PRIMARY CARE AND PEDIATRICS
Michael Watto, DO
Dr. Watto, DO, MPH, joined HealthFirst in February 2023 as their Medical Director. Dr. Watto provides primary and osteopathic care to patients in both the Laconia and Franklin HealthFirst locations
Dr. Watto has an extensive medical and military background. Certified by the American Board of Family Medicine, he completed his residency training at Martin Army Community Hospital, Fort Benning, Georgia. Dr. Watto completed his medical education at Kansas City University of Medicine and Biosciences, where he received his DO degree in Osteopathic Medicine. He has also earned a master’s degree in public health from the University of Texas Medical Branch, Galveston, Texas, and a Bachelor of Science degree from Penn State University. Dr. Watto spent more than 20 years in the US Army serving in a variety of roles as a physician leader. Highlights include his service as a flight surgeon, a deployment to Iraq, and providing medical care and ringside coverage to the All-Army Boxing team.
Michael and his family have lived in central NH for nearly a decade where he has worked at Speare Primary Care in Plymouth, NH since 2015 specializing in family medicine. He has held the position of Medical Staff President at Speare Memorial Hospital as well as Director of Health Services at Plymouth State University. Dr. Watto was recently honored as a “Top Doctor 2022” by New Hampshire Magazine. Other notable achievements include his selection as Franklin Pierce University Clinical Preceptor of the Year, earning the US Army Combat Medical Badge and being named a Distinguished Military Graduate.
An osteopathic medicine (DO) doctor differs from a medical doctor in that they use the same conventional medical techniques as MDs but with a few other methods. They bring a unique, patient-centered approach to every specialty across the full spectrum of medicine. They are trained to listen and partner with their patients to help them get healthy and stay well.
(LACONIA & FRANKLIN)
Eleanor “Nora” Janeway, MD
Dr. Eleanor “Nora” Janeway has been a primary care doctor since 1993. She graduated from the University of California School of Medicine and did her residency in Internal Medicine at The Cambridge Hospital in Massachusetts. She worked for 23 years at a neighborhood health center where she trained junior doctors in Internal Medicine and was a Harvard Medical School Clinical Instructor in Medicine. Dr. Janeway’s medical interests include safe and appropriate prescribing, treatment of Hepatitis C, care of elders, treatment of addiction, and women’s health care. Dr. Janeway sees patients aged 16 and older. She is fluent in Spanish and English. Dr. Janeway served as HealthFirst’s medical director from 2018 to January 2023. Dr. Janeway is the fifth generation of Janeway physicians. She lives in western NH, and when she is not seeing patients, she is planting her garden or clearing trails.
(FRANKLIN)
Lara Wheeler, MD
Dr. Wheeler is a general pediatrician, primary care provider, taking care of newborns through late adolescence. Dr. Wheeler provides preventative and acute care, including anticipatory guidance for normal growth and development and vaccine education for well-baby and well-child visits. Additionally, she treats acute and chronic disease and offers behavioral health counseling, diagnosis, and treatment including ADHD, anxiety, depression, and LGBQT issues. Dr. Wheeler has a broad knowledge of reproductive health care for adolescents including Nexplanon placement.
(LACONIA & FRANKLIN)
Ben Gardner, MD
Ben has been practicing medicine since 1996 and provides family medical care, pediatrics, sports medicine, and minor orthopedics. He serves as the Cardigan Mountain School’s physician as well as the health center’s Medical Director. He previously served as a physician with Dartmouth College Student Health Services, and Assistant Medical Director at Phillips Exeter Academy. He served for 16 years as the Medical Director at Choate Rosemary Hall, supervising 19 medical staff serving 850 students and 32 athletic teams. He also served as an Assistant Professor and Clinical Instructor at Yale University. Ben received his undergraduate degree from Princeton University and his medical degree from the Geisel School of Medicine at Dartmouth. As an Enfield resident, Ben has always been active in sports and has coached lacrosse and hockey for the Upper Valley youths.
“I’d be honored to welcome you and your family to HealthFirst Canaan where you’ll find a caring team of providers ready to get to know you.”
