Vermont Physicians Concerned About Health Care Reform

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(Host) Physicians are worried about how health care reform will affect their work and their medical practices.

They say they’re already under financial pressure, as they struggle to see more patients in less time.

And a new survey shows that they want to be involved in how the state transforms their profession.

VPR’s John Dillon reports.

(Dillon) Orthopedic physician Benjamin Rosenberg was keeping to his typical, hurried schedule on Monday. He was seeing patients in his Middlebury office roughly in 15 minute increments. By midday he was dictating a patient’s chart. Lunch was an afterthought.

(Rosenberg) "My first patient starts at 1:30 and so the nurse is getting him in the office right now. So I’ll see him between bites of sandwiches."

(Dillon) Dr. Rosenberg says sometimes 15 minutes is plenty of time to check on a patient’s progress, such as making sure a wrist fracture is healing properly.

(Rosenberg) "And then there’s the other patient who came in with a diagnosis of shoulder pain that has four potential causes of that shoulder pain. In order to adequately assess them, it really needs more than 15 minutes."

(Dillon) Rosenberg was recently interviewed by the research arm of the Vermont Medical Society.

And like other physicians surveyed, Rosenberg finds that his practice is under increasing pressure – financial pressure, time, pressure, and potentially – bureaucratic pressure.

On the business side, Rosenberg said reimbursements from insurance companies and government entities such as Medicaid have not kept pace with rising costs.

(Rosenberg) "I get paid less in real dollars, significantly less, now for the same procedures than I did when I started my practice 18 years ago."

(Dillon) Rosenberg’s says he’s not crying poverty; he says it’s a privilege to spend his days helping people. But he says it is difficult to run a private practice using a business model based on declining revenues.

And his situation is not unique. One physician cited in the survey said he feels like – quote – "a hamster on a wheel just seeing the volume of patients needed to keep the lights on."

Dr. John Brumsted is the chief medical officer for Fletcher Allen Health Care in Burlington, and the chair of the Medical Society’s research foundation. He says there’s a great deal of anxiety in the medical community right now.

(Brumsted) "So you take the physician workforce out there in the state and you have those folks stressed because they’re not feeling like they’re able to spend enough time actually with the clinical practice. And you throw into that other uncertainties."

(Dillon) Some of that uncertainty comes from health care legislation passed this year. The Shumlin Administration wants to move to a single payer system, and change the way physicians are paid.

(Brumsted) "One of the other things that came out very clearly in the needs assessment was that physicians are concerned about having appropriate say in policy making at the state level, policy making that greatly affects our patients." 

(Dillon) The Medical Society wants Governor Peter Shumlin to name at least one physician to the five-member board that will oversee Vermont’s reform efforts.

For VPR News, I’m John Dillon in Montpelier.

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