Ever wonder why your blood pressure goes up at the doctor’s office? It’s not too surprising, given that you spend 45 minutes reading year-old magazines in the waiting room, then another 15 minutes sitting on tissue paper in your underwear before your doctor finally drops in to the exam room for no more than five minutes.
Well, guess what? Vermont’s docs aren’t any happier about their time crush than their patients are. At least, that’s one of the major findings in a new report, published June 7, by the Vermont Medical Society Education and Research Foundation. The “2011 Physician Needs Assessment” was put together from interviews with a broad cross-section of Vermont physicians working in a variety of medical disciplines.
Among the report’s key findings: Vermont’s physicians say they don’t have nearly enough time to devote to each patient because more and more time is spent attending to non-medical — i.e., financial, regulatory and administrative — business. In effect, doctors are forced to see more patients than they want to each day just to keep their doors open.
Will Vermont’s recent adoption of a single-payer health care system, the first of its kind in the nation, do anything to address the problem? Too early to tell, suggests Paul Harrington, the Vermont Medical Society’s executive vice president. The new law acknowledges the shortage of primary-care physicians in Vermont — currently at 25, and expected to grow to 63 by 2015. However, because Vermont competes on a national stage for medical professionals, a lot will depend upon the details of how the single-payer system is implemented, particularly in terms of doctors’ reimbursement rates.
One primary care physician quoted in the report describes herself as “a hamster on a wheel just seeing the volume of patients needed to keep lights on. I’m not enjoying work.”
Vermont physicians also express concerns about losing their say in policy making that directly affects their profession. “A theme that resonated throughout the interviews was the fear of physicians losing their traditional role as keepers of their professional ethic,” the report reads. “The biggest threats to this traditional role include government and regulatory policies, increasing professional isolation, and the growing number of physicians making the transition from private independent practice to being employed.”
Finally, physicians say they feel that Vermont’s overall medical workforce is in jeopardy, as shrinking reimbursement rates for patients on government-sponsored plans “threaten the viability of many physician practices.
“The generally lower physician reimbursements found in Vermont,” the report continues, “the downward trending payments for care provided to patients receiving government-sponsored health care and general uncertainty over health care reform have combined to create a difficult financial environment that threatens the viability of many physician practices.”
One medical specialist quoted in the report said he’s decided to relocate to another state because his practice is no longer financially viable in Vermont. He “can’t afford new blood pressures cuffs, let alone the federal requirement to have an electronic medical record. His peers are all signing on as employees of hospitals, but that’s not something he wants to do. He doesn’t want a corporate bottom line determining what care is given.”
Incidentally, all these findings are consistent with what Seven Days reported last week in the story, “Why So Many Independent Vermont Doctors Are Joining Hospitals, Or Closing Up Shop.”
This article appears in Jun 8-14, 2011.
Got something to say?
Send a letter to the editor and we'll publish your feedback in print!
The answer to the question lies in the article itself. The question:”Will Vermont’s recent adoption of a single-payer health care system, the first of its kind in the nation, do anything to address the problem? The answer:”The generally lower physician reimbursements found in Vermont,” the report continues, “the downward trending payments for care provided to patients receiving government-sponsored health care “The lower payments from government sponsored health care are creating an enviornment where physicians are unable to pay the bills. So what does our state legislature do….that’s right add to that. So will it address the problem, not in the least. The legislature wasn’t interested in addressing the problem. They were interested in jumping on the political bandwagon of single payer health care. There was no tort reform, or anything of the sort. No incentive not to take your kid to the ER for a cold, no nothing. They enacted gov’t run health care because they knew that libtards in the state are too clueless to see the forest through the trees and all they had to do was pass a meaningless bill (that isn’t even currently legal under Obamacare) to appease the ignorant masses and hearald the Democrats in the statehouse. Well Played.
“Hello Everybody”Vermont say “hi” to Dr. Nick.
The problem runs much deeper than the doctor side of things. Doctors are having trouble making ends meet, employers are having trouble providing the funding available for health insurance and the gainfully employed are having trouble paying for their share of the premiums and co-pays. If you want to find the real cost of health insurance, talk to Green Mountain Healthcare and see what it would cost to purchase insurance for a family of four (though large employers can purchase it for a bit less). The only ones that seem to be making money with the current system are the insurance companies. The average doctor has 7 staffers working with them. Why? They need half of those because of the complexities in billing and reimbursement from insurance companies. No wonder they are having trouble making money to pay their staff, their mortgages and their student loans.
Awesome. Single payer is being blamed for the current state of Vermont health care system, when it hasn’t even started yet. My understanding is that the forthcoming health care reform for Vermont isn’t even single payer, its a public option called Green Mountain Care.The current environment is a symptom of the health insurance industry. The Medicare and Medicaid reimbursement system is a subsidy for the health insurance industry. It’s a second-class system so of course it doesn’t pay well.
Wait what? The M/M system is a subsidy for the insurance industry? How so? I would argue the opposite. The M/M system pays like 60% of the actual cost of a procedure, physicians then shift those costs onto private insurance patients. So really the private insurance companies are subsidizing M/M.
“Will Vermont’s recent adoption of a single-payer health care system, the first of its kind in the nation, do anything to address the problem?”Vermont adopted a single-payer healthcare system? This is quite a scoop.
