In the past two decades, medical care has changed greatly, across the country and in Waterbury. In 2011, a once-in-a-lifetime tropical storm devastated the town and its medical facility. It was followed 9 years later with an epidemic that, as of this moment, is still strangling the world.
At the start of the new millennium, there were two practices in Waterbury: pediatrician, Dr. Beth Ann Maier and Waterbury Medical Associates (WMA). Dr. Maier soon decided to retire, leaving WMA as the only area provider. The town’s long-time doctor, Robert Murray, M.D., and William Cove, D.O., had formed WMA in 1991 as a comprehensive primary and urgent care practice. Located at 6 North Main Street, WMA staff included the founders as well as Dr. Chris Payne, physician assistant Terry Higley, and nurse practitioner Alison Hobart. Accessibility was considered vital to the community; the office had extended hours during the week, Saturday morning appointments, and 24-hour medical on call. Doctors made hospital rounds and nursing home visits for their patients. For those unable to reach the office, the old-fashioned house call was available. The doctors also served as medical examiners, on call around the clock.
Throughout the 1990s, insurance companies including Medicare and Medicaid reimbursed primary care doctors at very low rates. Independent practices, including Waterbury’s, were forced to sell and become employees of the local hospital. Central Vermont Hospital (CVMC) purchased the practice in 1994.
In 2001, when Jennifer Gelbstein, M.D. joined the practice, it was obvious the building was too small. Renovations in the 1990s had increased the size of exam rooms, but the building still lacked air conditioning and areas for the nursing staff. The hospital constructed a larger facility at 130 South Main Street with an additional wing for physical therapy. WMA moved in April 2002. Terry Higley was called to active duty after the 9/11 attacks; a year later she returned to a practice in a different community.
During the 2000s and 2010s, health care became progressively more centralized. National policies pushed for development of patient-centered medical homes, a system of care where a patient’s treatment is coordinated through a primary care physician. Hospital-based physicians, or hospitalists, took over the care of in-patients. In 2008, CVMC adopted electronic medical records for its practices, an unexpectedly stressful transition. More and more bureaucratic procedures needed to be completed, decreasing productivity and, to some extent, provider satisfaction. Patients had to wait longer to get appointments, e.g., physicals, follow-up work, and non-urgent problems. CVMC opened walk-in clinics, first in Berlin, then in Waterbury. Urgent medical needs, including x-rays, were transferred to Express Care, the local clinic.
In 2010, Dr. Bob Murray retired after 38 years. For the first 19 years, he had been on call 24/7. Dixie Martin, LPN, became the longest-term employee; she started in the 1980s. Richard Burgoyne, M.D., joined the practice in 2009 to take Dr. Murray’s position. When CVMC opened Express Care on Rte. 100, he was tagged to manage the clinics and eventually left the practice to do that job full time. Dr. Justin Karlitz-Grodin transferred from a Montpelier practice to Waterbury.
CVMC became allied with Burlington’s Fletcher Allen Health Care in 2011. A successful partnership with Washington County Mental Health provided counseling to patients within the office setting. Attempts were made to establish specialty care from the Waterbury office, including OB/GYN services, orthopedics, and endocrinology. Each year, several students from the University of Vermont (UVM) College of Medicine rotated through the practice. Twice UVM recognized WMA as the Best Family Practice Clinical Trainers.
In August 2011, Tropical Storm Irene intensified throughout the state, dropping 5” of rain in 24 hours and causing major flooding in Waterbury Village. When Dr. Bill Cove went downtown at 8:30 p.m. on August 28th to check on the office, he found the electricity out and was warned by emergency personnel to hurry since the water was rising quickly. Twelve hours later when he opened the office door, the floor was a layer of squishy mud, doctors’ shoes floated in their offices, and the sunlight reflected in the puddles throughout the rooms. The real surprise was opening the basement to find water within a few steps of the first floor. All the pre-2008 paper medical records stored there were lost.
For the next five months, WMA improvised. Offices were in Barre, Building D at CVMC in Berlin, and the others were located at the Thatcher Brook Inn in Colbyville. The WMA building was gutted and repaired. It finally reopened in January 2012.
In 2018, Dr. Catherine Naden, joined WMA as a family practice and sports medicine physician. The following year, CVMC providers became employees of UVM Health Network; WMA was officially renamed University of Vermont Health Network, Central Vermont Medical Center, Family Practice-Waterbury. Dr. Payne became a half-time medical provider and a half-time time facilitator for a new medical student education program. A part-time nurse practitioner, Shelley Paquette, was hired to take up the slack. When she left, Alison Chick was hired as a physician assistant.
In November 2019, the medical records program was switched to EPIC. After one official training session, providers and staff had to learn the program on their own time. It was another stressful experience. One advantage of the new program is that all medical data in the UVM network, in-patient and outpatient, are on the same record.
COVID arrived in early 2020. In the first months after Vermont imposed a stay-at-home order for nonessential workers, the practice tried various ways to see patients via virtual medicine and limited office hours. Staff was split into teams for rotating office days and virtual days. House calls increased as well as parking lot visits. The hospital decided to close the Waterbury Express Care site due to finances and the difficulty of meeting COVID health requirements. Dr. Cove retired in September 2020 after 30 years with Peter Ireland, M.D., filling the position.
As everyone will agree, 2020 has provided unique challenges for health care. The COVID pandemic layered upon mounting bureaucratic paperwork and hoops-to-jump has increased fatigue and frustration throughout the country. The health care system is teetering. Waterbury Medical is no exception. Nevertheless, the inherent desire to provide a high quality, caring medical experience remains the top priority of WMA staff and doctors.