Goodwin Learning Academy helps families balance work, remote learning

Goodwin Learning Academy helps families balance work, remote learning

By: Kyle Stucker
Fosters Daily Democrat

Read the Full Article on Fosters Daily Democrat

SOMERSWORTH — Greater Seacoast Community Health has created a new learning center to lessen the struggles its employees are having while trying to balance pandemic childcare and remote learning with their work duties.

“Once this started it was seriously a breath of fresh air,” said Riona Corr, 32, a parent of three and the director of the WIC (Women, Infants and Children) program at Goodwin Community Health, one of the organizations that comprise GSCH.

Corr’s son Grady, a first-grader at Idlehurst Elementary School in Somersworth, attends the learning center inside Goodwin seven hours a day Monday through Thursday while Corr works downstairs. Corr also has a 3-year-old son who attends preschool and a baby girl her in-laws watch during the day.

At the learning center, teachers hired by GSCH assist Grady with his remote learning coursework, provide individualized instruction and handle other childcare responsibilities in a meeting space GSCH converted into a classroom in September.

“Before, I was just feeling this guilt, that I wasn’t doing enough for my child,” Corr said, describing her old COVID-19 routine, which involved sitting with Grady throughout the school day to help with remote learning, then squeezing her work into the afternoon and evening between making dinner and providing other care for Grady and other children. “It was just so draining.”

Patrice Baker, Goodwin’s parent and family education coordinator, said GSCH created the learning center because staff found, as the 2020-21 school year began, there still were many challenges and limited options for families seven months into the pandemic.

Many parents throughout the region and nationwide have left jobs and careers in order to provide childcare and education, or, like Corr, are struggling to balance home and work as they perform important frontline roles.

“It’s just a hard position to put our parents in,” Baker said.

The learning center is open to all of GSCH’s employees, which number in the hundreds across the various Goodwin, Families First, SOS Recovery Community Organization and Lilac City Pediatrics offices.

As of Monday, seven children were enrolled in the center. There were three first-graders, including Grady, two second-graders and an eighth-grader.

Baker said GSCH is committed to providing the center through at least the 2020-21. The program has availability for additional children and can safely grow by converting other meeting spaces at Goodwin.

“At this point, there aren’t many (face-to-face) meetings going on right now,” Baker said. “It’s a great use of the space.”

Baker said she hopes more employees will take advantage.

“I wish we could do more of it and open it up to the community,” Baker said, expressing regret GSCH isn’t able to make the center available to patients and other community members who lack the ability or means to secure an alternative. “We’d need a lot more space to do that.”

Three students were present Monday. Grady participated in video instruction with his Idlehurst class while a fellow first-grader named Brody worked on addition at his desk and Baker helped a second grader named Jayden on a worksheet that asked him to count the value of various sequences of coins.

Each student has their own desk, in addition to socially distanced areas in which the students can work on group activities together.

Learning center teachers Jaimie Steeves and Kendall Dapprich had some arts and crafts activities planned for the afternoon, when they’d have the boys make Halloween decorations for the classroom.

Steeves, Dapprich and Baker are assisted by three University of New Hampshire students at various points of the week, and part of the education provided also includes pandemic-related hygiene and life skills.

Steeves, a former daycare employee and paraprofessional, said she’s enjoying meeting a need for local families and that she unfortunately doesn’t “see the need changing” any time soon.

“The kids are great,” she said. “They’re so good at adapting and adjusting to this. At their age, I can’t imagine them going through this.”

Families First and Goodwin earn national recognition

Families First and Goodwin earn national recognition

PORTSMOUTH – Families First Health and Support Center and Goodwin Community Health Center have received recognition as level three Patient-Centered Medical Homes from the National Committee for Quality Assurance (NCQA). This is the highest level of recognition from the NCQA and is earned by providing accessible, quality, team-based health care while continuing to set goals for improvement.

The National Committee for Quality Assurance is a private, nonprofit organization dedicated to improving health care quality. NCQA’s Healthcare Effectiveness Data and Information Set is the most widely used performance measurement tool in health care. Both Families First and Goodwin have been recognized by the NCQA since 2011.

