In his recent report to the Green Mountain Care Board, Dr. Bruce Hamory, working for the consulting firm Oliver Wyman, made three glaringly inaccurate statements (“Advice: Hospitals need ‘major restructuring’ ”; Sept. 20).

The first is that there is not primary care provider shortage in Vermont. That remark is laughable. We have a terrible time with access for our patients in every region of the state. I would challenge him to anonymously make calls to primary care practices anywhere in Vermont. I guarantee that if he asks for an acute problem visit (fever and a rash), or a chronic multiple medical problem visit (diabetes, hypertension, heart disease), or lastly an establish care visit for a well person, the wait would be weeks to months.

The acute care visit we often cannot see same day and refer those to an urgent care or emergency room. These types of facilities are vastly more expensive than my clinic in Randolph. If we had more PCPs, Vermont would not have the expense of unnecessary ER and urgent care visits. Hamory admits in his report that patients face long wait times for primary care and specialty care, contradicting his assertion about the population of doctors.

The second inaccuracy is that we should see three patients an hour. It’s no secret that the more patients we see, the better it is for our bottom line. We are trying, but two an hour is all most of us can see. Years ago, before the advent of electronic medical records (EMR), we had paper charts. One could write a quick progress note or dictate the note, and frequently we could see three to four patients an hour, sometimes more. This would be if the problems were not complicated. Pediatrics could see four to five patients an hour, for simple ear infections or cold/flu. But with the advent of EMR, we are spending more time documenting on a computer than we do in patient care. It is terrible, but it’s a sign of the times. Seeing a suicidal teenager, followed by a complex medical patient and completing the required electronic documentation cannot be done in an hour.

The third inaccuracy is that Hamory says he spoke with thousands of Vermonters. That may be true, but did he have one on one conversations with health care providers? I am sure he spoke at community forums, but did he work the audience enough to have had thousands of conversations? This strikes me as an exaggeration he used to emphasize his conclusions.

Hamory is an infectious disease specialist. He was chief medical officer at Geisinger Medical Center in Pennsylvania, a 594-bed acute care hospital (by comparison, DHMC has 507 beds) from 1997 to 2008. Prior to that he was an administrator at Penn State University Medical School. It sounds like he is a subspecialist and a high-level administrator who I doubt has seen a primary care patient (at least after med school) or done an EMR note on one. Basically, he has no primary care experience in Vermont. Further, it looks like he hasn’t practiced medicine in 30 years.

Recently, Gifford Medical Center was over $10 million in debt, as were multiple hospitals in our state. The red ink is attributable, in part, to the COVID pandemic. During this time, we were unable to schedule elective procedures, which are major revenue generators for every hospital. We could not see as many patients. We had to purchase enormous amounts of personal protective equipment. We have shortages of nurses, lab techs, X-ray techs and many others. This forced us to hire travelers, at great expense. In addition, inflation was 9%. It is no wonder we were in debt. We are doing better now, as Dan Bennett, our recently outgoing CEO, has instituted programs to improve our bottom line. Under the new leadership of Michael Costa, I am confident that we will be back in the black soon.

Gifford is the largest employer in Randolph. Closure of our obstetrics, surgical services, in-patient beds and emergency room would dramatically alter our community. The vulnerable and elderly would have to drive a long way in bad weather. Single mothers with no transportation would also be in jeopardy. Vermont’s geography doesn’t allow easy access to many places.

I understand there was a law requesting this report, but Hamory and his lack of understanding of primary care invalidated himself as a reviewer. If we cannot believe him on the PCP shortage, number of patients per hour and the number of people he has spoken with, how can we believe the rest of his assertions? Why should we let an international consulting firm from New York City make recommendations on health care in rural Vermont?

The $1 million of Vermont taxpayer money paid to Oliver Wyman could have been divided four ways to the four vulnerable hospitals in Vermont to hire consultants to help them find ways to stay viable, not to close them down.

I implore the Green Mountain Care Board and the Vermont Legislature to work with us to ensure our long-term viability and not the cessation of rural services. Be patient, please; we are coming back.

Ken Borie has been a family physician in Randolph for 44 years and is the past president of the medical staff at Gifford Medical Center and of the Vermont Academy of Family Physicians.