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2006 A N N U A L R E P O R T T A B L E O F C O N T E N T S Message from Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Cardiovascular . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Spotlight on Philanthropy John Fennessey . . . . . . . . . . . . . . . . . . . . . . 7 Norris Cotton Cancer Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Neurosciences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Spotlight on Philanthropy Frank and Brinna Sands . . . . . . . . . . . . 11 Orthopaedics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Women’s Health and CHaD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Special Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Financial Statements and Operational Report . . . . . . . . . . . . . . . . 23 Community Health Improvements and Benefits . . . . . . . . . . . . . . 27 Board Memberships . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 1 M I S S I O N as Action Providing high quality health care, Comforting those with sickness and injury, Preventing illness among the well, Advancing health care, through Educating and Researching, Serving our community, Improving clinical practice, Communicating with depth, clarity, and sensitivity, and Collaborating with those who value this same mission. Nancy A. Formella, MSN, RN Acting President, Mary Hitchcock Memorial Hospital & Dartmouth-Hitchcock Alliance Thomas A. Colacchio, MD President, Dartmouth-Hitchcock Clinic Stephen P. Spielberg, MD, PhD Dean, Dartmouth Medical School “We thank you for your confidence in us and for your ongoing support of our mission, people, and programs, and for playing a vital part in transforming medicine.” 3 M E S S A G E F R O M L E A D E R S H I P Leading academic medical centers attract a special breed of passionate, dedicated, and talented people. We are extremely fortunate that so many physician scientists, compassionate nursing professionals, recognized leaders in premier medical education, and committed staff choose to focus their energy and talents on advancing patient care, education, research, and community service through Dartmouth-Hitchcock Medical Center and Dartmouth Medical School. As we look ahead, several notable achievements and future commitments set the stage for DHMC’s continued impact on the quality of health care—regionally, nationally, and internationally. Most notably, Dartmouth Medical School, in partnership with Dartmouth College and DHMC, will begin construction later this summer on the C. Everett Koop Medical Science Complex, a visionary new translational and clinical research facility on DHMC’s main campus. Thanks to the generosity of foundations, corporations, and nearly 50,000 individual donors, the Transforming Medicine Campaign has now reached over $142 million in gifts and pledges. Dartmouth-Hitchcock Medical Center also continues to have a profound impact on the advancement of medicine and national healthcare policy. For example, the current research of James Weinstein, DO, MS, is focused on leading a five-year, $13.5 million, multi-center trial that is receiving national and international attention, and revolutionizing how physicians and patients view and treat back pain. Also, Center for the Evaluative Clinical Sciences (CECS) senior faculty John Wennberg, MD, and Elliott Fisher, MD, MPH, continue to influence national healthcare policy at the highest levels through their work on healthcare delivery and outcomes. For DHMC, 2006 was another year of evolution and accomplishment. Following months of preparation by a diverse team of clinicians and staff, DHMC received full accreditation by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and Gold Medal status on all required patient safety and quality of care standards. Dartmouth Medical School continues to rank among America’s top medical schools and Norris Cotton Cancer Center was again recognized as one of the top 50 cancer centers in the country by U.S. News & World Report. DHMC was also named by Solucient as one of the top 100 hospitals in the country for cardiovascular care. The year was also one of transition for the leadership team. James W. Varnum retired in May after a stellar 28-year career as president of Mary Hitchcock Memorial Hospital and president of the Dartmouth-Hitchcock Alliance. Nancy A. Formella, MSN, RN, formerly DHMC’s senior nurse executive, was appointed acting president to succeed Jim. Nancy joins Thomas A. Colacchio, MD, president of the Dartmouth-Hitchcock Clinic, in leading and achieving consistently higher performance on measures of patient satisfaction, patient safety, quality of care, and financial strength for DHMC’s clinical enterprise. As one of America’s top academic medical centers, DHMC has a special obligation to our region and to the advancement of medicine. Our mission requires us to improve the health care and quality of life for the people in the communities we serve; to train tomorrow’s physicians and medical scientists; and to lead research efforts that save lives, accelerate healing, and improve clinical practice. This mission often requires DHMC to treat the most acutely ill patients in both New Hampshire and Vermont. It also means being the region’s “safety net,” by providing more free or discounted care and serving more Medicaid patients than the vast majority of other providers in the two-state region. DHMC is heavily relied upon for advanced specialized care, especially trauma services, cancer treatment, and the pediatric capabilities of the Children’s Hospital at Dartmouth (CHaD). We are fortunate to have so many passionate, dedicated, and talented people to meet these daunting challenges, and to have such strong support from the many communities we serve. We are especially fortunate to have the financial strength to support this mission, something that many of our peer institutions lack. Much of that strength derives from your continuing generosity, which is so critical to our current and future success. We thank you for your confidence in us and for your ongoing support of our mission, people, and programs, and for playing a vital part in transforming medicine. 4 Something extraordinary happens when a patient is treated at Dartmouth-Hitchcock Medical Center. An inspiring collaboration takes place here. Medicine is transformed by the participation of everyone involved in that patient’s care. Researchers and donors lay the groundwork for translating laboratory results into improved clinical practice. Professors communicate research findings and best practices toward the expansion of medical knowledge. Physicians refine and apply that knowledge with each patient interaction. And there is a simple result—we improve our quality of living. 5 C O L L A B O R A T I O N “Successful treatment in one area of the body can positively affect the others. That’s what I enjoy the most about my practice.” C A R D I O V A S C U L A R —Craig A. Thompson, MD, MMSc Craig A. Thompson, MD, MMSc Interventional Cardiology, Assistant Professor of Medicine “What is most interesting for me is being able to treat the entire patient and deal with all of the patient’s vascular problems. The disease process that affects the heart doesn’t lend itself to a compartmentalized approach. Rather than just simply focusing on peripheral vascular disease or stroke, I believe in a more integrated approach to taking care of the disease process. Richard J. Powell, MD Vascular Surgery, Associate Professor of Surgery & of Radiology “In taking care of patients with peripheral vascular disease, this is the most exciting time in history. Many new developments enable us to do a much better job of taking care of patients in less invasive manners. These include less invasive treatments for aneurysm disease and for carotid artery disease using carotid stenting. “A real strength of the cardiovascular program is the capacity for multiple individuals and multiple departments to have meaningful collaboration. This ultimately improves the local, regional and national delivery of healthcare in terms of clinical care, educational programming, and research. “Working collaboratively with multiple physicians to treat vascular disease enhances the clinical outcomes for patients. We are developing a multidisciplinary vascular clinic and are working closely with the cardiologists in developing protocols. When our vascular patients are screened for coronary disease, we emphasize preventive measures, such as making sure they are on the appropriate drugs that help prevent the development of atherosclerosis in the future. “The clinical research that we do here provides treatment opportunities for some patients who have limited options. Some patients come here specifically because of these clinical trials that are not available anywhere else regionally.” “The most rewarding thing to me as a surgeon is to see patients whose lives have been improved because of the care that we’ve been able to provide them.” —Richard J. Powell, MD “There are some unique characteristics of Dartmouth-Hitchcock, in culture and hierarchy, that really support this interdisciplinary team approach to patient care. “The work I've done is virtually always with teams and groups of individuals. I view that as being very significant, not only with building professional relationships but with enhancing clinical outcomes and improving patient management.” A patient arrived with unstable coronary syndrome. Before catheter-based interventions could begin, he had a stroke on the table and went into a coma. The stroke response team—Dr. Clifford Eskey, an interventional neuroradiologist and Dr. Timothy Lukovits, a stroke neurologist—along with Dr. Craig Thompson, an interventional cardiologist, redirected attention from the heart to the head. The three worked together, gave the patient clot-busting medication, and retrieved the blood clot from the patient's brain. He survived and recovered well. 6 John Fennessey appreciates the straightforward qualities of his doctors at DHMC. He calls them “exceptional.” J O H N F E N N E S S E Y S U P P O R T I N G : C A N C E R C A R E A T D H M C Fourteen years ago, Quechee, Vermont, resident John Fennessey came to the Emergency Department at DHMC