(CANAAN)
Dr. Elise Wojcik, DO
Dr. Elise Wojcik, DO, will be joining HealthFirst in late October 2023 as a board-certified Internal Medicine Physician, with specialty training in Geriatric Medicine. She earned her osteopathic medicine doctorate from the University of New England in Biddeford, Maine. She completed her Internal Medicine training at Ascension Genesys Hospital in Granc Blanc, MI, and her Geriatrics Fellowship at Beaumont Hospital in Royal Oak, MI. Although she is originally born and raised in Wisconsin, she met her husband in Maine, and decided to make New England her home. She is excited to relocate to New Hampshire with her family and provide quality medical care for her new neighbors at HealthFirst.
(LACONIA)
Catherine Holub-Smith, DNP
Dr. Catherine Holub-Smith, DNP, has achieved a very successful career in the healthcare field, first as a Registered Nurse and currently as an Advanced Pediatric Nurse Practitioner. She has gained significant clinical experiences from a variety of organizations, including a public health department, private practice, home health and hospice care, acute care hospitals, various schools, and rural primary care and family practices. During her journey, she discovered her love and passion for caring for infants, children, and adolescents. Catherine continued to advance her career by completing her Master of Science degree in Nursing and Community Health and becoming certified as a Pediatric Nurse Practitioner. While working as a Pediatric Nurse Practitioner, she has been able to help countless children and adolescents through early outreach and education, well and sick child clinics, school-based programs, and child and adolescent development and health education. Always seeking new knowledge and experience, Catherine completed her Doctorate of Nurse Practitioner degree in 2014. She continues to be recognized as a successful leader in the Nurse Practitioner field, having been awarded New Hampshire’s Nurse Practitioner of the Year in 2015 and the American Association of Nurse Practitioner’s State Award for Excellence in 2016.
(FRANKLIN)
Lisa Baker, PA-C
Lisa Baker, PA-C, is a Physician Assistant with 30 years of experience as a primary care provider. Lisa graduated from Northeastern University Physician Assistant program in 1993, also earning a master’s degree in health professions. After graduating she went to work in Snow Hill, North Carolina, working in a community health center through the National Health Service Corps. She was there for five years when she and her family decided it was time to come back home. She then went to work in Lincoln, NH, where she spent the next 18+ years working in a family practice setting. Lisa then moved to Speare Primary Care where she had worked for the last five years. Lisa enjoys being a ‘family provider’ and seeing multi generations of families. Lisa treats patients ages 13 years and older. She manages routine and complicated health care needs and places emphasis on relationships with patients to look at all aspects of their life, not just their medical conditions. Lisa is excited to be joining the HealthFirst care team.
(LACONIA)
Richard Young, APRN
Richard Young, APRN, graduated from Bethel College in St. Paul, MN, with a Bachelor’s in Nursing. After graduation, he became a commissioned officer in the US Public Health Service. He was subsequently deployed to provide nursing care to federal prison inmates in Rochester, MN, and also to Alaska Natives in Kotzebue, Alaska.
While working in the small rural hospital above the Arctic Circle in Northwestern Alaska, that Rich discovered his passion for the nurse practitioner role. Due to the isolation of the hospital in rural Alaska, he was required to work in several different nursing roles, including pediatric nursing, ER nursing, medevac nursing, med-surgical and obstetrical nursing. Rich enrolled in the Family Nurse Practitioner program at the University of New Mexico, graduating in 1998 with a Master of Science in Nursing. Rich believes the most important skill of a family nurse practitioner is to be an excellent listener who helps to facilitate the development of the FNP and patient relationship which is the heart of Primary Care. Rich brings a lot of experience in family practice medicine such as chronic conditions management including diabetes, high blood pressure, and asthma.
(LACONIA)
Alyssa Albro, APRN
Alyssa Albro, APRN, received her undergraduate degree from Brandeis University in 2013. She was then fortunate to be granted a research internship at New Hampshire Oncology and Hematology which provided her invaluable insight into the importance of holistic care. Alyssa earned her Master of Science in Nursing in 2018 and recently completed the Family Nurse Practitioner Program at the University of New Hampshire. She has spent the past 4 years working in the hospital setting at a Level 2 Trauma Center. Most recently, Alyssa worked as a Clinical Nurse Coordinator promoting best practices and advocating for the needs of all patients. She provides thorough and compassionate care, recognizing the importance of the physical, emotional, social, and spiritual factors that shape every individual. As a Nurse Practitioner, Alyssa believes in the importance of patient empowerment and will work with patients of every age to set reasonable and attainable goals throughout their health journey.
