This commentary is by Tom Papeika, a resident in Shrewsbury.
Rutland Regional Medical Center recently withdrew its request to transition inpatient pediatric care away from a small number of consistently underused beds toward a more modern model of care. The proposal had been scheduled for review by the Green Mountain Care Board under new authority granted by the Vermont Legislature. With the withdrawal, any future changes will now fall under the Agency of Human Services’ broader “transformation template.”
However the process unfolds, one point should be clear: change in how pediatric care is delivered is not only reasonable—it is responsible.
Hospitals in Vermont, like hospitals nationwide, are navigating workforce shortages, shifting patient volumes and the growing challenge of sustaining low-volume specialty services at the highest clinical standards. Rutland Regional is no exception. The hospital has been transparent that its inpatient pediatric unit is lightly used. Low volume directly affects the ability to maintain staffing, expertise and quality, which in no way is a criticism of the dedication of clinicians or the value of pediatric care; it is simply a modern clinical reality.
To remain strong and sustainable, hospitals must be able to make decisions guided by evidence and outcomes rather than by habit or fear. Maintaining a service model that no longer reflects how children actually receive care does not serve patients well in the long term, nor does it support excellence in medicine. Adapting care delivery to present-day needs is not a retreat—it is stewardship.
It would have been easier to avoid controversy and preserve a familiar structure. Instead, the hospital attempted the more difficult work of reimagining care in a way that aligns with today’s realities and tomorrow’s needs. That effort deserves serious, thoughtful consideration.
Unfortunately, much of the public response has been driven more by emotion than by fact. Claims that Rutland Regional would be “abandoning” children are not only inaccurate; they risk frightening families and undermining trust in an institution that has long served this community with care and commitment.
As a father and a grandfather, I understand the emotional instinct to want every possible service close to home. My own children were hospitalized when they were young. Each began their road back to health in a local hospital, and each was transferred when they needed more specialized care. Those transfers were stressful and inconvenient—but they were unquestionably the right choice for their wellbeing. The best care is not always the closest care, and it is rarely the care we cling to simply because it is familiar.
At its core, Rutland Regional’s proposal was grounded in data, practicality and a commitment to high-quality pediatric care. It sought to use limited resources wisely, not to diminish responsibility but to strengthen outcomes for children and families.
This moment also highlights the need for greater clarity around how the Green Mountain Care Board and the Agency of Human Services will coordinate their roles as health care continues to evolve. Act 68 grants both entities meaningful authority, and clearer alignment would help ensure that hospitals and communities are not caught between overlapping processes at a time when decisiveness and collaboration are essential.
Change in health care is never easy. It invites anxiety, disagreement and sometimes misunderstanding. Yet progress depends on the willingness of institutions—and communities—to engage thoughtfully with hard realities and to keep patient well-being at the center of every decision.
If we want Rutland Regional Medical Center to remain strong, resilient and responsive for decades to come, we must allow it to evolve. That means supporting evidence-based decisions, encouraging constructive dialogue and resisting the pull of fear when change feels uncomfortable. Done well, transformation does not weaken a hospital. It ensures that it remains a trusted cornerstone of care prepared to serve Vermont families now and for generations to come.
