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Business Talk Podcast Special Coverage

We are excited to announce that BusinessWest, in partnership with Living Local, has launched a new podcast series, BusinessTalk. Each episode will feature in-depth interviews and discussions with local industry leaders, providing thoughtful perspectives on the Western Massachuetts economy and the many business ventures that keep it running during these challenging times.

Episode 62: May 3, 2021

 George O’Brien talks with Dr. Mark Keroack, president and CEO of Baystate Health

Dr. Mark Keroack

BusinessWest Editor George O’Brien talks with Dr. Mark Keroack, president and CEO of Baystate Health. The two discuss a wide range of topics, including the current pace of vaccinations, strategies for improving those numbers, the challenges facing the country as it strives to reach herd immunity, and expectations for when the region, the state, and the nation might be able to reach something approximating ‘normal.’ Keroack provides keen insight into all these matters, and his takes certainly provide food for thought. It’s must listening, so join us on BusinessTalk, a podcast presented by BusinessWest in partnership with Living Local.

 

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Daily News

SPRINGFIELD — Boston Children’s Hospital and Baystate Health have formed a collaboration that will improve patient access to highly specialized pediatric care and strengthen the coordination of care between Boston Children’s and Baystate Children’s Hospital in Springfield.

The collaboration will provide patients throughout Western Mass. with improved access to pediatric specialty care at Baystate Children’s Hospital, and it will streamline care planning among providers at Boston Children’s and Baystate Children’s. The collaboration anticipates that the two hospitals will jointly develop pathways to ensure that children and adolescents get the right care in the right setting. In some instances, Boston Children’s clinicians will be available to provide care at Baystate Children’s.

“As the leading children’s hospital in Western Massachusetts, Baystate Children’s has long partnered with the community to advance the health and well-being of all children from prevention to critical care,” said Dr. Mark Keroack, president and CEO of Baystate Health. “We are delighted to build upon our exceptional care for families through a collaboration with the much-respected Boston Children’s Hospital, which will provide additional clinical expertise when needed for our young patients.”

Dr. Charlotte Boney, chair of the Department of Pediatrics at Baystate Children’s Hospital, added that “this collaboration acknowledges and strengthens the close working relationship with Boston Children’s Hospital that we have enjoyed for many years. This collaboration will facilitate our continued ability to keep specialty care local so that children and families have access to a broad range of high-quality, affordable services right here in Western Massachusetts. We look forward to exploring other opportunities that will strengthen our collaboration to serve our mutual missions of patient care, medical education, and community service.”

The two hospitals already work collaboratively in cardiology, neurology, and dermatology, and by enhancing medical education, remote consults, information technology, and other initiatives, the two institutions will be better able to coordinate care for their patients.

“At Boston Children’s, we are committed to providing comprehensive pediatric care — close to home whenever possible — to patients and families throughout Massachusetts,” said Sandra Fenwick, CEO of Boston Children’s Hospital. “This collaboration will strengthen the ability of two great institutions to improve access to the highest-quality care for the patients and families we look forward to serving together.”

Economic Outlook

Healthcare

 

Editor’s Note: One of the sectors most impacted by the pandemic — and one facing a great number of questions moving forward — is healthcare. We put some questions to Baystate Health President and CEO Dr. Mark Keroack, who has become a very visible leader during this crisis and was recently named one of BusinessWest’s Healthcare Heroes for 2020.

 

BusinessWest: Dr. Keroack, already we’re seeing a great deal of optimism and expectation accompanying the arrival of vaccines in this nation and this region. What are your thoughts on the impact these vaccines will have on the broader economic picture in this region and when that impact will be seen?

 

Dr. Keroack: The vaccines represent a major scientific breakthrough, and they are the beginning of the end of the pandemic. Economies depend on consumer confidence, and, therefore, I have always seen recovery from the pandemic and recovery of the economy as one and the same. Removing the pandemic will boost confidence and enable the economy to recover. What is less clear is which businesses will have survived the terrible stress test of 2020 to even be able to recover.

 

BusinessWest: ‘Normal’ is a word we hear a lot these days, as in ‘when things return to normal.’ With the vaccines now here, is there any more clarity on when ‘normal’ — as in pre-COVID — may return?

