Comments

You must log in or register to comment.

amoebashephard t1_jaaf1n9 wrote

Maybe if the hospitals invested in doctors instead of administrative staff it'd be a different story.

44

contrary-contrarian t1_jaag4w3 wrote

And if Vermont kept up with national wages. And if the US fixed it's broken healthcare system that pays billions to health insurance companies to act as useless middlemen that stand between patients and their providers for no reason other than a cash grab.

45

pachucatruth t1_jaaluof wrote

And if the government invested more into social programs so that results-based reimbursement was more effective in places like VT.

17

xxxDog_Fucker_69xxx t1_jacdo8j wrote

The issue when you conflate health care with business. The UVM buyouts we’re disastrous and accomplished nothing but make a practical monopoly for 150 miles.

Admins are great at business, but when it comes to healthcare my supervisors have absolutely no fucking idea what my coworkers and I even do.

They asked me what I do when actively responding to emergency situations (I carry a pager for work) they then audited my time sheet when they saw I was clocked in for 14 hours straight. Had to get a note from medical staff saying how long we were in the room.

Even more shocking is the admins have known were chronically short staffed in many fields of surgery and chose to continue paying significantly under market rate and continue to badger staff not to take raises or even ask for them. Ultimately this created a mass exodus and many became Travelers. Some teams are over 89% travelers and have had less than desirable outcomes when it comes to healthcare and general day to day operations.

The disconnect is so extreme I could talk about it for hours. I’m so glad UVM is buckling under the weight of its own financial incompetence. And to every travel nurse that comes in and makes $50k more than full time staff, I salute you and hope you take every penny from this morally bankrupt hospital.

9

HappilyhiketheHump t1_jaci9id wrote

Your legislators are mostly responsible for this debacle. While the hospital administrators have clearly had a hand in screwing this up, they did so at the direction and mandate of our legislature.

4

Dire88 t1_jaaq2ql wrote

What doctors?

People don't realize how bad it is right now. Vacancies for specialists at rural hospitals can take over 4 years to recruit for in good times.

In the post-COVID market? Even if you could find them, you'll pay double the pre-COVID rates. How sustainable is it for a dinky rural hospital to pay $400-$500/hr for a Gastroenterologist?

6

pm-me-egg-noods t1_jaa07j4 wrote

Can't get in with dermatology anywhere. Really, really need a dermatologist. Could be worse but not fun.

42

Full_Whereas_2694 t1_jaa2zvq wrote

My dermatologist was a 6 month wait. If I had chosen the Middlebury office I was an 18 month wait.

10

BudsKind802 t1_jaa8hrb wrote

My appointment with dermatology was made last February, and my appointment isn't until July. UVMMC is worthless for specialists unless you have something that can wait a long time, like my potential skin cancer

19

21stCenturyJanes t1_jaaz680 wrote

That sucks. Dermatology is definitely a problem here. I don't like my dermatologist - I'm not sure she's a good doctor - but I don't have anywhere else to go so I stay with her.

You can have your GP do a skin cancer check and if they see something they might get you into a specialist faster.

12

lantonas t1_jabj73b wrote

How dare you question your doctor? She went to college and got a degree! She is an expert!

−1

amoebashephard t1_jace9hl wrote

Lol.

College, medical school, residency. 12 years at least, 14 or 15 for some specialties. Thousands of hours of clinical time

6

aprilmoonflower t1_jaeu2fj wrote

And ironically this still doesn’t guarantee a good dr who also isn’t burnt out.

4

ResponsibleExcuse727 t1_jacipfn wrote

I feel like this isn’t so to staffing. Took about 8 months in like 2018 for me to get into a dermatologist. I believe for specialized things like that we just do not have many practices.

3

BrittaVT t1_jaf2q4g wrote

Yup, waiting in Middlebury. Where did you end up going?

1

redfieldp t1_jaaniol wrote

I would suggest calling and discussing your issue if it’s truly urgent. I had a six month wait for an annual skin check, but when I saw something that looked suspiciously pre-cancerous, I got an early appointment just to address that. This probably doesn’t cover you if it’s something more aesthetic or non-fatal, but worth mentioning

6

pm-me-egg-noods t1_jaev338 wrote

It's just a rash. If it were a mole I would raise hell. Thank you for letting me know they have options for really emergent things.

3

author124 t1_jab7k9c wrote

Try Four Seasons Dermatology, they're booking really far out right now but they have an online booking system and you can check for available appointments every day. I was originally scheduled for June and managed to find an available appointment last week.

