Editor’s note: This is the first of a two-part series.
MIDDLEBURY — Dr. Fred Kniffin has grown quite used to dealing with emergencies at Porter Hospital.
After all, he has worked many a shift as a physician in the Middlebury hospital’s Emergency Department.
Then, back in March, Kniffin agreed to help Porter with an entirely different kind of emergency. He agreed to serve as interim CEO of Porter Medical Center after his predecessor, Lynn Boggs, resigned following a controversial nine-month tenure.
Kniffin on May 25 sat down with the Addison Independent to share his thoughts on how PMC is doing in its quest to recapture its stability after some stormy times. Challenges have included a very unpopular round of layoffs in February, budget troubles, and the awkward rollout of a new compensation system for doctors and other health care providers that resulted in the resignations of several providers with Porter’s network of 12 practices.
Porter trustees placed their trust in Kniffin — a popular, personable physician with a candid style — to stop the metaphorical bleeding at PMC and put it on a steadier path before turning the reins over to a new CEO sometime next spring.
Roughly two months into his temporary stint, Kniffin is not about to say, “Mission accomplished.”
But he thinks he’s off to a pretty good start, with the hiring of some new providers, a draft fiscal year budget that has no red ink and the launch of a community discussion on whether Porter should affiliate with a larger medical institution.
“I think things are going pretty well,” Kniffin said. “I qualify that by saying we have lots of work to do and lots of challenges. I’m calling it incremental progress on a whole lot of different fronts.”
It began at PMC’s annual meeting this past April at which he acknowledged the institution’s problems.
“What I was really looking for when we started was not a ‘Forgive and forget,’ but really an ‘Acknowledge and move on,’” Kniffin said.
After venting their collective displeasure, members of the Porter Medical Center community are now eager to be part of the solution, according to Kniffin.
“Our Porter employees jumped right on board,” he said. “They love this place and care about this place. We see a lot of them, and they are easy to communicate with. I think the morale here is probably improving, though I don’t want to be presumptuous. I think they like the path we are on.”
Kniffin realizes that PMC’s residual wounds from the tumult of this past winter must be healed from the exterior as well as from within. To that end, he has led a series of “town halls” on and off the PMC campus to share the latest Porter news and solicit feedback from health care consumers. To date, he has spoken with folks at the Residences at Otter Creek and EastView retirement communities, Addison County Chamber of Commerce and Middlebury College, as well as with town officials and residents.
“The anger that people were feeling was reasonable and appropriate,” Kniffin said. “It was based in concern, and of their care about the place.
“If there is a take-home from this whole winter and the outcry, it’s that our community cares deeply about this place,” he added. “It’s an important resource and they want us to succeed. I have felt tons of support for not only myself, but my leadership team and the organization. The message is loud and clear: ‘We want you guys to succeed.’ That is energizing and exciting stuff.”
RECRUITMENT
PMC administrators said they are now making progress in recruiting new providers to replace the seven who they said chose to leave this past winter as a direct result of internal strife within the organization.
“What became clear when the dust started to settle is that it was not an evenly distributed loss,” Kniffin said of the doctor defections. “Specifically, we lost a disproportionate number of providers in the town of Middlebury. And we lost a disproportionate number of providers in internal medicine.”
PMC has primary care providers in four population centers: Middlebury, Bristol, Vergennes and Brandon. The loss of providers in those latter three communities was “minimal,” according to Kniffin, while losses within PMC’s various Middlebury practices were substantial.
PMC until recently had 10 providers in the town of Middlebury. Seven of them have either left or are on their way out due to concerns over recent internal strife within PMC, according to Kniffin.
“If we did nothing, we would be down to three (Middlebury-based family physicians) by this summer,” Kniffin said.
“That’s a big hole,” Kniffin said of the current provider shortage. “It’s been tough on the patients, for sure, and it has been tough on the practices, providers and the staff. We have to get this right, and we have to recruit hard.”
Many of the PMC patients who live in Middlebury “don’t travel well,” Kniffin noted. They can’t easily switch to new family physicians in Bristol, Vergennes and Brandon.
Kniffin noted that, fortunately, PMC recently set up its “Porter Access Center,” a new referral and appointment call center designed to better connect patients with health care services.
“We’re being very clear to say, ‘Call us and we will find you a new provider and make you an appointment,’” Kniffin said.
So the focus has been on recruiting new internal medicine providers to work in Middlebury, officials said.
And the search efforts are now yielding dividends, according to Kniffin. He announced two new family practice hires, slated to begin in June: Dr. Natasha Withers, a Middlebury College graduate who will be joining Bristol Internal Medicine; and Dr. Peter Wilhelm, who will join Middlebury Family Health.
All told, Kniffin said he’s interviewed around a half-dozen candidates for PMC’s family practice vacancies in Middlebury. He’s got a few additional job offers out and hopes to confirm another hire soon.
“We’re looking to put six to eight (Porter-employed) providers in Middlebury,” Kniffin said. That’s a few less than the 10 PMC-paid providers that were based in Middlebury earlier this year, but it’s a number that Porter officials believe will be able to satisfy current patient demands.
He also confirmed the recent hiring of five new Castleton State College graduates to fill some nursing and LPN vacancies in the hospital’s medical-surgery unit.
“These are people who put their hands on the patients, so we really needed them,” Kniffin said. “We had higher than normal turnover in some areas.”
Asked if recent publicity of PMC’s troubles has hampered recruitment, Kniffin said, “I have not found that to be an issue.” He said the administration has been candid in acknowledging recent troubles within the organization. The clincher, in terms of what induces a prospective new doc to join, tends to be what the applicant gleans from current Porter providers during the interview process, Kniffin said.
“The docs who work here have to believe that this is a place that they can say to a future colleague, ‘Come here; this is a good place to work,’” Kniffin said.
In the meantime, there has been capacity at other area practices to absorb patients who were suddenly left without a family doctor, according to Porter spokesman Ron Hallman. He specifically cited Addison Family Medicine and Middlebury Family Health.
“We absolutely suffered a painful loss of trying to rebuild the provider base,” Hallman said, “and individuals suffered significant personal losses, because they lost their relationship with their provider. But one of the things that had helped mitigate it from a big picture level is a lot of our colleagues have stepped up who did have capacity to pick up these patients into their practice.”
Editor’s note: A story in Thursday’s edition will look at Porter Medical Center’s proposed budget for next year and what the institution is doing to consider affiliations with other hospitals.
Reporter John Flowers is at [email protected].