(LACONIA)
Linda Carter, APRN
Linda Carter, APRN, is a Family Nurse Practitioner who brings over 35 years of healthcare experience to HealthFirst. She has worked in a variety of healthcare settings including acute care, non-profit home health, chronic disease management, developmental disabilities, administration, education, legislative committees, nursing associations, addiction recovery and mental / behavioral health. Linda also spent four years in the Army Nurse Corps at Walter Reed Army Medical and was honorably discharged as Captain. She completed her FNP at Rivier University knowing she had more to offer her patients. Linda prides herself on the ability to help people achieve their goals.
(FRANKLIN)
Carly Rose Burke, APRN
Carly Burke, APRN, is a Family Nurse Practitioner who received her diploma in nursing at Saint Joseph School of Nursing in North Providence, RI, and her undergraduate and masters nursing degree at Northeastern University in Boston, MA. She is board-certified by the American Association of Nurse Practitioners. In her last 10 years working as an APRN, she has worked in adult medicine, with a clinical interest in adult primary care, gerontology, and palliative care. In Carly’s free time, she enjoys spending time with family, hiking, and photography. HealthFirst welcomes Carly to its team of caring providers.
(FRANKLIN)
Megan Lewis, APRN
Megan Lewis, APRN, is a Family Nurse Practitioner practicing in Laconia. Megan will be offering a new and greatly needed role at HealthFirst by seeing patients with same-day, acute care needs. As a Lakes Region native, Megan began her healthcare career as an EMS provider and continued her journey by earning her Associate Degree in Nursing from LRCC in 2018. She earned her BSN from Palm Beach Atlantic University in 2019 and her MSN from Frontier Nursing University in 2023. Prior to becoming a Nurse Practitioner, she was a Registered Nurse at LRGH’s Orthopedic Unit, and most recently worked at Concord Hospital’s Emergency Department. Working in the back of ambulances, to hospital bedsides, to busy emergency departments, Megan is experienced in treating patients in a variety of circumstances. Megan is looking forward to offering care to the Lakes Region community as HealthFirst’s new same-day provider.
(LACONIA)
Rachel Hansen, APRN
Rachel Hansen, APRN, FNP-BC, is a Family Nurse Practitioner who graduated from Colby-Sawyer College with a Bachelor of Fine Arts. After graduating, she felt passionate about pursuing a career that would make a difference in peoples’ lives and entered the field of nursing. She received her BSN from the Massachusetts College of Pharmacy and Health Sciences. After being accepted into Dartmouth-Hitchcock’s nurse residency program in the trauma unit, Rachel practiced for many years at Dartmouth-Hitchcock in the inpatient medical-surgical unit as a float nurse. Following her time at Dartmouth-Hitchcock, Rachel entered the family nurse practitioner program at Rivier University. While continuing to work, she successfully completed her studies, received her MSN as a family nurse practitioner, and became a Board-Certified Advanced Practice Registered Nurse. Rachel loves to spend time in the woods with her husband, daughter, and energetic wirehaired pointing griffon.
“I am passionate about providing quality and compassionate care to my local community and am beyond excited to be a part of the HealthFirst Canaan family.”
(CANAAN)
Isabel Watts, APRN
Isabel is a Family Nurse Practitioner who received her BSN and MSN from Massachusetts General Hospital Institute of Health Professions. She completed a fellowship in community health and family medicine at Lamprey Health Care in Newmarket, NH. Isabel is passionate about preventative medicine and patient centered care. As a family nurse practitioner, Isabel enjoys taking care of patients across the lifespan, and supporting whole families in care decisions. In her free time, she enjoys cooking, hiking, spending time with her family and playing with her baby.
“I love nursing because it combines compassionate care with scientific thinking and problem-solving. I enjoy building collaborative relationships with patients and making them feel heard, believed, and supported.”
(CANAAN)
Jennifer Tichich, APRN
Jennifer Tichich, APRN, graduated with honors from the University of New Hampshire with a Bachelor of Science in Nursing degree. She worked in acute care as a Registered Nurse before pursuing a Master of Science in Nursing at the University of Colorado Health Sciences Center. She graduated Summa Cum Laude from the Adult Nurse Practitioner Program. She is board-certified as an Adult Nurse Practitioner through the ANCC. Prior to joining HealthFirst, she worked in Pain Management, Primary Care, Long-term care, and Occupational Medicine. In her spare time, she enjoys spending time with her family outdoors. They are avid hikers in the New Hampshire mountains and their faithful canine companion Molly, a Kolu Husky, enthusiastically leads each hike!
