Waiting Pains: Why it can take months to see a specialist at UVM

Published: Apr. 17, 2019 at 2:12 PM EDT
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Wait times for patients to see medical specialists at Vermont's largest hospital network can take months, according to some patients we've heard from. A Green Mountain Care Board report in 2017 found that 37 specialties weren't meeting access standards. So what progress has been made since then?

While it's easy to get a fast appointment for most emergency procedures -- like having a dermatologist examine a potentially cancerous mole -- other wait times can be lengthy. If you're a teenager who needs acne treatment you might have to wait six months. Still, for other ailments, even non-emergencies can be serious hardships for patients.

"I was hard-pressed to get out of bed and make it five steps to the bathroom at first," said Richard Knight. The North Ferrisburgh man says he's been in pain every day since October. His feet hurt -- badly. His primary care doctor wasn't sure what it is and couldn't help him, so Knight was told he needed to see a rheumatologist, but it took four months to see a specialist.

"I got a letter that said I had an appointment for April 15," Knight said. "Very frustrating. I can't work right now. I've been out of work for months and no income to help with anything."

Knight's story isn't unique. We've heard from others who say their appointments to see specialists within the UVM Health Network were booked months out. A similar story to what we heard last year.

"We're in a better place than we were, but there's absolutely room to go," said Dr. Jim Ulager, a primary care doctor and head of the UVM Medical Center task force looking at wait times. He says, their first steps were to set goals. Those include making sure patients would hear back within three days after a referral about when their appointment is, and that 80 percent of patients would be seen at a specialty clinic within two-weeks.

So are they meeting those? Dr. Ulager says while overall they are making progress, it's a mixed bag. He says they're hitting the goal of seeing patients within two weeks about 25 to 50 percent of the time. But one clinic was only at 15 percent. And while many clinics have gotten the referral lag down to four days or less, they found at least one where patients were waiting a month just to find out when their appointment is.

"That's not okay at all," Ulager said. He says while they are hiring for many specialist positions including gastroenterology, cardiology, rheumatology, and pulmonology, adding doctors is only part of the solution. "That's expensive to the system."

He says they're also getting creative by streamlining internal processes and using tele-health, so primary care providers can try to address patient's specialty concerns while they're already in the doctor's office. "When specialists are doing e-consults, they can do them much faster," Ulager said.

But changes aren't happening fast enough for patients like Knight. "I'm completely in limbo right now," he said. He's concerned that in the months he's been waiting, his mystery condition could have been getting worse.

Reporter Cat Viglienzoni: What would be your message to the people at the medical center about wait times?

Richard Knight: It's too long, for someone in my condition.

Knight said the doctor at his appointment on the 15th was very professional. He was diagnosed with gout and given some medicine. He says he's feeling a lot better now.