with a lump in his throat. It turned out to be cancer. “I feel that I would have been gone a long time ago if it wasn’t for the Cancer Center,” Fennessey says. “I was really ill, and they made me better.” Under the care of oncologist Pamela Ely, MD, PhD, Fennessey fought a long, difficult battle with cancer that required chemotherapy and radiation, and eventually a bone marrow transplant. Through it all, he recalls, “Dr. Ely was very kind and completely honest with me. I never felt that she was giving me false hope. If I asked her a question, she answered it, straightforward. I like that.” Although he moved from Quechee to Lincolnville, Maine, in 2003, Fennessey never considered receiving his care anywhere but DHMC, despite the four-hour drive to Lebanon. “They [Dr. Butterly and Dr. Turco] are exceptional doctors and there’s no one in Maine I’d rather see,” he says matter-of-factly. He ultimately prevailed against the cancer and gratefully credits Dr. Ely with saving his life. In recent years, he has been coming to DHMC for ongoing care from cardiologist John Butterly, MD, and endocrinologist John Turco, MD—both of whom were recommended to him by Dr. Ely. To his delight, the qualities he appreciated in Dr. Ely were ones he found in both Dr. Butterly and Dr. Turco. “Dr. Butterly is a very caring man, the sort of doctor I feel comfortable with,” he notes. Of Dr. Turco, he says, “He’s a nice guy and very straightforward with me about my diabetes.” Fennessey also notes an added bonus: he and Dr. Turco share a passion for golf. He is not only loyal to DHMC, he is also generous, having recently included the Medical Center in his estate plans. Fennessey hopes that his ultimate gift will inspire others to remember DHMC in their estate plans, a process that he says “was very easy and uncomplicated.” While Fennessey, a longtime donor to both the Fund for Dartmouth Medical School and the Dartmouth-Hitchcock Annual Fund, is no stranger to supporting DHMC, his latest gift will significantly enhance cancer research and patient care at Norris Cotton Cancer Center, a place where he has an especially strong connection. “I feel that I would have been gone a long time ago if it wasn’t for the Cancer Center,” he says. “I was really ill, and they made me better.” 8 E R A S I N G “While our main goal is to treat the cancer, we strive to do so in a way that enhances our patients’ lives. Whether that means getting dressed each morning without facing reminders of cancer, or simply getting back to things they love to do, we offer patients options that help them regain what they may have lost along the way.” —E. Dale Collins, MD Kenneth R. Meehan, MD Director, Bone Marrow Transplant Program, Associate Professor of Medicine (Hematology/Oncology) “I like to think of innovative new ways to treat people. We have a very unique clinical trial here where we give patients various types of medication to allow their bone marrow to release bone marrow cells into the blood and also to stimulate their immune system so these cells are released into the blood. We collect those cells and use them in the transplant. Worldwide, this is only the second or third trial utilizing this approach. “We know the immune system following transplant dictates 9 B O U N D A R I E S E. Dale Collins, MD Director, Comprehensive Breast Program Associate Professor of Surgery (Plastic-Reconstructive Surgery) “Breast cancer patients face big decisions, and one of the first is what treatment to choose for their care. A unique initiative in the Comprehensive Breast Program ties comprehensive health screening and decision making into the routine care of our patients. Before their surgical consultations, patients view an informational video and answer questions that measure their understanding. They also complete a simple, computerized questionnaire that gathers information on medical and family history, and identifies emotional concerns like distress, depression, or anxiety. “If a woman reports emotional concerns, an e-mail is automatically sent to our breast cancer coordinators, who are trained social workers. They make contact with the patient as quickly as possible to offer support and guide her or her family members to appropriate services. Patients have been unbelievably grateful to us for implementing this process. “The screening tool allows us to have upfront information about our patients’ medical history, level of emotional distress, understanding of treatment options, and personal values. We can provide a more comprehensive level of support—based on who they are and what is important to them, not just as patients but as people.” C A N C E R long-term prognosis. So if we can provide cells in transplant that will bump up or improve their immune system immediately post transplant, we hopefully will improve their outcome. “We use medications to stimulate a patient’s immune system after transplant and actually give back their own cells that have been expanded in the laboratory to become killer cells as a vaccine. That has only been done in maybe two other clinical trials. “Our team—about 40 people— meets every Tuesday to talk about all new patients. That sort of team spirit, where people really take responsibility, has put us on the map.” “To have an idea, test it in the laboratory, take it to clinical trial, treat a patient, and hopefully improve that person’s quality of life and outcome—that is very fulfilling and happens every day.” —Kenneth R. Meehan, MD C R E A T I N G S O L U T I O N S “What really attracted me to the medical center was the wonderful focus on patient care.” —Clifford J. Eskey, MD, PhD Clifford J. Eskey, MD, PhD Director, Interventional Neuroradiology Assistant Professor of Radiology & Surgery “When someone has a stroke, there is very little time to save the brain. If they get to the hospital within three hours, the proven treatment is intravenously administered TPA, a clot-busting drug. If it is too late or the patient can’t get intravenous TPA, we can place a very small catheter into the blocked blood vessel in the brain to deliver small amounts of TPA right at the clot, with a better chance of opening the vessel and with lower risk. Or, we can use a corkscrew device to pull the clot out and open the vessel. “We are also able to treat brain aneurysms less invasively. Instead of opening the skull to put a clip on the aneurysm, we go in through the blood vessels and fill the aneurysm with soft platinum coils, effectively blocking it off from the rest of the circulation so it can’t hemorrhage. “Being able to treat lifethreatening diseases with minimally invasive procedures is very gratifying, as is working with my colleagues in the clinical neurosciences at Dartmouth-Hitchcock Medical Center to provide state-of-the-art patient care.” Dr. Clifford Eskey is the only N E U R O S C I E N C E S interventional neuroradiologist in New Hampshire. Timothy G. Lukovits, MD Co-Director, Comprehensive Stroke Program, Assistant Professor of Medicine “Stroke can be caused by many diseases, so I have to be like a detective to determine the cause and best treatment. Through accurate and skillful testing and interpretation, I determine what has happened to the patient, which leads to logical optimal treatment. “Often it requires an extra level of review with multiple radiologists, which is easily available at DHMC. My field is multidisciplinary, allowing me to interact with other subspecialties, something I find most satisfying and stimulating. DHMC’s size and somewhat less formal atmosphere foster collaboration between the subspecialties, which has changed the way we manage patients with stroke. “When a patient is admitted with a frightening event like a stroke, there often is an opportunity to change lifestyle. A lot of the secondary stroke prevention that I do hinges on education of patients and families. On a given day I am seeing the patient and their family and friends multiple times, so I have lots of opportunities to help them learn. It’s an opportunity to change someone’s habits in a very effective way.” “Stroke can dramatically change a person’s life and the essence of what that person is in seconds. It’s critical for me to be actively involved with my patient and the family to help them understand the potential impact on their lives.” —Timothy G. Lukovits, MD 10 By investing in an extraordinary institution, the Sands are having a big impact on the health of people within their community—and around the world. F R A N K A N D B R I N N A T H I N K I N G S A N D S G L O B A L L Y, For many, “think globally, act locally” is no more than a popular catchphrase. But for Upper Valley resident Frank Sands, who is the chairman and former CEO of King Arthur Flour in Norwich, Vermont, and his wife, Brinna, it is a way of life. “We want our children and grandchildren to inherit a better world,” says Brinna Sands. It’s this desire that drives the couple to volunteer and support local “I have this sense that, long after we’re gone, our kids and grandchildren will benefit from this gift and know that we did something to help improve health care.” organizations and educational institutions, among them the Upper Valley Land Trust, a non-profit organization dedicated to providing permanent protection of land and its resources throughout the Upper Valley, and Dartmouth College, Frank Sands’ alma mater. “Dartmouth is very important to our family,” he notes. It’s easy to understand why. Frank’s father, Walter, was a graduate of the Class of 1922, Frank himself is a proud member of the Class of 1958, and Frank’s brother graduated from Dartmouth in 1959. Two of the Sands’ children are also Dartmouth alumni. While Frank and Brinna Sands have a long tradition of giving to the college, the lion’s share of their most recent generous gift will go toward supporting the construction of facilities for the Center for the Evaluative Clinical Sciences (CECS) within the C. Everett Koop Medical Science Complex, to be built on the Lebanon campus of Dartmouth-Hitchcock Medical Center. CECS’s new home in the Koop Medical Science Complex will put CECS investigators in close proximity with physicians and scientists, leading to a better flow of knowledge from the lab to the bedside and the community. A