The Patient-Centered Medical Home is a health care delivery model that focuses on putting the each patient at the center of a care team. Providers and other health care services coordinate with one another and include the patient in the design of their individual care plan. The Patient-Centered Medical Home model is meant to connect patients with the people and organizations from which they receive care and drive improvements in patient satisfaction and quality of services provided.

To support the patient-centered mission of reducing costs while improving quality, Families First and Goodwin have focused on improving the tools and systems used by patients and staff and forming closer relationships between patients, their providers, and the other services located at the two health centers.

Families First Health and Support Center  and Goodwin Community Health Center are part of Greater Seacoast Community Health, a network of community health centers providing primary care, dental care, prenatal care, pediatrics, behavioral health counseling, substance use disorder treatment, WIC, social work services, home visiting, parenting classes, playgroups, as well as a pharmacy. Other organizations affiliated with Greater Seacoast Community Health include Lilac City Pediatrics, SOS Recovery Services and the Strafford County Public Health Network. Services are open to everyone and aim to be respectful, recovery-friendly, LGBTQ-affirming and trauma-informed.


Seacoast doctors: Now is the perfect time to get a flu shot

Read the full article on

By: Karen Dandurant,

DOVER – No one is really sure what this year’s flu season is going to look like, but what is universally agreed upon is the wisdom of getting a flu vaccine shot.

There are two theories about this year’s flu season, one that it could be very bad because of COVID-19, and the second, that flu season itself might not be too bad because of the precautions being taken already for COVID-19. Masking, social distancing and hand hygiene may result in fewer cases, or less serious cases.

Medical professionals say flu vaccinations are generally in good supply, and the time to get that shot is now.

Dr. Apara Dave, infectious disease specialist at Exeter Hospital said they are on track to vaccinate staff and patients, with no shortage in supply.

“We have been giving them for some time now,” said Dr. Gretchen Volpe, infectious disease doctor at York Hospital. “We have had no issue yet with supply.”

Volpe said orders for the vaccine were put in before the COVID-19 pandemic happened, and that’s why supplies are good.

Volpe said in the past, but not now because of COVID, there had been some thought that getting the shot too early would mean immunity would wear off before the end of the flu season, which can last into March and April.

The Centers for Disease Control recommends early fall through the end of October as the best time to get a flu shot, although anytime during the flu season is still worth getting the shot.

“We are not saying to delay at all,” said Volpe. “It seems anecdotal and not worthy of concern this year. The vaccine is important in terms of protecting yourself and the people around you.”

Dave commented on the idea that getting the shot too early could mean a loss of some immunity late in the season.

“It’s not as big an issue as we once thought it was,” she said. “On the other hand, if you don’t get your shot and it’s Nov. 1, still get it. It’s not too late.”

Jackie Dockham, RN, infection control at Exeter Hospital, said that waning of immunity could be a problem for the elderly and those otherwise compromised.

Dr. Jonathan Thyng, a family physician with Dartmouth-Hitchcock, Nashua, said the strains used in the flu vaccine are created each year in part after watching cases in the southern hemisphere, which Thyng said seemed lower than usual.

“It’s too early to talk about the effectiveness of the shot,” said Thyng. “We will start testing soon, we can test for the flu and COVID with the same sample. Otherwise there is no reliable way to differentiate between the two.”

Dave said Australia saw a much milder influenza season this year, but likely because the nation did things right.

“Australia was very good about masking and social distancing,” said Dave. “They were also very proactive about immunizations, reaching a high rate of their population. If we stay vigilant, we might see that. But, if we stop being diligent, or become less diligent, the season could actually be worse.”

Wentworth-Douglass Hospital has begun offering flu clinics in several of their locations. Katherine Weeks, RN, associate director of clinical operations, said the hospital’s supply is good, and the clinics are open to the public.

“We are using the quad vaccine (four strains) for anyone from six months to age 64, and beyond,” said Weeks. “We also have the high dose, recommended for people age 65 and up. It is a stronger dose and offers added protections for people at a higher risk. We have flulaval for those who can’t take the usual shot.”

Weeks said the number of people who cannot get the flu shot are relatively small.

