Gifford Medical Center in Randolph. File photo by Mike Dougherty/VTDiggerThis story by Clare Shanahan was first published in the Valley News on Nov. 13.RANDOLPH — Victoria Davis has been a patient at the Sharon Health Center for more than 20 years, even choosing to drive about an hour from Piermont to Sharon to continue receiving care after she moved out of Vermont.On Nov. 7, Davis received a call from Sharon Health Center informing her that her chiropractic appointment this week was canceled and that Randoph-based Gifford Health Care, the network the Sharon center belongs to, had terminated its chiropractic services.“They ditched me, I’m ditching them,” Davis said of Gifford. “I was willing to drive from Piermont. It’s a long drive, but the people there are that good.”Gifford officials decided to end chiropractic services and urogynecology services on Nov. 7, effective immediately.That day, Gifford announced the decision to the three providers in these services — two chiropractors and one urogynecologist, terminated the providers and began contacting patients who had a scheduled appointment.“We discussed it with our providers that day and felt, given our overall situation with health care in Vermont and our financial situation, we needed to act immediately to focus our energy and our efforts on our core services,” Gifford CEO Michael Costa said in a Tuesday interview.The decision to close these service lines was motivated by a Sept. 18 consultants report, Costa said. The report assessed Gifford’s services and presented recommendations to keep the state’s medical network solvent. It was ordered by the Green Mountain Care Board, or GMCB, under Act 167 of 2022, which aims to improve Vermont’s health care system.The report recommends that Gifford close its emergency room and convert all of its inpatient beds into long-term mental health, geriatric psychiatry or memory care units.Since the report was released, Gifford has maintained that Oliver Wyman — the New York-based consulting firm contracted to issue the report — used inaccurate data to assess Gifford’s volume of care provided, according to an Oct. 28 press release. However, the report did prompt Gifford to have serious discussions about the types of health care it will provide in the future and how to remain solvent, Costa said.Oliver Wyman released its own statement Oct. 29 justifying the data it chose to use in the report, which assessed a number of Vermont health care providers.“OW required data that included financial information, as opposed to strictly volumes of services. … The volume data identified by some hospitals in recent news releases could not be relied upon for this analysis as it does not include financial information,” the release said.The decision to cut service lines was made “to make sure that we are in charge of our own destiny,” Costa said.Moving forward, Gifford does not plan to cut any additional service lines, he added.“It’s very hard to be all things to all patients, so we’re trying to make changes so future consultants and regulators don’t dictate what happens to health care in the White River Valley,” Costa said.In support of this stance, Costa said while Gifford does not find the Oliver Wyman report credible, they do not yet know how the GMCB or other Vermont regulators will use and interpret the information. For this reason, they wanted to get ahead of any potential problems.Beyond the financial implications, Gifford wanted to announce the service line closure before a Tuesday community forum, Costa said. At the event held at Vermont State University Randolph Center Campus Tuesday night, Costa acknowledged the closure and invited people to share their thoughts.“Asking people to come out and support Gifford and then cutting services a week later felt like the wrong thing to do,” Costa said.About 200 people attended the forum, which was intended 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 overwhelmingly positive, with community members explaining the importance of Gifford in their own lives. Most speakers were from Randolph, where Gifford Medical Center, the network’s hospital, is located. Many attendees were born or gave birth at Gifford’s birthing center in Randolph, or credited the medical network with saving their lives.“Gifford has been a part of my life all of the years I’ve been alive,” said Beth Dawley, a Stockbridge, Vt., resident born at Gifford.Dawley praised the shorter wait times that Gifford often provides, especially in comparison to Dartmouth Health and UVM Medical Center, the region’s largest hospitals which have high volumes of patients.