By Patrick Mcardle
RUTLAND HERALD
While admitting there can be wait times for patients seeking specialty care in Vermont, representatives of Vermont hospitals, including Rutland Regional Medical Center and UVM Health Network and Brattleboro Memorial Hospital, pushed back on a state report released this week.
Jeff Tieman, president and CEO of the Vermont Association of Hospitals and Health Systems, started his comments Wednesday by saying to anyone who has been affected by lengthy wait times to see a physician, “We need to do better.” He said everyone deserves to be able to access medical care when it’s needed.
“Unfortunately, especially here in Vermont, there are just not always the right number of physicians and nurses and other staff members in every specialty to make sure that always happens. There just isn’t. And we are barely emerging from a pandemic that disrupted health care delivery in every conceivable way,” he said.
The report on health care access from the Vermont Agency of Human Services, issued after an investigation that started in the fall, was criticized by the health care providers because the findings were based on comparisons between Vermont’s rural hospitals and hospitals in larger communities or other countries; failed to account for the regulatory requirements set on the state’s hospitals; and cited a “Secret Shopper” test conducted when 1,000 calls were placed in December and January to see how quickly appointments could be scheduled.
Claudio Fort, president and CEO of Rutland, said health care providers, administrators and patients had been aware of the issues and have worked to address them for many years.
“As we understand it, the study commissioned by the Agency of Human Services begins to identify these challenges but does little to diagnose the root causes or propose workable solutions,” he said.
Dr. Kat McGraw, Chief Medical Officer, Brattleboro Memorial Hospital, said she was at the press conference on behalf of doctors, nurses and other front-line staff in Vermont, as well as other chief medical officers. Over the past few years, as Vermont medical professionals responded to the needs of the pandemic, McGraw said she has been part of the ongoing efforts that are related to the concerns about wait times.
“We have been at our patients sides, as our entire health systems have pivoted to provide health care services never before imagined. In our most difficult times, we have had to triage and limit some less urgent services in order to provide that which was most necessary. We deferred some elective surgeries in order to accommodate the most urgent surgeries while also caring for COVID inpatients,” she said.
An access report is available from UVM, according to Dr. John Brumsted, CEO of the health network. He said among the main concerns identified included recruiting and retaining a workforce of medical professionals, a challenge which had existed before the pandemic, and the expansion of facilities.
Brumsted said Vermont’s “certificate of need” process, which requires state approval from the Green Mountain Care Board for a hospital to expand its facilities, can add “months or in some cases a year or two years into the process to get your regulatory process.”
“I would ask that as part of the access report that’s come out, that we not just look to the delivery system for all the solutions but that we look directly at the processes, the regulatory processes of the state of Vermont and make sure that those are not impeding our ability to address the access issues for Vermonters but are facilitating and enhancing those efforts,” he said.
Asked for specifics about the efforts to address access, Brumsted said UVM had increased the number of recruiters, increased salaries for nurses and other front line staff and expanded the access to electronic data systems through the network so medical specialists can be part of a care response, through “e-consults,” without the patient needing to visit the specialist’s office.
Shawn Tester, president and CEO of Northeastern Vermont Regional Hospital in St. Johnsbury, said he was amazed by how much time he has spent on housing issues for staff.
“For travelers (nurses) we ended up having to rent a dorm from one or our local high schools to house travelers because there’s literally no place for them to live when they come to work at our hospital. That gets to my point earlier around (the idea that) we really have to get creative and think outside the box,” he said.
Some of the responses have not yet been determined. Fort said Vermont hospital administrators had not had much time to review the data used to create the state report released on Tuesday, during their press conference on Wednesday.
“These are very complex issues, access to care and what type of care, what level of access you need. So we really need to be able to have some time to look at the methodology and the actual data and be able to compare that with what we know from our internal records,” he said.
McGraw noted the “Secret Shopper” data was collected at a time when hospitals and their staff were stretched because they were responding to the omicron variant of COVID which included deploying resources.
“That redeployment has an impact on our facilities broadly, so without accounting for that we really are looking at apples, and oranges and we can’t forget that,” she said.
The information from the state report, which can be found online at dfr.vermont.gov/health-services-wait-times includes information from public forums, press releases and the names of members of the team that reviewed the process.
patrick.mcardle @rutlandherald.com
As your daily newspaper, we are committed to providing you with important local news coverage for Sullivan County and the surrounding areas.