By PATRICK ADRIAN
[email protected]
BELLOWS FALLS, Vt. — Springfield Medical Care Systems executives said that, despite ongoing financial restructuring at Springfield Hospital, the board is not considering any changes to the Rockingham Health Center.
Springfield Medical Care Systems CEO Joshua Dufresne and Springfield Hospital CEO Michael Halstead met with Bellows Falls and Rockingham residents on Tuesday at Rockingham Free Public Library to answer questions and concerns about the plan to address Springfield Hospital’s financial crisis and potential impact on regional health services. This was the health care organization’s fourth of five scheduled town forums this past week.
Dufresne addressed concerns by James McAuliffe, a Bellows Falls resident and elected village trustee, about the potential impact to care and service at the Rockingham Health Center. The Rockingham Center provides seven-day walk-in services for primary and preventative care, including family medicine, pediatrics, mental health counseling, women’s health and physical therapy. They also provide on-call service after hours.
Springfield Medical Care Systems operates, in addition to Springfield Hospital, five walk-in health centers in the region, with clinics in Vermont at Rockingham, Londonderry, Ludlow, and Springfield and in Charlestown. In part of their overall restructuring the organization is looking at each clinic for specific areas to improve their overall efficiency. This may include changing hours or days according to a particular clinic’s patient use, or “seasonality”in the case of the Ludlow Health Center, whose patient use is higher during the winter ski-season months than in the summer, Dufresne said.
“We are looking at all our services to make sure that we aren’t being overly redundant in our services,” Dufresne said.“For example, if there is is a town or service area with two, we might ask whether we could merge the two clinics into one building to reduce overhead.”
But Dufresne said they they are not looking to make any changes to Rockingham’s walk-in clinic or its primary group. The Rockingham center does not have a neighboring facility nearby, and its patient use has been growing.
Care providers need to consider such efficiencies because there are impacts from staff turnover, Dufresne said.
Health care providers constantly compete for one another’s doctors, nurses and other licensed practitioners, and staff are recruited away from Springfield’s system and move to locations around the country, Dufresne said. While Springfield’s system has retained many dedicated staff over the years, smaller hospitals like Springfield lose many staff to competing providers offering higher pay. Compounding the problem is the nationwide shortage of primary care physicians and specialists needed by Springfield’s care centers; many medical school students are pursuing specializations that pay higher salaries.
Like many smaller hospital networks, Springfield’s system is looking at more efficient ways to recruit and retain staff, Dufresne said.
“Like situations where one might replace a staffing of two registered nurses with one nurse and one nursing assistant,” said Dufresne.
At Springfield Hospital, for example, the organization is looking to change in-patient staffing from two daytime physicians on-site to one physician and one nurse-practitioner, and from a night staff one physician and one nurse-practitioner on site to just the nurse-practitioner on site and the physician on-call (the emergency department would still have its physician on-site).
Filling staffing vacancies is also a major cost burden. Temporary physicians come through locum tenens agencies, which Dufresne equated to “physician rentals,” cost about three times as much in salaries and benefits as employed staff, mostly because the hospital has to pay both physicians and the staffing agency. In addition, care centers do not know what quality they will get with temporary doctors.
“If you start having staffing issues so great that you bring in so many locums, all your generated revenue is wiped out,” Dufresne said. “And we were heavy on locums the last couple of years because of heavy turnovers.”
In cases of walk-in clinics where staffing is already small, Dufresne said that the more likely approach to deal with staffing challenges would be to reduce a day of operation, such as closing on a Sunday or a Monday.
But Dufresne reiterated to Bellows Falls and Rockingham residents that the organization has no such plan at this time.
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