As of 2018, a total of 615 physicians were licensed and practicing primary care in Vermont. Primary Care includes the sub-specialties of Internal Medicine, Family Practice, Ob/Gyn and Pediatrics. Like other states, many more licensed physicians (including temporary physicians) in Vermont are providing specialty care (932.1 Full Time Equivalents (FTE)) than primary care (435.6.9 FTE).

The total number of FTEs for non-temporary primary care physicians declined significantly from 492 in 2010 to 435.9 in 2018. However, the FTEs of temporary physicians (locum tenens) increased from 8.3 FTE to 17.7 FTE in 2018.

The percentage of primary care physicians over the age of 60 increased from 9% in 2000 to 36% in 2018. The number and FTE of hospitalists (primary care physicians in an inpatient setting only) has also increased as employment trends evolve to reflect an increased balance of work and lifestyle responsibilities.

Healthcare professional need is often calculated as a ratio of clinician FTE to the population of a defined geographic area. Federal Health Professional Shortage Area (HPSA) designations for primary care are based on population to physician ratios greater than 3,000 people to 1 FTE physician. Vermont’s average ratio for primary care physicians was 1,437 to 1 FTE in 2018. Vermont may be better off than many other states nationally but distribution of physicians is not consistent in all areas of the state. The greatest need for additional primary care physicians exist in areas around Chelsea & Corinth, Arlington, Ludlow, Waitsfield. Brighton and Hardwick.

Recruiting physicians and their families to work in rural areas is a challenge unless there is an existing connection to the area. Spousal employment opportunities are also critical factors for physician recruitment and long-term retention.

Current and historic info at: http://healthvermont.gov/research/HlthCarePrvSrvys/HealthCareProviderSurveys.aspx

The total number, hours of patient care and geographic distribution of healthcare professionals is critical data for determining health professional shortage areas (HPSAs) and priority geographic regions for recruitment and retention incentives such as educational loan repayment resources from federal and state funds.

This indicator is part of Healthy Vermonters 2020 (the State Health Assessment) that documents the health status of Vermonters at the start of the decade and the population health indicators and goals that will guide the work of public health through 2020. Click here for more information.

Recruitment and retention incentives

• UVM's Area Health Education Center (AHEC) Program Office, Burlington, VT https://www.uvm.edu/medicine/ahec/
  • Champlain Valley AHEC, St. Albans, VT
  • Northeastern Kingdom AHEC, St. Johnsbury, VT
  • Southern Vermont AHEC, Springfield, VT
• The Vermont/New Hampshire Recruitment Center, a program of Bi-State Primary Care Association, http://www.bistatepca.org/recruitmen-center.
• Rural Recruitment and Retention Network www.3RNet.org

Healthcare organizations are major employers in many of Vermont’s small communities, and healthcare careers can be provide good wages and salaries for many positions.

The Vermont AHEC Network offers a variety of programs to increase awareness and interest in a wide range of health care careers, including primary care physicians, among high school and college students in Vermont. These programs include MedQuest and College Quest, Shadow Days in practices, Student Career Days and other efforts.

UVM's Area Health Education Center (AHEC) program office and regional AHECs manage and distribute the state-appropriated Educational Loan Repayment Program (ELRP) awards for Primary Care Providers, Dentists, Nurses and Nurse Faculty. UVM AHEC also employs a Physician Placement Coordinator who maintains contact with medical students, fellows and physicians who have lived in Vermont, studied or practiced here, to let them know about open positions back in Vermont. https://www.uvm.edu/medicine/ahec/. The Vermont/New Hampshire Recruitment Center, a program of Bi-State Primary Care Association, works with Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs) and others to recruit physicians to work in under-served areas of Vermont. http://www.bistatepca.org/recruitmen-center.

Continue to work with partners identified here as well as hospitals, FQHCs and others to coordinate recruitment and retention efforts and incentives for primary care professionals. VDH manages the loan repayment programs through AHEC, VSAC and National Health Service Corps (NHSC).

We will continue to collect data from key healthcare professions every two years, pursue federal Health Professional Shortage Areas (HPSAs) designations for eligible geographic regions, target our limited state and federal resources to geographic areas and specialties with greatest needs. We will also support J-1 visa waivers applications for qualifying healthcare organizations to hire qualified foreign-born physicians.

Similar to statewide efforts, local partners are using data to drive local strategy. For regional data on access to health indicators, check out our Public Health Data Explorer.

Data analysts from the Vermont Department of Health work with the Secretary of State’s Office of Professional Regulation, Medical Practice Board and other licensing boards to collect information about patient care hours, practice locations and other data through an online census of ~99% of all licensed healthcare providers in 40+ professions every two years in most cases.

This data is analyzed and reported by county, FTE, demographics, population ratios, practice type, and trends over time for key professions such as physicians, nurse practitioners, physician assistants, dentists, psychiatrists and other mental health providers. Shorter data briefs will be developed for other healthcare professions starting in 2017.

Data is updated as it becomes available and timing may vary by data source. For more information about this indicator, click here.