Editor’s note: Robert S. Emmons, M.D., is a psychiatrist with a practice in Burlington.
As a physician who has practiced in Vermont for 23 years, I listened closely to the first gubernatorial debate. Sen. Randy Brock read a letter from a doctor who, like me, is deeply worried about the direction Gov. Peter Shumlinʼs single-payer plan is taking medical practice in Vermont. I was astonished when the incumbent told the audience that itʼs not plans for single-payer, itʼs the “current system” that perturbs the letterʼs author. (In another moment of supreme silliness, Shumlin presumed to channel the late Gov. Richard Snelling on the topic of community rating.)
Gov. Shumlin shows a consistent pattern of dismissing points of view different from his own, so much so that in this case that he didnʼt even hear that an alternative point of view exists. When serious questions are asked about the potential downsides of his grand schemes, the governor writes it off as “doom and gloom.” In private life, this might amount to merely an annoying character trait, but as a mode of governance, it leads to a catastrophic disregard for the dangerous side effects of policy prescriptions.
In Rep. George Tillʼs 2012 survey of Vermont physicians, 52 percent indicated that they are apt to stop practicing within the next five years, many due to age, and 21 percent indicated that they would consider closing their practices due to the current climate of uncertainty created by Gov. Shumlinʼs plan. What is the potential impact? In Chittenden County, we recently lost two psychiatrists in private practice, one to unexpected illness and one to demoralization with her future prospects in this state.
If the governor cannot acknowledge that his single-payer plan creates major disincentives for physicians, then he cannot develop a substantive plan for attracting and retaining doctors.
Each of these psychiatrists leave behind hundreds of patients with nowhere to go for continued psychiatric care. In a state as small as Vermont, even the loss of one physician, in any specialty, has a big impact on access to care.
If the governor cannot acknowledge that his single-payer plan creates major disincentives for physicians, then he cannot develop a substantive plan for attracting and retaining doctors. The number of Vermont physicians who like the governorʼs plan do not constitute an adequate workforce. Slogans, hope, and “can do” pronouncements will be of no use to Vermont citizens if they cannot find physicians with openings in their practices.
I am supporting Randy Brock for governor because he takes a realistic approach to the problems of access and cost in Vermont medicine — preserving the supply of physicians is a constant theme that informs all of his proposals for payment mechanisms. I want a governor who is for all Vermonters, not just the ones who agree with him.
