LEND graduates implement innovative wraparound practices to address family healthcare needs

Lisa Plotnik, MD, FAAP, with patient, Lacey. Photo credit: Dartmouth-Hitchcock ManchesterThe Complex Primary Care Clinic at Children’s Hospital at Dartmouth-Hitchcock (CHaD) located within the Department of Internal Medicine-Pediatrics at Dartmouth-Hitchcock Manchester, provides primary care and consultation services to children and adults with developmental disabilities and complex care conditions. Led by Lisa Plotnik, MD (LEND 2016) and Stephanie Winn, MSN, APRN (LEND 2019), this innovative practice additionally provides primary care services to parents and siblings as a way to ensure that the healthcare needs of the entire family can be met in one location and that families may receive the supports needed for a full and satisfying life.

Lisa joined Dartmouth-Hitchcock Manchester in 2004, initially splitting her time between Internal Medicine and Pediatrics. Her practice grew as she took on adult patients with childhood-onset illnesses and disabilities and residentially placed children and youth with complex medical and behavioral health needs. She met parents who tirelessly advocated for their children and who also struggled to face their own health issues. She joined the 2016 NH-ME LEND cohort with the dream of launching a specialized primary care practice to address the needs of the entire family.

Stephanie first met Lisa during her time as camp nurse at Camp Allen while Lisa was serving as the Medical Director.  Being passionate about providing health care to individuals with disabilities, Stephanie went on to become a nurse practitioner and subsequently completed her first clinical rotation working with Lisa in her primary care practice. In 2019, they joined forces with a goal of helping families create care plans, manage multiple specialists, and coordinate community resources to ensure proper services and equipment. Accepting referrals from across the state of New Hampshire, they welcome families beginning the experience of supporting a child with a disability, as well as families looking for extra support as their child ages out of pediatric care. Together, they often take an active role in bridging the gap between behavioral health and medical care for people with developmental disabilities.

 An area of opportunity that Lisa sees is primary care consultation and guidance for complex patients by utilizing telehealth.  This model allows patients to establish care with her team while continuing with their primary care, labs, and therapies in their local community. “With telehealth taking off, this is the perfect way to conserve resources and for families to not travel long distances with patients who physically do not travel well or who fall apart upon arrival at our office due to the stress of travel. Telehealth also gives us the ability to see patients in their home environment and to assemble caregivers, specialists, and family members to problem solve and plan for our patients.”

Lisa and Stephanie noted that participation in LEND gave them the knowledge base of what other families historically have been through to successfully support their family members with complex care needs. Stephanie shared that LEND gave her a better understanding of the sibling experience and the mental health difficulties they may face living in a high-stress home environment. “Having learned side-by-side with family members, we can now put ourselves in their shoes, ask ourselves how we may make things go better for families by creating this practice.”

Complex Primary Care Clinic Brochure