Edit: woops thought this was the Burlington subreddit. Depends on where you are, but they have several locations. skinvt.com

6

pm-me-egg-noods t1_jaeus3p wrote

I'd drive to Burlington for this, can always toss in a Costco trip as well. Thanks for the tip!

1

airhogg t1_jaawgv9 wrote

I had a 6 month wait. They did have an option if you needed a mole check sooner if you thought one was super serious

3

pm-me-egg-noods t1_jaeuhd6 wrote

Yeah fortunately it's not something like that, just an annoying rash. Glad they have some sort of emergency provision though. Skin cancer metastasizes so fast!

2

theunbearablebowler t1_jaacie4 wrote

I work in medicine making referrals to different community health practitioners.

How are we getting by? Not well. In fact, I'd say we're barely getting by at all.

41

jocotenango t1_jab55tj wrote

I’m an ER nurse and part of the reason our waiting times are so long right now is because people are coming to us instead of waiting months and months to get an appointment somewhere. I can’t blame them: most have little health literacy and are genuinely scared something is really wrong with them. I discharge multiple people a day who I tell to follow up with their primary care within a week, and they say they already have an appointment but it’s 1-4 months from now. The whole system is really broken which is only making more and more healthcare workers leave the profession, snowballing the decline. Honestly I don’t see it getting better at any point in the near future. That being said, for those of you who are having to wait months for an appointment at a specialist or even your primary care, don’t be afraid to be the squeaky wheel. Call once a week to see if there are cancellations and whether you can get in any sooner.

ETA: the ER is a place that diagnoses and tests conditions that are emergent and life threatening. If your symptoms have been happening for days, weeks, or months, and are not progressing quickly, please try to make an appointment with your primary provider or go to an urgent care. You will be waiting in the waiting room of an ER for hours and you most likely won’t get the answers you’re hoping for.

31

Trajikbpm t1_jadfuqq wrote

It doesn't help PCPs here also don't do shit for anyone. You'll wait all that time for them to roll their eyes and send you on your way. I've gotten more results in urgent care.

My PCP ignored me for two years till I finally snapped and forced tests and found out I had stenosis so bad they want me on disability.

3

HappilyhiketheHump t1_jaamp4k wrote

Call the green mountain care board and your legislators. They took a stressed system, turned it into a state sanctioned monopoly, and then really fucked us all over with their grand financial experiment.

Now the insurers are bailing on the legislatures little monopoly and the the workers are fed up with forced overtime and shit pay. Prices are skyrocketing as inflation bites and our leaders have their thumbs up their asses.

So…FUCK YOU LEGISLATURE AND UVMMC ADMINISTERS!!!

28

coopaliscious t1_jac6aeu wrote

This should be the top comment. Letting UVMMC buy up everything eliminated choice, competition and reduced headcount of providers.

4

[deleted] t1_ja9zcsw wrote

I have been commuting an hour+ over the border to DHMC. The commute sucks, especially in the winter, but I am at least getting the treatments I need in a more timely fashion.

24

pm-me-egg-noods t1_jaa0539 wrote

I can't even get in at DHMC in a timely fashion, though it's gotten better in recent months.

12

ADinosaurNamedBex t1_jaam1up wrote

If you can swing it, DMHC has a program with the local hotels that allow you to get discount hotel rooms in the area. Made the early morning appointments there way more manageable.

11

OiWhatTheHeck t1_jaa0epj wrote

Getting my cancer treatment out of state.

22

Various-Chipmunk-165 t1_jaalfkm wrote

Currently pregnant and see a different OB every appointment at DHMC. I guess this is the norm now? But there’s absolutely zero continuity of care, and I often feel pretty rushed.

17

21stCenturyJanes t1_jaazfrm wrote

Isn't that standard practice for OB's though? Since you don't know who will be on call when you deliver, you'll have had a chance to meet all the doctors.

8

_hrodney t1_jabqiz5 wrote

At least a few years ago, DHMC has different OB teams (pods?) named after colors, and every pregnant person was assigned to one. And each team would have four (?) OBs, and you could request to meet each one if you wanted but at least I had most of my prenatal appointments with the same person and only met the others once.

6

internetmeme t1_jac8ddo wrote

I’m in TX but no you typically see the same doctor at all of your appointments throughout the entire pregnancy and then hopefully they can be on call or working when it is delivered, but in our case for our 2 kids it was someone else that delivered it. It’s all a package deal. Maybe this place you are referencing has an atypical arrangement?

1

21stCenturyJanes t1_jachjiu wrote

No, seeing all the providers to ensure you've met the one who ultimately delivers is pretty typical in my experience but obviously it's not universal. It makes sense though, you don't want someone you've never seen before to be delivering your baby, right?