C T I N G L O C A L L Y “We see the hospital as an extension of the Dartmouth community, and of the Upper Valley community,” Frank explains. Over the years, DHMC has also become an important part of the Sands’ lives: three of their grandchildren were born at the Medical Center, and Frank came to DHMC to have both of his shoulders replaced by orthopaedic surgeon John Nutting, MD. But according to Frank, it is Peter Williamson, MD, who gets the credit for inspiring this latest gift. “Pete is a classmate of mine,” he notes. Dr. Williamson is also the founder and director of DHMC’s renowned epilepsy program and co-chair of the Transforming Medicine Campaign. “Pete’s a wonderfully contributive guy,” says Frank of Dr. Williamson, whose own generous campaign gift will establish an endowed chair in honor of Alexander Garden Reeves, MD, retired DMS professor emeritus and former chief of neurology. Frank also notes the contributions of another friend and member of the Dartmouth College Class of 1958, Reverend Preston “Pete” Kelsey, whose generosity will create an endowed chair at Norris Cotton Cancer Center. “They are wonderful role models,” he explains. “And Brinna and I wanted to be part of that.” Brinna notes that they decided to direct their gift to CECS “because of the cross-fertilization that goes on between the College, Medical School, Medical Center, Tuck and Thayer.” Nationally and internationally recognized for its research on health outcomes, decision making, and policy, CECS draws on the expertise of physicians, scientists, and clinicianscholars throughout the Dartmouth community, with the goal of improving the healthcare system. The Sands’ gift may be going to a local institution, but the impact of their generosity will help improve the quality of health care throughout the nation and the world. “I have this sense that, long after we’re gone, our kids and grandchildren will benefit from this gift and know that we did something to help improve health care,” says Frank. 12 Q U E S T I O N I N G A S S U M P T I O N S “I lost a daughter to leukemia when she was 12, and saw her struggle from the age of 15 months. That certainly influenced my desire to help people with illnesses understand that there are treatment options.” —James N. Weinstein, DO, MS James N. Weinstein, DO, MS Chairman, Department of Orthopaedic Surgery Professor of Orthopaedic Surgery & Community and Family Medicine “In many instances in health care, there are choices for patients. Our Spine Patients Outcomes Research Trial (SPORT) provides evidence that supports patient participation in the care decision. This means we must integrate our patients’ preferences and values into that decision-making process. “DHMC has a wonderful resource available for our patients—the Center for Shared Decision Making, the first of its kind in the nation. This Center provides information for our patients about many of their conditions, including end-of-life treatment options. This information allows our patients to understand the best evidence to support one treatment or another, and to have a meaningful discussion with their doctor. It’s this connection with my patients that motivates and inspires me, each and every day.” O R T H O P A E D I C S William A. Abdu, MD, MS Medical Director, Spine Center Associate Professor of Orthopaedic Surgery “We understand that our patients often have very difficult problems. Our goal in the Spine Center is to make sure we can offer something to every one of our patients, whether it’s functional restoration, physical therapy, occupational support, counseling, pain management, or an operation. “All the disciplines are in one place in the Spine Center. This approach is uncommon, but we believe this is the best care for our patients. We all learn from each other, the collaboration is wonderful, and our patients benefit from the combined knowledge of the multidisciplinary team.” “We find it extremely motivating when our patients come back and have significant improvement in their quality of life.” —William A. Abdu, MD, MS 13 T R A N S F O R M I N G C . M E D I C A L E V E R E T T S C I E N C E Transcending Boundaries to Nurture Discovery Barriers between science and medicine are disappearing and collaboration is taking their place. Dedicated medical and science faculty, researchers, and clinicians know that today’s complex problems of disease and optimum patient care will not be solved by one person or even within one field of study. Creating solutions for intricate medical problems takes the combined resources of many disciplines to nurture discovery. K M E D I C I N E O O P C O M P L E X Stephen P. Spielberg, MD, PhD, dean of the Medical School, describes the collaborative approach as powerfully effective, requiring spaces specifically designed to transcend traditional boundaries and enhance collaboration, speeding the process of discovery and its translation into cures. The C. Everett Koop Medical Science Complex will bring state-of-the-art research and exceptional academic programs together in close proximity to clinical and patient care areas in uniquely designed environments intended to foster collaboration and discovery. “In our new translational research building, we will expand scientific investigation with an emphasis on multidisciplinary problem solving in neuroscience, cardiovascular science, immunology/infectious diseases, and other evolving areas,” Spielberg explains. focusing on healthcare delivery, optimizing care at the national to the local level, and evaluating new interventions, will interact with bench scientists,” Spielberg says. “Such physical juxtaposition will, hopefully, lead to a new era of more thoughtful flow of knowledge—from the bench to the bedside to the community and back. It’s an elegant system, with patients at the center of it all.” “Our Center for the Evaluative Clinical Sciences will be joined to the translational sciences building. Investigators in CECS, “The healthcare payment system is fundamentally broken and is a barrier to achieving high-quality health care.” —Elliott S. Fisher, MD, MPH Elliott S. Fisher, MD, MPH Professor of Medicine & Community and Family Medicine Center for the Evaluative Clinical Sciences “The healthcare payment system is fundamentally broken and is a barrier to achieving high-quality health care. “The Institute of Medicine (IOM) report that I participated in recommends that pay-forperformance consider broad aspects of performance, such as clinical quality, patient-centered care, and efficiency. We have to look beyond narrow measures in determining performance. “Although some see pay-forperformance as a ‘magic bullet,’ our committee raises serious doubts about its implementation. “The research that we are conducting on this issue at Dartmouth’s Center for Evaluative Clinical Sciences (CECS) should continue to influence IOM policy statements. Being part of IOM is a validation and recognition of the relevance and importance of the work we’re doing at Dartmouth around the relationship between spending, clinical practice, and the outcomes of care.” 14 P A T I E N T - C E N T E R E D W O M E N ’ S C A R E H E A L T H Michele R. Lauria, MD, MS Maternal-Fetal Medicine, Associate Professor of Obstetrics and Gynecology (Maternal-Fetal Medicine) & of Radiology “Working with families who have difficult decisions to make, explaining the limits of medical knowledge, the possible outcomes of specific choices and the uncertainties—in ways they can understand so they can make good decisions based on their personal beliefs—this is what I “I enjoy caring for families facing difficult choices, where there is clearly no correct choice.” find both challenging and rewarding. Best practices are “These situations typically arise with the use of ultrasound to diagnose congenital malformations. Often, there is a range of outcomes, and we can’t accurately predict where a child will fall in that range. Many of these couples are facing parenthood for the first time and are challenged to make their first parenting decisions prior to birth. This is often the first time they experience the unpredictability of life.” looking at developed from variations in care and outcomes from data derived from OBNet , a Web-based delivery registry. —Michele R. Lauria, MD, MS Richard P. Morse, MD Section Chief, Pediatric Neurology, Associate Professor of Pediatrics (Pediatric Neurology) & of Medicine “Pediatric epilepsy most inspires me in my day-to-day work. Helping a family and child overcome a challenging disease and blossom provides my inspiration. I can think of several children with intractable seizures who have been made seizure-free by a careful surgical approach to their epilepsy. When the entire epilepsy team works together and the outcome is reflected in the improved quality of life of the child and family, that is inspiring! “We all share a desire to translate bench research observations into the clinical arena. We are looking at the critical early post- 15 trauma events that may underlie the process of post-traumatic epilepsy, as well as a brain cooling project for neonatal brain injury. The pediatric neuroscience program is also moving forward with an initiative in deep brain stimulation for epilepsy. These projects and others influence the care of patients in allowing us to offer a more comprehensive approach to treating epilepsy. “We take a team approach in coordinating care, facilitated by the proximity of our offices and the frequent and varied forums that involve discussion of patient care. DHMC places great emphasis on finding ways to improve patient care.” “I get great personal satisfaction when I see a child with epilepsy get better.” —Richard P. Morse, MD The remarkable spirit of generosity is seen every day at Dartmouth-Hitchcock Medical Center. Community members and alumni of Dartmouth Medical School share our vision for creating leaders and defining clinical practice in health care. In the pursuit of clinical advancements, from more effective treatment discoveries to comfortable healing and disease prevention, our donors collaborate with our teams not only to express their personal vision for health and healing, but to truly transform medicine. This partnership confirms that our efforts are recognized, appreciated, and supported. 