(LACONIA)
BEHAVIORAL HEALTH
Ashley Douthart, LCMHC
Ashley Douthart, LCMHC, is a Licensed Clinical Mental Health Counselor as well as the Behavioral Health Director at HealthFirst. She received her Bachelor of Arts degree in Psychology from Colby-Sawyer College. She then went on to receive her Master of Science in Clinical Mental Health Counseling from Walden University, while working full-time as a Socialization Coordinator for children with autism spectrum disorders. Ashley joined the Behavioral Health staff at HealthFirst as an intern in 2013 and then became a full-time employee after completing her Master’s Program in 2014. While she is credentialed and licensed to work with clients of all ages, she enjoys supporting children and adolescents, and helping those clients with substance abuse disorders find treatment and enter into recovery. Ashley is an active member of her community, serving on the Community Emergency Response Team (CERT), Disaster Behavioral Response Team (DBHRT), and the Systems of Care and Project Aware Community Management Teams. She is also a Period of Purple Crying educator for the NH Children’s Trust. Ashley developed and launched a successful school- based counseling program in both the Winnisquam and Franklin School Districts over the past 5 years and is passionate about helping those in the most need. Ashley is a mom of four young children, and enjoys spending time with family, Disney movies, Harry Potter, and Autumn!
(FRANKLIN & CHURCH ST.)
Julianna Marone, LMFT
Julianna Marone, LMFT, is a licensed marriage and family therapist. She earned her bachelor’s degree in Psychology from Keene State College in 2013 and completed her master’s degree in Marriage and Family Therapy from Central Connecticut State University in 2016. Julianna has experience working with people of all ages and specializes in treating trauma, depression, grief, anxiety, and treating children whose parents are amidst separation or divorce. She is trained in Trauma-Focused Cognitive Behavior Therapy (TF-CBT) and Dialectical Behavior Therapy (DBT). Julianna has ample experience working with individuals and families who are having difficulties creating and maintaining positive and caring relationships. Julianna is a facilitator of the Child Impact Program in the State of New Hampshire and has extensive knowledge on tools to help co-parents work together to emotionally support their children living amidst separation or divorce. In Julianna’s spare time, she enjoys spending time with family, listening to music, singing in a women’s choir in Concord, NH, watching sunsets at the lake, and doing puzzles.
(FRANKLIN & CHURCH ST.)
Andrea Jergensen, LICSW
Andrea Jergensen, LICSW, is the Senior Clinician on the Behavioral Health team. She received her Bachelor of Science degree in Child Development from Colby-Sawyer and went on to receive her Master of Social Work degree from Wheelock College in 2013. Andrea has worked with a wide variety of populations including early intervention with children from birth to 3 years old, adolescents, and late adolescent to early adulthood. Andrea has primarily focused on working with at-risk populations who have experienced various forms of trauma and clients who struggle with substance use. Andrea enjoys using multi-modal approaches to her counseling while also utilizing a trauma-informed approach. Andrea also provides school-based services for clients as well. She is a member of the NH Chapter of the National Alliance on Mental Illness (NAMI). As a member of NAMI, she is working towards certification as a therapeutic group facilitator. She also serves on the Board of Directors for Archways, a local family resource center who supports individuals and families struggling with substance use disorders. HealthFirst’s Behavioral Health team is always seeking ways to better support its patients through ongoing collaborative care, and she specifically works to provide ongoing communication between mental health, medical, nutrition-based, and case management focused providers. Andrea is passionate about providing opportunities to educate others on HealthFirst’s integrated behavioral health model and removing the stigmas associated with pursuing mental health treatment.
(FRANKLIN & CHURCH ST.)
