Cooley Dickinson Hospital’s satellite expansion comes with LGTBQ focus

NORTHAMPTON — For years, Dr. Emily Lash has provided care to patients from birth to old age — with her skills as a prenatal, delivery, newborn, pediatric and family physician giving patients flexibility in choosing a long-term doctor.

But at her new practice, the Cooley Dickinson Health Care doctor has placed a more deliberate emphasis on some much-sought-after nuance to bedside manner: gender-affirming care for patients of any age.

“The medical establishment has a lot to make up for in the way that people have been marginalized — their gender identity hasn’t been acknowledged in the past,” Lash said while standing in a new office space on a recent Wednesday evening. “Having this available to people here in the Valley, I think, just allows people to truly be healthy. You have to have your whole self recognized to get appropriate health care.”

Lash is part of a team of physicians at Oxbow Primary Care, a new Cooley Dickinson Health Care practice at 15 Atwood Drive that treats patients of all ages for regular checkups, with an added focus on obstetrics and LGBTQ-friendly care.

Oxbow Primary Care opened Nov. 4 in the large complex of office buildings on Atwood Drive off Interstate 91’s Exit 18 — the site of the former Clarion Hotel.

While the three-building complex includes other government entities and nonprofits — Hampshire Probate and Family Court and Clinical and Support Options, to name two — Cooley Dickinson has leased much of the rest of the space as it both expands its services and consolidates many of them into one central location.

The other two buildings in the complex, 22 and 8 Atwood Drive, house practices including Atwood Internal Medicine, Hampshire Cardiovascular Associates and Northampton Family Medicine, along with other services such as physical therapy, neurology and podiatry, to name a few. A combined 125 Cooley Dickinson employees now work at the Atwood Drive office buildings, hospital officials said.

Along with the new primary care practice, Cooley Dickinson’s General Surgical Care and Infectious Disease Care have moved from 22 Atwood Drive to the second floor of 15 Atwood. The new space is 7,600 square feet, with private check-in and checkout spaces and 14 total exam rooms.

Cooley Dickinson Chief Medical Officer Estevan Garcia said he has been working since he started over two years ago to increase access to medical services for all people in the Pioneer Valley. He recognized a need for expanded primary care service, he said, noting that those who live in the Hilltowns have been particularly underserved.

There has already been a primary care facility at Atwood Drive and branches across the Valley, Garcia said, but as the hospital kept recruiting new providers while its patient base grew — more than 40 new full-time primary and specialty care providers have been added in the past two years — the need for another facility became increasingly apparent.

“The community is underserved in general,” Garcia said, “and while Cooley Dickinson has a robust number of providers … the concern was that we needed to continue to grow that for the expanding community in the area.”

Three primary care doctors currently work at Oxbow, with a fourth on the way in December. And although it is in the same building as Hampshire Probate and Family Court, Oxbow is on the second floor and has a separate entrance in the back.

The practice is unique as it provides both family medicine and obstetrics, Garcia said, with Lash and Dr. Katherine Jarrell providing these services.

Obstetrical care at Cooley Dickinson has been ongoing for ages, but the idea for this new service is that doctors have the requisite skills to take care of every family member, regardless of age, from prenatal to geriatrics, said Kevin Neill, vice president of the Cooley Dickinson Medical Group.

The two new doctors who specialize in obstetrics spent time with Cooley Dickinson’s existing women’s health providers for a month before starting, Neill said. According to Garcia, the doctors even do in-home visits for newborns.

“We wanted to make sure there was a rapport and a relationship and a confidence across the care groups that every entity that’s taking care of deliveries of babies was skilled,” Neill said.

Garcia said Oxbow’s Family Nurse Practitioner Aleah Nesteby serves as the “backbone” of the practice’s LGBTQ-affirming care, though each practitioner, including incoming Medical Director Dr. Miranda Balkin, are dedicated to inclusivity.

Northampton and the surrounding area has a large population of people who identify as LGBTQ, Garcia said. Cooley Dickinson has long taken care of the LGBTQ community as every provider has been certified and received social sensitivity training, Garcia said, but the new space gives people a central option for focused LGBTQ care.

The primary care providers at Oxbow are either experts or are learning about the proper prescription of hormonal therapy for those who are transgender, Garcia said. Cooley Dickinson provides surgery above the waist, or “top surgery,” and refers patients elsewhere for surgery below the waist, or “bottom surgery.”

“This is a really nice way to build the support for the community and make sure we’re providing care,” Garcia said. “Because it can be a challenge, especially in some of our rural communities, to find someone who is prescribing hormonal therapy.”

There’s an intersection between obstetrics and gender-affirming care that Lash said can be difficult for people who are LGBTQ. She said Oxbow, however, aims to support people who are nonbinary as they go through pregnancy and beyond.

“Now, what we are able to do, is expand the amount of people that we can see and expand their access to resources,” Lash said. “And we have a dedicated space where they know everyone from the check-in person to their provider will support them and be respectful.”