16 T H A N K Abbott Laboratories Fund Abcomm, Inc. Alison Abdu and Barry L. Glass Dr. and Mrs. William A. Abdu Dr. and Mrs. Donald W. Abel Academy of Movement Dr. Miriam and Sheldon G. Adelson AGS Foundation for Health in Aging Dr. Jeral L. Ahtone Clarence and Estelle Albaugh Trust Mr. and Mrs. Judd H. Alexander Dr. and Mrs. Raymond Alexanian Joseph Alexant Allergan William G. Allyn (deceased) Dr. Katharine Swift Almy Joel B. Alvord American Academy of Family Physicians American Academy of Neurology American Cancer Society, Inc. American College of Rheumatology American Heart Association American Institute for Cancer Research AmeriCares Foundation Ameriprise Financial Services, Inc. AMG Charitable Gift Foundation Amgen, Inc. Estate of Gladyce V. Amidon Mr. and Mrs. Charles H. Anderson Dr. and Mrs. Blair J. Andrew Androscoggin Valley Hospital Foundation William P. Annable Anonymous (14) Anthem Blue Cross Blue Shield Dr. and Mrs. Walter R. Anyan, Jr. AO Foundation Dr. and Mrs. Frederick M. Appleton Margaret F. Aronson Dr. Bradley A. Arrick and Danielle D. Jones Dr. Diane L. Arsenault and Peter R. Pirnie Dr. Lori Arviso-Alvord and Jonathan D. Alvord Astellas Pharma US, Inc. AstraZeneca LP Mr. and Mrs. David M. Atkinson Au Bon Pain Dr. and Mrs. James P. AuBuchon Auto Re-Nu-It Auto Body, LLC Aventis Pasteur Louise R. Avery Axcan Scandipharm Inc. Elliot A. Baines Drs. Emily R. Baker and Michael L. Beach Dr. and Mrs. Richard J. Baker, Jr. Mr. and Mrs. William J. Baldasaro Nicholas Baldick Dr. and Mrs. Perry A. Ball Dr. Karen and John Ballen Bank of America, N.A. Bank of America Banknorth, N.A. Gail and Steve Barba Mr. and Mrs. Kenneth S. Barclay The Barley House, LLC 17 Dr. and Mrs. John F. Barlow The Bryant and Doris Barnard Family Foundation Michele Barnett Mr. and Mrs. Raymond J. Barrette Robert V. Bartles and Loren L. McGean Drs. Lavonne and Paul Batalden The Bayson Company Prof. Deborah R. Becker Ed and Judi Becker Bedford Ambulatory Surgical Center, LLC Joel and Catherine Bedor Philip E. Beekman Katherine A. Beinder Alexander Graham Bell Association for the Deaf and Hard of Hearing K. Reed Berkey Berlex, Inc. Dr. and Mrs. James L. Bernat Anne and Arthur Berndt Dr. and Mrs. Philip M. Bernini Dr. and Mrs. Henry H. Bernstein Lawrence H. Bernstein Lawrence H. Bernstein Foundation Theodora B. Betz Foundation Suzanne and George Beyea Mr. and Mrs. Burton M. Bickford Prof. and Mrs. Robert B. Binswanger Biogen Idec BioSan Laboratories, Inc. Dorothy S. Bischoff Dr. and Mrs. Harry C. Bishop Dr. Laurie Blach Mr. and Mrs. Leon D. Black Dr. and Mrs. William C. Black David J. Blackwell Elizabeth A. Blauvelt Dr. and Mrs. Raymond M. Bleday Dr. George T. Blike Atie E. Blinn Barbara and Foster Blough Boatwright Foundation Inc. Mr. and Mrs. Antranig A. Boghosian Mr. and Mrs. John C. Bogle Bonneville & Son, Inc. Mrs. Murray Bornstein Naomi T. Borwell Boston Financial Management, Inc. The Boston Foundation Boston Scientific Corporation Mary Kay Boudewyns and Robert Sadlemire Drs. Philip and Suzanne Boulter Dr. DeRayne Boykins Dr. and Mrs. William E. Boyle, Jr. Katharine S. Boynton Mr. and Mrs. Robert Boynton Mr. and Mrs. G. Paul Bozuwa BrainZ, USA Dr. Mark G. Brauning Mr. and Mrs. William J. Breed Pauline Brine Mr. and Mrs. Charles E. Brinley Bristol-Myers Squibb Company Mr. and Mrs. Allen H. Britton, Jr. Broad Street School PTO Jennifer and Peter Brock Y O U D O N O R S The Jennifer Brock Charitable Lead Annuity Trust Drs. Constantine Brocoum and Ophelia Chang Dr. Carlene H. Broderick Dr. Mark J. Brodkey Marlene Brody Mr. and Mrs. David K. Brooker Dr. Katherine M. Brower Lucy Brown Dr. Mark W. Brown The Buchanan Family Foundation Dr. and Mrs. Kenneth W. Burchard Burdick Foundation J.E. and Z.B. Butler Foundation Marjorie W. Butler Drs. John R. and Lynn F. Butterly Dr. Ira Byock and Yvonne Corbeil The Byrne Foundation Dorothy and John J. Byrne, Jr. The Jack & Dorothy Byrne Foundation Drs. Thomas W. and Joan E. Byron C&S Wholesale Grocers, Inc. Cadbury Schweppes California HealthCare Foundation Mr. and Mrs. Robert A. Campbell The Capital Group Companies, Inc. Ann Fraser Carpenter Chris P. Carpenter Mr. and Mrs. Russell L. Carson Ann B. Carter Carvers For Kids Dr. Kristin Pisacano Casale Mr. and Mrs. Ernest Castellano Catholic Medical Center Joyeuse Gile Cavaney Centurion Corporation Cerner Corporation Joseph Cerniglia George B. Chandler Mark W. Chapman and Martha Blakemore Chapman Mr. and Mrs. William Henry H. Chapman II Dr. Mildred Chen Drs. Ambrose and Yvonne Y. Cheung Children’s Fund of the Upper Valley Estate of Janet I. Chipman Chiron Corporation Chittenden Bank Community Fund Michael Choukas Mr. and Mrs. Stephen F. Christy Dr. Kyung H. Chung David and Ann Cioffi Citizens Financial Group, Inc. Citizens United for Research in Epilepsy City of Lebanon Marilyn L. Clark Mr. and Mrs. Ray G. Clark Mr. and Mrs. Richard R. Clayton ClearChannel Worldwide Robert E. Clegg, Jr. Mr. and Mrs. Frederic S. Cluthe Coca-Cola Bottling Company of Northern New England, Inc. Mr. and Mrs. Edmund S. Coffin Dr. Jeffrey Cohen and Renee Vebell Mr. and Mrs. Richard B. Cohen Susan N. Cohen Dr. and Mrs. Mitchell D. Cohn Oscar Mandel Cohn Charitable Trust Estate of Oscar M. Cohn Dr. and Mrs. Thomas A. Colacchio Coldwell Banker Redpath & Company Mr. and Mrs. William S. Colehower Dr. and Mrs. Lawrence S. Coleman Mr. and Mrs. Miles C. Collier John and Helene Collins The Commonwealth Fund Community Foundation of Western Massachusetts ConEdison, Inc. Connecticut River Bank, N.A. Cook’s Equipment, Inc. Bill and Nancy Cook The Jane B. Cook 1992 Charitable Trust Dr. and Mrs. Milton Cooper Mr. and Mrs. Hans R. Copeland Mr. and Mrs. Martin F. Corcoran, Sr. Cordis Dr. and Mrs. Cornelius J. Cornell, Jr. Michael Costello and Jayne McLaughlin-Costello Estate of Eleanor and Norris Cotton County of Sullivan Mr. and Mrs. Michael T. Cowhig Pamela P. Crary Drs. Joseph and Carolyn Cravero Mr. and Mrs. Richard T. Crawford The Cremona Fund, Inc. Dr. and Mrs. Robert W. Crichlow Mr. and Mrs. Courtland J. Cross Mary S. Cross Dr. and Mrs. Harte C. Crow Dr. and Mrs. John F. Crowe Dr. John M. Crowe Mr. and Mrs. James W. Crowell Crown Point Cabinetry Corporation Mr. and Mrs. Thomas C. Csatari CTC Communications Cubist Pharmaceuticals, Inc. Ann M. Cullen Cullenberg & Tensen, PLLC Mr. and Mrs. Andrew W. Cunningham, Jr. Mary S. Cunningham Dr. Sandra J. Cunningham Drs. Jesse W. and Judith S. Currier Mr. and Mrs. Philip R. Currier Mr. and Mrs. Frederick G. Cushing, Jr. Cystic Fibrosis Foundation Therapeutics, Inc. Cystic Fibrosis Services, Inc. D & R Products Company, Inc. Drs. Lawrence and Linda Dacey Mr. and Mrs. W. Brian Dade Dr. Peter A. Dale Dr. and Mrs. Miguel Damien Damon Runyon-Walter Winchell Cancer Research Foundation Elaine and David Dana Drs. William Danford and Nancy Pettinari Barbara E. Daniell Daniell Family Foundation, Inc. Danielson Surgical Associates Dr. and Mrs. Kenneth S. Danielson Mr. and Mrs. Phidias G. Dantos 2006 With nearly 25,000 donors providing over $37 million in support through gifts and pledges for Dartmouth-Hitchcock Medical Center and Dartmouth Medical School, 2006 was an extraordinary fundraising year. All contributions to the Medical School and the Medical Center support the Transforming Medicine Campaign, which seeks to raise $250 million by the end of 2009. The enthusiastic response we received from our philanthropic community is a testament to the confidence our donors have in our ability to transform medicine by advancing patient care, medical education, scientific research, and community service. We are profoundly grateful to our friends, alumni, faculty, staff, and other supporters for their continued generosity. While gifts of all amounts are sincerely appreciated, included here are the names of donors who made gifts to the Medical School or Medical Center totaling $1,000 or more during 2006. Estate of Louise C. Darrow Dartmouth Class Of 1961 Dr. John G. Davenport Mr. and Mrs. Philip de Toledo Steve Dearing Mr. and Mrs. Gary M. DeGasta Delta Dental Dr. and Mrs. Carl S. DeMatteo The Demers Group Susan Dentzer Depuy Spine Derryfield Restaurant Robert A. Derzon Carol J. Descoteaux Dennis A. DeVaux Linda M. DeVere Devine, Millimet and Branch, P.A. Mr. and Mrs. Bradley Dewey, Jr. Dr. William E. Dewhirst Sandra G. Dickau Mr. and Mrs. S. Whitney Dickey Martha E. Diebold Digestive Care, Inc. Frances K. Dimmick Cleveland H. Dodge Foundation, Inc. Mr. and Mrs. Richard P. Donadio Drs. Eric D. Donnenfeld and Marlene B. Donnenfeld Dr. and Mrs. Richard W. Dow Mary L. Downing Downs Rachlin Martin PLLC Mr. and Mrs. Allan M. Doyle, Jr. Dr. Pepper/Seven Up, Inc. Robert T. Drape Mr. and Mrs. Bruce M. Dresner Dr. Kristina M. Duarte and Bridget Baird Dr. Kathleen R. Dube Dr. Ann-Christine Duhaime and Stanley A. Pelli Mr. and Mrs. Robert S. Dustin Mr. and Mrs. Donald R. Dwight Drs. Diane Marie Dwyer and Joseph G. Gall Mae E. Eagleson East Bay Community Foundation Eastern Mountain Sports Eastman Golf Association Dr. and Mrs. Walter L. Eaton, Jr. EBI, L.P. The Echlin Foundation John Edmiston Edwards Lifesciences LLC Dr. and Mrs. Burton L. Eisenberg Dr. David Eisner Mr. and Mrs. H. Newcomb Eldredge Elliot Hospital Stephan and Barbara Elliott Jennifer Ellis Dr. and Mrs. Robert M. Ellsworth Mr. and Mrs. Louis B. Ely, Jr. Embryon, Inc. Endowment for Health Engelberth Construction, Inc. Mr. and Mrs. Otto A. Engelberth John S. Engelman Ensearch Management Consultants Stephen W. Ensign Epply Charitable Foundation William R. Epply Dr. and Mrs. John F. Erkkinen Mr. and Mrs. Harry F. Espenscheid Estes & Gallup Builders, Inc. Tony Eun EV3 Inc. Drs. C. Douglas and Megan W. Evans Mr. and Mrs. Joseph P. Exner Expedition Inspiration, Inc. Exxon Mobil Foundation Mr. and Mrs. Fred J. Eydt Dr. and Mrs. Charles S. Eytel Fahey Family Foundation Mr. and Mrs. Peter M. Fahey Sherman Fairchild Foundation Fairfield County Community Foundation, Inc. Sami A. Fam Dr. and Mrs. Gilbert J. Fanciullo Fantini Baking Company, Inc. Mr. and Mrs. Wallace J. Farr Mr. and Mrs. Russell B. Faucett Dr. and Mrs. Charles S. Faulkner II Mr. and Mrs. Quentin P. Faulkner Faultless Starch / Bon Ami Company Mr. and Mrs. John J. Fennessey Mr. and Mrs. Allan R. Ferguson Dr. Susan