Primary Care Shortage Looms In Rural Vermont

Dec 4, 2013

The state of Vermont is facing a shortage of primary care physicians, and it’s a problem that could get worse as more people access health care insurance.

One aim of the Affordable Health Care Act and Vermont’s new marketplace, Health Connect, is to insure more Vermonters. And surveys suggest that Vermont has an adequate supply of physicians per capita. But they are not evenly distributed throughout the state, and many are specialists, not primary care doctors.  So Paul Bengtson, CEO of Northern Vermont Regional Hospital in St. Johnsbury, is worried.

“My initial answer is no, there won’t be enough primary physicians and primary provides to fill the gap as quickly as it will need to be filled,” Bengtson said. 

Bengtson says recruiting family doctors—especially young ones--to rural areas is tough, even though there is some groundbreaking medical care going on there.   Tom Broderick, Medical Director at Corner Medical in Lyndon, a family practice affiliated with NVRH, knows first- hand how hard it can be to lure doctors to the Northeast Kingdom.

“Well, we haven’t taken any new patients in three years, just because we don’t have the manpower, as our patients are aging and getting more complicated and sicker, to do the sort of medicine we want to do and keep bringing people into the fold.”

And they are not alone.  According to a 2012 survey conducted by the VT Area Health Education Center, one half of  Vermont’s primary care physicians and two-thirds of internists either  limited or closed their practices to new patients in 2012.  And  a survey by the state’s Department of Health in 2010, shows that in half of Vermont’s counties, about a quarter of primary care physicians are over the age of 60. At Lyndon’s Corner Medical two recent hires are doctors already near retirement age.

One is Joe Hebert, who spends part of each winter in Arizona.

“I call myself semi-retired,” he said.

John Scott, another relatively new addition to the staff, figures he will retire in 10 years, and he sees no young doctors ready to take his patients.

“I think it’s going to be very serious,” Scott said about the statewide shortage.

Scott thinks the best solution is to help medical students who want to be family doctors pay off loans so they don’t have to go into more lucrative specialties to stay afloat after graduation.  That kind of assistance is available at UVM’s College of Medicine, and also from the federal government, but those resources are limited, and aren’t a quick fix. So Scott is worried about the next five to six years.

“I think that there are a lot of people that are going to have insurance that are still going to end up in emergency rooms because they aren’t going to have access to primary care,” Scott said.

The Bi-State Primary Care Association is stepping up recruitment efforts. The state of Vermont is also trying to boost health care workforce development. David Reynolds, who until his recent semi-retirement was Deputy Director of Health Care Reform Policy in the Shumlin administration, says he thinks a single payer system would make Vermont more attractive to primary care providers.

“It’s a simplified system, one payer, paying equitable rates, I think we’ll have something that will draw people here because they can practice medicine, not money,” Reynolds said.

But where the money will come from to create a universal health care system is still a big question. Meanwhile, the primary doctor shortage is getting worse not better, in rural Vermont.