“If they have had a life-threatening allergic reaction to the ingredients on the shot in the past, they should talk with their doctor,” said Weeks.

The three Seacoast-area community health centers – Families First Health Center in Portsmouth, Goodwin Community Health in Somersworth and Lilac City Pediatrics in Rochester – have state-supplied flu vaccine for both children and adults who are patients in their practices.

“The general recommendation is to get vaccinated in October to ensure you are protected through the whole flu season,” says Coreen Toussaint, RN, clinical manager at Goodwin. “Anyone immunocompromised or with many comorbidities should definitely get flu shot as soon as possible.”

While these health centers only vaccinate their established patients, there are many other ways for people to get vaccinated, such as at pharmacies.

Dockham said CORE physicians do flu clinics for their patients. She said some of those are planned to be drive-up.

“Others are going to be on Saturdays, when the offices are closed,” said Dockham. “All will be by appointment. Our employee clinics started this Tuesday.”

Families First Helps People in Coastal New Hampshire and Southern Maine Reduce Medical Debt

Read the full article on

By: Matt Walker
Published September 23, 2020

Medical debt can drastically alter one’s quality of life.

For millions of Americans who live on tight budgets — including 38 million who earn less than the federal poverty threshold  — an unexpected medical expense can quickly derail a quest for financial security.

In fact, about 40% of Americans would not be able to cover an unexpected expense of $400 without going into debt.

That’s why, perhaps now more than ever, it’s extremely important for U.S. residents to not only be able to access reliable health care but to also be able to afford it.

Families First Health and Support Center, in Portsmouth, New Hampshire, is one of a number of community health centers across the country helping people accomplish both of these things through its integrated care model suitable for all income levels.

“Providing services, regardless of the ability to pay, is a big part of our model,” said Families First Communications Director Margie Wachtel.

The organization, which is part of Greater Seacoast Community Health, that also includes Goodwin Community Health and Lilac City Pediatrics, a network of community health centers, serves the Seacoast region of New Hampshire as well as portions of Southern Maine.

The health centers provide a host of health services, including primary care, pediatrics, dental care, prenatal care, and behavioral health counseling. They also offers substance use disorder treatment, mobile health services, WIC nutrition services, social work services, a pharmacy, parenting classes, playgroups, and home visiting, according to the organization website.

Wachtel gave us a rundown of how community health centers operate and what they offer that private health care often does not. “There are two big differences between the community health center and a private medical practice,” Wachtel said. “The first one is affordability. The second one is, really, diversity of services and trying to meet the needs of the whole person.”

This is demonstrated by the fact that Families First and its partner health centers offer behavioral health care, substance abuse treatment, and a dental center — in addition to general wellness services — all under one roof, she said.

The health center also has two vans that provide home visits and mobile health care for the homeless, as well as a family center focused on parent education and support.

“Our model is about acknowledging that there are many factors that go into keeping people healthy,” she said. “It’s not just getting people medical care when they’re sick, but also social services and preventative services.”

Families First’s vision is to provide everyone in its community with the opportunity to live a long and healthy life.

“To all of us at Families First, you’re more than just your medical problems or test results,” according to the not-for-profit organization’s website. “Many things go into making people healthy and families strong, so we provide a lot of them right here to treat you as a whole person and make it easy for you.”

For those in the Seacoast area of New Hampshire and in Southern Maine who may not be familiar with Families First, the organization’s website offers a wealth of information about the services they offer and how residents can obtain them.

As Wachtel explained, affordability is one of the main differentiating factors between community health centers and more traditional health care options that can lead to crippling medical debt.

“We get government funding, grant funding, and donations that help us be able to serve patients, sometimes for a very nominal fee, depending on their income,” she said.

First, the community health center will attempt to help the uninsured acquire health insurance, and the underinsured expand their coverage to get the services they need, Wachtel said.

“Families First is here to help New Hampshire residents learn about options for affordable health insurance through the New Hampshire Marketplace and Medicaid,” according to the organization website. “Both programs help pay for regular checkups, prescription drugs, ER visits, hospital stays, specialist visits, and mental health and substance use treatment. Our enrollment counselors will work with you to figure out which health insurance coverage you may be eligible for. Our enrollment counselors will work with you to figure out which health insurance coverage you may be eligible for.”

