Joining the Hartford HealthCare/Charlotte Hungerford Hospital staff last year brought Michelle Apiado, MD, full circle: Her first job following her family medicine residency was as a community physician in Torrington, with privileges at CHH.
In the intervening years, Dr. Apiado opened the hospital’s Canton primary care office and ran a private practice there, served as medical director of a community health center in Torrington, worked as a hospitalist at CHH and, most recently, was a primary care physician at Sharon Hospital.
“Because I’ve been in the area for 20 years, I’ve seen generations of family now,” says Dr. Apiado. “Patients I saw as children are now parents; the parents are now grandparents. It’s just wonderful seeing their transition through the different stages of life.”
Family medicine: A holistic approach
Dr. Apiado grew up in Dix Hills, New York, and remained on Long Island to attend Stonybrook University as an undergraduate. She earned her medical degree at Howard University College of Medicine and completed her family medicine residency at University of Maryland.
“I originally went in thinking I would be a pediatrician, because I love kids,” Dr. Apiado recalls. “But it was easier to understand what the kids were going through if I knew the rest of the family.” She says the holistic aspect of family medicine – which, as she puts it, “takes care of the whole family” – especially appealed to her.
“Not only do we take care of everyone from newborns to the elderly (from the womb to the tomb, we would say), but family medicine looks at the person as a whole – as a son or a daughter, as a family member,” she says. In addition, she adds, the specialty takes a mind/body approach to medicine, considering both the mental and physical aspect of a patient’s health.
Dr. Apiado, who is also certified in integrative holistic medicine, says she sees different health issues like the branches of a tree: “You see the diabetes, the obesity, the migraines,” she says, “but what’s causing all of that? I like to dig into the roots and find out why people have these problems.”
The impact of COVID-19: Primary care in the age of coronavirus
Dr. Apiado was hired in May 2019 to offer comprehensive health services at Hartford HealthCare Medical Group’s new primary care location in Litchfield. She worked in their Avon office until the new facility was ready in February. COVID-19 came along shortly thereafter.
Like many physicians, Dr. Apiado has relied heavily on telemedicine during the pandemic. “We couldn’t see patients for a while, so we would screen them on the phone and send then to a testing site if we suspected COVID – and if they were severe, we’d send them to the hospital,” she said. “But most of the time, COVID patients were quarantined at home.”
She says that “seeing” patients via video has had both pros and cons. “It is difficult for me because I’m used to examining the patient,” she explains, “but I find that it’s also helpful in that it allows me to be invited into the patient’s home, to see another aspect of their life.” While she can’t take a patient’s temperature, or look down their throat during a video call, she says, she can examine someone for anxiety or depression, for example, by asking questions and seeing their expressions and how they react to her questions.
“I was also able to identify a bulls-eye rash from a tick bite, and over the years I’ve gotten to know my patients and their patterns and how they react – some get sinus infections at certain times of the year, or I know it’s their allergies or asthma rather than COVID,” she says. “We just have to ask more questions using telemedicine – it requires more of a history.”
Dr. Apiado says she is seeing pre-op patients in person now, and as the state opens up, is once again scheduling physicals and examining patients with health concerns in her Litchfield office. “Patients are nervous,” she says, “especially in this area, where we have an elderly population.” But Dr. Apiado says that her office is taking many safety precautions to prevent unnecessary exposures.
“We’re trying not to keep patients waiting in the waiting room – we put them in an examining room right away,” she says. “We prefer patients not to have someone with them, but will accommodate that if they need to. We take patients’ temperatures before they come into the office, and we screen then with COVID questions both a day or two before they come, and when they walk in. If we suspect someone has COVID, we send them to the hospital for drive-through testing.”
Patients still have diabetes, high blood pressure and other chronic conditions, Dr. Apiado points out, and while many patients have put off routine visits at the height of the pandemic, she warns that they shouldn’t delay those visits for too long. “And any new pain – a headache that doesn’t go away, rashes that are unusual, growths of any sort – I wouldn’t put those things off.”
Dr. Apiado recalls how recently, one of her patients suffered for a couple of days with abdominal pain before calling her. “It turned out she had COVID – she was exposed and didn’t know it,” Dr. Apiado says. “I encourage people to call their primary care provider if they have any symptoms they may be worried about.”
A part of the community and the CHH team
Dr. Apiado says that what drew her to CHH and the Litchfield area originally was both its supportive medical community and the allure of its pastoral setting. The native New Yorker quickly became a part of the local community, volunteering with organizations in Torrington like the Susan B. Anthony Project, which provides crisis and support services for victims of domestic violence and sexual assault, and the McCall Center for Behavioral Health, which provides a full range of alcohol and other drug prevention and treatment services. (She is now on the board of both organizations.)
“We are so lucky to have all this land where people can walk, where they can keep their distance and still enjoy nature and exercise and the fresh air,” Dr. Apiado says of Connecticut’s northwest corner. Dr. Apiado recently moved to be closer to her new office. “I love being back in this area,” she says. “Charlotte Hungerford has been very supportive over the years and we’re happy to be a team again.”
Lori Miller Kase is a freelance writer living in Simsbury.
Todd Fairchild has been taking pictures since 5th grade. In 2012, he decided to leave his corporate career to pursue professional photography full time. He has photographed weddings all over the world and has also captured many special events, such as Hartford’s annual “Dress for Success.”.