 

Dr. Mark Keroack

Dr. Mark Keroack

“The light at the end of the tunnel is real, but it is still months away, and we are now in a perilous situation with more virus circulating in the community than we had last spring.”

Dr. Keroack: I believe that when a majority of people — more than 70% — receive the vaccine and are immune, case numbers will fall precipitously because the virus will not be able to find new hosts easily. That will enable governmental leaders to lift the restrictions we all have been struggling with these past several months. I suspect that will happen in late spring or early summer.

 

BusinessWest: Dr. Keroack, this has been a trying year for the healthcare system and hospitals in general. Can you in any way anticipate what 2021 will be like — both in terms of providing services and from a business (bottom-line) perspective?

 

Dr. Keroack: I think we should expect consumer attitudes to be changed in the wake of the pandemic. For several months, people have been getting used to different ways of getting their needs fulfilled, whether it is virtual visits, remote working, takeout dining, or online retail. I think this will put greater pressure on traditional bricks-and-mortar enterprises, including Baystate, to revisit their business models.

 

BusinessWest: In many ways, you have been the face of the pandemic in this region, often sending out strong statements on the need to socially distance, wear masks, and take the steps necessary to stem the spread of the virus. What is your message to the community now, 10 months after the start of the pandemic, and with what many are calling a light at the end of the tunnel in sight?

 

Dr. Keroack: The light at the end of the tunnel is real, but it is still months away, and we are now in a perilous situation with more virus circulating in the community than we had last spring. Many people, especially older people, are doing what they need to do to protect themselves, but many more are minimizing or still denying the risks of infection. It is now more important than ever to follow the guidance on masking, social distancing, and handwashing. Furthermore, we need to restrict our visits to indoor spaces that are not our homes, particularly if masks are not being worn.

 

BusinessWest: The governor recently rolled back, if that’s the proper phraseology, many of the restrictions on certain types of businesses. Do you believe further restrictions will be needed before the current situation improves?

 

Dr. Keroack: I think it is likely that the latest restrictions will not be enough to slow down the spread of the virus. We are seeing that some mayors are issuing regulations that go beyond what the governor recently proposed, and I suspect he too will have to roll back things still further before we are through the current crisis.

 

BusinessWest: Continuing with that thought, many businesses have closed over the past several months, and many more are barely hanging on amid the restrictions placed on them. It’s often been said that elected leaders have to choose between saving the economy and saving lives. Is there any way, in your opinion, to effectively do both?

 

Dr. Keroack: There are examples of countries that have done both. They are characterized by high rates of rule following, easy access to testing, and financial support for people who are sick and cannot work. Many Asian countries had great success opening their economies while also driving down infection rates. Other countries, like the U.S., were more likely to object to or doubt the effectiveness of the guidelines, and we saw a lot of people deciding to exempt themselves, sometimes with disastrous consequences. We also are not consistent in terms of sick leave, so many were tempted to go to work while sick. For all these differences, it is fair to say that now nearly every country is sliding backward to higher virus levels, because even the most compliant groups get fatigued by these restrictions.

 

BusinessWest: As a business leader and manager of one of the region’s largest employers, can you talk about the ways this pandemic has changed business and how it’s conducted, and which of these changes may be permanent?

 

Dr. Keroack: I mentioned earlier the importance of flexibility and meeting the customer where they are. We have recommitted to improved customer service and easier access to care. We are still learning in healthcare to be more like more customer-friendly sectors. I also expect that the strains on the economy will cause healthcare to be examined again for being too high in cost. Baystate Health is the lowest-cost large health system in the state, and yet we still need to drive down costs further. We also need to remember that embedded in the pandemic was the George Floyd killing, which led to a reckoning with systemic racism in our country. Baystate Health as an organization has made eliminating racism and enhancing diversity, equity, and inclusion in our health system a top priority. Finally, I think we need to re-examine and improve how we do preventive public health in our state, and I hope Baystate Health can play a role there.

 

BusinessWest: They say adversity makes those who endure it stronger. How will this region become stronger because of this lengthy and difficult battle against COVID-19?

 

Dr. Keroack: If the pandemic has taught us anything, it is that we are all connected to each other. Infections historically have attacked those in lower socioeconomic groups more severely. When those infections spread easily, we all suffer when we have not dealt fully with advancing economic opportunity across all our communities. If we come out of this with a greater sense of community and togetherness, we will have gained something valuable from what was otherwise a terrible ordeal.

