Traits that are increasingly rare in American medicine are alive and well at Gifford Medical Center, U.S. Sen. Bernie Sanders told a dozen administrators and physicians gathered in the hospital conference room last Thursday. That fact, he said, has helped Gifford become certified for a designation that will free up hundreds of thousands of federal dollars for the medical center.
The positive traits, Sanders said, include:
• Easy access to primary care providers;
• An emergency room that treats mostly emergencies, not people who belong in doctors’ offices or the hospital;
• Innovative and humane end-of-life care;
• Active involvement with the community, on many levels.
Sen. Sanders takes an active interest in such issues as chair of the Senate Subcommittee on Primary Health and Aging. A month ago he notified Gifford that it is now a “Federally Qualified Health Center” or FQHC.
The designation brings substantial new re- sources, starting with an $812,000 grant and later to be supplemented by higher reimbursement rates for Medicaid patients.
Sanders’ quickly-arranged meeting Thursday with Gifford personnel seemed to be his way of emphasizing the sort of health care that is envisioned for a FQHC. The Senator seemed pleased at the answers to his questions from Gifford Administrator Joe Woodin and others.
Also impressed was the staff director for the Senate subcommittee, Sophie Kasimow, who was traveling with the senator.
“We’re excited at what you’re doing,” Kasimow said at the end of the hour-long meeting.
‘Ahead of the Curve’
Sanders noted that though he was impressed, he was not surprised. Gifford, he said, “has always been a little bit ahead of the curve” when it comes to community-based medicine.
Specifically, he recalled the days in the 1970s when Dr. Thurmond Knight and others created the first “birthing room” in Vermont, as well as the early acceptance of acupuncture as an appropriate treatment in some cases.
At the present time, Woodin told the senator, Gifford is offering “great access to primary care,” unlike many urban hospitals. That means that when someone gets sick, they can find a family doctor to go to, rather than lining up at the emergency room.
Those who do come to the ER are likely to need it—in fact 22% of them end up being hospitalized, according to Medical Director Josh Plavin. That statistic elicited a “Wow!” from the senator.
“You know your patients, and that makes all the difference in the world,” he said.
Gifford representatives told Sanders they were thrilled at the important new responsibilities the hospital will take on as a result of designation as an FQHC. Most importantly, these will include subsidized dental care and more psychiatric care.
“We are so pleased to sign up for these services, Woodin said. “This is a very unique opportunity. These are services that need to be provided.”
Patients at the hospital often need mental health care as well, Dr. Plavin said. “We just need to take care of our patients.”
With the new FQHC designation, Gifford will likely hire a psychiatrist and enter a new cooperative relationship with the Clara Martin Center, he said.
As for dental care, “a number of dentists are interested in working with us,” he said.
Sen. Sanders also asked about Gifford’s approach to obesity and smoking cessation programs.
“We do some, but we really could do a lot more,” said Dr. Plavin.
Sanders urged coordination with the schools, Vermont Tech, and other community groups.
Later, as a speaker at the Randolph Rotary Club, Woodin expanded on some of the same topics.
In particular, he said, access to primary care has increasingly become an “urgent need” in medicine.
“It’s a continuing problem in America,” he said. “The numbers are ging the wrong way.”
He noted that the new FQHC designation will also help recruit primary care physicians by giving assistance with their medical school debts. These can reach $200,000 or even $250,000, Woodin noted.