Introducing Mark Smyly, PA

Heritage Health welcomes Mark Smyly, a Physician Assistant, to the Kellogg Clinic. Mark, a Coeur d’Alene native, loves skiing, golf, and spending time with his friends and family.


Heritage Health welcomes new Chief Operations Officer

Eddie Larsen, COOHeritage Health has hired Eddie Larsen to be its new Chief Operations Officer, who brings a wealth of experience and knowledge to the organization. Larsen previously worked as a Chief Operating Officer for Aviva Health in Roseburg, Ore. He also has experience working in information technology for health care organizations. “I am looking forward to getting to know everyone,” said Larsen. “I have appreciated the warm and kind welcome.”

Eddie says he believes in balancing work with fun and laughter. “I don’t want work to be a four-letter word,” he said. “I believe in empowering people. I am not a micromanager. I want to help people grow to be the next generation of leaders at Heritage Health.” He said collaboration and teamwork are core principles and that he looks forward to “contributing” to making Heritage Health a stronger organization. Larsen is currently pursuing a doctorate in Business Administration from William Howard Taft University. He earned a Master of Business Administration from California Coast University and a Bachelor’s Degree in Management Information Systems from the University of Phoenix.

Eddie has a 16-year-old daughter, and he loves the outdoors, camping, hiking, and reading.

Welcome to the team!

Amanda is our new registered dietitian!

She will be helping patients out of our Coeur d’Alene Clinic.

“I am incredibly excited to start my journey at Heritage Health because I am passionate about working with patients one on one to meet their nutrition goals and tailoring each person’s plan of care to their individual needs,” says Amanda. “I believe that small, achievable changes can make huge impacts on someone’s path to better health.”

Amanda graduated from the University of Idaho’s Coordinated Program in Dietetics (Go Vandals!) and she has been a dietitian for over eight years.

Her background is working in nutrition support in the home settings, educating and transitioning patients from hospital to home with tube feeding and being part of the care team in skilled nursing facilities and psychiatric facilities.

She is no stranger to the Coeur d’Alene area, having graduated from Lake City High School. After having the opportunity to live in Alaska, Florida, and Idaho, she decided with her husband to make North Idaho their permanent home.

She enjoys spending time with her husband, one-year-old daughter, and labradoodle, or hanging out with friends and family (at an appropriate social distance).

She enjoys experimenting with recipe modifications in cooking and baking, traveling, running/walking/hiking, dancing, watching the Green Bay Packers and generally enjoying everything that the Coeur d’Alene area has to offer.

Heritage Health announces new leadership roles for Purrington, Rehil-Crest

Dr. Peter Purrington has been appointed as the Chief Clinical Officer for Heritage Health.

Purrington has served as Heritage Health’s Chief Medical Officer since 2018. In this new role, Dr. Purrington, will take a broader view of the organization, leading and directing clinical care across medical, dental, behavioral health, and addiction service lines.

“Dr. Purrington is a proven strategic leader for Heritage Health,” said CEO Mike Baker.  “We’ve grown from a humble volunteer clinic into a professionally managed healthcare organization. His new role will be essential to meeting the needs of the community into the future.”

Dr. Purrington will focus on quality and safety initiatives, including the transition to value-based care and building business intelligence solutions that will facilitate and support clinical care.

“I am excited about my new role with Heritage Health,” said Purrington. “My focus is about improving our care for patients and making sure our staff is functioning at a high level to meet those needs.”

Dr. Purrington earned his medical degree from George Washington University and is board-certified in Family Medicine and Healthcare Quality Management. He has also earned a Masters in Business Administration through the University of Maryland.

In addition, Anthony Rehil-Crest, MD, MPH has been named the Vice President of Medical Services.

Dr. Rehil-Crest will be responsible for guiding and directing clinical care in Heritage Health’s four medical offices, supporting over 45 providers in primary care, psychiatry, and Post-acute care.