 

BusinessWest: Personally and professionally, what has it been like for you to lead a company like Baystate though this crisis? What have you learned about yourself, as a leader, if anything?

 

Dr. Keroack: There have been many stressful days, given the unknowns and dangers of this virus. I worry a lot about protecting our employees and see the stresses they have been going through. I am blessed with a wonderful team that has strong experience in infectious-disease management and epidemic containment. I also am gratified by the can-do attitude from so many on the front lines. They show tremendous commitment, compassion, and innovation. I think the major lessons I learned as a leader is to make sure people understand the reasons behind what we are trying to do and then to trust them to find the solutions. I have not been disappointed in that trust.

 

Healthcare Heroes

His Efforts to Coordinate the Region’s Pandemic Response Saved Lives

Mark Keroack

Mark Keroack

Dr. Mark Keroack doesn’t feel like a Healthcare Hero. But he’ll gratefully accept the honor on behalf of everyone who does deserve the award.

In his estimation, that’s a lot of people.

“Whenever some new challenge comes up, it’s been our tradition to step up and play a leadership role in Western Mass.,” said the president and CEO of Baystate Health. “I wish I could convert my award into an ‘unsung heroes award.’ So many things happened behind the scenes to enable us to step up.”

And so many people stepped up. Like Dr. Sarah Haessler, an epidemiologist who has long had a keen interest in emerging infections. “She got us to construct an ebola-treatment unit in 2014, and she put together a small team of people interested in unusual infections,” Keroack said. “That team reassembled this year, in early January, when they started issuing alerts looking out for anyone traveling from China.”

Or Dr. Lauren Westafer, an emergency medicine physician who helped determine, early on, that not rushing to place patients on ventilators actually decreased COVID-19’s mortality rate. “We were far ahead of the curve on that,” Keroack said.

Or Baystate Medical Center President Nancy Shendell-Falik, a former nurse who understands patient flow, he said, noting that Baystate, on an average day, has about 720 patients, but was able to open up hundreds more beds by postponing elective surgeries and finding other creative ways to open up space and redeploy staff.

Or Dr. Andrew Artenstein, the system’s chief physician executive — and, like Haessler, an infectious-disease expert — who led Baystate’s Incident Command Center. In addition to his day-to-day role coordinating the system’s pandemic response, he drew national attention after penning an account of a rendezvous at a small mid-Atlantic airport, where he and his team brought a $3 million check to purchase a large shipment of face masks and N95 respirators — and were temporarily accosted by the FBI.

“We realized we were on our own,” Keroack said of those early days, noting that the health system also received PPE donations from the construction trades and local manufacturers, who had shifted to making such equipment. It was a lesson to the region that local players could produce what they needed and not have to depend on a fractured global supply chain.

“I wish I could convert my award into an ‘unsung heroes award.’ So many things happened behind the scenes to enable us to step up.”

But he mostly applied the ‘hero’ designation to every frontline provider who continued to push past their health and safety anxieties and do their jobs. “They were able to do the right thing in spite of their fears, and are heroes in my book.”

That book includes story after story of collaborations Baystate forged in support of prompt community outreach, testing, education, and information, all with the goal of limiting the spread of COVID-19 and helping make Massachusetts — one of the hardest-hit states in the pandemic’s early days — an eventual model of how to control it.

On the local level, Keroack participated in Springfield Mayor Domenic Sarno’s weekly COVID-19 press briefings, leading the mayor to note that “Dr. Mark Keroack’s leadership and medical insight has truly been a great benefit for our city of Springfield as we have worked together to defeat and mitigate the spread of this virus.” Baystate also tested the homeless population and expanded testing to key neighborhoods in the city at the request of the state and local officials.

Keroack also convened calls with Westfield Mayor Don Humason regarding clusters of positive cases in Westfield’s Russian community and possible spread beyond its borders. Meanwhile, he conducted weekly calls with the Western Mass. legislative delegation and other area hospital CEOs, while crafting a plan with state officials on how Baystate would provide surge beds for the region.