Kristyn Adler, LICSW
Kristyn Adler, LICSW, is a licensed independent clinical social worker who obtained her bachelor’s and master’s degrees in social work and psychology at the University of Vermont. After completing her studies, she remained in VT working with disadvantaged youth and families, gaining experience in therapeutic foster care, crisis intervention, residential treatment, intensive community-based wraparound services, juvenile detention, and school-based environments. As a certified Lifeguard Instructor, she enjoys bringing her training in therapeutic and adaptive swimming into her clinical work. Driven by her passion for serving survivors of significant adversity, she received comprehensive training in eye movement desensitization and reprocessing therapy (EMDR) and has remained involved in VT’s Human Trafficking Workgroup for the last several years. Kristyn brings both playfulness and compassion into her work and strives to create genuine, warm, and supportive connections with those she serves. In her downtime, she enjoys swimming, spending time with her family on Lake Winnipesaukee, crafting, attending concerts, and playing with her two Havanese pups.
(CHURCH ST.)
Alexandra Smith, LCMHC
Alexandra Smith, LCMHC, is a Behavioral Health Specialist. She received her Bachelor of Science in Psychology, with a concentration in Mental Health, from Plymouth State University. She then went on to complete her Master of Science in Clinical Mental Health Counseling with a certificate in Addictions Treatment at Plymouth State University. Alex is a Certified Trauma Professional (Cert. # 712400) who specializes in treating trauma, anxiety, depression, as well as co-occurring substance use disorders. Alex uses an eclectic trauma-informed approach and is credentialed to work with clients of all ages.
(LACONIA)
Courtney Clairmont, MFT
Courtney Clairmont, MFT, is a Marriage and Family Therapist at HealthFirst. She received her Bachelor of Science degree in Human Development and Family Studies from the University of New Hampshire. There, she participated in an internship working to support victims of domestic violence, sexual assault, and stalking. She then went on to receive her Master of Science degree in Marriage and Family Therapy from the University of New Hampshire. During her master’s program, she worked with individuals, couples, and families through the therapy center at UNH, and participated in an internship at a local community mental health center working with children and families. Courtney uses an integrative approach, pulling from various models to meet each client’s unique needs. She works at both the Franklin and Laconia HealthFirst locations, and also provides school-based counseling services. When she is not in the office, Courtney enjoys spending time with friends and family on the lake, reading, hiking, and baking.
(FRANKLIN & CHURCH ST.)
Laura Walker, CMHC
Laura Walker, CMHC, is a Behavioral Health Specialist who received her Bachelor of Arts degree in Education from Michigan State University. She went on to become a Certified Holistic Health Coach, specializing in clean eating, diet management, and overall wellness. She received her Master of Science degree from Plymouth State University with certificates in Addictions Treatment and Personal Approaches to Transformation and Healing. Laura is currently in training to offer Child and Parent Psychotherapy. She is credentialed to work with clients of all ages, and her practice focuses on trauma-informed treatment to address anxiety and depression, as well as issues related to self-esteem, self-care, emotional self-regulation, coping strategies, cognitive flexibility, interpersonal relationships, and life transitions. Laura uses an eclectic approach, drawing from a variety of theoretical models to meet client’s diverse needs. In a safe, compassionate, and non-judgmental space, she will work collaboratively with clients to help identify what’s holding them back. Laura works in both the Laconia and Franklin offices of HealthFirst. Laura is a proud mom of a talented teenager, and she enjoys reading, writing, delighting in time outdoors, playing cards, volunteering at her son’s sporting events, and spending time with family.
(FRANKLIN & CHURCH ST.)
Dustin Bousquin, CMHC
Dustin Bousquin, CMHC, is a Behavioral Health Specialist who received his Bachelor of Science in Psychology, with a concentration in Mental Health, from Plymouth State University. Dustin then went on to complete his Master of Science in Clinical Mental Health Counseling from Plymouth State University. Dustin takes an integrated approach when treating his patients, pulling from different modalities that include CBT, DBT and a client centered approach, working with his patients to form an individualized treatment plan to fit a wide array of needs. While Dustin enjoys working with kids, teens, and LGBTQ+ individuals, his diverse skill set and qualifications allow him to work with anyone to help them achieve their mental-health goals. When not working, Dustin enjoys camping, spending time with friends and his cat, hiking, reading, and spending time by the lake.
(CANAAN)
MEDICATION ASSISTED TREATMENT
Kelley Watkins, APRN, FNP-BC, PMHNP-BC
Kelley Watkins, APRN, is a dual board-certified Family Nurse Practitioner and Psychiatric Mental Health Nurse Practitioner. She has a deep passion for the care of individuals with mental health and substance use disorders. She incorporates the principles of patient-centered care including respect, education, physical and emotional support, and integrative care with primary care providers. Additionally, Kelley provides treatment for Hepatitis C and has over a decade of experience in treatment of acute and chronic illnesses.