K. Ferrand Dr. and Mrs. David R. Fett Fidelity Investments Charitable Gift Fund Frances W. Field Doris A. Fielding Drs. Mary P. and Mark F. Fillinger First Colebrook Bank Dr. and Mrs. William X. Fischer Fisher Scientific International Inc. Annabelle Fishman Dr. and Mrs. Reginald H. Fitz Flight Attendant Medical Research Institute Dr. and Mrs. Timothy P. Flood Ford Motor Company Forest Pharmaceuticals, Inc. Nancy and John Formella Foundation for Healthy Communities Foundation for Informed Medical Decision Making Foundation for Orthopedic Trauma Dr. Diane Louise Fountas Joan P. Fowler Francis Families Foundation The Jane & Stephen Frank Foundation Dr. Judith E. Frank Mr. and Mrs. Stephen Frank Fraternal Order of Eagles Grand Aerie Fraternal Order of Eagles NH State Grand Aerie Fred’s Plumbing and Heating, Inc. John D. Freeman David Friedensohn Dr. and Mrs. Alan J. Friedman Mr. and Mrs. Gerald A. Friedman Frisbie Memorial Hospital Mr. and Mrs. Milton Frye Dr. and Mrs. Freddie Ho Keung Fu Bob and Sharon Fuehrer Dr. Ann Furtado Dr. Imre Gaal, Jr. Gabelli & Company, Inc. Gay H. Gahagan Charitable Lead Trust Elizabeth L. Galbreath Dr. Stephen J. Galli Valerie A. Galton Dr. John V. Gandolfo Mr. and Mrs. Paul B. Gardent Garnet Hill Dr. and Mrs. Theodore H. Gasteyer II Deborah and Bradley Gebbie Geisinger Health System The Gemi Fund Genentech, Inc. General Electric Foundation Geokon, Inc. Mr. and Mrs. William V. Geraghty Dr. Barbara and Michael Gerling Dr. and Mrs. S. Peter Gibb Dr. Gary H. Gibbons Prudence D. Gilmore Mr. and Mrs. Gordon C. Gilroy, Sr. Mr. and Mrs. Edward F. Glassmeyer GlaxoSmithKline GlaxoSmithKline Foundation John C. Gleason Holly Glick and Jonathan Frishtick Globus Medical, Inc. Dr. and Mrs. Richard G. Glogau Paul W. Glover, Jr. Mr. and Mrs. Richard F. Gluck GlycoFi, Inc. Gertrude M. Goff The Arnold P. Gold Foundation Goldman Sachs Philanthropy Fund William Goldman Foundation Mr. and Mrs. Robert G. Goldstein Dr. Joseph S. Gonnella Good Beginnings Inc. Mr. and Mrs. Philip P. Goodkin Estate of Marion L. Goodwin W.L. Gore & Associates Dr. E. Ann Gormley and Richard Wallace Mr. and Mrs. James F. Gosselin Dr. and Mrs. Robert E. Gosselin Mr. and Mrs. Thomas L. Gosselin Goss-Logan Insurance Agency, Inc. Mr. and Mrs. George A. Graham, Jr. Mr. and Mrs. Wayne G. Granquist Charles Grant Dr. and Mrs. Joseph L. Grant Great Eastern Radio, LLC Great State Beverages, Inc. Dr. Alan I. Green and Frances S. Cohen Mr. and Mrs. Raymond C. Green The Greenspan Foundation Dr. and Mrs. Jeffrey S. Greenwald Mr. and Mrs. Tom Greig Garth H. Greimann Mr. and Mrs. Steven D. Griffin Mr. and Mrs. Alfred L. Griggs Dr. and Mrs. Walter C. Griggs Grimshaw-Gudewicz Charitable Foundation Guidant Foundation Edna & Monroe C. Gutman Foundation, Inc. Charles Haffajee The Hagen Group Mr. and Mrs. David K. Hall Mr. and Mrs. Sheffield J. Halsey Dr. and Mrs. Charles Hamlin Mr. and Mrs. Warren S. Hance Richard Hanlon George D. Hano and Diane Crowley Hanover Lions Club Hanover Transfer and Storage Mr. and Mrs. Robert W. Hardy Dr. William D. Harley Mary and Kathleen Harriman Foundation Dr. Allan C. Harrington Sheila A. Harrington Mr. and Mrs. Charles F. Harris, Jr. Jeffrey M. Harris Mr. and Mrs. Francis W. Hatch, Jr. Hawkins Delafield & Wood LLP Dr. Hamilton R. Hayes Warren J. Hayes Robert E. Haynes, Sr. Head Family Trust Estate of Dr. John M. Head Health Care Direct, Inc. Dr. and Mrs. John A. Heaney 18 The enthusiastic response we received from our philanthropic community is a testament to the confidence our donors have in our ability to transform medicine. Marian Heiskell Mr. and Mrs. Armin B. Hemberger Dr. Bonnie and Edward Henderson Dr. and Mrs. W. Hardy Hendren III Mr. and Mrs. Paul Hendricks Hendricks/Felton Foundation Prof. John W. Hennessey, Jr. Mr. and Mrs. Fred L. Henning, Jr. Mr. and Mrs. Robert R. Henry Heritage United Way Dr. and Mrs. Kenneth L. Herrmann The Hershey Company Mr. and Mrs. John C. Heston, Jr. Hike for the Cure Hill-Rom, Inc. Hinckley, Allen & Snyder LLP Hazen B. Hinman, Sr., Foundation, Inc. Dr. Francis H. Hinnendael Mr. and Mrs. Harold R. Hiser, Jr. Sandra U. Hoeh The Hoffman Family Foundation Mr. and Mrs. Romer Holleran Dr. Don A. Holshuh HP Hood, Inc. Dr. and Mrs. Bruce J. Hookerman Drs. P. Jack Hoopes and Vicki Scheidt Dr. Harriet W. Hopf and Leo M. Hopf Albert L. Hopkins and Lynne L. Zaccaria Florence O. Hopkins Charitable Fund, Inc. Mr. and Mrs. Michael T. Horvath Mr. and Mrs. Amos Hostetter Brian and Jennifer A. Hotz Deanna Howard and Dr. Thomas Sullivan Mr. and Mrs. Coleman W. Hoyt Mr. and Mrs. John A. Hubbard Wentworth Hubbard Marion Huber Trust James A. Hughes Matt Hurley Dr. and Mrs. John W. Hyland Hypertherm, Inc. IBM Matching Grants Program Dr. and Mrs. Richard S. Idler IKI Manufacturing, Inc. Susan C. and Stephen J. Immelt The Impact Group INCE Integrated Therapeutics Corporation International Myeloma Foundation Investment Management Advisory Group, Inc. iParty Retail Store Corporation Dr. Thomas W. Irvine, Jr. Irving Oil Corporation Dr. and Mrs. Mark A. Israel Mary E. Ives Mr. and Mrs. Carl E. Jackson Jane’s Trust Mr. and Mrs. James P. Jannuzzo Mr. and Mrs. Daniel P. Jantzen Mr. and Mrs. Wendell Jesseman Jewish Communal Fund JMH Wealth Management, LLC Johnson & Johnson Johnson & Johnson Contribution Fund Carol A. Johnson Ellen Foscue Johnson 19 Linda J. Johnson Peter A. Johnson and Claire P. Lyon Robert Wood Johnson Foundation Dr. and Mrs. Stephen J. Johnson Dr. and Mrs. James R. Johnston Albert C. Jones Mr. and Mrs. A. Wilson Jones Ellen Kaatz Warren K. Kaplan and Carolyn J. Stopak Kappa Kappa Gamma Katz Family Foundation Dr. and Mrs. Arnold M. Katz Drs. Samuel L. Katz and Catherine Monnier Wilfert-Katz Dr. and Mrs. Haig H. Kazazian, Jr. Dr. William M. Keane Judith J. Keating Dr. James K. Keeley Mr. and Mrs. Alan C. Keiller Kathleen and Mark Kelley Kellogg’s Dr. James V. Kelsey Reverend and Mrs. Preston T. Kelsey II Mr. and Mrs. Robert P. Kelsey, Jr. Abigail E. Spies Kennedy and Bradley Kennedy Dr. and Mrs. Alexander W. Kennedy Elizabeth C. Kent Mr. and Mrs. S. Leonard Kent The John and Estelle Ketterer Foundation Mr. and Mrs. John Ketterer Kristin H. Ketterer and Robert A. Oden III Kettering Family Foundation Sidney Kimmel Foundation for Cancer Research Mr. and Mrs. Bruce P. King Kinney Pike Insurance Inc. Susan C. Kirincich and Charles P. Wooster Kiva Foundation Kleen Laundry & Drycleaning Knox Family Foundation Mr. and Mrs. Frederick P. Koallick Kohl’s Komen Vermont Race For The Cure Susan Komen Breast Cancer Foundation Dr. Alan T. Kono Dr. and Mrs. C. Everett Koop Drs. Murray and Antoinette Korc Dr. and Mrs. Gary Korenman Dr. Kenneth J. Koval and Mary Reynolds KPMG LLP KPMG Peat Marwick KTRS-AM, L.L.C. Michael Kulacz Dr. Benedikt Kurz and Ms. Sandia Wang Pierre Lafitte Dr. Bruce F. LaFollette Drs. John M. and Margaret J. Lagnese Lakes Region Ice Racing Club Lake Sunapee Bank Mr. and Mrs. Brian T. Lally The Lancaster National Bank Emily Landecker Foundation, Inc. Constance M. Landmann Lang Middlebury LLC Dr. and Mrs. Robert J. Lang Mr. and Mrs. Walter E. Lankau, Jr. Drs. Laurie and John Latchaw Patricia A. Latona LaValley Building Supply, Inc James S. Lawrence Dr. and Mrs. D. James Lawrie, Jr. Estate of Jennie Ethel Laws Carola B. Lea Dr. David C. Leach Mary Susan Leahy Mr. and Mrs. David P. Leatherwood Dean F. LeBaron Mr. and Mrs. Stephen J. LeBlanc Ledyard National Bank Dr. and Mrs. Donald J. Lefkowits Virginia Leighton Mr. and Mrs. R. Willis Leith, Jr. Dr. Hugh F. Lena Jr. The Leukemia & Lymphoma Society of America Annette R. and Samuel M. Levine Dr. and Mrs. Gary M. Levine Dr. and Mrs. Richard M. Levy Mr. and Mrs. Howard H. Lewis Nancy Lewis Hiroko Li Dr. and Mrs. Robert Paul Liberman Ted and Suzanne Lieser Eli Lilly and Company Barbara C. Liming Agnes M. Lindsay Trust Lippincott Williams & Wilkins Peter Lique-Naitove Litchfield Middle School Littleton Regional Hospital Charitable Foundation Live Nation LM Charitable Gift Trust Drs. W. Charles and Gretchen K. Lobitz Mr. and Mrs. Douglas M. Loudon Estate of Dr. Mark L. Lowmiller Lumina Foundation for Education Daniel Lussier Lydall Thermal Acoustics Dr. Franklin Lynch, Jr. Dr. Joseph P. Lynch Lyndonville Savings Bank John D. & Catherine T. MacArthur Foundation Dr. Donald A. Macdonald, Jr. Prof. and Mrs. Robert M. Macdonald Heidi Mackay Mr. and Mrs. Richard S. Mackay MacLean-Fogg Company Mr. and Mrs. Roderick J. MacLennan D. Hugh MacNamee Memorial Trust Fund Duke MacNamee Major League Baseball Players Trust For Children Barbara H. Malcolm Reverend and Mrs. R. DeWitt Mallary, Jr. Dr. Lisabeth Maloney and Joseph Maloney Dr. and Mrs. Alan J. Mandel Mr. and Mrs. Stephen F. Mandel, Sr. Dr. and Mrs. Paul D. Manganiello Carla Manley-Russock and Robert Russock Dr. Bernard J. Mansheim Estate of Dr. Philip A. Marden Dr. Sandra L. Margoles Mr. and Mrs. Stephen R. Marion Blanche S. Marsh Mr. and Mrs. Gordon L. Marshall Mr. and Mrs. Jeffrey A. Marshall Drs. Howard Martin and Donna Ambrosino W. William Martinez Mascoma Savings Bank Foundation Mascoma Savings Bank Pauline F. Mason Dr. and Mrs. David M. Mauney Maverick Lloyd Foundation General William Mayer Foundation, Inc. Susan M. Mayer Priscilla K. Maynard Mayne Pharma (USA), Inc. Mr. and Mrs. Gary R. Mayo McCarthy Building Company Inc. Mr. and Mrs. Philip H. McCaull Dr. and Mrs. Robert W. McCollum Drs. Martha Dawes McDaniel and Stephen K. Plume Kelly McDermott McDowell Foundation Dr. Fletcher H. McDowell The Foster G. McGaw Educational Foundation Paul McGoldrick Dr. and Mrs. Donald O. McIntyre Dr. O. Ross McIntyre Jennifer McKay Dr. Sylvia Wyman McKean and Thomas McKean Leo C. McKenna McKesson Corporation McLaughlin Family Foundation Judith L. McLaughlin Michael Scott McLaughlin Foundation Peter McLaughlin and Jane Kitchel John R. McNair Daniel W. McNeill Linda Meader Medical College of Wisconsin Medical Education Consultants, LLC Medical Metrx Solutions Medtronic, Inc. Olivia Meek The Melanoma Research Foundation Dr. Vincent A. Memoli Merchants Bank Foundation Merck & Co., Inc. Merck Partnership for Giving Dr. and Mrs. Anthony L. Merlis Merriam-Graves Corporation Merrill Lynch, Pierce, Fenner & Smith, Inc. Mr. and Mrs. Keniston P. Merrill Mr. and Mrs. Dennis G. Merrow Mr. and Mrs. Peter C. Mertz Mr. and