“Since I started as a medical provider with Heritage Health over 5 years ago, I have been amazed at how quickly we have become such a large and important part of the medical community in Northern Idaho,” said Rehil-Crest. “I’m excited to be part of the team that leads our talented group of medical providers. I hope to continue to prepare providers for future challenges so that they can focus on the care of their patients and families. I’m looking forward to watching Heritage Health continue to grow and continue to be the clinic that our community looks to for compassionate and quality care.”

He will continue seeing his current patients in the main Coeur d’Alene office.

“Dr. Rehil-Crest is beloved by his patients and known for his compassionate care,” said Dr. Peter Purrington, Chief Clinical Officer. “He has been a role model for our providers. We’re excited to expand his leadership to our other clinics.”

Rehil-Crest is a graduate of New York Medical College and earned his Masters in Public Health through the University of Washington.  He completed his residency at the University of Utah Hospital and Clinics. He is board-certified in Internal Medicine and has been with Heritage Health as the Associate Medical Director of the Coeur d’Alene office since 2014. 

Quarantine life

Don’t forget the extra side of pickles mom, my eight-year-old son yells as I am calling in our delivery takeout dinner for tonight. It doesn’t matter that we have a whole jar of pickles in our refrigerator already, or that we have items in our kitchen that could make the food I am ordering via the phone. 

I cannot say this was my first takeout meal since the COVID-19 restrictions began. I was asked to write about what a dietitian eats at home with her kids during this social isolation period. I immediately closed my eyes and envisioned a calm parent, dressed in a clean, decorative apron working alongside their two sons (ages 8 and 9), smiling, laughing, perfectly chopping, stirring and instructing the boys on how to prepare a dish together.

My thought comes to a screeching halt when I open my eyes and see my boys using our last roll of toilet paper to decorate the house while our sweet cocker spaniel puppy chases the tail of the toilet paper gnawing on the end of it.  

Reining in my boys during this quarantine has been exhausting. Homeschooling in addition to keeping energized children occupied while working from home has not been an easy transition for many of us! 

I am a social person who likes connecting with people on a regular basis. My family and I like to patronize local restaurants. The idea of escaping a couple of times of the month to dine at a restaurant where I do not have to mess up the kitchen, have the family mess up the kitchen or clean the mess of the family in the kitchen after working all day is a highlight, and a treat we look forward to.

Since this closure, preparing and cooking balanced meals three times a day along with planning healthy snacks is exhausting. I am not alone; however, this awful virus has affected people much worse than what I am complaining about. 

I admit, my family and I have ordered takeout food more than usual. I am not a unicorn. Dietitians do eat out. We do eat more than lettuce on top of lettuce sandwiches with a side of lettuce. I think we should give ourselves a break from this new normal without feeling guilty about eating takeout.

It is about making better choices within your budget when you eat out!

Who says you must upgrade the size of the meal you order? Who says you need to get a side of fried foods? Why does having a somewhat balanced meal go out the window when we dine in or get takeout foods?

It doesn’t.  

When my family and I dine in or get takeout, a similar rule of thumb applies as if we were eating a meal we prepared at home: select four out of the five food groups with most meals.

The five “food groups” include grains (ideally whole grains), fruit, vegetables, protein and dairy. This is the same advice I give my patients who strive to acquire a pattern for healthy eating. 

Attempt to make your plate reflective of the My Plate. Yes, you can do this when you dine out or get takeout. 

Think about this, if you order takeout and select noodles, rice, breaded protein and a side starchy fried item; how are these foods going to keep us full long term, provide adequate micronutrients and reduce inflammation? Temporary fullness yes, long term, no. Refined white grains with an extra-large serving of protein are the most overconsumed food groups when we eat out. In a recent article from Fox News Lifestyle published on April 6th, one of the most popular takeout orders from Uber Eats during this quarantine so far has been french fries and soda.

