choice make S.M. typical of a growing number of women who are going through pregnancy while still using opioids or struggling with sobriety, usually through medication-assisted treatment such as methadone or Subutex, said Walker. She added that this growing demographic is an intriguing and sometimes overlooked aspect of the opioid epidemic — one that has now become a focal point of her work as a certified midwife.

And in many ways, this work reflects the values and passions (that’s a word you’ll read often) that brought her to the rewarding profession of midwifery — and will her bring to the podium at the Healthcare Heroes gala on Oct. 17 to accept the award in Community Health.

Our story begins during her undergraduate work when Walker took a job with Planned Parenthood in Gainesville, Fla. She worked at the front desk, selling birth-control pills and checking people in for their appointments.

“I was really inspired to grow in women’s health,” she explained. “I met nurse midwives and nurse practitioners who worked there, and started working in the Health Education department there, doing sex education, HIV-prevention outreach, and more, and from there I decided I wanted to go to midwifery school.”

She would earn her degree at Columbia University and, while doing so, see her career ambitions crystalize.

“My roots were really in gynecological care, but then I developed a love for caring for women and families during pregnancy and birth,” she explained. “I found that I love that intimate connection that you make with families.

“Meanwhile, one of my biggest passions was caring for underserved populations — people who maybe didn’t have access to all the care options,” she went on. “I wanted to provide them with the same type of care as someone who was more able to select what kind of care they wanted; that was really important to me.”

These twin passions have come together in a powerful way with New Beginnings, which Walker conceptualized several years after coming to CDH in 2014 after stints at Leominster Hospital and in St. Croix.

Tracing the origins of the program, she said it was one of many strategic initiatives that sprang from the work of an opioid task force created by CDH in 2016. That group’s work revealed that there were many unmet needs and, overall, that services needed to be better-organized and better-focused.

“I really wanted to be involved with that task force because I felt that the care we were giving to patients with substance-abuse disorders wasn’t really poor care, but it was all over the map,” she told BusinessWest. “There was no consistency in the messages that patients were getting and the education they were getting, and I knew that we could do better.”

One of those many efforts to do better is New Beginnings.

Delivering Results

At the heart of the program and its group sessions is the belief that women going through pregnancy while using opioids or trying to stay sober can benefit from being in the same room together, talking about their experiences, their emotions, their fears, and their hopes for the future.

And S.M.’s story, and her recollections of her year in the program, provide ample evidence that these beliefs are well-founded.

“It was really helpful coming here and knowing that there were other pregnant women who were either going through the same thing or had been there,” she said. “There were other women I’d met through New Beginnings who had kids and had them taken away. That made me feel … I don’t want to say better. It made me feel … well, not as mad at myself, knowing that someone else had been through this and had struggled with being able to have their kids in their life because of their addiction.

“I also came to know the risks of actually having her taken away,” she went on, referring to her daughter, who was playing with other children in the middle of the room as S.M. talked. “And knowing how mad I was just for using, that made me want to just do everything I could.”

These sentiments speak to that goal of empowering women to become successful mothers, said Walker, adding that empowerment comes through accountability and being responsible, but also through education.

And from the start, education has been one of the main focal points for New Beginnings, said Walker, who cited neonatal abstinence syndrome as an example.

“We expect it, and it’s treatable, but it can be challenging, because that baby may need a lot of soothing care, and sometimes needs to be held or soothed or rocked 100% of the time,” she explained. “All this could be challenging for anyone, but if you are someone with your own chronic illness who may not have a lot of support … all those things add up to make it really challenging.

“So if someone was coming into that without having any knowledge of how to care for their baby or what to expect from their hospital stay, that can be really shocking,” she went on. “I felt that we could do a better job of providing that educational prenatally, and there needed to be an avenue for that.”

Elaborating, she said that, typically, most pre-natal visits (for all women) run only about 15 minutes or so. This isn’t much time for women to learn or be supported. In response to this, she created two-hour group prenatal sessions for those involved with New Beginnings. The first hour would be the physical exam, she noted, while the other 90 minutes would be spent providing education and support in a group setting.

“We can cover so many more topics in that amount of time, as opposed to the 15-minute sessions, and you’re also speaking to many patients at a time,” Walker said. “And one of the great things about group prenatal care is that patients are able to hear from other patients and get their perspective.”

As noted earlier, the group sessions can extend to the post-partum period, which, as Walker said, is an extremely vulnerable time for those trying to stay sober.