Mrs. Robert F. Meserve Mr. and Mrs. Robert S. Meyer Michael Meyers MGI Pharma, Inc. Mr. and Mrs. Clifford L. Michel Dr. and Mrs. Robert E. Michler Mr. and Mrs. Lawrence Midtbo Mill Park Foundation, Inc. Miller Nissan Jeep Volvo Miller Trading Company Mr. and Mrs. Morgan L. Miller T H A N K Estate of William A. Miller William H. Miller Million Dollar Round Table Foundation Maurice J. Mintzer Mr. and Mrs. James P. Mithoefer Dr. and Mrs. Richard M. Moccia Dr. and Mrs. John F. Modlin Dr. and Mrs. Mark B. Moeller Dr. Kenneth Moller III and Tracey Burton Monadnock Mountain Spring Water Inc. Monterey Fund, Inc. Benjamin Moore & Company Charles Moore Mr. and Mrs. George A. Moore Dr. and Mrs. John M. Moran Morgan Stanley Richard B. Morgan Dorothy W. Mori Mr. and Mrs. Wayne Morong Dr. and Mrs. Daniel H. Morrison Professor and Mrs. Leonard E. Morrissey, Jr. Dr. and Mrs. Harry R. Morse Motorsports Charities Inc. Mount Sunapee Resort Mr. and Mrs. William T. Mroz Eleanor M. Mudge Dr. and Mrs. Gilbert F. Mueller, Jr. Jim and Mary Ann Mulkin Dr. and Mrs. Albert G. Mulley, Jr. Multiple Myeloma Research Foundation Mumler Family Trust Estate of Margaret Mumler Dr. and Mrs. W. P. Laird Myers Emily S. Nagle Benjamin Naitove Trust Matthew Naitove Noah Naitove Nanogen Mr. and Mrs. Robert E. Nasar Mr. and Mrs. Cyrus H. Nathan National Multiple Sclerosis Society National Niemann-Pick Disease Foundation Dr. and Mrs. D. Dirk Nelson Dr. and Mrs. Eugene C. Nelson Eunice P. Nelson Mr. and Mrs. John K. Nelson Linda L. Nelson Mr. and Mrs. Walter B. Nelson Dr. and Mrs. William H. Nelson Katherine A. Nerrie Mr. and Mrs. William H. Neukom New England Employee Benefits Company, Inc. New England Wire Technologies Corporation New Hampshire Association of Chiefs of Police, Inc. New Hampshire Business Review New Hampshire Charitable Foundation New London Hospital New York Community Trust NH Fisher Cats Dr. and Mrs. David W. Nierenberg NMT Medical, Inc. Mr. and Mrs. F. George Nordstrom Jennie L. Norman and William C. Walker Y O U Northern New England Clinical Oncology Society Dr. Mark R. Northfield Northmac Inc. Dr. Christiane L. Northrup Northway Bank Norwich Wines & Spirits Novartis Pharmaceuticals Corporation Novo Nordisk Pharmaceuticals Inc. Sandra Nowicki James E. Noyes and Laraine Solomon The Joseph C. Nugent Family Charitable Trust Mr. and Mrs. Joseph C. Nugent, Jr. Dr. and Mrs. William C. Nugent, Jr. Nutt Hospital Investment Management Mr. and Mrs. David C. Nutt Oakhurst Dairy Mr. and Mrs. Bud Oatway Mr. and Mrs. Donald L. O’Bryant Occum Marin LLC Frederic and Joyce Oeschger Mr. and Mrs. Charles B. Officer Dr. and Mrs. Makio Ogawa Dr. and Mrs. Daniel L. Ogg Dr. and Mrs. Thomas B. Okarma Onyx Pharmaceuticals, Inc. Orr & Reno Professional Association Ortho Biotech Inc. Orthopaedic Research and Education Foundation Mr. and Mrs. Kirk L. Oseid Meghan O’Shaughnesy Mr. and Mrs. Stephen C. Osman Mr. and Mrs. Rudolph M. Ostermueller Bethany Ottman The Ovarian Cancer Research Fund, Inc. Ovatios Pharmaceuticals, Inc. Owens Family Foundation Mr. and Mrs. George F. B. Owens, Jr. P&G Pharmaceuticals, Inc. Marilyn M. Paganucci Anne Page Mr. and Mrs. Scott Page Elsa U. Pardee Foundation Christopher P. Parios and Susan L. Wyant Dr. and Mrs. Steven A. Paris Dr. and Mrs. George W. Parker Dr. Richard A. Parker Parkland Medical Center Ara Parseghian Medical Research Foundation Dr. Philip F. Parshley, Jr. Mr. and Mrs. Larry S. Partridge Passumpsic Savings Bank The Thomas C. and Janet M. Paul Fund Mr. and Mrs. Thomas C. Paul Mr. and Mrs. David B. Payne Dr. and Mrs. Norman C. Payson Virginia W. Peart Estate of Alvin W. Peck Dr. Vincent D. Pellegrini, Jr. Peninsula Community Foundation S. Richard & Patricia R. Penni Charitable Trust The Pepsi Bottling Group, Inc. Margery B. Perlo Elizabeth Shaw Perry D O N O R S Mr. and Mrs. Bob R. Perry Estate of W. Scott Peters The Charles E. and Joy C. Pettinos Foundation Karl Pfister III Pfizer Foundation Pfizer, Inc. Marcia M. Pierce Dr. Marvin S. Platt Daniel Pond Dr. and Mrs. Steven P. Poplack Dr. and Mrs. John T. Porvaznik Mr. and Mrs. Steven B. Potter Carol R. Powell Dr. Patricia M. and Prentiss Pratt Kim Preston Mr. and Mrs. Peter Preuss Proctor & Gamble Pro-Cut International Ltd, LLC Professional & Scientific Associates, Inc. ProPac Marketing, Inc. Gloria Raffaelly Pucci Mr. and Mrs. John M. Purdy Winifred M. Purdy Foundation Mr. and Mrs. Agnar Pytte QLLA Charities, Inc. QL Resorts, LLC Q-Med Scandinavia, Inc. Jacqueline R. Quayle Prof. and Mrs. J. Brian Quinn R.S.D. Leasing Radiant Mortgage Inc. K. Philip Rahbany Dr. Lawrence G. Rand Rasselstein GmbH Mr. and Mrs. J. Rodney Reck Dr. and Mrs. Alexander G. Reeves Susan A. and David W. Reeves Robert B. Regius Shirley M. Reid Estate of Robert M. Reininger Dr. and Mrs. Theodore Renna Research Applications Financial Tracking Inc. Eric Resnick Riblet Foundation Trust Mr. and Mrs. Henry J. Riblet Andrew Richard Dr. John E. Richards, Jr. Ride-Away Handicap Equipment Corp. Mr. and Mrs. Harold C. Ripley Riverstone Resources LLC Denis Rizzuto Susan Roberson Dr. and Mrs. Andrew B. Roberts Mr. and Mrs. David H. Roberts Dr. and Mrs. David W. Roberts Mr. and Mrs. F. David Roberts Sylvia M. Roberts-Moss Mr. and Mrs. Sanford R. Robertson Mr. and Mrs. Dana R. Robes Mr. and Mrs. Frederick A. Roesch Dr. and Mrs. William D. Rogers Dr. and Mrs. Peter R. Rogol Dr. and Mrs. Richard W. Rooker Dr. Joseph M. Rosen and Stina L. Kohnke Mr. and Mrs. David A. Rosenblum Mr. and Mrs. Robert G. Rosenblum Samuel Rosenblum Foundation Mr. and Mrs. Jay Rosenfield Mr. and Mrs. E. John Rosenwald Jr. Samuel B. Rowse Dr. Walter Royal III Dr. Frederic Rueckert, Jr. Gordon W. Russell Peter L. Rutledge and Christine M. Lauchenauer Drs. Stephanie Z. and Stephen R. Ruyle Albert J. Ryan Foundation Bonnie Johnson Sacerdote Foundation Saint Johnsbury Academy The Salmon Foundation, Inc. Sam’s Club #6352 Sam’s Club Foundation Sam Wyly Separate Property Dr. Charles A. Sanders Dr. and Mrs. John H. Sanders, Jr. Carolyn H. Sands The Frank and Brinna Sands Foundation, Inc. Mr. and Mrs. Frank Sands Sanofi Aventis Michael A. Satzow Rick Sayles Dr. and Mrs. Ernst J. Schaefer Dr. Mark M. Scheffer Schering-Plough Pharmaceuticals, Inc. Dr. Malinda J. Scherpa Mr. and Mrs. Edward M. Scheu, Jr. Mr. and Mrs. John T. Schiffman Dr. William R. Schillhammer, Jr. Mr. and Mrs. Mark C. Schleicher Dr. and Mrs. F. Richard Schneider Dr. Anne Schuchat and Fariborz Paydar Charles Schwab Corporation Foundation Mr. and Mrs. Robert L. Schwartz Dr. and Mrs. Joseph D. Schwartzman Dr. Berthold E. Schwarz Tod H. Schweizer Scleroderma Research Foundation Mr. and Mrs. Robert T. Scott Mr. and Mrs. Walter A. Scott Walter A. and Mary Catherine Scott Foundation Securitas Security Services USA, Inc. Mr. and Mrs. Steven G. Segal Dr. and Mrs. Dilip K. Sengupta Sepracor 20 Serono, Inc. Drs. Alan D. Sessler and Martha Ann Smith Dr. John L. Seymour, Jr. Mr. and Mrs. Mel A. Shaftel Michael S. Shannon Antoinette M. Shapiro John M. Shapiro Charitable Trust Dr. and Mrs. Cyril E. Shea, Jr. Mr. and Mrs. Morton A. Shea Mr. and Mrs. Stuart S. Shepard Shepherd & Goldstein, LLP Shepley Bulfinch Richardson and Abbott, Inc. The Eliot B. Shoolman Charitable Lead Trust Mr. and Mrs. Richard H. Showalter, Jr. Mr. and Mrs. Richard S. Shreve Drs. Christopher R. and Margaret A. Shuhart The SIDS Alliance Mr. and Mrs. Herbert J. Siegel Mr. and Mrs. Andrew C. Sigler Dr. Anne M. Silas William & Edna Silverman Charitable Fund Mr. and Mrs. William A. Silverman Hugh A. Simonds (deceased) Mr. and Mrs. Charles J. Simons Mr. and Mrs. Carl N. Singer Singer Family Foundation SIR Foundation Sisters of Holy Cross Robert J. Slattery Mr. and Mrs. Ronald T. Sliwinski Dr. Barry D. Smith Edwin H. and Ruth B. Smith Foundation Dr. and Mrs. Frank Rees Smith Drs. Hugh C. and Aynsley M. Smith Joanne B. Smith The Stephen “Hurricane” Smith Fund, Inc. Stephen M. Smith Prof. and Mrs. William M. Smith Mr. and Mrs. Austin L. Smithers SNHU Athletic Department Somersworth Middle School SourceCF Southern New Hampshire Medical Center Mr. and Mrs. David P. Spalding Sam Sparhawk III Spectra Dr. and Mrs. Peter K. Spiegel Drs. Stephen P. and Laurel Spielberg Dorothy Spies Mr. and Mrs. Howard W. Spiess Drs. Mark E. Splaine and Joyce A. DeLeo Mr. and Mrs. Biria D. St. John Orson L. St. John, Jr. St. Joseph Hospital St. Jude Medical Foundation Barbara J. St. Pierre Mr. and Mrs. John C. Stahler Robert L. Stahlman The Stanley Medical Research Institute State of New Hampshire Stave Puzzles, Inc. Mr. and Mrs. John L. Steffens Steffens 21st Century Foundation II Dr. Harise Stein and Peter D. Staple Jeffrey Steinkamp 21 Sterling Investment Partners Advisers, LLC Priscilla S. Sterling Lou & Harry Stern Family Foundation Mr. and Mrs. E. William Stetson III Mr. and Mrs. Peter R. Stettenheim The Stettenheim Foundation George M. Stevens & Son Company Mr. and Mrs. Bayne A. Stevenson Stitch ‘n Bitch Ruth D. Stoddard Dr. and Mrs. Robert Stragnell Mr. and Mrs. John B. Strasenburgh Strategic Hotel Capital, LLC Drs. Karen Lizbeth Straus and Randolph H. Renzi Dr. James C. Strickler Mr. and Mrs. Stanley S. Stroup Stryker Biotech Mr. and Mrs. Scott M. Stuart Sugar River Savings Bank Sulzberger Foundation Inc. SUNA Dr. and Mrs. Stephen David Surgenor Dr. Jeffrey L. Susman and Sarah May Mr. and Mrs. Laurence T. Susman S. Donald Sussman Dr. and Mrs. John E. Sutton, Jr. Dr. and Mrs. Elliott B. Sweet Mr. and Mrs. Kurt M. Swenson E. Clinton Swift and Bonnie R. Allard-Swift J. T. Tai & Company Foundation Sheila H. Tanzer TAP Pharmaceutical Products, Inc. Martha Taylor Tele Atlas North America, Inc. Mr. and Mrs. John Telischak Carolyn C. Tenney Mr. and Mrs. Theodore H. Teplow Dr. Lloyd B. Tepper Teva Neuroscience, Inc. Dr. Vijay M. Thadani Mr. and Mrs. John M. Thatcher, Jr. Brad and Bee Thayer Dr. and Mrs. Charles A. Thayer Redmond and Milou Thayer The Preuss Foundation, Inc. Mr. and Mrs. Robert H. Theriault, Jr. Sara S. Thomas Dr. and Mrs. William H. Thomas Drs. Craig B. and Tullia Thompson Dr. Sally B. L. Thompson Barb Thrasher Drs. Robert L. and Shari L. Thurer Estate of Minetta E. Tibbetts Mary C. Tiedemann Louise I. Tillotson Timken Aerospace Title Mortgage Solution L.L.C. Dr. Ivan M. Tomek and Sheri J. Hancock-Tomek Mr. and Mrs. Frank N. Tomlinson Estate