Patients who are ineligible for insurance coverage can apply for discounted medical services.

To be eligible for the Families First sliding scale payment options, patients must fill out a short form and provide proof of income within 30 days of their visit. The community health center offers its discounts based on family size and household income.

Once approved, patients will be eligible for the approved discount for one year, at which point they will need to submit proof of income again.

“No one is ever turned away from Families First due to lack of health or dental insurance or inability to pay,” according to the organization.

In the face of the COVID-19 pandemic, Families First has had to shift some of its services to a telehealth model.

“We now offer telehealth for most types of medical visits and behavioral health (counseling) visits, as well as for some dental visits,” according to the website. “If you would like your visit to be by phone or video rather than in person, just let us know when you schedule your appointment. We strongly recommend telehealth visits for patients who are over age 60, or over age 50 with a chronic health condition.”

Wachtel said that, while the benefits of telehealth for patients have long been recognized, until recently most insurance companies would reimburse providers only for in-person visits.

“It’s been a positive thing that’s come out of COVID because telehealth was always a good idea, but it was not reimbursable by a lot of insurance providers,” she said. “It was something that was talked about, and now with COVID, they just made it happen.”

Having access to a medical care team is easier than ever via telehealth services.

“Patients and providers can communicate online or over the phone, letting each patient connect with their healthcare team from home,” according to the organization.

Even while navigating the challenges presented by the COVID-19 pandemic, Families First is helping people avoid debt and striving to fulfill its mission to “deliver innovative, compassionate, integrated health services and support that are accessible to all in our community, regardless of ability to pay.”

Physicians see the effects of institutional racism every day

Read the Full article at the Concord Monitor


Published 9/11/20

The board of directors of the New Hampshire Academy of Family Physicians openly denounces institutionalized racism, which results in the unwarranted deaths and disparate health outcomes of Black Americans.

As physicians, we see firsthand the undeniably deleterious impact that racism has on patient health, and we are not alone in this observation. The American Academy of Family Physicians, the American Medical Association, the American Public Health Association, and leaders from both the Harvard T.H. Chan School of Public Health and the Johns Hopkins Bloomberg School of Public Health, as well as many health system leaders, recognize that racism is a public health crisis needing our immediate attention, as it affects us all both directly and indirectly.

Now, as a nation, we condemn the violation of human rights and abuse of power resulting in the deaths of unarmed Black men and women. We mourn with our fellow Americans over the deaths of George Floyd, Breonna Taylor, Ahmaud Arbery, Tony McDade, Sandra Bland, Eric Garner, Trayvon Martin, Philando Castile, Freddie Gray, and the tragically long list of Black lives disproportionately taken too soon.

Although the infamous words “I can’t breathe” are months behind us, we must not forget.

New Hampshire is one of the least racially diverse states in the country, yet we are not immune to the manifestations of racism and unconscious preferences that lead to unequal health, social and economic opportunities and outcomes. Our physician members cannot forget the stories of our patients whose children have been taunted, belittled, wrongfully disciplined, or disregarded because of their family background. We cannot unhear or unsee our patients’ anxiety, fear, or missed opportunities caused by biased policies and practices within our schools and workplaces.

Furthermore, as physician scientists, we rely on best evidence to provide the highest quality care for our patients – we now understand the biology of how chronic stress and trauma exacts a toll on the physical health of people of color in the United States.

As family physicians, we always have been, and always will be, here for difficult conversations. It is part of our calling to bring about the betterment of public health and engage in responsible public advocacy for our patients and communities. There is no equivocating on this: Racism is a public health crisis. The practice of discriminatory policies coupled with the abuse of power result in devastating effects on our Black and brown communities.

We are troubled and saddened by the staggering maternal and infant mortality rates for Black mothers and babies, where pregnant Black women are over three times more likely than white women to die during childbirth, and Black babies die over twice as much as white babies. We see how the impact of racism on our toddlers, children, teens, and adults result in poor physical and mental health.

