A new medical home

by Paul Smart
March 10, 2011 12:46 PM | 0 0 comments | 11 11 recommendations | email to a friend | print
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Photo by Dion Ogust.
When the doctors at Maverick Family Health of Woodstock quietly opened the new Maverick West clinic on Route 28 in Boiceville last month, they said they did so as part of a longstanding mission to make quality medical care available to all reaches of rural Ulster County. In doing so, they became part of the vanguard in some of the key issues underlying the health-care debate of the day. They support the idea of family medicine, where each patient’s health is seen within a coordinated whole.

“We had been working for years in the Phoenicia community already, and felt it important to expand our services to a wider population,” says Maverick founder Randy Rissman. “Boiceville was central, where several roads converged, with the area’s major supermarket and the Onteora junior and senior high schools right there. It was the perfect location of a rural medical center.”

Rissman, who will celebrate 31 years as an area doctor this coming summer, points out how the new offices will include several key new services. Kingston Physical Therapy, which also operates an office in Maverick’s Zena offices, will be there. So will be Maverick Family Counseling, which offers help for children and adolescents as well as older clients (it’s run by Rissman’s wife Barbara).

The new health center, which will formally open next month, will feature lab facilities from Bio-Reference. Residents will no longer have to go to Kingston or Saugerties for their testing needs.

“The philosophy of family medicine is that one become part of the community,” Rissman said. He attended a medical school in his native Iowa where the emphasis has long been on service to rural communities over specializations based on diseases or parts of the body. “The ideal I learned was that you practice medicine as a means of serving your community. We see the whole person, as well as the person’s family.”

Rissman’s partner of 15 years, Marty Krakower, holds a specialty in family practice. Both men have experienced several generations of one family, seeing their people through difficult tijmes.

“We go every day to the hospital to visit our patients,” Rissman says. “Just as we touch our patients’ lives, they touch our lives as well. It goes both ways.”

On the Maverick website, the American Academy of Family Physicians describes their practice as “the medical specialty which provides continuing, comprehensive health care for the individual and family. It is a specialty in breadth that integrates the biological, clinical and behavioral sciences. The scope of family medicine encompasses all ages, both sexes, each organ system and every disease entity.”

Noting that “family medicine is the natural evolution of historical medical practice,” the AAFP sees the field’s re-emergence as a response to patients’ worries about medicine’s fragmentation in recent decades. “Family medicine is a three-dimensional specialty, incorporating (1) knowledge, (2) skill and (3) process. Although knowledge and skill may be shared with other specialties, the family medicine process is unique. At the center of this process is the patient-physician relationship with the patient viewed in the context of the family. It is the extent to which this relationship is valued, developed, nurtured and maintained that distinguishes family medicine from all other specialties.”

Patient advocates, navigators

Rissman talks of how he, Krakower and the other leading practitioners at Maverick Family Health (including an internalist, Dr. Gina Carena) see themselves as patient advocates as well as “navigators” who work to find means through the arcane systems of insurance coverage on behalf of their community. He mentions the concept of a “medical home, a place where you know what’s going on with someone.”

Maverick’s office growth, Rissman points out, is market-driven. Maverick’s is shifting all its patient records to an electronic medical recording system reimbursable by the federal government. They see the new system being used to its fullest in five years’ time.

Rissman also speaks well of the newly-appointed head of the Centers for Medicare and Medicaid Services, Donald Berwick, who Republican senators are trying to block because of his past statements in support of the British health-care system. Berwick’s Institute for Healthcare Improvement is a not-for-profit organization he founded for the improvement of health care throughout the world.

Has the medical world been cleaved into distinct specialized parts? Yes, Rissman answers. He sees the private insurance industry’s interventions between doctor and patient as the biggest threat. “It is odd to us in the family health movement that people blame the government when they are not the controlling interest,” he says. “You have to ask who’s looking after a patient’s best interest.”

Primary care in the area is alive and well. Rissman lists many other practices similar to his in Saugerties and Kingston, New Paltz and across the river. Thanks to the Kingston-based Institute for Family Health, which last month announced it has been chosen one of the first federally funded teaching health centers in the nation, an entire generation of primary-care doctors have been trained in the mid-Hudson region, most of whom still practice here. Under the new designation, twelve additional primary-care physicians will be trained in the next five years. The idea of seeing people in the context of their families, and providing them a medical home is especially compelling in an area such as ours.

Has the doubling of his office space into two equal facilities complicated things for the practice?  

Not at all, Rissman answers. “It has actually simplified matters a great deal,” he says. “We’ve got less congestion now and more services, which in the end means more access to patients.”

A formal opening for Maverick West will take place on Saturday, April 16. ++


For more on Maverick Family Health, located at 404 Zena Road in Woodstock and 4080 Route 28 in Boiceville, call 679-5271 or 657-7820. Or visit the new website at

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