2

internetmeme t1_jachuff wrote

I don’t know what your experience is in the labor room but the important relationship is the nurse that will be with you for the 2-12 hours before the delivery. The doctor comes in for 5 minutes, delivers the baby, and is gone. We had a great nurse for one child and an okay nurse for another. So I didn’t see the relationship with the doctor as that important in the delivery.

1

tunanoodle14 t1_jaclx5m wrote

I just had a baby at UVMMC and my midwife was with me for my entire labor

1

FunkyOldMayo t1_jaafkxa wrote

I got diagnosed with a rare neurological disease back in November, I was in the hospital for about a month, and discharged just before Christmas.

I was supposed to have, and was scheduled to have, a neurology checkup every other week.

I’m going for my first follow-up tomorrow.

So, overall, not well.

Edit for clarity:my appointments we continually pushed or cancelled due to lack of providers.

15

Jerry_Williams69 t1_jaauunw wrote

This is the case everywhere. COVID and the idiot politics that came with it put a few more nails in the healthcare coffin and then set it on fire. Believe it or not, I have an easier time getting neurology care at UVM than I did back in Michigan. I think this is the exception and not the norm.

Big part of the problem is housing. Doctors and nurses can't find places to live, so they don't put down roots. Other big part is that doctors and nurses get low-ball pay here. UVMMC is fascinated with being "competitive for the region". Fuck that. Want to fix it? Set the bar for the region. They could give all their nurses $5-$10/hr raises and would still pay significantly less than they do now for travelers/contract workers.

14

jerassica t1_jab3d5y wrote

UVMMC could give all of their nurses a $5/hr raise and still pay far less than other Vermont hospitals…. Soooo, not surprised there. That’s the trend in most academic hospitals though. You “get” to work there…. Which is total BS.

And totally agree- this is the problem everywhere. Same issues in Florida, Texas, all over the country…

I’m an ER nurse, though left the field last year after enduring yet another attempt at assault by a patient for the umpteenth time while 22 weeks pregnant. I still work in nursing, but do not provide direct patient care. I know everyone is frustrated with the healthcare system, but know that your providers are just as frustrated. Try not to take it out on them. :)

13

Jerry_Williams69 t1_jab3rp9 wrote

Oh I will never take it out on the workers. I have inside eyes. I'm married to an OR nurse. I don't get why UVMMC is lowballing permanent staff, but doesn't flinch when paying their army of travel nurses $3000-$5000 per week each.

9

whaletacochamp t1_jaal9u3 wrote

Every job in every sector is understaffed. It’s the new reality we live in. Not entirely sure what everyone is doing….

13

Loudergood t1_jaasp8z wrote

Boomers finally retired.

13

whaletacochamp t1_jaauhbh wrote

Not wrong. My department was staffed by the same people for 40 years. They all retired at once and now we have a bunch of younger folks who aren’t as eager to settle into one job for the rest of their productive lives. Can’t blame em.

10

Loudergood t1_jaax7co wrote

When job hopping gets you 10x the raise it's a no brainer.

8

valuemeal2 t1_jabp14h wrote

Boomers retired and over a million people died of covid

6

thelasagna t1_jacaejg wrote

And even more are disabled from long covid, or having to care for someone disabled, etc. and I think a lot of people during the pandemic realized that life was too short to tolerate shitty jobs

5

whaletacochamp t1_jachbwr wrote

You’re not wrong. And the rest of us can’t stay physically or mentally healthy enough to work.

3

SilverKelpie t1_jaa5qd5 wrote

Fine with everything except dentistry. Going to New Hampshire and Massachusetts for dentists.

12

Careful_Square1742 t1_jaa7hsf wrote

really? I got a colonoscopy in 4 weeks and a derm appointment in 5 weeks. in chittenden county

dental is tougher but I've had the same dentist for 8 years. I schedule my cleanings 6 months out and get the day and time I want every time

11

tiddymctitface t1_jaaa91g wrote

We drive to Boston to see an endocrinologist

11

oldbeardedtech t1_jac77k3 wrote

Links to these types of threads should be top responses to any "moving to VT" posts. It's bad everywhere, but we're exceptionally bad and this is an important factor to some.

I was told 18 months to get in with an allergist in S Burlington and got in to Dartmouth in 6 weeks.

System was broken prior to covid and then got exponentially worse

11

The_Observer_Effect t1_jacjf5r wrote

**We have real estate agents in Southern Vermont making posts, really, of smiling near-dancing public brags about their amazing profits lately --- on the same page as talk of families losing their homes because of this quickly, artificially/externally fed, widening wealth gap. And people, now realizing their kids may never own houses in the towns they were born, are starting to say some pretty dark things 😞 Well, it's a tricky time everywhere.