“I set up an independent command center, and every day at 7:30, we’d call a group of people who included hospital presidents, heads of medical groups, people from infection control, supply chain, finance, communications … 15 people got on the Zoom meeting every day,” he said, adding that information from those sessions would be distributed as a bulletin at 11 a.m. “It was the most widely read thing at Baystate. Everyone knew every day where we were.”

Mark Keroack (right) and U.S. Rep. Richard Neal take part in an outdoor roundtable on COVID-19 issues in the spring.

Keroack also served as the only Massachusetts hospital CEO appointed by Gov. Charlie Baker to the state’s Reopening Advisory Board. “The Reopening Massachusetts plan needed to balance restarting commerce while avoiding a surge of virus cases,” said Mike Kennealy, Secretary of Housing and Economic Development. “Dr. Keroack’s medical expertise and healthcare-sector experience, and his perspective as a resident of Western Massachusetts, helped to ensure those dual objectives were addressed.”

For his part, Keroack praises the state’s phased approach, which has understandably been frustrating to business owners.

“We’re using data to move from one phase to another, and we’ve had good coordination between authorities and scientists, as opposed to some states, where they butted heads with each other,” he added. “In Massachusetts, there hasn’t been any daylight between what science is telling us and what local and state officials are saying.”

If there was an unseen ‘hero’ amid all the named ones, Keroack suggested it may have been a public that understood its role, and today still largely adheres to guidelines around social distancing, mask wearing, and other protocols.

“I’m proud of how we worked together and came together as a community,” he told BusinessWest. “Parts of the country were at loggerheads, fighting with each other about masks, getting their hackles up about personal liberties. I look at that craziness and think, thank God we didn’t have to go through that.”

On the other hand, the community’s responsibility was clear. “We had the advantage of knowing what happened in Italy and New York, so we didn’t have to twist people’s arms to take this seriously. The public understood the issue around shutting down.”

At the same time, he’s proud of Baystate’s role in working with local boards of health and the Department of Public Health around contact tracing. “In six months, from the announcement of the first case, we have gone from having to beg to get a person tested to being a regional testing center that does 1,000 tests a day,” he said, with the total tests approaching 100,000 toward the end of September.

About a third of those tests, he added, have not even been Baystate patients, but patients from other hospitals and folks living at nursing homes, assisted-living facilities, and homeless shelters. “We got outside the walls of our own system into the community and really played a role in public health.”

While the pandemic is far from over, Keroack already recognizes some of the changes that might emerge from it, from an expanded role for telehealth to a better understanding of where society’s safety nets have proven inadequate.

“This has kind of exposed some of the shortcomings of our healthcare system and of our social support system, like the number of people in this country who don’t have paid sick time, and go to work even when they’re sick,” he said.

Some of the long-term impacts of COVID-19 are still emerging, he added, but Baystate — and the team of heroes with whom he insists on sharing his honor — will continue to, as he said, step up and play a leadership role.

“Every time a pandemic hits society, people who live through it are changed forever. That’s true of every pandemic throughout history,” Keroack said. “We’ll look at the world differently in terms of healthcare as a right, or childcare and sick leave — we’ll look at these issues very differently than we would have just a few years ago. At least, I hope we will.”

Joseph Bednar can be reached at [email protected]

Daily News

SPRINGFIELD — Baystate Health and Kindred Healthcare, LLC announced plans to form a joint venture that will build and operate a $43 million, state-of-the-art behavioral-health hospital in Western Mass.

The 120-bed facility will address the shortage of behavioral-health beds in the region, increasing patient access to Baystate Health’s specialty inpatient behavioral healthcare for adults (including geriatrics), adolescents, and children by more than 50%. Kindred will manage day-to-day operations of the hospital, and Baystate Health psychiatrists and advanced practitioners will provide care under the medical leadership of Dr. Barry Sarvet, chair of Psychiatry at Baystate Health.

The hospital will be designed specifically for behavioral-health services to foster a better healing environment for patients. The hospital will feature distinct units to meet patients’ varying treatment needs and is expected to employ more than 200 direct caregivers and ancillary staff.

“In building a state-of-the-art behavioral-health facility to serve the area’s most vulnerable patients, we recognize that such a major undertaking could not be achieved without a quality partner,” said Dr. Mark Keroack, president and CEO of Baystate Health. “Kindred’s strength in building and operating specialty hospitals, coupled with Baystate’s behavioral-health clinical expertise, is the perfect fit. We are looking forward to creating an unparalleled community resource dedicated to the needs of all behavioral-health patients.”