of Jean Torrance Town of Canaan, New Hampshire TransCanada PipeLine U.S.A. Ltd Dr. Thomas L. Treadwell John and Evelyn Trevor Charitable Foundation John B. Trevor, Jr. Truman Charitable Fund Trust Company of Connecticut Gregory J. Tsongalis Amos Tuck School of Business UBS Global Asset Management (Americas) Inc. UCB Pharma, Inc. UMass Memorial Health Care, Inc. Union Bank United Health Foundation United Healthcare Services, Inc. United Way of the Upper Valley University of Colorado University of Massachusetts University of North Carolina at Chapel Hill Upper Valley Hotel Group LLC Mr. and Mrs. Frederic K. Upton The V Foundation Margaret C. Vail Vanguard Charitable Endowment Program James and Lucinda Varnum The Venetian Foundation Verizon Foundation Vermont Community Foundation Vermont Mutual Insurance Company Anne-Lee Verville VETTE Corporation VFW Ladies Auxiliary VFW Ladies Auxiliary Department of NH VHA Mr. and Mrs. Drury L. Vinton Mr. Andy L. Voda Dr. and Mrs. George H. Vogt Drs. Nancy Wade and John Leary Dr. Lucy R. Waletzky Patrick T. Wallace Wal-Mart Wal-Mart Foundation Brian F. Walsh and Linda J. Patchett Dr. and Mrs. Daniel B. Walsh Earl C. Ward Mr. and Mrs. Gail L. Warden Dr. and Mrs. Bruce L. Warshauer Dr. and Mrs. Lewis J. Warshauer Bruce Warwick Mr. and Mrs. Bruce M. Waters Watson Wyatt & Company Arthur K. Watson Charitable Trust Thomas J. Watson Foundation Mr. and Mrs. Donald E. Watson Abby N. Watt Dr. and Mrs. Theodore R. Waugh Wausau Paper Foundation, Inc. Mr. and Mrs. Barry Waxman Samuel Waxman Cancer Research Foundation Mr. and Mrs. John H. Weaver The Walter H. and Hannah H. Webb Extended Family Foundation Mr. and Mrs. Hartley D. Webster Dr. and Mrs. James N. Weinstein Mr. and Mrs. Robert J. Weissman Mr. and Mrs. Rodger E. Weismann, Jr. Wellpoint Foundation Wellpoint, Inc. Wells River Savings Bank Estate of Maxine L. Wells Dr. and Mrs. John E. Wennberg Mr. and Mrs. William S. Wesson Alfred P. West, Jr. Dr. and Mrs. Franklin H. West Herman O. West Trust Drs. John D. West III and Stephanie R. Lash George Weston Bakery Mr. and Mrs. Helmut Weymars Mr. and Mrs. Frank L. Whitcomb Frank W. Whitcomb Construction Corp. White Cliffs Golf Shop Dr. and Mrs. Jon C. White Mr. and Mrs. Robert F. White Mr. and Mrs. Stephen L. Whitman Dr. and Mrs. John H. Williams Mr. and Mrs. Stanton N. Williams Debra Laughton Williamson Dr. and Mrs. Douglas E. Williamson Dr. and Mrs. Peter D. Williamson Wilson Sonsini Goodrich & Rosati Wilson Tire, Inc. Estate of Stanton W. Wilson Donald Winterton Dr. and Mrs. Charles Wira Edith M. Wisiol Mr. and Mrs. Daniel H. Wolf Natalie W. & Leo E. Wolf Foundation Arthur and Helen Wood Dr. and Mrs. Robert W. Woodhouse Woodstock Foundation, Inc. Woodsville Guaranty Savings Bank World Learning Worldwide Healthcare Comm - Serono Worldwide Peak Mr. and Mrs. James E. Wright Sam Wyly Mr. and Mrs. William W. Wyman Mr. and Mrs. John E. Xiggoros Mr. and Mrs. Yeong-Shyang Yang Mr. and Mrs. Harold Yanofsky Mr. and Mrs. Barry B. Yellen York Cross of Honour Medical Research Foundation Dr. and Mrs. Oglesby H. Young Susan Young Dr. and Mrs. David S. Zamierowski Mr. and Mrs. John C. Zimmermann III Marie & John Zimmermann Fund, Inc. Dr. and Mrs. Douglas P. Zipes Dr. Michael Zubkoff and Leslee A. Michaels T H A N K Y O U D O N O R S Dartmouth-Hitchcock Medical Center 2006 2005 $ 28,012,905 $ 24,069,505 Unrestricted and Annual Funds $ 1,639,882 $ 1,730,575 Restricted Funds $ 15,044,055 $ 13,882,453 Total Current Operations $ 16,683,937 $ 15,613,028 $ 6,585,937 $ 5,815,144 $ 4,743,512 $ 2,641,333 Total Philanthropic Contributions (July 1-June 30) Current Operations Endowment Total Endowment Plant and Equipment Total Plant and Equipment D H M C P H I L A N T H R O P I C C O N T R I B U T I O N S Dartmouth-Hitchcock closed the 2006 fiscal year in a position of financial strength. Total unrestricted revenue and other support reached $913.9 million for the system while experiencing steadily increasing demand for patient care services. Our net assets improved by $89 million, and we retained our A+ bond rating in the eyes of two major rating agencies, Standard & Poor’s and Fitch. Research and training awards received by Dartmouth Medical School also reached new highs, totaling $133 million in 2006. Also in 2006, we formally recognized our commitment to exceptional financial performance as being critical to long-term fulfillment of our patient care, teaching, research, and community service missions. We initiated a comprehensive performance improvement plan early in the year designed to strengthen operating performance on a broad array of measures—quality of care, patient safety, access to care, operating margin, financial liquidity, and others. We ended the fiscal year with an operating margin of $1.3 million; with non operating gains of $14.5 million, DartmouthHitchcock realized a total margin of $15.8 million. More importantly, we registered improvements in access to care, patient flow, and a number of important quality indicators while continuing to strengthen our financial performance. 2003 $972,825 S E L E C T E D F I N A N C I A L I N F O R M A T I O N Operating Expenditures (000s omitted) Dartmouth-Hitchcock Medical Center 2006 2005 Operating Expenditures (000s omitted) Dartmouth Medical School $ 203,198 $ 189,051 2006 2005 Dartmouth-Hitchcock 912,601 842,936 Dartmouth Medical School $ 203,198 $ 189,051 Veterans Affairs Medical Center 110,535 97,696 Dartmouth-Hitchcock 912,601 842,936 Total $ 1,226,334 $ 1,129,683 Veterans Affairs Medical Center 110,535 97,696 Total $ 1,226,334 $ 1,129,683 Revenue Sources Payment for Patient Services from Revenue Sources Third Parties and Patients $ 878,999 PaymentBudgets for Patient Services from Federal Third Parties Affairs and Patients $ 106,946 878,999 for Veterans Services Federal Budgets Funded Research 137,673 for Veterans Affairs Services 106,946 Tuition Income and Fees 16,848 Funded Research 137,673 Gifts, Bequests, Endowment and Tuition IncomeIncome and Fees 16,848 Investment 35,464 Gifts, Bequests, Endowment and Other Income 66,400 Investment Income 35,464 Total $ 1,242,330 Other Income 66,400 Total $ 1,242,330 $ 819,073 $ 819,073 94,040 128,472 94,040 15,043 128,472 15,043 45,550 75,478 45,550 $ 1,177,656 75,478 $ 1,177,656 2006 2006 $1,242,330 2005 2005 $1,177,656 2004 2004 $1,106,195 T O T A L R E V E N U E 2 0 0 3 - 2 0 0 6 24 S E L E C T E D F I N A N C I A L I N F O R M A T I O N Revenue Sources (000s omitted) 2006 Payment for Patient Services from Third Parties $ DMS D-H 10,965 $ 868,034 Federal Budgets for Veterans Affairs Services Funded Research TOTAL $ 878,999 $ 106,946 106,946 3,589 137,673 134,084 Tuition Income and Fees 16,848 Gifts, Bequests, Endowment and Investment Income 18,453 17,011 35,464 23,063 $ 203,413 43,337 $ 928,382 $ 110,535 66,400 $ 1,242,330 DMS D-H VA TOTAL $ 10,977 $ 808,096 Other Income Total 2005 Payment for Patient Services from Third Parties 16,848 Federal Budgets for Veterans Affairs Services Funded Research $ 819,073 $ 94,040 94,040 3,656 128,472 124,816 Tuition Income and Fees 15,043 Gifts, Bequests, Endowment and Investment Income 16,379 29,171 45,550 21,229 $ 188,444 54,249 $ 891,516 75,478 $ 1,177,656 Other Income Total 25 VA 15,043 $ 97,696 O P E R A T I O N A L A N D P A T I E N T Dartmouth-Hitchcock R E P O R T Veterans Affairs Medical Center 2006 2005 2006 Patients Discharged Outpatient Visits Patient Days of Service Northern Region 2005 2,519 2,481 15,269 15,137 449,609 432,932 Average Daily Census 42 42 Operations Performed 2,566 2,755 Concord Offices 177,750 176,295 Outpatient Visits Manchester Offices 344,885 330,128 Nashua Offices 221,318 209,973 Keene Offices 349,319 344,577 156,715 1,699,596 185,871 1,679,776 Lebanon Community Practices Other Total Outpatient Visits Patients Discharged New Hampshire 173,785 170,794 Same Day Procedures 4,611 3,953 Home Health Visits 2,144 2,844 58,151 59,856 Dartmouth-Hitchcock 6,414 6,211 Dartmouth Medical School 1,105 1,104 649 649 Medical Students 294 304 Residents and Clinical Fellows 362 347 Basic Medical Sciences 197 185 Other 122 95 28 1,003 29 960 Volunteer Hours Employees (full-time equivalents) 11,548 11,296 9,030 8,909 1,015 ** 21,593 1,049 21,254 ** 105,055 103,428 Average Daily Census 288 283 Operations Performed 16,420 15,708 1,120 1,108 Emergency Department Visits 28,728 29,187 Volunteer Hours 46,000 48,500 Postdoctoral Research Fellows Total 29,343 32,800 ** Includes patients admitted for observation and intensive care nursery bassinet patients. Vermont Other States Total Patients Discharged Patients Days of Service Births Dartmouth Medical School Physician Office Visits—Psychiatry Veterans Affairs Medical Center Education Programs Graduate Students in 26 Responding to the letter and spirit of the New Hampshire Community Health Benefits Law Core Values of Community Health Improvement Identifying and coordinating a Target for Change Strengthening community partnerships and leaders Expanding community education for health and Benefits C O L L A B O R A T I N G T O I M P R O V E C O M M U N I T Y The Community Health Improvement and Benefits program is a very vital part of Dartmouth-Hitchcock’s mission. Our aim is to work collaboratively to promote wellness, prevent illness, and remove barriers that hinder access to health care by working hand in hand with the communities we serve. A Making a focused impact on at least one major public health issue is our Target for Change as we work to effect positive change through community partnerships and leaders. A recent example is the leadership role DHMC played in strengthening the education, prevention, and treatment options for addiction in the Upper Valley and surrounding region. L Z H E I M E R ’ H E A L T H With clinical leadership from Alan Green, MD, PhD, chair of Dartmouth Medical School’s Department of Psychiatry, DHMC opened the Addiction Treatment Program in September 2005. Dr. Green notes that this intensive outpatient treatment program has been “extremely effective and well subscribed” in its first year of operation. In addition, the program has been supplemented by a more tightly coordinated network of addiction prevention, education, and treatment resources in the community. Dr. Robert S Santulli’s vision