CHELSEA, Vt. (WCAX) – A primary care doctor in Chelsea was recently fired. Now, the small town is facing a new reality at its local health clinic. Our Laura Ullman investigates why a primary care doctor was let go in the middle of a shortage, and what it means for the future of primary care in rural Vermont.
“I probably am jumping at something because it’s new and I don’t like change,” Will Gilman said.
Gilman has been a patient at the Chelsea Health Center his whole life. He’s concerned about all the staffing changes at the health center, where his primary care doctor, Laura Barber, was recently let go.
“Something about going from an MD down when you had an MD here for seven years. Seemed like a step backwards to me,” Gilman said.
Now, Gifford’s Chelsea Health Center is staffed with a physician assistant and a temporary nurse practitioner who comes in two days a week.
A good deal of the Chelsea community is upset. Gilman put a petition in his store downtown.
“Within 12 days, we had 189 people that signed it. And I had numerous emails thanking me for doing this,” Gilman said.
Gifford sent a letter to Barber’s patients telling them to call different Gifford clinics to book an appointment with a new doctor. Gilman said he called every single doctor’s office. None were taking new patients– maybe he could get on a waitlist but the primary care doctor shortage in rural Vermont is getting worse. Gifford’s primary care doctors in Bethel and Rochester both recently retired.
“I’ve had multiple patients before I finished Chelsea come in and say, ‘What am I going to do? I have a cold called, I cannot get an appointment anywhere.’ And all I could say was, ‘I don’t know,’” Dr. Barber said.
Gifford says the decision to let Barber go was about time and money.
“If productivity at a clinic drops so low as to not meet financial metrics where we can keep it open, they lose the whole clinic,” said Josh White of Gifford Health.
Almost every health organization has productivity measures– standards of how many patients are seen in a given time frame. The intention is to get as many patients seen as possible while also having as much money come into the system as possible. White says Barber was not meeting these guidelines. Barber contends that everyone she called would get an appointment scheduled in due time.
So who’s next for the Chelsea health clinic?
“It will be whomever is interested. We would get an appropriate, qualified individual regardless of their credentials,” White said.
White says hiring doctors is difficult because primary care is not a flashy specialty. It’s highly regulated, it doesn’t pay well and it’s hard to attract and keep doctors in rural areas. And White says nurse practitioners and physician assistants can do most everything a doctor can do, and sometimes they’re just a better fit for the job.
“There are a lot of NPs and PAs that are highly qualified and do an excellent job and on a case-by-case basis, you’ll find NPs and PAs that are stronger than physicians,” White said.
Gilman says he’s concerned about how the change will affect him and his community.
“My personal situation is complicated and it’s nice to see a doctor who’s had more experiences, who may have seen more of these cases. There aren’t a lot of quadriplegics around in small towns,” Gilman said.
While Chelsea may have lost Dr. Barber in the Gifford clinic, she says she soon will be working for another primary care provider in the area.