Gifford cuts chiropractic care over concerns over healthcare reform

This story by Clare Shanahan first published Nov. 13 on Valley News.

RANDOLPH — Victoria Davis has been a patient of Sharon Health Center for more than 20 years, even choosing to drive about an hour from Piermont to Sharon to continue receiving care after leaving Vermont.

On Nov. 7, Davis received a call from Sharon Health Center informing him that this week’s chiropractic appointment was canceled and that Randoph-based Gifford Health Care, the network to which the Sharon center belongs, had discontinued chiropractic services.

“They abandoned me, and I’m abandoning them,” Davis said of Gifford. “I was willing to drive from Piermont. “The road is long, but the people there are so nice.”

Gifford officials have decided to discontinue chiropractic services and urogynecology services effective Nov. 7, effective immediately.

That day, Gifford announced her decision to three providers at those services (two chiropractors and a urogynecologist), terminated the providers, and began contacting patients who had appointments.

“We discussed this with our providers that day and felt that given our overall health care situation and financial situation in Vermont, we needed to take immediate action to focus our energy and efforts on our core services,” Gifford CEO Michael Costa said. Tuesday interview.

Costa said the decision to shut down those service lines stemmed from a Sept. 18 consultant report. The report evaluated Gifford’s services and offered recommendations to protect the state’s medical network analyzer. It was ordered by the Green Mountain Nursing Board, or GMCB, under Bill 167 of 2022, which aims to improve Vermont’s healthcare system.

The report recommends that Gifford close its emergency room and convert all inpatient beds into long-term mental health, geriatric psychiatry or memory care units.

Since the report was released, Gifford has alleged that Oliver Wyman, the New York-based consulting firm contracted to publish the report, used inaccurate data to evaluate the volume of care provided to Gifford, according to an Oct. 28 press release. But Costa said the report prompted Gifford to have serious discussions about the types of health care she would provide in the future and how to remain solvent.

Oliver Wyman released his own statement on Oct. 29 justifying the data he chose to use in the report evaluating some health care providers in Vermont.

“OW needed data that included financial information as opposed to exact service volumes. … Volume data identified by some hospitals in recent news releases cannot be relied upon for this analysis because they do not contain financial information,” he said.

Costa said the decision to cut service lines was made “to make sure we are responsible for our own destiny.”

He added that going forward, Gifford does not plan to cut any additional service lines.

“It’s very difficult to be all things to all patients, so we’re trying to make changes so that future advisors and regulators don’t dictate what happens to healthcare in the White River Valley,” Costa said.

Supporting that stance, Costa said that while Gifford did not find Oliver Wyman’s report credible, they did not yet know how the GMCB or other Vermont regulators would use and interpret the information. Therefore, they wanted to prevent possible problems.

Beyond the financial ramifications, Costa said Gifford wanted to announce the closure of the service line before the community forum on Tuesday. At an event held Tuesday night at Vermont State University’s Randolph Central Campus, Costa acknowledged the closure and invited people to share their thoughts.

“It felt like the wrong thing to do to ask people to come out and support Gifford and then cut services a week later,” Costa said.

Nearly 200 people attended the forum, which was held to “discuss the future of Gifford and access to rural health care in the White River Valley,” according to a Gifford news release.

Feedback at the event was extremely positive; community members explained Gifford’s importance in their lives. Most of the speakers were from Randolph, where the network’s hospital, Gifford Medical Center, is located. Many of the participants were born or gave birth at Gifford’s birthing center in Randolph or credited the medical network with saving their lives.

Born in Gifford, Stockbridge, Vt. “Gifford has been a part of my life for all the years I have lived,” resident Beth Dawley said.

Dawley praised the shorter wait times Gifford often provides, especially compared to Dartmouth Health and UVM Medical Center, the region’s largest hospitals with high patient volumes.

“We cannot afford that kind of delay in more ways than one,” Dawley said.

Dawley wasn’t the only community member to highlight the speed of Gifford’s services. Others noted that they were seen in a timely manner when they had to use Gifford’s emergency room, and because they were local, they could access the facility quickly in an emergency.