“What we’re finding statistically is that the biggest risk for relapse is in the six- to 12-months post-partum time,” she noted. “Initially, in the first six months, there’s still a lot of that new-baby glow — even though it’s a hard time, there can still be sweetness. As they get older, it can get more draining; as one patient, who framed it in a good way, told me, ‘the newness wears off.’”

Only a year or so since working with its first participants, New Beginnings is generating measurable results.

Changing Room

S.M. told BusinessWest that the post-partum period was, indeed, a difficult time for her as she worked to keep sober amid the many changes and challenges that came into her life with motherhood.

She said she kept coming to group sessions staged by New Beginnings not because she had to, but because she wanted to — and needed to.

“I was having a hard time, but I just kept holding myself accountable,” she said. “There were days when I wanted to stay home and watch TV, but I made myself come to those meetings.”

She still struggles with being a mother — and with staying sober — but she knows she doesn’t have to face these challenges alone.

And that’s what New Beginnings is all about.

George O’Brien can be reached at [email protected]

Cover Story

MGM Looks to Step Things Up in Year Two

It’s been nearly a full year since MGM Springfield opened its doors in Springfield’s South End. It’s been a year of learning — for both the casino’s team and the consuming public as well. As the headlines have announced, the casino has fallen well behind projections for gross gaming revenues (GGR), but in most all of the other ways to measure the success of the operation, it has not underperformed.

Mike Mathis started by stating what has become obvious — and also addressing the topic on the minds of most everyone in this region when it comes to MGM Springfield.

Gross gaming revenues (or GGR, an acronym that is increasingly becoming part of the local lexicon) are not what they were projected to be for the first year of operation, which will end August 23.

Those projections, made several years ago during the licensing process for the $960 million facility in Springfield’s South End, were for roughly $400 million this first year. Instead, the resort casino is on pace to record closer to $275 million, as the chart on page 8, which includes numbers through the end of July, makes clear.

“In the context of a three-year ramp, which is how we view it, we’re off to a slower ramp-up than we’d like,” Mathis, president and COO at MGM Springfield, admitted. “The gaming revenues are less than we hoped for, and the work is understanding where we are performing well and where we are underperforming.”

With that, Mathis hit upon ongoing work that began literally within days of the casino’s opening. And it continues in earnest today, with the expectation that those numbers can and will improve in year two.

Repeating what he said at the six-month mark for MGM Springfield, Mathis noted that new casinos generally go through a lengthy ramp-up period (three years is the timeframe he repeatedly mentioned) before fully hitting their stride. And that this ramping process involves some learning curves, especially when gaming is being introduced to a region, as is the case in Massachusetts.

And much was learned, said Mathis, referencing everything from Super Bowl watching habits — it became clear that most people would rather watch at home than go to the casino, although Mathis still hopes to change that — to the bands that people will come out to watch (it appears locals really like local groups rather than imports), to the casino games people like to play.

A promotion to give away a Mercedes Benz each week for a month is one of many strategic initiatives to drive visitation to MGM Springfield.

Looking ahead to year two, which will kick-off with four performances by Aerosmith and a host of other birthday-celebration events, Mathis said MGM Springfield will enter it with considerable acquired knowledge, as well as what appears to be some momentum.

Indeed, while June’s GGR numbers were the worst for any full month since the facility opened — Encore Boston opened that same month and probably had something to do with that performance — July’s numbers were better, said Mathis, and slots GGR has been generally higher over the past several months.

“There are many examples of facilities that have taken their first year to figure out what the customer is going to react to, what the competition is doing, and achieve real growth,” he said, adding that he firmly believes MGM Springfield will join that list.

He’s pinning those hopes on everything from changes and additions to the casino floor (more on those later) to the possible introduction of sports betting within the Commonwealth, an addition to the gaming landscape now being considered by the Legislature, to the ‘growing-the-pie’ impact of Encore Boston’s opening earlier this summer.

But while the focus has been on GGR, as it should be, said Mathis, there are many other means by which to measure success during MGM’s first year. And with most all of these, the casino has been on target.

These include overall visitation (more than 6 million by the end of the first year); non-gaming revenues (the restaurants and hotel, for example); impact locally in terms of providing a boost to other businesses, especially those in the broad realm of tourism and hospitality; bringing people to the region; boosting the business of meetings and conventions; and employment, especially with regard to hiring Springfield residents and promoting people through the ranks.

“We’re very excited about all the visitors and tourists and eyeballs we’ve brought to the downtown — I know I’ve met many customers who have said ‘this is my first time in Springfield,’ or that they’ve brought their families from other areas to the downtown to show it off,” Mathis told BusinessWest. “One of the emotions I have is a huge sense of pride in what we’ve done here; we’ve given the people of Springfield and Western Mass. a headquarters tourist destination that they can show off to friends and family.”

