In an effort to assist primary care physicians in Vermont – a community described as “in despair” by one practitioner – the Vermont Medical Society has launched two initiatives designed to help physicians improve practice management and engage in policy discussion.
The initiatives, the Practitioners’ Resource Center and the Vermont Partnership for Value and Science Driven Health Care, are the culmination of a two-month qualitative research project by Cy Jordan, a physician and the former medical director for Vermont Program for Quality.
Jordan, who now works for the Vermont Medical Society’s Education and Research Foundation, said spent two months early this year interviewing practicing and retired physicians, both independent and those working for larger hospitals. Jordan also interviewed hospital executives and the heads of medical teams at the state’s hospitals. The summary of the results of his work was released in a report on June 7.
The 20-plus interviews indicated that doctors “are not happy,” Jordan said. “The thing that keeps them going is the patients.” Business details is getting in the way of patient care, he said. His report states that physicians face “financial stresses that require practices to see more and more patients in a day just to keep the doors open.”
Jordan proposes to remedy this problem, through the creation of the Practitioners’ Resource Center,
which would provide training for practitioners who want to increase the efficiency and effectiveness of their practices.
The center is “not about politics,” Jordan said. Its purpose, according to the report, is to “assist practitioners with identifying and solving problems that directly interfere with everyday processes of care, particularly problems consuming time that could be redirected towards ensuring individualized, timely quality care.”
Jordan said the study also showed that physicians believe they aren’t able to inform policy discussions that affect their work.
“[Physicians] feel like all these decisions are being made and they’re not part of the conversation,” Jordan said. With business interests in control of much of the $5 billion Vermont health care industry, Jordan said doctors lack solid information to contribute to policy decisions.
“A bottom line world is simple,” Jordan said of the business side of the industry. He said ensuring that patients receive quality medical care is much more complicated. “This is a big conversation that has to be part of health care reform,” he said.
To this end, Jordan proposed the formation of a second initiative — the Vermont Partnership for Value and Science Driven Health Care. The proposed partnership would utilize resources at the two area medical schools, at Dartmouth College and the University of Vermont, to collect and compile financial and medical health care information.
Jordan said he had proposed the partnership plan to John Brumsted, chief medical officer at Fletcher Allen Health Care who was enthusiastic about the plan. Brumsted has been named interim CEO of the hospital when Melinda Estes leaves in August. He had not presented it to Dartmouth, Jordan said, but he anticipates the medical school would likely be on board as well.
Jordan is seeking philanthropic funding for the partnership. He said the Vermont health care industry wouldn’t be likely to fund such an effort, as it could undermine their interests in the Statehouse. Jordan said he hopes to obtain state support as well.
Anya Rader Wallack, Gov. Peter Shumlin’s special assistant for his health care reform effort, said she wanted to see the partnership coordinate efforts with already existing efforts, such as the state’s Blueprint for Health. She said coordination is key, but “we can’t do enough” to get doctors involved in health care reform. She said the current plan for the partnership is still too vague, but if the state finds that it is something useful moving forward, it would do what it could to support it.
The Practitioners’ Resource Center will likely need staff and funding as well, which Jordan said he is also pursuing.