While there is increasing collective awareness of implicit bias and recognition of the vitality of cultural competency and workforce diversity, more needs to be done in creating a culture that celebrates and uplifts the richness of those who work and live in this state. We are deeply distressed by the overwhelming disproportionate impacts of the coronavirus pandemic, which is unmasking longstanding disparities in access to quality health care and safe and secure housing, as well as the economic security that results from good jobs with meaningful benefits. These disparities are the result of years of existing policy and systems-level action, and inaction, by our institutions and societal structures.

Under the charge of Gov. Sununu, the N.H. COVID-19 Equity Response Team released its initial report on July 12, outlining disparities in cases and outcomes throughout the state. There, we recognize the continued divide between communities of color and white patients in the state. The report notes: “As cases of COVID-19 increased in New Hampshire, quantitative public health data, along with anecdotal evidence, began to tell the story we expected to hear: People of Color were more likely to contract COVID-19; more likely to work in essential industries and positions that placed them in hazardous situations; more likely to not be able to easily access testing; less likely to be able to socially/physically distance and less likely to be able to recover from the economic and social impact of the pandemic. This pandemic, like all others before, was quickly amplifying and widening the divide.”

Our board of directors released a call to action to our fellow physician colleagues to actively engage in efforts to address inequities and structural racism in our respective spheres of influence. Today, we invite our community members to join us in our commitment to making our communities well by the following:

  • Educate: Increase education on equity, implicit bias, and their effects within the state.
  • Policy: Ask your leaders to dedicate policy to ensure all community members have the opportunity to grow professionally, civically, and physically by creating policies that cultivate a culture of equity.
  • Collaborate: Collaborate with different groups, organizations, or people to understand and implement both individual and collective changes that can break down barriers.
  • The New Hampshire Academy of Family Physicians recognizes that in the context of American history, if Black lives do not matter then all lives cannot matter.

(Dr. Joann Buonomano is president and Dr. Marie-E. Ramas is vice president of the New Hampshire Academy of Family Physicians board of directors.)

Overlap of flu and COVID-19 this winter worries Seacoast medical community

Read the full article here


By Karen Dandurant


PORTSMOUTH – Influenza and COVID-19 resemble each other in symptoms, and it is possible for people to contract both illnesses at the same time, so the medical community is urging everyone to get a flu vaccine to help minimize what could be a terrible season.

While there is no preventive measure yet for COVID-19, doctors say getting a flu shot has taken on an even stronger importance this year.

“We know the season will be bad,” said Dr. Travis Harker, chief medical officer at Appledore Medical Group in Portsmouth, and a family practice physician. “One thing we know for sure is that COVID-19 is most deadly when the system is overwhelmed. If we do not do all we can, our hospitals are going to be filled with cases of both illnesses.”

Dr. Kasra Djalayer, an internist with Greater Seacoast Community Health, which includes Families First and Goodwin Health, said the overlap of coronavirus and flu is concerning to many epidemiologists.

“Both can cause severe epidemic and can cause death,” said Djalayer. “That causes a double burden on the health care system. The risk of co-infections gets higher when two viruses are circulating in the same region. Anybody can get co-infected at the exact same time. Whatever happens, there is one important step people can take that may change the trajectory of either epidemic: Get the flu vaccine.”

“Even before the COVID-19 pandemic, receiving a flu vaccine each flu season has been highly recommended,” said Dr. Irene P. Rupp Hodge, an infectious disease doctor, and the medical director of Frisbie Memorial Hospital’s Center for Wound Care and Hyperbaric Medicine. “This certainly will remain the case for the upcoming flu season. By wearing masks, avoiding contact with people when sick, and utilizing the flu vaccine as recommended, this should reduce the spread of influenza this season, which will be a benefit to the public’s health in general and will free up resources to continue to combat the COVID-19 pandemic.”

Djalayer said influenza occurs in epidemics nearly every year. According to the Centers for Disease Control and Prevention, during the 2017-2018 flu season, 61,000 Americans died.

“Influenza virus is capable of changing its structure and genetic composition in a process called mutation,” said Djalayer. “Due to the high rate of mutation, it compromises our immune system to fight against the new virus. For this reason, new vaccines are produced every year in order to stimulate our immune system to fight against the influenza virus with new genetic composition. We need to vaccinate people every year because the immunity slowly vanishes during the year.”