(LACONIA, FRANKLIN & CHURCH ST.)
Kim Haney, LADC
Kim Haney, LADC, helps HealthFirst best serve and deliver substance use services and MAT to our patients in a holistic, wrap-around approach. HealthFirst has started to provide MAT clinic services at the local family resource center in Franklin to reach those in our community better and allow them to feel connected to various resources to help in their success and road to recovery. In addition to managing the MAT program at HealthFirst, Kim provides individual and group counseling services to those with substance use and various co-occurring disorders. Prior to working at HealthFirst, Kim ran the state’s Doorway Program, overseeing and providing counseling and SUD services in the Manchester/Nashua. She enjoys working with clients from various backgrounds with the belief that people can make the changes in their lives if they have the support and tools to do so. She has a client-centered, strength-based approach to treatment to help clients find what they need to live the life that they want. Her primary focus is on substance use/misuse, recovery, and any related mental health issues. While most of her work is in the area of substance use/misuse and recovery, Kim also works with individuals in regard to trauma and recovery, and with family members of addicted individuals.
(LACONIA, FRANKLIN & CHURCH ST.)
Nancy Nemcovich, LADC
Nancy Nemcovich, LADC, has worked in the field of substance misuse for 34 years. She graduated from Keene State College with a BA in Psychology and NH Technical College with a certificate in Alcohol Counseling. Her career started in 1984 at Seminole Pole Hospital, a 28 Day Substance use treatment program in Sunapee, NH. During her career she has worked for the state of NH Multiple DWI Offender Program for 20 years, Concord Hospital Substance Use Services for 20 years, and with court ordered adolescents. She is currently working with Aware Recovery Care Program, an in-home addiction treatment program in NH through BC Insurance. She is also a member of the Tilton Rotary Club and is a Board Member for the Tilton Northfield Family Resource Center, and the Franklin Mayor’s Drug Task Force.
(LACONIA, FRANKLIN & CHURCH ST.)
PSYCHIATRIC NURSE PRACTITIONER
Ingrid Farrell, DNP
Ingrid Farrell, DNP, has over 20 years’ experience in healthcare. As a registered nurse, Ingrid worked in a variety of settings including emergency departments, cardiac, and intensive care units. It was while working in the emergency department that Ingrid discovered her passion for working with people with mental illness and addiction. Seeing the effects of stigma and the lack of access to behavioral health care led her to pursue her career as a nurse practitioner specializing in psychiatric care. She graduated in 2022 from the College of St. Scholastica with her doctorate degree and is a board certified psychiatric-mental health nurse practitioner. Following graduation, Ingrid and her husband moved to New Hampshire where she worked as an attending psychiatric nurse practitioner in the inpatient setting. Ingrid is an active member of the American Nurse Association, the American Psychiatric Nurse Association, and the New Hampshire Nurse Practitioner Association. She believes the path to improved mental health starts with developing therapeutic relationships and establishing mutual goals of treatment. Ingrid is dedicated to providing compassionate, person-centered care at HealthFirst as a psychiatric nurse practitioner as well as working closely with the Medication Assisted Treatment (MAT) team.
(LACONIA, FRANKLIN & CANAAN)
NUTRITION
Laurie Terwilliger, RDN
Laurie Terwilliger, RDN, is a Registered Dietician Nutritionist working part-time at HealthFirst Family Care Center, Inc. Whether you are trying to manage a chronic disease or just want to lose weight and learn how to eat healthier, Laurie works with each individual to develop a personal diet plan that fits with his or her lifestyle. Laurie holds a Bachelor of Science degree in Zoology from San Diego State University and a Master of Science degree in Zoology from Washington State University. After working as a field biologist and science teacher, Laurie applied her extensive science background to the study of nutrition. She completed her dietetics coursework at the University of New Hampshire and was accepted into the Dietetic Internship Program at Keene State College where she gained practical experience in the clinical, community and food service fields of dietetics. Her special areas of interest are in diabetes education, geriatric nutrition, and promoting healthy food and eating patterns to prevent and/or manage chronic disease.
(LACONIA & FRANKLIN)