-- Say: Human population went from around 4 billion to 8 billion in less than a lifetime. How much of this ALL is ultimately symptoms of that?

3

zisnotabird t1_jaa8iqs wrote

I’ll soon be learning how long a wait it is to see a psychiatrist for evaluations 🥲 Had to wait 3 months for an optometrist even when I told them I was having sudden vision changes.

10

No-Ganache7168 t1_jabcleo wrote

My teen was suffering from an ED and had to drop out of school last year and it took 2 months to find her a counselor with help from her pcp who treated her in the meantime. No one was taking new patients. The one who finally took her did not specialize in ED. We called every mental health provider who does specialize within driving distance and none were taking new patients.

9

casewood123 t1_jaaim4t wrote

Hoping that I don’t have a catastrophic medical event.

8

DocTentacles t1_jaannqm wrote

Been waiting over a week for a doctor to sign off on a medication I've been taking for years. Ran out half a week ago. They say it's been "top priority" the past three times I've called.

8

DernKala1975 t1_jaaqafc wrote

It’s not just VT of it makes you feel better. Exact same situation in western Mass.

8

OkVeterinarian219 t1_jacdala wrote

There is a walk in dermatology clinic in St Albans on Wednesdays from 9-12. First come first serve. Show up around 8:30am to put name on sign up sheet and they call you into the office as your turn comes up. I went a few weeks ago and was in and out by 10:00am. Excellent experience.

7

BrittaVT t1_jaf48kq wrote

Thanks for this! Their name & address?

1

greenmountaintop t1_jab9bgb wrote

My gastro doc dropped me. Was considered a new patient as I had not been in in the last year. Not taking new patients. Ridiculous! Now looking for a new one. Got referral to Dartmouth , but nobody calls back. This is why I end up in the ER.

6

illusivealchemist t1_jadnq55 wrote

Yeah i see gastro at dhmc and i can tell you they are fucking booked. It took me a year to get an endoscopy scheduled and another year and a half to get more testing. It’s fucking n u t s.

1

pijpnord t1_jaa6krl wrote

About 6 months on specialists if not emergency. PCP is 3.5-4 months.

5

landodk t1_jaa8zpt wrote

My son’s pediatric office just doesn’t have a full time secretary. Getting through is a luck thing

5

papercranium t1_jacfipq wrote

I get really good primary care, but only because I qualify for a special program through my employer. It's one of the reasons I won't leave, even though I've had offers with better pay.

I had to go to DHMC to check on a heart murmur (everything's fine), and by the time they could get me in for an ECG, my insurance's approval for the procedure had expired. My PCP chewed them a new one and got it covered, but seriously?

5

Dangerous_Mention_15 t1_jacvp65 wrote

It's really bad.

The area hospitals have the physical capacity to take care of patients (beds, equipment) but inadequate staffing and are unable to hire sufficient full-time staff (physicians, nurses, etc.). The common problem is lack of housing that is affordable with respect to the relevant salaries.

Many hospitals are rationing who they accept in transfer (and likely skirting EMTLA requirements) and patients are frequently boarding in hospitals where they are at or exceeding the level of care at that hospital can provide. Prior to Covid, these patients would generally be transferred in a timely manner. At this stage, many patients are receiving somewhat sub optimal care at they aren't be transferred to larger hospitals to have the appropriate specialists to take care of their condition.

To give an example, let's say you have a full-time RN position paying $80,000 per year, this will allow that individual to purchase a house at 3X-4X gross income -> $240,000-$320,000. Understandably, it is exceedingly difficult to find a house within a reasonable commute and in a decent community from the UVM medical center. As such, there are over 490 open nursing positions at UVM medical center. People go where they are wanted, and these nurses are largely taking jobs in other communities where they can have a more viable lifestyle.

Additionally, the green mountain care board provides another regulatory layer with increased overhead expenses and the UVM Medical Center has a near monopoly of care for much of Vermont. As such, Vermont has the fifth highest health costs per capita in the country (despite being relatively healthy otherwise) and difficulty in accessing health care. For instance, obtaining an MRI brain in the Burlington area via UVM Medical Center will cost 4X – 5X the cost of an MRI brain and an imaging center in the neighboring state.

5

smokeythemechanic t1_jaddlwd wrote

I'm still baffled how every single field is now so short staffed in a post-covid world. Like where did all the workers go?

5

Otto-Korrect t1_jaaqy38 wrote

No family doctors any where around here. Best you can do is an NP, and even they are tough to get time with.