Rick Sullivan, president of the Western Mass. Economic Development Council, agreed. Using yardsticks as unscientific, but still effective, in his view, as waiting times for a table at restaurants in the downtown area, he said the Casino has brought more vibrancy to the central business district. Also, it has deeply broadened the region’s tourism portfolio, prompting not only greater visitation, but longer stays.

Mike Mathis says year one has been a learning experience on many levels for all those on the MGM team.

“The biggest impact MGM has had in the year it’s been open, and the biggest impact it will have going forward, is that you now have gaming and increasing entertainment opportunities to marry to the other tourist attractions that we can be more than just a one-day travel destination,” he said.

Raising the Stakes

Mathis calls it ‘keeping the floor fresh.’

That’s an industry phrase — one of many that are new to people in this region — and one that refers to the need to constantly change, or freshen, the casino floor to bring both more new business and more repeat customers, said Mathis.

“You can’t get complacent about continuing to earn customers’ loyalty in a highly competitive market,” he noted, adding that efforts to freshen the floor at MGM Springfield include the construction of a new bar just inside the Main Street entrance to the casino — what Mathis calls the ‘back corner,’ because most people enter from the parking garage side — as well as some new electronic table games, some ‘stadium gaming,’ described as a mix of table games and slot machines, and special promotions.

“There’s a whole new zone in that corner, where we’re trying to bring some energy to what would otherwise be the back of the building,” he explained. “We’re trying to drive more business to the back; it’s a heavy investment but part of our work to improve the product.”

These steps are part of the ongoing efforts to improve GGR, said Mathis, but also part of what would be considered normal ramp-up of a casino facility as it adjusts to customers’ wants and needs, and the ebb and flow of the competitive landscape.

“I’ve said this in the past, and our competitors have the same view, which is that you need three years to get to a normalized operation,” he said. “And we’re seeing that ourselves; there are holidays and certain events we think are going to be some of our busiest, and for whatever reason they’re quieter. And then we’ll have a random day in the middle of the week that exceeds a weekend day.

“It’s really about trying to understand the patterns and being nimble and reacting to the patterns,” he went on. “Obviously in a market like this, weather is a factor, and we’re learning what the impact of weather is — good and bad.”

Local sports teams are a factor as well, he said, adding that while they have huge followings, this support doesn’t necessarily extend to viewing at the casino, as was learned during the first Super Bowl of the casino era in Massachusetts.

“In this case, business was less than we would normally see in one of other operations — although it was still a really strong day,” he said, “I think there’s a tradition of going to a house party because of the success they’ve had; we’ve got to figure out how to make MGM Springfield the regional house party for the Super Bowl.

“We’ve got great relationships with all the franchises, and we have strategies on how to activate the space and make it fun and interesting, fun and familiar,” he went on. “It’s a fun challenge; it’s not what we expected, but it’s a good problem to have because there’s a huge opportunity there.”

This process of watching, listening, learning, and responding to trends that were not expected extends to every aspect of the operation, he said, including entertainment and that aforementioned affinity for local acts.

“There are some acts that we think that would traditionally do well as they route the country, that don’t perform as well here,” he explained, “And there were other acts where we were pleasantly surprised by the response; country is popular here, so we’re going to look at country a little more.

“Thematically, there are really great regional bands that have a following here that aren’t national and that we’ve had a lot of success with,” he went on, mentioning Trailer Trash, a ‘modern country band,’ as one example. “Anyone in a new market has to figure out what are those great local bands that drive big crowds, local crowds.”

GGReat Expectations

Of course, there are many other things to figure out as well, said Mathis, adding that the broad goal, obviously, is to bring more people to the casino and inspire them to do more (and spend more) while they’re there.

This explains the freshening of the floor, as well as the four Aerosmith shows (now nearly sold out) and a number of other initiatives designed to bring people to the casino — and bring them back repeatedly.

These are the simple forces that drive GGR, said Mathis, who returned to that ongoing work to identify areas where the casino is underperforming, and addressing them.

Overall, he said the broad assignment is to build loyalty, not merely a visit or two to the resort and its casino floor.

“Part of the first year is gaining new visitors and customers who are seeing it for the first time and building loyalty,” he explained. “And in this market, because of the existence of some pretty strong competitors, there’s already strong loyalty and traditions and gaming habits that, quite frankly, we have to disrupt, and that takes some time.”

Meanwhile, there are some lingering patterns when it comes to where customers are coming from — or not coming from — that still need to be addressed.