Baystate had planned last year to partner with US HealthVest, LLC on a $30 million behavioral-health hospital, but ended that relationship in November following news reports alleging substandard care at other HealthVest facilities, and began searching for a new partner.

“Our partnership with Baystate creates a unique opportunity to expand access to high-quality behavioral-health services in Western Massachusetts,” said Rob Marsh, senior vice president and chief operating officer for Kindred Behavioral Health (KBH). “Kindred is a leader in treating medically complex and rehab-intensive patients, leveraging partnerships and innovation to enhance care. Through KBH, we are building upon our existing clinical and operational capabilities to address the unmet need for behavioral-health services.”

Baystate Health remains interested in a centrally located Holyoke location and is in discussions with the city of Holyoke regarding the potential acquisition and development of a property on Lower Westfield Road.

It is anticipated that, from the time the site is secured, it will be at least two years before the new hospital is operational, pending regulatory and other approvals. Until the new hospital is completed, Baystate will continue to operate its inpatient behavioral-health units at its community hospitals — Baystate Franklin Medical Center, Baystate Noble Hospital, and Baystate Wing Hospital. Upon completion of the new facility, those units will be closed.

Emergency-care services will continue to be provided at all Baystate Health hospitals, and the treatment of medically complex patients will continue at Baystate Medical Center in its Adult Psychiatric Treatment Unit.

COVID-19 Daily News

SPRINGFIELD — The New England Journal of Medicine recently published a striking note from Dr. Andrew Artenstein, chief physician executive and chief academic officer at Baystate Health, about the extreme measures being taken to secure personal protective equipment (PPE) — a story involving secret airport handoffs and questioning by the FBI.

“Our supply-chain group has worked around the clock to secure gowns, gloves, face masks, goggles, face shields, and N95 respirators. These employees have adapted to a new normal, exploring every lead, no matter how unusual,” Artenstein wrote. “Deals, some bizarre and convoluted, and many involving large sums of money, have dissolved at the last minute when we were outbid or outmuscled, sometimes by the federal government. Then we got lucky, but getting the supplies was not easy.”

He then told about securing a large shipment of three-ply face masks and N95 respirators, the latter from China. After agreeing to pay more than five times the amount it normally would pay for a similar shipment, Baystate send three members of the supply-chain team and a fit tester to a small airport near an industrial warehouse in the mid-Atlantic region. Artenstein arrived as well, to make the final call on whether to execute the deal. Two semi-trailer trucks, marked as food-service vehicles, met the team at the warehouse, and drivers were instructed to take two different routes back to Massachusetts to reduce the chance of being intercepted.

That didn’t stop two FBI agents from showing up as well. “The agents checked my credentials, and I tried to convince them that the shipment of PPE was bound for hospitals,” Artenstein wrote. “After receiving my assurances and hearing about our health system’s urgent needs, the agents let the boxes of equipment be released and loaded into the trucks. But I was soon shocked to learn that the Department of Homeland Security was still considering redirecting our PPE. Only some quick calls leading to intervention by our congressional representative prevented its seizure. I remained nervous and worried on the long drive back, feelings that did not abate until midnight, when I received the call that the PPE shipment was secured at our warehouse.”

Artenstein’s entire note can be read by clicking here.

“When encountering the severe constraints that attend this pandemic, we must leave no stone unturned to give our healthcare teams and our patients a fighting chance,” he concluded. “This is the unfortunate reality we face in the time of COVID-19.”

HCN News & Notes

SPRINGFIELD — Baystate Health is taking preemptive measures to protect the health and safety of its patients, the community, and its healthcare workers by initiating a new visitor policy for all of its hospitals.

Under the new policy, only one visitor per patient is allowed at a time, and people experiencing symptoms of fever and/or cough should not visit.

The new policy is in effect at all Baystate Health hospitals, including Baystate Medical Center and Baystate Children’s Hospital in Springfield, Baystate Wing Hospital in Palmer, Baystate Franklin Medical Center in Greenfield, and Baystate Noble Hospital in Westfield.

Additionally, for Baystate Children’s Hospital, no visitors under the age of 12 are allowed.