4

SocialEmotional t1_jac1sir wrote

It's exhausting. Especially when you need help for mental health or have a child you need evaluated for autism. We just keep hearing "sorry, waitlists"

4

Hanginon t1_jab4imx wrote

My doctor retired over a year ago and I still haven't found a new one. -_-

3

Automatic_Plant2277 t1_jabv9jk wrote

I babaysit a girl who has to to all the way to NYC to see a doctor. I have also thought about flying to Mexico and seeing a doctor because this shit is fucking crazy. I’m from the west and was able to see a doctor within the week but after moving here I’m so frustrated with the medical community. I also think my doc is racist and I have to change but how can I if there isn’t any doctors taking new patients. Also if I do get a miracle, what will happen if my next doctor is also racist????

3

illusivealchemist t1_jadnj8x wrote

I have gone to mx before for care and it was wonderful. But how fucked up is it that we have to consider this? Our medical people are burnt out - my family in the medical field are so toasted and have lost a lot of patience, which is not good for anyone. The hopsital group my doctor sibling works for is the devil, so that doesn’t help. :/ and all the nurses i talk to, as i’ve met a lot of the ones that are travel nurses for cvmc/psych hospital here, say they make fair wages only by traveling. My mother is a nurse who traveled before and during the pandemic around the new england area and says more nurses are doing that, resulting in a failure for local people to be retained bc the prospective money elsewhere is greater, esp seeing contracts are like, 13 weeks or so. Something has to change for all workers in the country, including medical staff. It’s bad.

Also, i am sorry about your racist doctor! What hospital group are they associated with - uvm or dhmc?

2

nolyfe27 t1_jac6gbt wrote

I go to the open health clinic when I have no other option. It isn't just for migrant workers. Anybody can go

3

illusivealchemist t1_jadmfzs wrote

My friend goes there (she is waiting for her new job benes to start) and says it’s excellent care actually

1

CanVast5274 t1_jacaqln wrote

Well I’ve just waited two years for my appt to test me for ASD. Multiple hospitals had a year long waitlist that extended to 2. I’ve finally got in now into Dartmouth.

3

texmarie t1_jacc6dx wrote

Pretty bad. I don’t have the energy to go into my specific things, because it’s pretty similar to everyone else here, so I just want to add that everyone I interact with at CVMC treats me like they expect me to start yelling at them. So I think it’s pretty rough for the frontliners too.

3

hotpieismyking t1_jacg1o3 wrote

I've been going to the VA for 10+ years .. im practically an expert at waiting for medical services

3

No-Tomorrow1576 t1_jabmvq3 wrote

I made an appt with a neurologist last summer and was told it would be a year before I could get in, I was put on a cancellation list so I was seen sooner, it was telehealth

2

thelasagna t1_jaca35m wrote

I’ve been commuting out of state for my care - it’s not ideal in any way but it’s better than the long waits.

2

mel5915 t1_jadttqw wrote

No PCP’s accepting new patients at any of the hospitals or major medical centers. This is crazy

2

NobodySpecific t1_jae1sn9 wrote

I scheduled an appointment with a new primary care in January 2022. I was forced to do that after my previous practice decided I was no longer a patient of theirs for reasons I don't understand.

The appointment booked in January 2022 was for October 20th, 2022. On or about October 1st, I was told that new appointment was cancelled and I couldn't reschedule. I've been trying to see a doctor since 2021 for major depression related issues.

I've now given up trying to get a new primary care doctor, and it seems nobody at UVM will take patients without a referral from a primary care doctor, so no luck there.

I'll continue to get by without help because it appears that's the only option. I have insurance and an HSA, so money isn't an issue.

2

ElmoNeedsAmmo t1_jadsfo8 wrote

It took a surprisingly quick 3 month wait to get set up with a GP, had a 15 minute appointment where I barely was able to address 1 of my 3 major heath problems, and came out of it without a concrete treatment plan. Now it's been a month of phone tag following up, still no action. And I am expecting to get "why did you wait so long to get all of this looked at", "why didn't you tell us" next time I go in there.

I would love medical care. I would love to not just suck it up and suffer every day. I just don't know what I can even do at this point. I try to be kind and thoughtful and understanding of what's going on in their world, but I guess you have to get assertive at some point or something? It's not in my nature to be aggressive like that and they're already going through enough, but I don't feel I have a choice.

1

EscapedAlcatraz t1_jaal8t9 wrote

Does everyone still want us to build more housing here in Vermont?

Didn't think so.

−16

kosmonautinVT t1_jaazf09 wrote

Yeah, we don't need housing for any more doctors or nurses

7