A N D O T H E R M E M O R Y D I S O R D E R S led to the Upper Valley Memory Center. “Talking to Dr. Santulli and other agency personnel and being able to ask them questions [about memory disorders] was priceless.” —Marie Spencer 27 Most successful programs begin when a catalyst brings people of vision together to create a program that improves the quality of life for others. And so it was with the establishment of the Upper Valley Memory Center (UVMC). The catalyst in this case was Robert Santulli, MD, associate professor of psychiatry at Dartmouth Medical School, geriatric psychiatrist at Dartmouth-Hitchcock Medical Center, and now director of the UVMC. The people of vision he brought together were those who work with the elderly in a number of arenas. Their goal is to offer services, information, and support, and to create awareness of Alzheimer’s and other memory disorders within the Upper Valley community. When Marie Spencer learned about UVMC, her father had been diagnosed with Alzheimer’s disease and her mother had other dementias. Marie, her sisters, and her brother were looking for one central place to get information and meet others struggling with similar problems. UVMC helped Marie’s family in several ways. Ultimately, it helped them understand their challenges in a new way. “We’ve done the best we possibly could for our parents,” said Marie. “That’s all anyone could ask.” C O M M U N I T Y H E A L T H L E A D E R S H I P The first DHMC Community Health Leadership Awards were given in 2006 to two key volunteers. Each winner received a small financial gift to be used for community health. Colleen Warren, a DHMC nurse, spearheaded an evidence-based approach to addressing tobacco use with inpatients. She coordinated training 200 nurses and other clinicians to support these A W A R D S interventions. Colleen used her award to create a fund to help needy patients pay for nicotine replacement medicines. John “Andy” Daubenspeck worked to keep the doors open at Headrest, a long-standing community agency that provides treatment for addiction and runs a crisis hotline. He became president of the Headrest board when illness, death, and turnover in its leadership threatened to A close its doors. Andy’s dedication and leadership brought out the best in staff and the board. Today, Headrest is thriving. Andy used his award to arrange Headrest services for clients of 10 Bricks, the homeless shelter in Lebanon. D D I C T I O N T Colleen Warren (right) speaks with a clinician who learned how to intervene with patients about tobacco use and addiction. R E A T M E N T P R O G R A M S “Their whole life changes when they get better. Instead of looking for their drug so they don’t go into withdrawal, they go to work or start taking care of their kids. Their lives just get better.” —Donald West, MD During its first year, the Addiction Treatment Program at DHMC evaluated 166 area residents. The comprehensive initial evaluation process includes psychiatric evaluation for co-occurring disorders, as 60 percent of people seen have a pre-existing mental health condition as well as an addiction, including alcoholism, illicit drug use, or illegal use of pain medications. Roughly half of patients admitted to the intensive outpatient program completed the entire 12-week program, which is designed to enable patients to continue working and living at home while receiving treatment. The program focuses on helping participants avoid substances, cope with cravings, and engage in healthy replacement activities, key strategies in addiction treatment, notes Dr. Turner. “Because the program is embedded in the Department of Psychiatry, patients have excellent access to a psychiatrist and, if necessary, can detox in the community, which is very rare in a rural community,” says Win Turner, PhD, clinical director of the Addiction Treatment Program. For people with opiate addictions, the program’s Buprenorphine Clinic provides outpatient treatment. Buprenorphine reduces cravings, minimizes withdrawal, and helps people wean themselves from opiate use, says Donald West, MD, medical director of the Addiction Treatment Program and Buprenorphine Clinic. Twenty-one of the 46 people seen at the clinic were able to keep their jobs, stay in school, and/or manage their households. Dr. West, who is also the medical director of inpatient psychiatry at DHMC and has a subspecialty in addiction treatment, says, “This is the most gratifying work that I do in psychiatry.” Dartmouth-Hitchcock Community Benefits Number of Patients Helped Patients Receiving Charity Care DHMC/Northern Region Southern Region Patients with Medicaid DHMC/Northern Region Southern Region Patients with Medicare/CHAMPUS DHMC/Northern Region Southern Region 5,400 6,255 29,654 25,562 43,799 26,847 Value of FY 2006 Community Benefits at Cost Uncompensated Medicaid Cost of Financial Assistance Support for Medical & Other Professional Education In-kind Support of Research & Other Grants All Other Community Benefit Activities Total Community Benefits Value $34,508,700 21,916,523 13,086,443 1,757,258 6,383,542 $77,652,466 28 B O A R D Mary Hitchcock Memorial Hospital and Dartmouth-Hitchcock Clinic 2006 Boards Of Trustees Emily R. Baker, MD Trustee, Dartmouth-Hitchcock Clinic Lebanon, NH Stephen P. Barba Board Vice-Chair, Dartmouth-Hitchcock Clinic Trustee, Dartmouth-Hitchcock Clinic and Mary Hitchcock Memorial Hospital Concord, NH Stephen F. Christy Trustee, Dartmouth-Hitchcock Clinic and Mary Hitchcock Memorial Hospital Lebanon, NH Thomas A. Colacchio, MD President, Dartmouth-Hitchcock Clinic Trustee, Dartmouth-Hitchcock Clinic Lebanon, NH John C. Collins Treasurer and Secretary, DartmouthHitchcock Clinic Trustee, Dartmouth-Hitchcock Clinic Lebanon, NH Lawrence J. Dacey, MD Trustee, Dartmouth-Hitchcock Clinic Lebanon, NH Carol J. Descoteaux, CSC, PhD Trustee, Dartmouth-Hitchcock Clinic and Mary Hitchcock Memorial Hospital Manchester, NH William H. Edwards, MD Trustee, Dartmouth-Hitchcock Clinic Lebanon, NH Nancy A. Formella, MSN, RN Acting President, Mary Hitchcock Memorial Hospital and Dartmouth-Hitchcock Alliance Trustee, Mary Hitchcock Memorial Hospital Lebanon, NH Robert C. Fuehrer Board Secretary, Mary Hitchcock Memorial Hospital Trustee, Dartmouth-Hitchcock Clinic and Mary Hitchcock Memorial Hospital Peacham, VT Alfred L. Griggs Board Chair, Mary Hitchcock Memorial Hospital Trustee, Dartmouth-Hitchcock Clinic and Mary Hitchcock Memorial Hospital Northampton, MA Dartmouth Medical School Board of Overseers 2006 Alan C. Keiller Board Treasurer, Mary Hitchcock Memorial Hospital Trustee, Dartmouth-Hitchcock Clinic and Mary Hitchcock Memorial Hospital West Windsor, VT Nils M. P. Daulaire, MD, MPH White River Junction, VT Jennie L. Norman Trustee, Dartmouth-Hitchcock Clinic and Mary Hitchcock Memorial Hospital Harrisville, NH J. Brian Quinn Chair, Dartmouth-Hitchcock Assembly of Overseers Trustee, Dartmouth-Hitchcock Clinic and Mary Hitchcock Memorial Hospital Hanover, NH Carolyn H. Sands Trustee, Dartmouth-Hitchcock Clinic and Mary Hitchcock Memorial Hospital Lebanon, NH Alan D. Sessler, MD Board Chair, Dartmouth-Hitchcock Clinic Trustee, Dartmouth-Hitchcock Clinic and Mary Hitchcock Memorial Hospital Rochester, MN Richard S. Shreve Trustee, Mary Hitchcock Memorial Hospital Orford, NH Hugh C. Smith, MD Trustee, Dartmouth-Hitchcock Clinic and Mary Hitchcock Memorial Hospital Rochester, MN Stephen P. Spielberg, MD, PhD Dean, Dartmouth Medical School Trustee, Dartmouth-Hitchcock Clinic and Mary Hitchcock Memorial Hospital Hanover, NH Donald E. Watson President, DHMC Auxiliary Board Trustee, Mary Hitchcock Memorial Hospital White River Junction, VT Michael J. Goran, MD Trustee, Dartmouth-Hitchcock Clinic and Mary Hitchcock Memorial Hospital The Sea Ranch, CA Diana J. Weaver Trustee, Dartmouth-Hitchcock Clinic and Mary Hitchcock Memorial Hospital Versailles, KY Wayne G. Granquist Board Vice-Chair, Mary Hitchcock Memorial Hospital Trustee, Dartmouth-Hitchcock Clinic and Mary Hitchcock Memorial Hospital Weston, VT William W. Wyman Trustee, Dartmouth-Hitchcock Clinic and Mary Hitchcock Memorial Hospital Hanover, NH 29 M E M B E R S H I P S Robert H. Young Trustee, Dartmouth-Hitchcock Clinic and Mary Hitchcock Memorial Hospital Rutland, VT Thomas A. Colacchio, MD President, Dartmouth-Hitchcock Clinic Lebanon, NH Ex officio Gary M. DeGasta Director, Veterans Affairs Medical Center White River Junction, VT Ex officio Susan G. Dentzer Chevy Chase, MD Eric Donnenfeld, MD Rockville Center, NY Freddie H. Fu, MD, DSci (Hon) Pittsburgh, PA C. Everett Koop, MD Hanover, NH Ex officio Renee M. Landers, JD Boston, MA Stuart MacLeod, MD, PhD, FRCPC Vancouver, BC Albert G. Mulley, Jr., MD, MPP DC Trustee Boston, MA Thomas B. Okarma, MD, PhD Chair Menlo Park, CA Norman C. Payson, MD Concord, NH James E. Wright, PhD President, Dartmouth College Hanover, NH Ex officio Martin N. Wybourne, PhD Hanover, NH Ex officio Oglesby H. Young III, MD President, DMS Alumni Council Concord, NH Ex officio Dartmouth-Hitchcock Medical Center Board of Trustees 2006 Thomas A. Colacchio, MD President, Dartmouth-Hitchcock Clinic Lebanon, NH John C. Collins CEO, Dartmouth-Hitchcock Clinic Lebanon, NH Gary M. DeGasta Director, Veterans Affairs Medical Center White River Junction, VT Peter M. Fahey Port Washington, NY Nancy A. Formella, MSN, RN Acting President, Mary Hitchcock Memorial Hospital and DartmouthHitchcock Alliance Lebanon, NH Cecil B. Pickett, PhD Cambridge, MA Alfred L. Griggs, Chair Northampton, MA Peter Preuss La Jolla, CA Albert G. Mulley, Jr., MD Boston, MA Charles A. Sanders, MD Chapel Hill, NC Alan D. Sessler, MD Rochester, MN Barry P. Scherr, PhD Hanover, NH Ex officio Stephen P. Spielberg, MD, PhD Dean, Dartmouth Medical School Hanover, NH Stephen P. Spielberg, MD, PhD Dean, Dartmouth Medical School Hanover, NH Ex officio William W. Wyman Hanover, NH Robert L. Thurer, MD Boston, MA Richard M. Weinshilboum, MD Rochester, MN The patient is at the center of all we do, whether we are teaching residents and medical students, caring for patients, or doing research. And that’s a very powerful factor in our being able to provide such a high level of care for our community. One Medical Center Drive Lebanon, NH 03756 www.dhmc.org