Indeed, while MGM Springfield is overperforming, in Mathis’s view, when it comes to drawing customers from along the I-91 corridor, “north-south,” as he put it, things are different when it comes to east-west flow.

“It’s been a challenge to get folks to go west within the Commonwealth and give the facility a chance,” said Mathis adding that bookings like Aerosmith are designed to address that specific problem, and he believes there have been some inroads.

As for those efforts to disrupt current gaming patterns and loyalty with other casinos, Mathis noted that there are several arrows in that quiver, including everything from some new games to be introduced in the coming weeks, to a new promotion that involves giving away a Mercedes each week for several weeks, to a recently concluded program called MGM Millions, a lottery-like game that enabled players to win a wide variety of prizes including bonuses and loyalty privileges.

“That was very successful,” said Mathis, “and what we learned is that people like the lottery, and they’d rather have a smaller chance of winning a larger giveaway than a higher chance at smaller gifts — and that’s part of the learning curve.”

It also includes the addition of Symphony Hall to MGM’s portfolio of performance venues (the casino recently assumed management of that facility), which enables the team to book acts such as Steve Martin & Martin Short, coming Sept. 12, Boyz II Men (Sept. 22), and Smokey Robinson (Oct. 18).

“It’s another great venue that fills a niche we didn’t have previously,” he said, noting the hall’s 2,500 seating capacity. “That’s something in the tool shed we didn’t have our first year, especially since we can program into it, so we’re excited.”

He’s excited also by the prospects of sports betting.

“We’ve seen in our other markets that it can provide as much as a 10% lift to the overall business, not just the sports-betting component,” he said. “People will tend to stay longer, they’ll eat in the restaurants, they’ll place a bet, and spend some time on the casino floor on the machines or on the tables. So it’s an important initiative for us, especially in a market like Springfield and New England where people are passionate about their sports; we think it’s a manner of when, not if, this will happen.”

And, moving forward, Mathis said that while Encore Boston might impact MGM negatively in some ways, overall it will grow the pie when it comes to gaming, as evidenced, he believes, by the Springfield casino’s improved numbers for July.

“That demonstrates what we’ve always said — that there’s an ability to grow this market; there’s different customers for different experiences,” he said. “I like to think that the people in Boston will grow the market.”

Beyond the Floor

While much of the focus has been on the casino floor and GGR, Mathis said there are many other facets to this business, and he’s pleased with, and somewhat surprised by, the performance of some of these operations.

“I’m pleasantly surprised by how well-received our non-gaming amenities have been,” Mathis told BusinessWest. “The hotel is far above our projected occupancy rates, and the rate we’ve been able to charge is above what we project as well.”

He said the hotel has been generating a wide mix of business, from casino guests, to families visiting the area, to convention and meeting groups.

“We’ve done entire hotel blocks for different corporate groups that have come in and let us host their annual meetings or their incentive meetings for top salespeople,” he noted. “On every given day there are different types of customers in the hotel. We’ve been really pleasantly surprised by the amount of cash business we’re driving, the occupancy; that’s translating into the restaurants, exceeding our expectations on the amount of business overall.”

So much so that the MGM team is looking at perhaps adding more offerings, on top of the Wahlburger’s restaurant due to open next spring according to the latest estimates (groundbreaking will be within the next few weeks).

Meanwhile, business at the casino’s many bars has also exceeded expectations.

“We’ve also been pleasantly surprised by the amount of night life and bar business we’ve been doing,” said Mathis. “New Englanders enjoy their local IPAs and enjoy our nightlife lounges, so we’ve built some extra bars, such as the plaza bar to support our outdoor entertainment, and it’s been very successful.”

While generally pleased with what’s been happening within the casino complex itself, Mathis said the first year has shown that MGM Springfield’s impact extends beyond those four walls — and also that block in the South End.

As an example he points to the Red Rose restaurant abutting the property. Already a mainstay and hugely popular eatery, the restaurant has clearly received a tremendous boost from the casino.

“I was talking to the owner, Tony Caputo, on a Friday night recently,” Mathis recalled. “And he talked about business being up considerably since our opening, and how it actually started before we opened, during the construction process.

“Anecdotally, I’ve heard that many of the restaurants are up 20%, based on the overflow visitation we’re bringing — there’s more people than we can lodge and more people than we can feed,” he went on. “That was part of the strategy intentionally, and it’s bearing out.”

Rick Sullivan agreed.

