Dr. Stephen Leffler: UVM Medical Center starts 2023 with creativity, commitment

This commentary is by Stephen Leffler, M.D., president and chief operating officer of the University of Vermont Medical Center. He lives in Hinesburg. 

Here’s one place I didn’t expect to find myself in my health care career: Standing at a construction site on a snowy December afternoon, applauding as my colleagues officially broke ground on a new apartment building and child care center for employees of the University of Vermont Health Network.

As a trained emergency department physician and now president of the University of Vermont Medical Center, I know how much there is to be done inside the walls of our hospital — which serves as the region’s community hospital, academic medical center, Level I Trauma Center, children’s hospital and NICU. 

A few years ago, I might have asked why we were partnering to invest in apartments and child care, when there is so much else to be done. But anyone who has lived through the past few years — every patient who has waited too long in our extremely busy emergency department or for an appointment to see a specialist; any nurse, doctor or other employee who has struggled to maintain or even find housing and child care — knows the answer today.

There is lots of news coverage about the national challenges our health care system is facing, especially the widespread workforce crisis due to the lack of available doctors, nurses and other vital staff, which is requiring hospitals to rely on expensive contract labor. 

This crisis caused UVM Medical Center to post a $27 million loss last year, and caused our network to lose $90 million. Despite these efforts, including significant pay increases for many of our employees, we still struggle to staff our facilities, which has a direct impact on our ability to increase access to care for patients. 

That’s why our organization is making investments in housing and affordable, high-quality child care. They are massive barriers for recruiting and retaining the permanent workforce we need to deliver great care to the patients who need us.

Other obstacles facing health care have been in the national news, such as the crisis in both long-term care and mental health, which make it nearly impossible to discharge patients who no longer need hospital-level care. The stories describe sicker patients and higher volumes, lost revenue and services in peril. 

These challenges are impacting us at UVM Medical Center along with hospitals all over the country, and they were taking shape before Covid-19, which depleted any cushion there had been of time or money.

In response, many hospitals — even in our region — have found it necessary to close beds, reduce services or divert patients from their emergency departments as a way to manage their financial losses. 

Given our role in the regional health care system, we have worked very hard not to close any services up to this point. Realistically, we cannot remain on this path forever, and there are likely more tough decisions in our future. But I am proud of the creativity and efficiency our teams have marshaled so far, continuing to lean into our academic and patient-care mission even with the challenges surrounding all the work we do.

As Vermont’s only academic medical center, we are fortunate to attract top talent and educate new medical professionals, who are absolutely vital to the future of health care. This is a critical pipeline for doctors and nurses that we continue to build. We are fortunate they often stay in Vermont and northern New York after the completion of their training.  

Our academic commitment also supports investments in technology — like eConsults — which can reduce the time needed to get a specialist’s opinion. 

We continue to optimize the efficiency of our operating rooms to reduce wait times for procedures, and to streamline hospital operations so patients can go home when they’re ready — making room for patients from the emergency department or other hospitals who need the acute level of care we provide. 

And we are making the significant investments in housing and child care I mentioned earlier. We are listening to our people when they tell us that the lack of housing means we lose out on talented team members, and that the lack of child care too often forces our employees out of the workforce completely. 

Increasing availability of these community resources will help us recruit and support our employees so they can focus on delivering great patient care.

Like all of our local, regional and national partners in health care, we have many problems to solve going into 2023. I want you to know that the UVM Medical Center is creative and dedicated to serving each of you and your families. I am incredibly proud of our team’s commitment to our patients and for their perseverance. We are focused on innovating to address our short-term and long-term challenges, and we will not stop pushing forward on behalf of the people of Vermont and northern New York.


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