“We can’t afford, in more ways than one, to have that kind of delay,” Dawley said.Dawley was not the only community member who emphasized the speed of Gifford’s services. Others pointed out that when they had to use Gifford’s emergency room, they were seen in a timely manner, and, being local, they could access the facility quickly in an emergency.Robin Goodall, a long-time Randolph resident whose children were born at Gifford, credited the hospital with saving her life on two separate occasions; the first was when she went to the emergency room at Gifford in 2010 after her legs gave out. After going to Gifford, she was transferred to Dartmouth Hitchcock Medical Center where she was diagnosed with the autoimmune disease Guillain-Barre syndrome.Despite receiving care at multiple facilities, Goodall said it was her doctor at Gifford who set that care in motion and “got me to the place that I needed to be.”“If emergency care in Central Vermont gets curtailed in a way that this report suggests that it should, there are a lot of people who are not going to make it out of those situations,” Goodall said.For Jonathan Hines, of Braintree, Vt., there is another element of Gifford’s care that is worth noting, and that is how local it is.“The nurses, they’re our neighbors, they’re people I know, I connect with, I see in the grocery store. When they yell at me about not taking my meds, I listen,” Hines said. “We’re not just numbers or something on somebody’s checklist, we’re people that help each other through hard times.”In addition to the accessibility and care provided at Gifford’s emergency room, community members spoke to the value of Gifford’s birthing center — which is one of only two hospital-based birthing centers remaining in the Upper Valley. The other is at DHMC.Emily Lewis moved to Randolph in 2020 and gave birth to her son at Gifford in 2021, she said. She and one of the “few people I did meet outside my coworkers” works in the Gifford Medical Center Birthing Center.“I cannot tell you how much it meant to me to know someone personally when I was at Gifford giving birth, and that’s one of the things that is amazing about this community. … Every time we drive past Gifford my 3-year-old son points to it and says ‘Mom! That’s where I was born!’ ” Lewis said.Siobhan Anderson-Judkins, who works in Residence Life at the Randolph campus of Vermont State University, said she “depends heavily on Gifford for the safety of my students.”“We are extremely fortunate that we are close to Gifford, to where if a student is having any medical condition that is not severe (enough) to need an ambulance, we can drive them for free to Gifford and pick them up when they are done with their care,” she said.Gifford also provides a nurse practitioner who sets up an office at Randolph Union High School three days a week, giving students access to medical care they might not otherwise receive, Lisa Manning Floyd, the school’s principal, said.Gifford also helps the high school write policies and implement programs to combat nicotine addiction.“It’s one thing when your principal stands up and says, ‘You shouldn’t do that. It’s not healthy.’ It’s another thing when your pediatrician is working with the school to do that,” Manning Floyd said.The hospital also plays a crucial role in the community by providing jobs for families and has assisted the high school in short-term emergency situations, Manning Floyd said.“Neither schools nor hospitals exist without community,” Manning Floyd said.At the forum, Gifford Medical Director Josh White addressed the closure of the chiropractic and urogynecology programs and acknowledged that they had received negative feedback from patients.“If there’s anyone in the audience who is negatively impacted by our decision to close chiropractic services, I want to acknowledge your pain… I know this negatively affected people and we have a mandate to the community to support the whole, but I don’t want to pretend that there weren’t individuals who are not suffering,” White said.White encouraged anyone affected to contact his office and share their experiences.No one at the forum voiced concerns 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 Nov. 8 letter that announced the closure, offered assistance in transferring records to a new provider and shared a list of practicing chiropractors in the Upper Valley.Urogynecology patients were transferred to either urology or gynecology providers in the Gifford network, Costa said.Davis was most disappointed by the immediacy of the decision and how it will impact the providers.“If people could plan on it, that’s one thing,” she said. “But, to just make these decisions like it doesn’t affect human beings — the physician or the patients — I just think that’s really unprofessional and uncaring and the medical profession is supposed to be about caring.”The three terminated providers could not be reached by deadline.Davis has been waiting to see her chiropractor at Gifford, Dr. Michael Chamberland, for months. She plans to travel to continue to see him if he settles at a new practice in Vermont, she said.“I have not found a chiropractor who is as good as he is, he’s amazing,” Davis said.The Green Mountain Care Board and Vermont’s Agency of Human Services have “tentatively” scheduled a public meeting Nov. 20 to discuss the report, according to the Vermont Medical Society.Read the story on VTDigger here: Gifford cuts chiropractic care amid anxiety about health care reform.