“There’s more activity downtown now, there’s more people walking around,” he told BusinessWest. “It’s not like you can’t get a seat at a lunch place, but it is busier and that’s good; I never mind waiting a little longer to get a table — that’s a good thing.”

An even better thing, he went on, is MGM’s apparent ability to ‘extend the stay,’ as those in the tourism business say. Elaborating, he said there is some anecdotal evidence building that the addition of the casino is prompting more people to look to the region as something more than a day trip.

“People are looking to match a day at the casino and the Seuss Museum, or the Basketball Hall of Fame, or Six Flags, or the Big E,” he said. “People will do the Big E for the day and the casino for a day; we’re starting to see that.”

Likewise, he and others are seeing people visiting the region for special events and happenings make a point of also visiting the casino and, therefore, downtown Springfield.

He said he witnessed this first-hand when it came to teams that came from out of town for a sled hockey tournament at Amelia Park ice rink in Westfield, and he expects the same for the Babe Ruth World Series, also to take place in that city.

“It’s a place to take people,” he said, adding that as more of this happens, the overall impact of the casino will only grow.

Toward Year Two

As he talked about what’s coming up for the casino’s first birthday party — Aerosmith, a huge cake, the Patriots cheerleaders, and more, Mathis flashed back 350 days or so to when he and Springfield Mayor Domenic Sarno rode down Main Street in a Rolls Royce manufactured in Springfield during a parade that preceded the formal ribbon cutting.

The year that followed that triumphant moment has been one of intrigue and learning, for many constituencies, and one where expectations have mostly been met.

In year two, the focus will be on maintaining the current course, but also achieving progress with those expectations that haven’t been met. u

George O’Brien can be reached at [email protected]

Autos

Ben Sullivan, COO of Balise Motor Sales, says pick-up truck sales, especially those involving small trucks, have been moving steadily higher in recent years.

As Pick-ups Evolve and Offer Consumers More, Sales Spiral

While most of the focus in the auto-sales market has been on the meteoric rise of the SUV, pick-up truck sales have also been climbing, and for the same reasons. Like SUVs, the trucks now offer many of the features and amenities of a car — from leather seats to solid gas mileage.

Ben Sullivan notes that while SUVs and cars seem to be making all the news these days — the former because of how well they’re selling, and the latter because how they’re not selling — there is that third segment of the market that is making a lot of noise in its own right; trucks.
This is not a recent phenomenon, noted Sullivan, chief operating officer for Balise Motor Sales, adding that truck sales have been solid for some time and especially since the end of the recession and during the recent, and prolonged period of relatively low gas prices. But the number of truck sales continues to be move higher, and for several reasons, one in particular.

“What we’ve seen over the past decade is a significant investment by the manufacturers in not only styling, but ride comfort, quietness, electronics, safety equipment, and especially fuel economy,” said Sullivan. “To the point where they’ve made the pick-up truck probably the primary choice for people; they can drive it to the country club on the weekend and to a work site during the week. It gives people a lot of flexibility.”

He noted that while the sales of mid-sized, half-ton trucks (think Ford 150, Chevy Silverado, and Dodge Ram, the three most popular sellers, and in that order) have been relatively flat, there is considerable movement in the smaller-truck market, featuring brands like the Toyota Tacoma, Ford Ranger, and Chevy Colorado.

He called this development a “resurgence,” because small trucks were popular in the ’80s, then things cooled off considerably, and now, they’re picking up again (pun intended), and in rather dramatic fashion.

“For years, the small-pick-up-truck market fell dormant behind the explosive growth of the half-ton-pick-up-truck market,” he explained. “Been there’s been a real resurgence in the small pick-up.”

But while the smaller trucks are selling, there is solid movement across the board, especially when there are incentives available.
Indeed, Jeff Sarat, owner of Sarat Ford Lincoln in Agawam, said he normally sells about 20 to 25 super-duty trucks — that would be the F-250 through F-550 and up — each July. Last month, he sold 54, more than a 100% increase.

Jeff Sarat says pick-ups now offer almost everything cars and SUVs do, including solid gas mileage.

“Ford came out with some really aggressive programs — 0% for 72 months – so they created a market, which was phenomenal for business,” he said. “I had multiple customers buy more than one, because businesses — and that’s really who’s buying those type of trucks — they haven’t had that deal for three years.”

The response was quick, too, he added, as Ford didn’t even start the promotion until mid-July. “My guys just got on the phone and started calling people: “hey, we can lower your payment 100 bucks and put you in a brand-new truck.’ And people were flocking in. It was awesome.”
Ford agrees, extending what was supposed to be a two-week promotion through Labor Day, creating worries that Sarat might actually run out of trucks before the October-through-December season, which is traditionally a good time for truck sales — he usually sells about 100 super-duties over those three months — as businesses make year-end purchases for tax purposes.