Harker said the precautions being taken against COVID-19, masking, good hand hygiene and social distancing should help, even in preventing some flu cases, but he said he hopes people take the extra step and get the flu vaccination.

“One thing we know for sure is that the vaccination can help minimize the impact of influenza,” said Harker. “That might also help minimize the COVID impact.”

Martha Wassell, MPH, director of infection prevention at Wentworth-Douglass Hospital, said that even those people who might not have gotten the flu shot in past years should do so now.

“For whatever reason you didn’t in the past, now is the time to change your behavior,” said Wassell. “It’s the right thing to do for you and for those around you, especially if we do encounter the perfect storm of both illnesses striking at once.”

Wassell said to her knowledge a person with both viruses has not yet been seen, but she imagines it will be, and it will be bad.

“I would dread that day,” said Wassell. “I would assume this would overwhelm the person who is host to both illnesses.”

While the two illnesses can look very similar, Harker said testing can determine which illness a person is experiencing.

“We have set up protocols to manage both illnesses and do the testing for diagnosis,” said Harker. “Schools are going to pose a unique challenge this season and will have a low threshold for sending people home during this uncertain time.”

“They will need to use good judgment. It’s challenging, especially with young elementary school-aged children, who may not really understand the need for the precautions that are necessary. I have been impressed in my practice, seeing children as young as two, wearing a mask because they do not want to bring the illness home to grandma.”

Harker said Black and Latino populations are seeing five times the amount of COVID-19 cases as other populations.

“Black people represent four times the death rate, and Latinos, two times the death rate,” said Harker. “I think part of the answer is systemic racism, housing, and education opportunities, but that’s not the only reason. These populations are having a higher risk of comorbidities like diabetes and high blood pressure. COVID-19 is spread through the respiratory system, but it also attacks the blood vessels, so these comorbidities put them at a higher risk.”

Harker said it’s not too early to get the flu shot, and he said the shot is safe. It is too early to gauge the effectiveness of this year’s shot or how bad the season will be, according to Harker.

The CDC’s Advisory Committee on Immunization Practices recommends influenza vaccination for all individuals 6 months of age and older, for all healthy non-pregnant adults less than 65 years of age as well as for individuals over or at the age of 65. Patients with a history of Guillain-Barre Syndrome, who are pregnant or are immunocompromised, or have a history of egg allergy should consult their primary care doctor before getting the flu shot.

Harker said the population who cannot get a flu shot is small, but that if everyone else gets one, herd immunity may protect those people.

Djalayer noted flu shots are offered in many doctors’ offices, pharmacies, clinics, health departments as well as by many employers, and even in some schools.

“We need to be as ready as we can,” said Harker. “If things go south, we may need to lock down again. If we take the right steps up front, we may be able to avoid that and we can get through this upcoming very challenging season. If most people do the right thing, we should be OK.”

One more very important point, raised by Wassell, is people getting the flu shot and doing what they can to protect themselves and others could have an added bonus.

“It could help protect valuable resources we may need to deal with both illnesses,” said Wassell. “It can preserve space, beds, resources and staff we may need soon. If we can directly reduce the percentage of people getting the flu, we will be better able to handle whatever does come down the road.”

Goodwin becomes the first NH Community Health Center to host Family Physician Residents


Read the Full article on



August 18, 2020, SOMERSWORTH – Goodwin Community Health has become the first Community Health Center in New Hampshire to serve as a professional outpatient home for a physician residency program.  The program is a result of a new partnership between Goodwin’s parent organization, Greater Seacoast Community Health and Portsmouth Regional Hospital’s (PRH) new Graduate Medical Education (GME) program.  PRH launched its new program on July 1, 2020, as an affiliate member of Tufts University School of Medicine (TUSM).

The program adds four physicians to the team of family medicine providers at Goodwin.  The resident physicians have completed medical school and will spend three years training at Goodwin, PRH and local specialty practices on the seacoast.