Baystate Health’s visitation policy during this time is designed to reduce patient and employee exposure to illness. Visitation is at the discretion of Baystate Health.

HCN News & Notes

PALMER — Baystate Health’s Senior Class will hold a free seminar on Thursday, March 26 titled “Abdominal Pain, Gallbladder, or Hernia.” The event will take place from 6 to 7:30 p.m. in the Snow Conference Room at Baystate Wing Hospital, 40 Wright St., Palmer.

Baystate Wing Hospital Surgeon Dr. Zeling Chau will lead the discussion, which will focus on causes and symptoms of abdominal pain.

“Just about everyone at one time or another will get a bellyache,” Chau said. “Most symptoms of abdominal pain will resolve fairly quickly, often without any treatment at all. However, in some cases, chronic or severe abdominal-pain symptoms can be an indicator of a more serious underlying health problem that requires medical attention.”

Susan Fontaine, senior coordinator of Loyalty Programs at Baystate Health, added that “many people suffer from various types of abdominal pains they think are diet- or stress-related when, in fact, it could be a hernia or gallbladder problem that is easily treated. Dr. Chau will explain the early warning signs you should know to prevent a simple hernia or gallbladder issue from becoming a more critical health risk. And there will be plenty of time for questions and answers.”

Baystate Health Senior Class is a free loyalty program dedicated to health and wellness, offered exclusively for men and women ages 55 and over.

The “Abdominal Pain, Gallbladder, or Hernia” seminar is offered at no cost, and a light dinner will be served. Registration is required by calling (413) 794-5200 or visiting abdominalpain.eventbrite.com.

For more information on Baystate’s Loyalty Programs, including Baystate Health Every Woman and Senior Class, visit baystatehealth.org/loyalty.

HCN News & Notes

SPRINGFIELD — Baystate Health’s Cardiac Surgery program received national recognition by the Society of Thoracic Surgeons (STS) for achieving a high level of clinical excellence on behalf of its patients.

Baystate has received the coveted 3 STAR ranking from the Society of Thoracic Surgeons, the highest possible ranking bestowed by the organization, placing its award-winning Cardiac Surgery program among the top 10% in the categories of coronary artery bypass surgery, aortic valve replacement surgery, and mitral valve repair surgery. The new rankings place Baystate in the top 1% to 2% of more than 1,000 cardiac surgical programs in the U.S.

“Achieving such a distinction in one cardiac surgical procedure is certainly a significant accomplishment, but achieving this degree of excellence in three separate procedures is truly remarkable,” said Dr. Thomas Schwann, associate director of the Heart & Vascular Program and chief of the Division of Cardiovascular Surgery for Baystate Health. “These results are a testimony to the skill, dedication, and compassion of our entire Baystate cardiovascular team. Their expertise continues to build on the long tradition of innovation, clinical excellence, and compassionate, patient-centered care that have been the hallmark of our program for over 40 years.”

HCN News & Notes

PALMER — Baystate Health’s Senior Class will hold a free seminar on Monday, March 30 titled “Hearing Loss and Balance Care.” The event will be held from 1 to 2:30 p.m. in the Snow Conference Room at Baystate Wing Hospital, 40 Wright St., Palmer.

“Hearing loss by itself doesn’t cause balance problems, but hearing loss can occur together with balance-impairment symptoms and can indicate problems with the inner ear and vestibular system,” said Susan Fontaine, senior coordinator of Loyalty Programs at Baystate Health. “It’s important to also know that a balance disorder may occur in different situations and may have various causes.”

The program will be offered by audiologist Deborah Stroetzel and Lori Manseau, physical therapist and manager of Baystate Rehabilitation Care at Baystate Wing Hospital. Together, they will discuss hearing loss, from diagnosis to treatment, and vestibular problems such as vertigo and inner-ear issues that affect balance, and how both are treated.

Baystate Health Senior Class is a free loyalty program dedicated to health and wellness, offered exclusively for men and women ages 55 and over.

The “Hearing Loss and Balance Care” seminar with Stroetzel and Manseau is offered at no cost, and refreshments will be served. Registration is required by calling (413) 794-5200 or visiting hearingloss-andbalance.eventbrite.com.

For more information about Baystate’s loyalty programs, including Baystate Health Every Woman and Senior Class, visit baystatehealth.org/loyalty.

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]