Looking ahead, those we spoke with said truck sales, like SUVs, will continue to move higher at the expense of the car, because, again like SUVs, the product continues to evolve, improve, and provide more of what consumers are demanding.

Work in Progress

Sullivan recently relocated to Western Mass. from Texas, specifically the Dallas area. The Lone Star State is known for many things — from oil to cattle to Friday night football — but it might just be the pick-up truck capital of the world.

“They really like their pick-ups in Texas,” he said with a smile, noting that while nationally, one auto purchase in five is a pick-up, in Texas, it’s at least one in four. And in keeping with the state’s character, bigger — and better-appointed — is better.

“You’re not a gentleman cowboy unless you’re driving an F-250, which is a diesel engine, with King Ranch leather interior,” he said referring to the expensive brand of leather from that ranch in Texas. “And that thing is probably an $80,000 truck by the time everything is said and done.”
Western Massachusetts, and the Northeast as a whole, is a long way from Texas, geographically and also with regard to the popularity of pick-ups, but this region is gaining some ground in that regard, if you will, and numbers supplied by Sullivan bear this out.

He said that since the start of the year in Massachusetts, Connecticut, and Rhode Island, roughly 300,000 vehicles have been sold. Of those, 31,000 would be considered mid-sized, half-ton trucks; 20,000 are larger work trucks, and 13,000 are smaller, quarter-ton trucks, leaving a total of 54,000 pickups sold to date, not quite 20% of the total volume of vehicles.

And, as noted, while the biggest surge has been with the smaller trucks, sales are steady across the board, thanks to a still-solid economy that is fueling sales to consumers and businesses alike, and especially the former.

“Those guys are having good years, and they’re adding people,” said Sarat, referring to the builders, contractors, landscapers, and others that rely on larger trucks and work them hard. “When the economy is up, it’s good for everybody, and that especially helps us because we specialize in trucks.”

And the numbers are only expected to climb higher for those reasons cited earlier by those we spoke with. Where once people had to sacrifice things like comfort, luxury, room, technological bells and whistles, and especially gas mileage when they bought a pickup, now, they don’t have to.

Indeed, Sarat used the Ford F-150 to get his points home. This model remains popular among non-commercial drivers, although some businesses use them in their fleets as well. ‘I drive one,” Sarat said. “If you have a family of five, you can all hop in it and go somewhere — and put something in the bed if you need to.”

And, as noted, the trucks are becoming more car-like in terms of comfort and features which each passing model year.

“Every year, the technology gets better, and the safety features get better,” Sarat said. “I have an app on my phone that I can use to start my truck anywhere in the world. If a check-engine light goes on, from that app on my phone, I can see, ‘OK it’s an oxygen sensor, I’ve got to get it in for service,’ or maybe it’s nothing major, and it’s on because this is something I can fix.”

Safety features like self-parking and anti-collision assist are common in today’s trucks as well, and self-driving vehicles aren’t far away, he added. Plug-in hybrid options are creeping into the truck market as well, for people who crave fuel efficiency – or just want to use less fossil fuels. Even traditional, gas-powered trucks are being built with fuel economy in mind.

“I just drove to Ohio last week with my son, 580 miles. And I got out there on one tank of gas,” he said. “My fuel economy was better than I’ve ever had in any truck. Once I got out there, I still had about 100 miles left. That, to me, was impressive.”

Whether it’s efficiency, safety, or other technology, “it’s slowly getting better,” Sarat said. “It’s ever-changing. They’re definitely not stagnant, that’s for sure.”

Sullivan agreed, adding that all these amenities obviously come with a cost, but it is one that consumers seem ready and willing to pay.

“Manufacturers still have to make the affordable work trucks,” he explained, adding that there’s a work-truck grade, a grade above that, and maybe a few above that. “But by the time you’re done with the leather interiors, the technology and the touch-screen displays, the heated and cooled leather seats, you can drive the price of those trucks up quite a bit.”

By that he meant north of $60,000 or $70,000 — and even higher if one wants a fully loaded F-150 King Ranch. And what’s interesting, he noted, is that the manufacturers haven’t yet determined just what the ceiling is for these vehicles in terms of luxury and appointments — and what people might be willing to pay for all that.

“What the manufacturers have been playing with at the top is … ‘how much truck is too much so that no one will buy it?’” he told BusinessWest. “I don’t think they’ve found that yet.”