Joanne Buonomano, MD, FAAFP, CPE, Chief Medical Officer and Family Physician at Greater Seacoast Community Health, will be the site director and will supervise the residents together with a growing team of outside community physicians, including Dr. Robert Mathes and Dr. Deborah Harrigan.

“We are proud to be the first community Health Center in the state to expand access to patient care through a residency program,” says Dr. Buonomano.  “With a shortage of primary-care physicians in the state and country, we are honored to be selected by these talented new physicians.  We look forward to guiding them through the final step of their training. The announcement is an exciting one for the community and health system, as this residency training program will assist in bringing more doctors to the area, enhance the culture of learning and diversity  at Greater Seacoast Community Health locations, and foster improvements to patient care and the patient experience.’

The launch of the residency program expands Greater Seacoast Community Health’s distinctiveness among community health centers as a teaching environment.   In 2014 The Goodwin Community Health Dental Center began hosting dental students from both Tufts University School of Dental Medicine and University of New England College.

The resident physicians are Matthew Nagelschmidt, MD; Guillermo Obregon, MD; Wesley Phillips, MD; and Nisha Vanmali, MD.



Matthew Nagelschmidt, MD, earned his undergraduate and graduate degrees in Biomedical Engineering from the University of Connecticut, while also working for Medtronic’s Research and Development team (formerly Covidien Surgical Solutions). He then completed his medical training with Saba University, in the Caribbean






Guillermo Obregon, MD, was born and raised in south Texas and Nuevo Laredo, Mexico. He earned a bachelor’s degree in health education and a master’s degree in biomedical science from Texas A&M University. Dr. Obregon completed his medical education at Central Michigan University College of Medicine.






Wesley Phillips, MD, was raised in Southern Ontario Canada. Dr. Phillips attended Trinity School of Medicine in the Caribbean. He enjoys family medicine because of its integral role in community health and wellness.






Nisha Vanmali, MD, was born and raised in Richmond Hill, Ontario. Dr. Vanmali attended the University of Western Ontario in London specializing in Biology. She completed her medical degree at the Medical University of the Americas (Nevis).






About Greater Seacoast Community Health:

Greater Seacoast Community Health is a network of community health centers providing primary care, pediatrics, dental care, prenatal care, behavioral health counseling, substance use disorder treatment, mobile health services, WIC, social work services, a pharmacy, parenting classes, playgroups and home visiting. The network includes Families First Health & Support Center in Portsmouth, Goodwin Community Health in Somersworth, and Lilac City Pediatrics in Rochester. The Strafford County Public Health Network and SOS Recovery Community Organization are also affiliated with Greater Seacoast. Services are open to everyone and aim to be respectful, inclusive, recovery-friendly, LGBTQ-affirming and trauma-informed. For more information, visit

About Portsmouth Regional Hospital:

Portsmouth Regional Hospital is a 220-bed acute care hospital located in Portsmouth, NH. Portsmouth Regional Hospital serves the Seacoast region’s residents in New Hampshire, Maine and Massachusetts and is one of the area’s largest employers. Portsmouth Regional Hospital is the only ACS Verified Level II Trauma Center on New Hampshire’s Seacoast. Portsmouth Regional Hospital is the Seacoast’s only comprehensive heart and vascular program, and its only 24/7 neurosurgical and stroke clot retrieval programs. For more information about Portsmouth’s services and physicians, visit:

How to ease children into this most unusual school year

Read the full article on Seacoast Online

By Karen Dandurant

PORTSMOUTH – While most school districts are beginning their year with remote learning, or some form of a hybrid model because of COVID-19, kids are searching for ways to deal with their new normal and the specialists say they might need help.

Children of all ages have not been in a classroom since March. They are grieving the loss of socialization, cut off from their friends, from sports and other extra-curricular activities that were a big part of their daily life.

Some are eager to return to school, while others are fearful and cautious. Child experts say the adults in their life need to recognize their feelings, and to learn new ways to talk with them about growing up in an unprecedented time.

Jodie Lubarsky is the Child, Adolescent, and Family Services Director at Seacoast Mental Health Center. She said kids are having a range of emotions, not the least of which are fear and grief, and one way to address this is to have conversations that are transparent and honest.

