Some patients and doctors who use the University of Vermont Medical Center in Burlington say they face long wait times for surgeries and other medical procedures despite claims by the hospital that there is plenty of capacity.
The patients and doctors wrote their complaints in public comments to the Green Mountain Care Board. The board is considering whether to grant a permit, called a certificate of need, to a group of investors seeking to open an independent surgical center in Colchester. That group argues, in part, that its proposed Green Mountain Surgical Center is needed to help deal with a surgical backlog.
The UVM Medical Center is not a party in the case but has worked with the Vermont Association of Hospitals and Health Systems, which has been intervening. Christina Oliver, the vice president of clinical services at the UVM Medical Center, testified April 13 that there is plenty of capacity in the center’s surgical rooms.
Oliver said the hospital performs 20,000 surgeries and 13,000 endoscopic procedures a year. She said utilization in the hospital’s main operating rooms is 74 percent, versus a national benchmark of 75 percent.
Utilization rates at other facilities are lower than in the main operating rooms: The rate is 71 percent in endoscopy rooms in the main campus, and 41 percent in procedure rooms in the main campus. Operating rooms at the Fanny Allen campus in Colchester have a 63 percent utilization rate, she said.
“With our current volumes, we can easily accommodate all urgent, emergent” and other cases, Oliver said. “If our volumes were to increase, we have substantial capacity and would simply increase our hours of operation.”
Additionally, Oliver said patient satisfaction in the hospital’s operating rooms and procedure rooms is high. In the operating rooms at the hospital’s ambulatory surgical center, patient satisfaction has been 94 percent for the past three years, she said, and patient satisfaction in endoscopy rooms has been 95 percent for the past three years.
Public comments, which are being accepted through May 1, tell a different story. Patients and their doctors say people are suffering as they wait to get treatment for back pain, seizures, possible skin cancer and prostate cancer.
Dr. Andrea Regan, who works at Charlotte Family Health Center, wrote in public comments that her patients “are unable to get timely, affordable care” through the UVM Medical Center.
Regan wrote that a patient in her 80s “had to go into a nursing home for three weeks because she couldn’t get a total hip replacement in less than two months.” She said another patient in her 40s “with a recent witnessed seizure will not get a call back to even schedule an appointment for four to six weeks.”
Another of Regan’s patients, in her 30s, “with severe right lower quadrant pain cannot get a CT scan within two weeks unless she goes through the emergency department,” Regan wrote. “She is waiting because she works two jobs and has a high-deductible plan.”
Dr. Anita Licata, who works at Four Seasons Dermatology in Colchester, said wait times for outpatient procedures done at the UVM Medical Center have increased as the hospital has acquired orthopedic surgery and cardiology practices.
“We refer patients to UVM Plastic Surgery for the excision of malignant skin cancers, and have been told there will be a delay of two months or more at times, primarily due to inadequate access to outpatient surgical slots at UVMMC,” Licata wrote. “The surgeons are available. The space is not.”
Melinda Moulton, the CEO of Main Street Landing, wrote that she chose to use the UVM Medical Center to get cataract surgery, “but the experience was overbearing. It took long periods of time to get an appointment and when I arrived to my appointments I had to wait sometimes hours to be seen.”
“I have a friend who tore his Achilles heel — it took him weeks to be seen at the hospital,” Moulton wrote. “I have another friend who had to wait months for the removal of his cancerous prostate with appointments being changed or put off.”
Jane Evans, a Burlington resident, said that when she hurt her back last summer she had to wait four months to get an appointment for steroid injections. “By the time of the appointment, my back issues had thankfully resolved and I no longer needed treatment, but it would have helped greatly through the months I suffered,” she wrote.
Evans said she is now waiting one month for a knee injection at the UVM Orthopedic Center on Tilley Drive in South Burlington. She said that when her husband tore his ACL in a skiing accident, they chose to go to Associates in Orthopedics — before it was acquired by the UVM Medical Center — “because there was an incredibly long waiting list to see a doctor at the UVM Orthopedic Center.”
Yvonne Lacaillade, a Colchester resident, wrote in March that she was trying to get a dermatology appointment “for suspicious growths” but could not be seen until November “unless my doctor does an ‘urgent’ referral,” in which case she could see the doctor in May.
Lacaillade wrote: “Approve the surgical center so others do not have to wait for what the center will provide. It doesn’t help me at this point and for my problem but hopefully it will be a big asset for other patients.”
Martha Cady, of Essex Junction, wondered about the scheduling of surgeries and colonoscopies. “If the hospital has plenty of capacity, why are they booked so far out in advance?” Cady wrote.
Oliver said April 13 that surgeons sign up for blocks of time in operating rooms and procedure rooms, and schedule surgeries within those time blocks. When surgeons don’t schedule surgeries, the time gets converted into “open time” that any surgeon can use, she said.
“This is one of the reasons why we don’t use wait time as an acceptable measurement,” Oliver said. “We have open time available every day that is staffed but is unused.”