Robin Goodall, a longtime Randolph resident whose children were born in Gifford, said the hospital saved her life on two separate occasions; The first was in 2010, when he went to the emergency room in Gifford after his legs collapsed. After attending Gifford, he was transferred to Dartmouth Hitchcock Medical Center, where he was diagnosed with the autoimmune disease Guillain-Barre syndrome.

Although she received care at multiple facilities, Goodall said it was her doctor at Gifford who set that care in motion and “got me where I needed to be.”

“If urgent care in central Vermont is restricted in the way this report suggests, there are a lot of people who will not be able to get out of these situations,” Goodall said.

For Jonathan Hines of Braintree, Vt., there’s another notable element of Gifford’s care, and that’s how local it is.

“Nurses are our neighbors, people I know, communicate with, see in the market. When they yell at me for not taking my medication, I listen,” Hines said. “We’re not just numbers on someone’s checklist or anything, we’re people helping each other through tough times.”

In addition to the accessibility and care provided at Gifford’s emergency room, community members spoke of the value of Gifford’s birth center, which is one of two remaining hospital-based birth centers in the Upper Valley. The other is at DHMC.

Emily Lewis said she moved to Randolph in 2020 and gave birth to her son in Gifford in 2021. She and one of “the few people I’ve met other than co-workers” work at the Gifford Medical Center Birth Center.

“I can’t tell you how much it means to me to get to know someone personally when giving birth at Gifford, and that’s one of the great things about this community. … Every time we pass Gifford, my 3-year-old son points at her and says, ‘Mom! That’s where I was born!’ ” said Lewis.

Siobhan Anderson-Judkins, who works at Residence Life on Vermont State University’s Randolph campus, said she “relies heavily on Gifford for the safety of my students.”

“We are extremely fortunate to be close to Gifford, where if a student has a medical condition that is not serious (enough) to need an ambulance, we can take them to Gifford for free and pick them up when they are done with their care,” he said.

Gifford also provided a nurse practitioner who set up an office three days a week at Randolph Union High School, giving students access to medical care they might not otherwise receive, school principal Lisa Manning Floyd said.

Gifford also helps the high school write policies and implement programs to combat nicotine addiction.

“It’s one thing for your manager to stand up and say, ‘You shouldn’t be doing this.’ It’s not healthy.’ It’s one thing for your pediatrician to work with the school to do this,” Manning Floyd said.

The hospital also plays an important role in the community by providing jobs for families and assists the high school in short-term emergencies, Manning Floyd said.

“Without community, neither schools nor hospitals can exist,” Manning Floyd said.

At the forum, Gifford Medical Director Josh White addressed the closure of chiropractic and urogynecology programs and acknowledged they received negative feedback from patients.

“If there is anyone in the audience who has been negatively impacted by our decision to close chiropractic services, I want to acknowledge your pain… I know this has negatively impacted people, and we have a mandate to support the community as a whole, but I do not want to pretend that there are individuals who are not suffering,” White said.

White encouraged anyone affected to contact his office and share their experiences.

No one at the forum expressed concern about the closure.

Patients with scheduled appointments, like Davis, received a call from the medical center informing them of the change. All of Gifford’s chiropractic patients received a letter on Nov. 8 announcing the closure, offering assistance in transferring records to a new provider and sharing a list of chiropractors practicing in the Upper Valley.

Urogynecology patients are transferred to urology or gynecology providers in the Gifford network, Costa said.

Davis was most disappointed in the urgency of the decision and how it would impact providers.

“If people could plan for it, that’s one thing,” he said. “But making these decisions as if they don’t affect people — the doctor or the patients — is really unprofessional and reckless, and I think the medical profession should be about giving care.”

Three terminated providers could not be reached by deadline.

Davis has been with Gifford chiropractor Dr. He was expecting to see Michael Chamberland. He said he plans to travel to continue seeing her if she settles into a new practice in Vermont.

“I haven’t found a chiropractor as good as him, he is amazing,” Davis said.

The Green Mountain Nursing Board and the Vermont Human Services Agency have “tentatively” scheduled a public meeting for Nov. 20 to discuss the report, according to the Vermont Medical Association.