“Kids have grieved, and a second wave of grief is imminent,” said Lubarsky. “Kids have not been to school under the new guidelines and their classroom will not look like it did before. I think each grade will have its own differences in the ways it has to adapt. I think the process for a kindergarten student will be vastly different than that of a high school senior.”

Lubarsky said the adults should prepare for this second wave of grief. She said it is the caregivers who can help kids feel safe and comfortable.

Lubarsky said the Department of Education released guidelines, leaving the decision to each school district to decide how to structure their school year. She said educators want to teach, but must also learn a new way of doing it.

“There is no one size fits all, no right or wrong answer right now,” said Lubarsky. “What works for a small rural school may not work for a large urban school. Parents need to be comfortable with their own decision and not worry about how others perceive their choices.”

While many children are feeling stressed out, so are their parents, the experts said.

Children thrive on structure and routine but that may prove challenging in a COVID-19 world.

“This is a time of massive uncertainty for kids,” said Kelsey Goodwin, a pediatric rehab therapist at York Hospital. “I have always worked with kids, stressing the need for structure to their day. Well, the pandemic brought that to its knees. I still advocate for structure for kids even if it ends up being a bit non-linear to what they are used to. A lot of the kids I work with say they like coming to see me because it represents a sense of normalcy between their new situation and what they were used to before. I am still here even if other things in their life are not right now. The kids want things to be the same and I want them to understand there will be a new form of structure in their lives, but they can have structure.”

Goodwin said it has been five months since kids stepped inside a traditional classroom.

“Even when they go back, things will not be the way they remember,” said Goodwin. “So many new rules and restrictions will be in place. We need to make sure kids understand this.”

Balok-Searles said she is seeing kids with various symptoms of depression.

“They are showing anxiety at having to home-school,” she said. “They are upset at not being able to socialize. Some are struggling a lot. Parents feel they lost a lot of the education time they should have had by now. I see one child who lost the end of his middle school year. He never got that closure and now he is a freshman in high school. That is a big transition to happen in a bubble. We need to acknowledge this is abnormal.”

“Too much screen time suppresses melatonin,” said Goodwin. “It messes up sleep. We have always advocated for kids to not use devices at least a half hour before bedtime. Parents should try to find a way to break up the time kids spend in front of a screen, into shorter time periods.”

Goodwin said many kids and families are having a difficult time regulating their concerns.

“I see the worry in kids and in their families,” said Goodwin. “Not being able to see their friends is causing kids to grieve; it’s tough. Change is happening. Having structure can help and having parents model calm supportive behaviors is crucial. Parents will help kids navigate this new world.”

“We have to have hope and we have to impart that to our children,” said Lubarsky. “There will be times of anxiety and conflict. We need to hope this will get better and put one foot in front of the other. We need to tap into our resilience and figure out how to come out of this in the end. We need to work together, and we can get through this.”

The Centers for Disease Control (CDC) has good information for parents regarding schools opening, at

The Greater Seacoast Community Health 2019 Annual Report is Now Available

The Greater Seacoast Community Health 2019 annual report is now available in digital format. The report outlines the scale and reach of services offered by Greater Seacoast Community Health, which is comprised of Goodwin Community Health, Families First Health and Support Center,  and Lilac City Pediatrics.

The report also reviews the year at a glance, as well as our finances and our response to the COVID19 pandemic.


View the 2019 Annual Report Here


Learn more about Greater Seacoast Community Health 

Joann Buonomano, MD, FAAFP, CPE, CMO

Dr. Buonomano, our Chief Medical Officer, comes to Goodwin after spending 19 years as a rural family doctor at Ossipee Family Medicine, a satellite office of Huggins Hospital in Carroll County New Hampshire.

Throughout her career, she has provided medical services for hospital inpatients, has delivered over 500 babies and has worked with a large community health center in North Carolina, serving a Native American population. Dr. Buonomano graduated from Boston University School of Medicine and completed her family medicine residency in Fayetteville, North Carolina. She is a fellow in the American Academy of Family Practice and has recently participated in the Academy’s yearly medical delegation trip to Haiti.