Southern West Virginia News

Washington, D.C. – Congresswoman Carol Miller (R-WV) participated in a Ways and Means Health Subcommittee Hearing to discuss the economic and regulatory burdens that independent physicians face, which can lead to the closure or consolidation of independent physician practices.

Congresswoman Miller began her remarks by highlighting how patients in rural West Virginia and across the United States deal with the financial burden and time it takes to get to a hospital for necessary care.

“I live in West Virginia, a very, very rural state. Sometimes it can take from an hour to almost five hours to get to your doctor or to your hospital because our terrain is very challenging. It’s critical that our local, rural physician practices exist so that they aren’t always burdened with a far drive and expensive visits to a hospital for something very minor. Today’s economic environment with inflation through the roof, thanks to the reckless spending that continues to go on with this Administration, many independent physician practices simply cannot afford to keep their doors open. Frankly, the federal government doesn’t reimburse well enough to make [staying open] feasible for you to do it at all. This is a huge issue for physicians as well as patients,” said Congresswoman Miller.

Congresswoman Miller asked Dr. Jennifer Gholson, a Family Practitioner, about differences between physician-patient relationships in rural areas versus large health systems.

“Dr. Gholson, I was really disheartened to hear about your struggles you and your practice have endured because of bad federal policy. I know firsthand how devastating it is for rural communities to lose their local doctor. To help paint the picture for my colleagues that might not be from rural areas, can you go into detail about the different physician-patient relationship that happens in independent practices, particularly in rural areas compared to physicians in these huge practices?” asked Congresswoman Miller.

“To paint the picture of how rural my community is, we are a one stoplight town. My patients could walk to my practice to see me because we were right downtown. I was able to do home visits with my patients which gave incredible insight into what was going on in their life. I would see them at Walmart [or Church] and they would talk to me about their care. Even though I closed my practice in 2022, I still get those questions from my former patients even today. You really are part of the community. You're part of the fabric. You sponsor the local baseball teams. You're at team events as team physicians. The whole community becomes like family,” responded Dr.Gholson.

Congresswoman Miller continued by asking Dr.Gholson about competing with larger health systems.

“As much as I’d love to see every independent practice thrive,I know there are tons of challenges out there that you all face that can drive youto close or sell your practice and move intoa larger health system.Prior tohaving tomake an impossible choice toc loseyourpractice,canyou tell us someof pressures camewithcompetingfor workforcewithlargerhealthsystemsor iftherewas anypressuretoconsolidateyourpractice?”asked CongresswomanMiller.

“Competing withthelocalhospitalwas probablythebiggestthingwithmyworkforcethatIcouldnotcompetewithwhattheywereabletopaymynursingstaff.WealreadyhadnursingshortagegoingintoCOVID-19,andCOVID-19exacerbatedthenursingshortage.Itwasverydifficulttocompete,andthehospitalshadanadvantagebecauseofthefacilityfees,theywereabletogarnerfromthecarethattheywerereceiving,sothatmadeitverydifficulttocompete,”respondedDr.Gholson.

CongresswomanMilleraskedDr.TimothyRichardson,aIndependentPhysicianwithWichitaUrologyiftherewereanyMedicareregulationsorreimbursementrequirementsthatlimitedhispractice’sabilitytoprovidehigh-qualitycaretorruralpatients.

“Dr.Richardson,inorderforpeopletounderstandmoreofthebusinesssideofhowMedicarereimbursement[policy]issimplynotenoughtoevencovercostsofoperatinginaruralareaarethereexampleswhereMedicareregulationsorreimbursementrequirementshavelimitedyourpractice’sabilitytoprovidehigh-qualityservicestoyourruralpatients?”askedCongresswomanMiller.

“Ithinkeverything’smoredifficultwhenyou’retreatingpatientsinruralareasunlessyouactuallyhaveaproviderinthatarea.Fromaspecialiststandpoint,you’retraveling.Wegetinourcargrabourstaffgrabourequipmentourscopeanddrugsputthemoinourtrunkanddrivetothatcommunitytorunaclinicsometimesdosomeoutpatientsurgeriesatthatlocalruralhospitalandthendriveback.It’saburdentoyourqualityoflife[to]yourpracticeathome.We’vehaddiscussionofconsolidatingcaremakingpatientsdrivetoWichitaMetroareabecausewearesooverburdenedthere.Wejusthaven’thadhearttodoitbecausethemanypatientssimplycannotwouldnotmakethetravel.Theydon’thavethesocialsupporttheresourcestodrivethreeorfourhours.Onegoodthingcameoutpandemicwastelemedicine.TherearesomanyofthesepatientsinruralKansasteneedaappointmentmedoneeasilytelemedicinewetriedtotakeadvantagethat,”respondedDr.Richardson.

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