Reflecting on the guidelines of the My Plate, half you of one’s plate (ideally 9” diameter plate) should include vegetables &/or fruits. The other half should include a quarter plate full of lean protein and a quarter plate full of whole grains. The outlier includes a serving of dairy. Since an order of small fries would be considered a serving of “grains,” ordering a bun on a sandwich would overfill my grain group.

So, I would need to decide on an open-faced sandwich and fewer fries? Lettuce wrap my sandwich and still have the fries? Steal my husband’s fries? Decisions like these can prevent us from overeating empty nutrient valued foods and select higher quality foods. How can we get full without overeating fries? Order vegetables. Most take out and dine in restaurants provide an option to order a side of vegetables or salad. 

When dining in, I love ordering the bottomless salad (dressing on the side) or the bottomless vegetables. Including vegetables with any meal adds fiber, micronutrients and fullness. This can be applied to almost any takeout or dine-in meal you order.

Here is an example of how my two kids order when ordering out. 

The 9-year-old:

Grilled chicken on whole wheat bread, side salad (dressing on the side), mandarin oranges and a cup of milk. Five out of five food groups chosen! 

  • Lean Protein: Grilled chicken breast
  • Dairy: Milk
  • Whole grains: Whole wheat bread
  • Vegetables: Salad
  • Fruit: Mandarin oranges

The 8-year-old: 

Canadian bacon pizza, side of steamed vegetables (typically broccoli), apple slices and a cup of milk. Five out of five food groups chosen! 

  • Lean Protein: Canadian bacon
  • Dairy: Cheese and milk
  • Grains (whole if available): Flatbread
  • Vegetables: Steamed broccoli
  • Fruit: Apple slices

Now, they may not always be full after eating the above meals, but after they eat the fruit and vegetables, the inclusion of seconds is encouraged. If we only gave our hungry, energized boys bowls of bottomless macaroni and cheese or all you can eat pizza, that is all they would eat. By including additional food groups, as small as a couple of carrot sticks with some apple slices, instills a habit of eating a variety of food and can slow the eating process down. 

Just a couple of simple changes can be made for helping our kids and ourselves be healthier while eating at home, takeout included! 

  • Include fruit and vegetables with lunch and dinner meals
  • Include fruit with breakfast
  • Change bread products from white to whole wheat
  • Change pasta items to whole grain or whole wheat pasta
  • Limit grazing on empty calories food throughout the day
  • Eat from a bowl or plate, not from the box or bag
  • Eat at a table without screen distractions

Here is an easy way to prepare a fiber-rich Macaroni and Cheese that my kids give a thumbs up to:


· 8 ounces whole wheat pasta (or whatever shape your kids prefer) 

· 2 tablespoons whole wheat pastry flour

· 1 teaspoon garlic powder

· 1 cup shredded cheese blend (we use provolone, mozzarella, and sharp cheddar)

· 1/4 cup shredded Parmesan cheese

· 1/4 teaspoon fine sea salt

· 1/8 teaspoon ground black pepper


 1) Bring a large pot of salted water to a boil

 2) Add macaroni and cook until al dente (approx. 10-12 min). Drain well

 3) While the macaroni is cooking, whisk together milk, flour and garlic powder in a large saucepan until completely blended.

 4) Cook over medium heat, stirring constantly, until thickened (approx. 6-8 min). 

 5) Add cheese and stir until gently melted. 

 6) Add drained pasta to the sauce. 

 7) Season with salt, pepper, stir well

Serve with a side of vegetables, fruit and a healthy beverage. 

Approximate Nutritional Info:

Per serving: 370 calories (100 from fat), 12g total fat, 7g saturated fat, 30mg cholesterol, 370mg sodium, 50g carbohydrates (5g dietary fiber, 3g sugar), 19g protein.

Jennifer Ramsrud is a clinical dietitian at Heritage Health, currently meeting with patients via telehealth. To schedule a dietitian, visit with Jennifer, please contact (208) 620-5212.