Dr. Richard Bernstein: Healthcare at UVM Medical Center – the long wait

This commentary is from Richard Bernstein, MD, of North Ferrisburgh, who practiced family medicine at the Charlotte Family Health Center between 1975 and 2013. During that time, he was the attending physician in the Department of Family Practice at the Center physician at the University of Vermont and clinical assistant professor at the University of Vermont College of Medicine, teaching medical students in his office in Charlotte.

Back in my retirement days, when I was a practicing family physician in Charlotte, I noticed a curious disparity in the availability of specialists in Vermont and New Hampshire.

Patients requesting referrals to the University of Vermont Medical Center would have long wait times before they could be seen. I could get them in faster by relying on personal relationships with independent vendors outside the UVM system.

But more often than not, when I felt they needed to be seen even sooner, I’d call Dartmouth Mary Hitchcock Medical Center and find a much more accommodating atmosphere for referral requests.

This disparity was a running joke in our office and I’ve seen more than one new patient who said, “I’m coming to you because I hear you’re the guy who’s going to send me to Dartmouth. It will be months before my doctor can get me to Medical Center in Burlington.”

As it turns out, what was true then is still true today, 25 years later.

The medical center is not indifferent to this situation. A few years ago, my neighbor reported that his primary care physician told him that he should see an orthopedic surgeon to consider hip replacement. The first appointment he could get in the Burlington area was in four months. Since he was in pain and having difficulty walking, I advised him to call Dartmouth. Instead, he called the Burlington Orthopedic Office and asked if they could suggest someone he could see in Dartmouth. A couple hours later, he got a call from the Burlington office telling him they had just canceled and could see him in three weeks.

The problem has been brought home to me just now. A dear friend has been suffering from generalized joint and tendon pain since he contracted Covid last spring. After two steroid treatments provided only temporary relief, her GP recommended a referral to an arthritis specialist and called both UVM and Dartmouth.

Last week, my friend received a call from UVM offering their first available appointment, at the end of May. Just today, however, he received a call from the Dartmouth planner, asking if he could come in on December 14th.

Why does this problem exist? It certainly isn’t due to an inadequate number of doctors in Vermont. Vermont actually has the fifth highest number of doctors per capita in the country, just behind the District of Columbia, Massachusetts, New York and Maryland.

If the problem is not understaffing, then it is definitely an administrative problem in the misallocation of medical resources.

The University of Vermont Medical Center describes a three-part mission: patient care, health care provider training, and medical research.

Medical research understands much of this so-called three-legged stool. A publication from UVM’s Larner College of Medicine boasts that the organization receives $90 million to $100 million annually in medical research funding.

When UVM doctors are in the lab doing research or in the hospital teaching, they are not in the office seeing patients. Also, when doctors travel, they aren’t even available to care for patients. Some doctors are paid by drug and medical device companies to test their products and present information to other doctors.

In 2019, a UVM cardiologist received $183,000 from a medical device company, according to ProPublica. A UVM endocrinologist received 31 payments for travel and speeches. An orthopedic surgeon received 88 payments for consultation, travel and accommodation.

Undoubtedly there are many reasons for the inability of the medical center to meet the timely care needs of its patients. However, hearing public presentations on UVM Medical Center, I have always been impressed by the number of times retired CEO John Brumsted works in the phrase “academic medical center,” as if to immunize the organization from public criticism of his practice. clinic.

Surely, we at Vermont are proud of our nationally recognized medical center and its research. That is, however, until some sort of disease strikes and we find ourselves unable to find timely medical care for our families. At that point, who wouldn’t prefer a big building filled with available doctors with a real person answering the phone and saying, “Will next week be soon enough?”

In 2019, VTDigger reported that Vermonters spent $6.5 billion on health care, about half of which went to hospitals. This equates to $10,442 per person annually.

That’s a lot of money to ask us, and in return, we may ask the new CEO of the medical center a few things. What is the difference between Burlington and Dartmouth? How should things change if patient care at UVM really was priority #1? 1? And considering the price we pay, why isn’t it?

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Tags: Dartmouth-Hitchcock, Dr. Richard Bernstein, long wait times, priority no. 1 for Patient Care, UVM Medical Center

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