Unaffordable child care, skyrocketing student loan debt and high overall costs of living are driving a shortage of health care workers in Vermont, according to leaders in the sector.
At a panel Wednesday, hosted by the Green Mountain Care Board in Montpelier, health professionals from around the state discussed the factors exacerbating a shortage of workers, and mulled potential solutions.
This trend has already created problems in Vermont’s health care systems. Residents are experiencing longer wait times for certain procedures. In some cases, patients have to wait up to 100 or 200 days to see certain specialists.
Data collected by the Vermont Department of Health shows the ratio of physicians to the general population has declined over the last decade. In 2006, there were 80 full-time physicians for every 100,000 residents. In 2016, there were 75 per 100,000 residents.
A lack of health workers is a national struggle. The United States should expect a shortage of up to 122,000 doctors by 2032, according to the Association of American Medical Colleges.
In order to address Vermont’s high cost of living and compete with hospitals in neighboring states, like those in Massachusetts that are easy for southern Vermonters to travel to, hospitals have been giving out large sign-on bonuses and raising pay. President of Brattleboro Memorial Hospital Steve Gordon said his hospital recently raised the minimum pay for nurses to $30 an hour.
“When I mentioned that at a recent hospital board meeting there were a lot of gasps,” Gordon said.
Some panelists also spoke about the stifling burden of student debt that plagues medical school graduates. In 2016, the average medical school debt was $190,000, the American Medical Student Association found.
Trey Dobson, chief medical officer of the Southwestern Vermont Medical Center, said he was recently interviewing a surgeon for a position who said she had about $250,000 in debt at a 7% interest rate. So while the need for incentivizing loan repayment programs came up frequently in the panelists conversations, Dobson recommended the creation of repayment programs that are innovative enough to grapple with such large amounts of debt.
Joyce Judy, president of the Community College of Vermont, spoke about the transfer partnerships her institution has with UVM, which can save a student thousands of dollars if they chose to transfer into medical programs later in their academic careers. She also said community colleges have a unique ability to make careers in the health care sector more accessible by offering apprenticeship programs, so students can earn a paycheck while gaining a new degree.
“People cannot stop work and continue their education,” Judy said. “So how can you help them earn and learn at the same time?”
For example, CCV entered into an apprenticeship partnership this fall semester with CVS to train pharmacists. In the program, students are able to work and earn their degree simultaneously. She said these programs are specifically helpful for people from low-income families or who are first generation college students.
Vermont does have an advantage in the nation’s race to attract and retain health care workers because it is home to universities that are training future physicians. However panelist Melissa Davidson, associate dean for Graduate Medical Education at UVM, said only 25% of its residents from UVM’s Medical Center get jobs in Vermont after graduation. Davidson said the university does not yet know why but that it is pursuing research on this topic.
However, she said UVM has insights into why more medical student residents aren’t choosing to attend UVM’s residency programs. The number one reason people don’t attend is because there are no jobs for their spouses or partners in the Vermont area. Other top reasons were a lack of affordable child care in the state and a lack of diversity.
And while universities in the state are creating various forms of partnerships and programs that can help address Vermont’s health care worker shortage, Gordon of Brattleboro Memorial Hospital recommended that hospitals and universities partner in a more formal way, possibly through a commission, to share solutions to this statewide shortage.
“We’ve got to get our act together,” Gordon said. “So that everyone in Vermont knows about these programs, and so that we can standardize these programs.”
