Delivering Outpatient Medical Subspecialty Care to Northwest Patients

Written by Margaret M. Burke

Charlotte Hungerford Hospital, in partnership with Hartford HealthCare’s Ayer Neuroscience Institute, is expected to open a new Hartford HealthCare HealthCenter in the coming months. It will be located at 1914 East Main Street in Torrington. The building, formerly a Bed, Bath & Beyond, has been extensively renovated to ultimately provide 23,500 square feet for outpatient medical subspecialty care. It is conveniently located in a shopping plaza just off of Route 8 and has plenty of free parking.

The center will open in phases. The first phase, which encompasses 7,000 square feet, will include a galleria area and the co-location of adult neuroscience specialties: neurology, neuromuscular diseases, epilepsy, neurosurgery and movement disorders (including the Chase Family Movement Disorders Center). There will be neuroscience physicians and physician assistants in the new space.

“We are incredibly proud to bring a breadth of neuroscience services under one roof, in a new state-of-the-art space,” said Bimal Patel, president of Charlotte Hungerford Hospital and senior vice president of Hartford HealthCare. “This facility provides access to the area’s top experts and latest treatments in a convenient setting to best meet the needs of our patients.”

The existing neurology offices in Winsted, Thomaston and Torrington will move to the new building. “Torrington was already a hub for lots of services like rehabilitation, physical therapy, occupational therapy and speech therapy, so it makes sense to have medical care there as well,” explained Dr. Benjamin Dorfman, who specializes in the treatment of movement disorders. He will be one of the full-time physicians at the new center.

The co-location of neuroscience services into a newly designed large space is expected to greatly benefit patients, especially those who receive care from more than one neuroscience subspecialist.

“I think the advantage of the new space is that it brings all these neurological subspecialties under one roof,” said Dr. Hugh Cahill, medical director of neurology for Charlotte Hungerford Hospital. “Neurologic care involves a team approach with different subsets of specialties contributing to the overall care of the patient. Having everyone under one roof allows better communication between doctors and nurses, the technologists, and other team members.”

“I think co-location is always a good thing for patients because it makes it easier to pool resources in one location and give people access to multiple specialists without having to travel to different sites every single time,” said Dr. Dorfman, who agreed that the move will be a big advantage for his patients.

Dr. Dorfman also pointed out that the building has been specifically designed with their patients in mind. Individuals with movement disorders such as Parkinson’s disease or those who are recovering from a stroke often have difficulty moving and may require a walker or wheelchair. The new center is on one level with highly accessible entrances and exits. It has well-designed, spacious treatment rooms containing updated equipment.

“Most of my training was in older buildings. You can really feel the difference when things are cramped and there isn’t much room for moving things around to make it comfortable,” continued Dr. Dorfman. He said the designers really paid attention to the details, down to picking the right kind of furniture, like chairs that are easier for patients to get in and out of.

Patient Populations and Services

The neuroscience specialty physicians care for many different types of patients. Dr. Cahill specializes in the care of patients with seizures, strokes or headache disorders. He explained that their group cares for hundreds of patients who have had a stroke, especially since Charlotte Hungerford Hospital was designated a primary stroke center in 2022. Prior to that, a patient presenting to the Emergency Department with symptoms of a stroke would have to be transferred to Hartford Hospital. Now a patient can receive all their acute stroke care at Charlotte Hungerford Hospital. The follow-up care will all be consolidated at the new center.

In terms of movement disorders, the most common ailments Dr. Dorfman sees are tremor disorders (which includes Parkinson’s disease), restless leg syndrome, and dystonia or spasticity. “Restless leg syndrome is probably the most common movement disorder,” he said. “A lot of people live with it without ever seeking treatment because they think it doesn’t warrant treatment or they don’t know that it is something you can treat.”

Dr. Dorfman also pointed out that movement disorders can be part of other diseases, such as spasticity associated with cerebral palsy. So even if a person doesn’t have a primary neurologic disease, they can benefit from seeing a neurologist to treat symptoms related to another disease managed by a different physician.

One of the treatments for spasticity that will be available for patients in the new center is the use of botulinum toxin injections. Deep brain stimulation is a surgical treatment for several different movement disorders including Parkinson’s disease, essential tremor, and dystonia. It involves the implantation of electrodes into the brain which can then be externally programmed to deliver electrical stimulation to relieve certain neurologic symptoms. The frequency of programming visits can vary depending on how stable a patient’s disease is, but needing a program adjustment a couple times each year is fairly typical, said Dr. Dorfman. Deep brain stimulation programming will be available at the center so patients will not have to travel long distances every time they need to have their settings adjusted.

Emphasis on Access to Care

Both Drs. Cahill and Dorfman agreed that one of the greatest challenges for individuals with neurologic disorders is access to care. They are both proud to be part of a group providing care to the residents of northwest Connecticut.

“The Ayer Neuroscience Institute is heavily invested in bringing specialty care to areas of Connecticut that typically don’t have specialist care,” said Dr. Cahill. He affirmed that their goal is to get patients to the right provider as fast as possible and to make it as easy as possible to get an appointment. “When things are as complicated as neurology, when many doctors are involved, having all those people under one roof is really a best practice,” he commented about the new center.

One way to increase access to care is to allow for telemedicine visits. These became common out of shear necessity during the height of the COVID-19 pandemic, but they continue to be an option for patients. Dr. Dorfman said that while virtual visits for patients with neurologic disorders have limitations, particularly for the purposes of establishing a diagnosis during an initial evaluation, they may be reasonable for follow-up visits, although he still wants to see them in-person at least once per year. For his patients with movement disorders, he can still watch them walk and perform balance exercises, see the speed and size of their movements, and assess their degree of tremor. Telemedicine visits can be particularly helpful for patients with movement disorders because they have a hard time getting around either because of geographic distance or weather.

Dr. Dorfman, who is also an assistant professor in medicine at Quinnipiac University, reported that the new center will be a site for elective clinical rotations for residents in the university’s Rural Family Medicine Residency Program. This aligns with their mission of expanding access to care by training the next generation of rural medicine providers.

Why Practice in Northwest Connecticut?

“What brought me to the northwest corner of Connecticut was just the impressive offerings the group within the Ayer Neuroscience Institute and the Chase Family Movement Disorders Center had,” said Dr. Dorfman. “It gives the combination of the support of a large hospital network, but also the camaraderie of a smaller group. We have a good collegial atmosphere.”

“This is where I am from and my whole family is in the area,” Dr. Cahill explained that his patient care relationships are very important to him. “One of the things that attracted me about coming back to Connecticut is that I am truly caring for my next-door neighbors.”

Margaret M. Burke, Pharm.D., BCPPS, is a freelance medical writer with more than 25 years of clinical pharmacy experience, including board certification as a pediatric pharmacotherapy specialist. She lives in Manchester.