“They enacted gov’t run health care because they knew that libtards in the state are too clueless to see the forest through the trees and all they had to do was pass a meaningless bill (that isn’t even currently legal under Obamacare) to appease the ignorant masses and hearald (sic) the Democrats in the statehouse.”J Carter would be a great deal more persuasive if she didn’t call us childish names (libtards) and insult us (the ignorant masses). She should instead spend her time refining her faulty logic. Indeed, single payer isn’t currently legal under the Medical Care Reform Act but it is a fact that Vermont will get a waiver prior to implementing single payer. Physicians today incur significant and unnecessary operating expenses in the need to support a large administrative staff, employ outside billing and collection agencies and engage in ongoing battles with insurance company “Death Panels”. One of the significant advantages of a single payer system is that it enables small practice physicians to be first and foremost doctors! J Carter might be on more solid ground if she adopted a medical care delivery model that followed the current ideology that the Republican dominated House of Representatives believes is the cure for all that ails the nation, “Don’t increase taxes (rates), simply cut expenses”. This is one case where their simplistic sloganeering might prove true.
“it is a fact that Vermont will get a waiver prior to implementing single payer.”You must know something that everyone else doesn’t. Massive Dem sweep of both houses in 2012, perhaps?”Physicians today incur significant and unnecessary operating expenses…”Maybe you can help Shumlin’s team illustrate how cutting this expense will result in higher overall reimbursement rates. No one has even taken a shot at this yet in real numbers, and there’s very likely a reason for that – there’s no way to do it with a straight face. And as this article illustrates, higher reimbursement rates are an absolute prerequisite to even considering a single payer plan in this state.
“time refining her faulty logic. Indeed, single payer isn’t currently legal under the Medical Care Reform Act but it is a fact that Vermont will get a waiver prior to implementing single payer. “Oh this is too good. I have faulty logic, yet in the next sentence there is an admission that in fact ObamaCare specifically makes single payer illegal. And the best part, that it is a “fact” Vermont will get a waiver. I ask, who has the faulty logic? Just way too good and a perfect illustration as to how Sanders get’s re-elected over and over and over and over.
Did someone say doctors are having trouble making ends meet? It’s very hard to feel sorry for doctors. They may work hard and tough hours, but they are highly paid and live well. No sympathy here.
Single Payer in Vermont expands access to healthcare to everyone, however over 90% of Vermonters already have access to care through existing programs or private insurance.The core issue we face is a matter of cost of care, which Single Payer simply does NOT address. Vermont needs to encourage paying for and rewarding quality, not simply paying for procedures.A Single Payer system would likely reimburse providers of care near the current Medicare rates on a fee for service basis, which alone don’t even currently cover the costs of care for most providers without a mix of private payers to subsidize these losses.Healthcare reform in Vermont instead needs to address the issue of price transparency, which would produce an immediate downward pressure on costs. Currently, the largest provider networks here (ie Fletcher Allen) actually have the highest costs.However, smaller providers of high quality care with lower cost structures are unable to actually market their services to attract patients because Fletcher Allen is not required to disclose their fee schedules to patients.For instance, if patients could see that a flu shot costs $400 at Fletcher Allen, while only costing $20 at another clinic, then patients could start behaving like rational consumers in a competitive marketplace.
The biggest red flag on the proposed single payer system is that the legislature, in a truly Orwellian move, made the process secret by law.Do you grasp that? It’s so good and so common sense that deliberations must be secret.
Eric brings up a great point. No one knows what a procedure costs until after the fact, and then the hospitals only give you an itemized bill upon request. They do not tell you up front and even if you ask they can’t answer you. A transparent upfront cost would help let people shop for services. However, in all the talks about health care I have yet to hear anyone simply acknowledge the elephant in the room. Technology… the plain and simple fact is health care is more expensive because we aren’t using the same techniques that were used 20 years ago. The fact of the matter is an MRI machine costs alot, ergo an MRI is expensive. 20 years ago no such thing existed. My daughter had an illness that could not be diagnosed, $50,000 later they screened her genome for genetic abnormalities. If everyone wants to cut costs, then by all means, go back to the days where they gave you a shot of whiskey and a stick to bite down on. But I prefer to have first class health care, even if it costs more.
“So really the private insurance companies are subsidizing M/M.”You may be too young to know what health insurance is. The word’s definition has been corrupted over the years.Insurance tries to absorb the risk and expense across a large population of individuals who pay into the system. Unfortunately, Medicaid and Medicare get those who can’t afford it and also have conditions the insurance doesn’t want to cover. Think cherry picking.
@JCarter – where on earth do you get your information? Costs for technologies have gone down considerably, but in the US we pay out amounts that are literally out of control thanks to what’s known as ‘deregulation’ and the Insurance industry lobbyists.@Slim – This may be true of specialists, but not for family and general practice doctors. Otherwise – why would family and general practice doctors be closing offices and moving out of state if they were well paid?Two infographics show several of the issues by comparing the US to the world at:http://www.medicalbillingandcoding.org/medical-costs-1/http://www.medicalbillingandcoding.org/medicals-costs-2/It's also interesting how taxpayer money subsidizes the pharmaceutical industry’s creation of drugs, but we also pay more than any other country for using them. Double dipping anyone?
Mel, You are correct in that an x-ray from 20 years ago is less today. You are wrong in that is simply costs more. As I stated and I gave a perfect example. I had my daughters GENOME screened. It cost over $50,000 for that test. 20 years ago that wasn’t even possible, there was no test for that type of thing and I doubt there was a single diagnostic test that cost anywhere close to that. We have new technologies, we have new diagnostic tests, they cost more then out dated tests. It’s not really a difficult concept. But you can have the rectal thermometer that costs $2 I will use the $30 temple one. On a side note, if they actually went back to that I think you would see a huge decrease in ER visits for a cold.