The Ride Stuff

While Texas and the rest of the pick-up-truck buying world awaits an answer to that question, dealers here and seemingly everywhere continue to record healthy sales of the vehicles.

It’s a movement that seems destined to continue and probably accelerate, because today’s trucks are not yesterday’s trucks.
As Sarat noted, they are anything but stagnant. They are moving — in every sense of that word.

George O’Brien can be reached at
[email protected]

Autos

Rob Pion, says Buick is trying to make inroads in the SUV market and has a lineup to do just that.

Buick’s SUV Lineup Helps Company Shed ‘Uncle Car’ Image

Editor’ Note: With this issue, BusinessWest launches something new and different for its auto-sales section — first-person looks, and some commentary — about some of the vehicles that are, let’s say, in the news.

And that person will be me.

That laughing you just heard was brother Robert. He’s reading this and thinking, if not saying out loud, ‘George is going to do car reviews?!?’

Well, sort of, as I will explain.

First, as to why my brother is laughing … while, like most all guys (and people for that matter), I like cars and shared every Baby Boomers dream of owning a 1972 Dodge Challenger, I am not a ‘car guy.’

Am I, however, like most people. My ability to ‘work’ on cars is limited to adding washer fluid and putting air in the tires. I wash it, I vacuum it, I put Armor All on the steering wheel, I put gas in it, and I drive it. That’s most people. So am I qualified to do this? I guess. As much as anyone else.

What is this? Well, it’s not reviews of the cars and trucks coming onto the market these days. I won’t be rating cupholders, trunk space, and headlights — although they’re all important. I’ll be using test drives to talk about emerging stories in this business — and talk a little about the cars, trucks, and SUVs themselves.

First, more about me … my first car was a 1973 Chevy Impala. There are a lot of Boomers nodding their heads right now. That was a lot of people’s first car. It was a large, four-door sedan, and I have been driving those ever since, with one real exception.

My now ex-wife and I were in Aruba in 1994, visiting the far side of the island. Those who have been there know it looks like the kind of place Kirk, Spock, Dr. McCoy and the crew member destined to die in that episode would beam down to and put the phasers on ‘stun.’ It’s desolate, with lots of sand and pink rocks and things like that. Anyway, to get around, you need a four-wheel drive vehicle, so we rented a Chevy Tracker, a small, as in very small, domesticated version of a Jeep.

We liked it so much, we said ‘when we get back, we gotta get one of these.’ And we did.

My sister in law likened it to a ride at Six Flags. ‘You have to be at least this tall to ride in it,’ she would joke, ‘and you must keep your hands and feet inside the vehicle until it comes to a complete stop.’

Other than that, large four-door sedans. With big back seats and big trunks. This, despite the fact that I don’t think I’ve had a human passenger in my back seat since a funeral procession. In 1993. But I have to have a big back seat. As for the trunk, it’s for the golf clubs, but hardly anyone builds a trunk big enough to put all the clubs down sideways or even on an angle. So I have to take the driver out, which is a pain.

All of this provides a nice segue to … Buick.

This is the company that invented the large four-door sedan. Well, not really, but everyone thinks they did. That’s seemingly all they made for decades, for guys (and women) like me.

I had an uncle who only bought Buicks. I think everyone has an uncle who only bought Buicks. They’re an ‘uncle’ car. Or at least they were.

For some time now, Buick has been working hard to put young people into their vehicles. In the late ’90s and early 2000s, you might remember that GM hired Tiger Woods to be its Buick spokesperson. His mission wasn’t to sell to golf fans, but to the younger audience, and he had some success. That’s some.

Today, Buick is letting its cars do the talking, only the cars are, for the most part, SUVs. (I have been told that in the lingo of the industry, SUVs are not cars; they are SUVs. Large four-door sedans are cars. That’s what I’m told.)

Back to Buick … they’re not selling many cars anymore, but they’re selling more SUVs — and to people of all ages, as Rob Pion, third-generation general manager of Bob Pion GMC Buick in Chicopee, explained as we took the Buick Enclave (Avenir model), the largest of the models in the lineup, for a spin.

Big Improvement

At first, I thought it was the SUV.

The world really does look much different when you’re riding high in a large SUV (maybe 30 inches from the ground) as opposed to your standard four-door sedan (maybe 20 inches).

But it’s not the vehicle, Memorial Drive looks much different from any height, as became clear as we headed north on that road from the Pion dealership toward South Hadley.

