By Shelley Widhalm
The Surveyor

Dr. Fabio Pivetta of Berthoud doesn’t believe in lots of unnecessary tests and prescriptions for his patients at Banner Health Clinic. Instead, he involves them in their care as he practices evidence-based medicine.
“I’m keeping up with the literature, looking at the current research and looking at the best practices in medicine,” said Dr. Pivetta of the Berthoud area. “When you’re using the best research … you tend to be more judicious in care … You do things that have evidence that support them.”

Dr. Pivetta, D.O., joined Banner Health Clinic, 401 10th St., in February with a specialty in family medicine to help meet increased demand for patient scheduling. He joins Dr. Dena Shepard-Madden, M.D., who will retire on June 30 and Aaron Schmucker, a nurse practitioner. Dr. Shepard-Madden’s retirement will be honored with a public celebration 3-5 p.m. that day at McKee Medical Center in Loveland.

“He brings a lot of caring, compassion and experience to the position,” said Dr. Shepard-Madden, MD, who has been at the clinic for 10 years. “He fits in the general philosophy here of putting the patient first and doing what we can to make health care easier for the health care consumer.”

Dr. Pivetta is patient-centered, concerned about what works and doesn’t work for his patients, plus educates not only the patients but the entire staff, Dr. Shepard-Madden said.

“He listens, which is probably the greatest skill any physician can bring to a patient encounter,” Dr. Shepard-Madden said. “He’s able to put information in a way patients can understand.”
With Pivetta on the staff, patients now can be seen within one to two days instead of one to two weeks out, unless it’s an emergency, then appointments are made the same day, Dr. Shepard-Madden said, adding that the clinic also wants to be prepared to address the town’s growth.

“That gives us a chance to have more patients seen,” Dr. Shepard-Madden said. “We weren’t turning away patients, but we were getting full.”

Dr. Pivetta, who has 23 years of experience in health care and 20 in family medicine, wants to teach his patients about the potential benefits and harms of each avenue of care, involving them in shared decision-making. He takes into account their goals and expectations, then identifies the best way to proceed with managing their care, he said. He does this by considering convenience, such as if a test is feasible, and best options, he said.

“I do think historically doctors were more paternalistic,” Dr. Pivetta said, adding that he also recognizes decision-making can be difficult, so he will give advice if patients ask. “It really is saying, here are the options, here are the pros and harms and implications, and we go through each option.”

Dr. Pivetta gained a passion for evidence-based medicine during his family practice residency training at E.W. Sparrow Hospital at Michigan State University College of Human Medicine in East Lansing. His doctor of osteopathy is from the Michigan State University College of Osteopathic Medicine, which he earned in 1997.

“In general being a judicious provider, you’re not ordering a lot of tests and medication,” Dr. Pivetta said. “You’re using evidence from a preventative standpoint, which in general decreases overall costs.”

As a provider, Dr. Pivetta worked in clinics in Berthoud, Longmont and Holt, Mich. He also served as a clinical instructor at Rocky Vista University College of Osteopathic Medicine and University of Colorado School of Medicine. His last two positions were with Kaiser Permanente Longmont Medical Offices for six years and Centura Health Physician Group-Berthoud for 15 years.

“I live here and am part of the community. I practice here,” Dr. Pivetta said. “I like the smaller community practice feel.”