are slated to close their practices by May. VTDigger illustration/Google Street View
Four primary care doctors in Shelburne will shutter their practices this spring.
Doctors Susan Shull, Gordon Gieg, Christine Northrup and Judith Steinberg — who operate their own practices out of a shared building on Shelburne Road — are slated to close by May, a staff member at the practice confirmed.
The closures may be a harbinger of what’s to come, as weakened small practices struggle to outlast the pandemic, industry advocates warned lawmakers last week.
“This is reflective of the vulnerability of the small primary care practices in the state,” said Jessa Barnard, executive director of the Vermont Medical Society.
Barnard, along with Susan Ridzon of the advocacy group Health First, and Stephanie Winters from the Vermont Academy of Family Physicians and the Vermont chapter of the American Academy of Pediatrics, alerted lawmakers to the closings in a letter last week.
Two of the four Shelburne doctors are retiring. Those decisions were expedited by Covid, Ridzon said in an interview. The other two physicians decided to take salaried employment at financially stable positions at larger organizations, Ridzon said. The doctors declined to comment for this story.
The closures reflect the reality that operating rural solo practices is “not sustainable the way it is,” Ridzon said. Expenses and administrative burdens have risen steadily for years while reimbursement from insurance companies has remained flat, she said.
Covid is “hammering final nails into, in particular, the private practice coffins,” she said.
In the letter, which was sent to the Legislature’s health care committees, Ridzon, Barnard and Winters asked legislators to increase the state’s Medicaid payments for primary care practices. They also requested a new round of grants from previous federal money, as well as allocations for the health care system in a new federal stimulus package.
“We cannot lose more access to primary care in Vermont,” they wrote.
Nationwide, small practices have been hit hard by the impacts of the pandemic. According to a 2020 survey from the Physicians Foundation, 8% of doctors — roughly 16,000 nationally — closed practices due to Covid-19. Roughly a quarter were primary care offices.
About four in 10 said patient volume decreased by more than 25%, making it “difficult or impossible for most physician practices to sustain for more than a few months,” the survey reported.
After Vermont doctors voiced fears about long-term viability, the state set up programs to provide grants for faltering practices, but the funding expired in December. That helped, but “we know that expenses aren’t going away,” Barnard said.
The closures caught the attention of legislators. The health care committee chairs, Sen. Ginny Lyons, D-Chittenden, and Rep. Bill Lippert, D-Hinesburg, sent a letter to Agency of Human Services Secretary Mike Smith, asking for “an immediate review.” They also asked Smith to provide financial support for the private practices.
“The immediate, critical nature of this situation, and the importance of primary care services to the health of Vermonters,” require a quick intervention, Lyons and Lippert wrote.
Lawmakers can’t act until they have more details, Lyons said.
“We need to know as soon as possible, so if we need to do something, we can,” she said. “It’s so critical for survival of our primary care docs. We really need to pay attention to what we’re asking.”