Back when Tiger Woods was plugging Buicks and Bill Clinton was in the White House, BusinessWest operated out of a small office on Memorial Drive. Back then, this was the land that time forgot — there was a dead mall (Fairfield), a Ponderosa Steak House (maybe it was a Bonanza), and other chain restaurants seen nowhere else. Things look much better now with new hotels, a strong lineup of stores where the mall was, and many new businesses.

But there is that huge open lot where the Hu Ku Lau used to be.

“We’re not sure what’s happening there,” said Pion as we drove by the grassy lot, obvious concern in his voice. “Everyone’s watching that closely to see what develops.”

Enough about Memorial Drive … back to the Buick and the Enclave Avenir, sticker price just under $60,000. It’s large, with three rows; looking in the rear-view mirror, the back window looks like it’s in another state — one of those in the Midwest — and well-appointed. It features what’s called ‘intelligent all-wheel drive,’ which means it did well on its SATs, and has every safety device one might expect, as well as all the technology, meaning connectivity. It’s six-cylinder engine delivers 310 horses and decent mileage for something this large — 17 city/25 highway mpg (see, I can do car talk). Meanwhile, it easily passes the golf-bag test.

And it’s really, really quiet, meaning my tape recorder had no problem picking up Pion as he talked about how Buick’s SUVs — the smaller Encore, mid-sized Envision, and large Enclave — are expected to compete with the top luxury brands in the market and bring younger audiences into the Buick showrooms.

BusinessWest Editor George O’Brien tries out the Enclave Avenir, the top of the line.

“GM’s vision for this is to go against BMW, Lincoln, Mercedes … the premium SUVs,” he said, referring specifically to the Enclave Avenir, but ostensibly to the whole lineup. And while Buick is still lagging well behind other brands when it comes to SUV sales, it is starting to gather some momentum, especially with the smaller model, the Encore, priced in the mid 20s to just over $30,000.

“We’re getting young people to at least come in and give it a look,” Pion said of the SUV lineup. “Many wouldn’t even do that before.”

Buick still has a long way to go to not only shed it’s old-person’s-car image but also become a serious player in the white-hot SUV market.

But based on this drive down Memorial Avenue and the vehicles now in the Buick showrooms, the carmaker known for sedans, as in big sedans, would appear to have a fighting chance. u

2019

There’s a reason why chambers of commerce, throughout their history, have taken a minute or two at their regular breakfast meetings to recognize their members celebrating important birthdays or key developments in their history.

And that reason is … milestones are certainly worth celebrating.

Indeed, as anyone in business will tell you — and they undoubtedly have — while launching a new venture is anything but easy, staying in business is much, much more difficult.

Especially when we’re talking about staying in business for 100 years or 50 or even 20. All one really needs for perspective is to think about all the businesses and nonprofits that cannot make such claims.
Staying in business for even a decade or two almost always requires perseverance, imagination, some daring, some sacrifice, the ability to look around the proverbial corner, and, yes, luck.

All of the above, and especially that last ingredient can and usually are required because there are myriad things that can keep a company or an institution from reaching some of the milestones being marked on the pages that follow.

Just a partial list includes a serious recession — or two, or three, or four; the lack of a ‘next generation’ to carry things on; developments that seem to come from nowhere — everything from digital photography to the automobile itself (yes, the car destroyed a good number of buggy-whip-manufacturing businesses in Westfield); from those red boxes dispensing videos in the supermarket or pharmacy, to the chain pharmacy itself.
Yes, staying in business is extremely difficult, and that’s why milestones are celebrated.

And while celebrating years and significant developments, companies use such occasions to reflect not only on what has happened, but what can happen moving forward. It is the same reason why the country is stopping to celebrate everything from the moon landing to Woodstock this year.

People are stopping not just to note that 50 years has gone by since those events, but to ponder how those developments have changed the landscape since.
And so it is with milestones being celebrated by companies in this region and on the pages that follow. These institutions are marking not just the passage of time, but how a company like Balise Motor Sales or a ground-breaking development like the Bay Path University Women’s Leadership Conference can change the landscape, literally and also figuratively.

And in many cases, as you’ll see, what allows companies and institutions to survive and thrive for years and decades is not only a willingness to adapt and the ability to adapt, but also a resolve to remain true to the mission and the principles that were there in the beginning.
So it is with BusinessWest magazine, which is celebrating its own milestone — 35 years since it was launched by John Gormally, a man who has become a serial entrepreneur.

There has been considerable change, but what hasn’t changed is the mission of providing comprehensive, reliable, sometimes entertaining business news.
The stories on the pages that follow have similar threads. Many things have changed over the years, but what’s really important is what hasn’t changed.
And that’s a big part of celebrating a milestone.