Emergency Department Providers

Dominic Ayer, PA-C

As a certified physician assistant in the Emergency Department, Dominic provides care for patients of all ages with a variety of conditions.

A veteran of the U.S. military, he previously served as a medic in the United States and internationally, including in Afghanistan and Iraq. His philosophy of patient care is centered on shared decision-making. “I am here to advise and guide a patient in making the right decision about their health care and emergency testing that’s available,” he says. “I am not in charge of a patient’s care. The patient is in charge.”

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Oliver Barnyak, MD

Oliver is very excited to be at Gifford. There’s a variety of patients who come through the emergency room doors, which is what first peaked his interest in emergency medicine.

“It is still my favorite aspect of medicine and nowhere gives you more of that than a small, rural ED.”

Point of care ultrasound and delivering palliative care from within the Emergency Department are Oliver’s passions.

When he’s not in the ED, Oliver enjoys hiking, cooking, sailing, and skiing with his wife and two dogs.

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Jared Blum, MD

Dr. Blum arrived at Gifford Health Care in 2016. While his specialty is Emergency Medicine, Dr. Blum’s passion is toxicology. “I enjoy the challenge of trying to make the diagnosis to help critically ill and sick patients in the ED,” Dr. Blum says. Certified by the American Board of Emergency Medicine, Dr. Blum received his MD from UVM’s College of Medicine. He attended Brown University for his residency.

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Matthew Bouteiller, PA-C

Physician Assistant, Matthew Bouteiller, joined Gifford’s staff in 2019 in the Emergency Medicine department. He has extensive knowledge of working with critically ill patients, having worked in the field for most of his twenty-year career. Before coming to Gifford, Matthew spent the majority of his emergency medicine career working at Mercy hospital in Springfield, Mass. with emergency medicine solutions. Nationally Certified, he received his PA at Springfield College in 2002. While he has stayed mostly in New England, Matthew has traveled to Peru and India for expedition and leadership training.

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Antonio Ciccone, DO, MBA

Dr. Antonio Ciccone is board certified in both emergency medicine and family practice and brings more than 25 years of experience to his role at Gifford Medical Center in the Emergency Department.

Residency trained in emergency medicine, Dr. Ciccone has practiced in a wide range of clinical settings, including emergency departments, primary care, and multi-specialty practices. His background allows him to approach patient care with both an acute care perspective and a broader understanding of long-term health needs.

Over the course of his career, Dr. Ciccone has held numerous leadership roles, including Emergency Medical Director and Chief Medical Officer, while continuing to provide direct patient care. He has also been actively involved in medical education for more than 20 years, teaching and mentoring students, residents, and advanced practice providers.

Dr. Ciccone has a strong interest in community education and outreach. He has delivered presentations for both healthcare professionals and community audiences on topics such as stroke care, preventive health, and recognizing medical emergencies.

His approach to care emphasizes listening, respect, and equitable treatment for all patients. He values the ability to care for individuals from all backgrounds and is committed to ensuring each patient feels heard and supported.

Dr. Ciccone earned his Doctor of Osteopathic Medicine degree from the University of Medicine and Dentistry of New Jersey and his Master of Business Administration from New York University’s Leonard N. Stern School of Business

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Warren Fenner, PA-C

As a certified physician assistant in the Emergency Department, Warren “Ren” Fenner provides care for patients of all ages with a variety of conditions.

Ren brings 12 years of experience as a physician assistant at Critical Access Hospitals like Gifford. His philosophy of care is collaborative. “Open lines of communication with patients is always important, including all facts to make decisions together,” he says. “Being kind and respectful is also always important.”

Ren’s ties to Gifford run deep—he was born here—and his relationships with members of our medical team brought him back.

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Connor Looney, PA-C

Connor Looney, PA-C, serves on the Emergency Department team at Gifford Medical Center in Randolph, Vermont. He is an emergency medicine physician assistant with more than 15 years of experience in community and academic hospital settings. He values connecting with patients, meeting them where they are, and developing care plans that align with their goals. Connor enjoys the pace and purpose of emergency care and is drawn to the collaborative, close-knit environment of community hospitals. He lives in White River Junction with his wife, two daughters, and their dog, Lulu.

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Rachel Spengler, ENP-C

Rachel has worked in Emergency Medicine for 35 years. She trained in Albany, NY, gaining experience in large medical centers before returning to Vermont to serve smaller hospital Emergency Departments and the communities of her home state. While in Albany, she also worked at Mountain Sports Medicine at Mount Snow Resort—her hometown—for over 20 years, where she developed a strong interest in sports medicine, wilderness medicine, outpatient orthopedics, and trauma care.

By 1995, Rachel was practicing full-time in Vermont and has remained here since, serving in Emergency Departments across Southern Vermont, including SVMC Bennington, Springfield Hospital, Mount Ascutney Hospital in Windsor, and Grace Cottage Hospital in Townshend, closest to where she now resides. Since 1998, she has been co-owner and practicing clinician (PA-C) with Emergency Services of New England, Inc., providing contracted PA staffing to local EDs and walk-in/urgent care clinics throughout Southern Vermont and New Hampshire. Through this work, she has had the privilege of collaborating with—and mentoring—many of the region’s finest Emergency Medicine PAs.

Born and raised in Vermont, Rachel has spent most of her adult life here. She lives in South Central Vermont with her 20-year-old son, who works locally in construction, and has family in Wilmington and Massachusetts. Outside of work, she enjoys spending time with friends and family, traveling, scuba diving, sailing, skiing, snowboarding, snowshoeing, and mountain biking. Her hobbies include gardening, cooking, architectural sketching, and painting.

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Ellen Stein, MD, MBA, FAEMS, FAWM

Dr. Ellen Stein is an emergency medicine physician in the Emergency Department at Gifford Medical Center with experience in academic, rural, and prehospital care settings.

She earned her Doctor of Medicine from Dartmouth Medical School and holds a Master of Business Administration from Stanford Graduate School of Business. She completed an EMS Fellowship at the University of New Mexico School of Medicine.

Prior to joining Gifford, Dr. Stein practiced with the University of Vermont Medical Group, providing care across multiple emergency departments in Vermont and New York.

Dr. Stein has a strong background in EMS and prehospital medicine, including medical direction, paramedic education, and simulation training. She also has experience in wilderness medicine and has provided care in remote and international settings.

Her approach to care is grounded in curiosity, listening, and helping patients feel more comfortable during difficult moments. She values taking time to understand each patient’s story and believes that a thorough history is an essential part of effective care.

Outside of work, Dr. Stein enjoys spending time outdoors, including hiking and mountain biking, and looks forward to exploring the trails throughout the region.

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Joshua White, MD

Dr. White, who serves as Gifford’s chief medical officer, is a strong advocate for his patients. “I believe that every patient wants to know, first and foremost, that you have their best interests at heart,” he said. “That you care about them and are their advocate.” Dr. White particularly enjoys critical care and orthopedics in his work at Gifford, and believes his work with Community Health Initiative (CHI) Haiti, a nonprofit he co-founded, has made him a “vastly better clinician.” He also is influenced by his wife, Kim, a personal trainer and gym owner who has increased his understanding of health, the root causes of disease, and the challenges we face with traditional approaches to medicine.

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