NMC Commentary

Is Pediatrics in Swanton Changing?

Yes, at least temporarily. Northwestern Pediatrics has sent a letter to the families of our patients who are cared for at our Swanton location letting them know that beginning in January, their appointments will be in the Northwestern Pediatric Offices in the Doctors Office Common in St. Albans. The pediatric services provided at the clinic at Missisquoi Valley Union High School in Swanton will continue. Meanwhile, we continue to work with local partners to find a sustainable option for pediatric appointments at a Swanton office.

Dr. Chip Chiappinelli has cared for pediatric patients in Swanton for forty years, dating back to the early days of Mousetrap Pediatrics and continuing through his tenure with Northwestern Pediatrics. He is an involved, respected, and valued member of the Swanton community and will continue as such, regardless of his office location.

We understand that local access to care is tremendously important – it is a fundamental part of all that NMC does and why we exist. The Pediatric needs of the greater Swanton area are best met through approximately two days a week of physician presence. It is not economically sustainable to rent an office full time and not use that space full time. In today’s market, it simply cannot cover its costs. That’s where creative thinking and partnerships come in. At NMC, we have been able to re-establish local access to Neurology and Endocrinology in our medical clinic space. On different days of the week, different providers are working out of the same space so it rarely stands empty. This allows these important providers to be in our community for the amount of time that matches their volume of patient appointments. This meets the medical needs of our patient and is more economically sustainable. Something like that is what we need to find in Swanton. As I said, we are working with local partners to find appropriate space that Dr. Chiappinelli can use on a part-time basis so pediatric care can be provided in Swanton.

In the complex world of healthcare regulation, even the seemingly simple act of changing office locations is a challenging and costly process that I am sure people outside healthcare cannot imagine. The paperwork and processing of re-credentialing a provider shifting to a different office with each of the various insurance companies and payors is burdensome and creates unnecessary delays and costs in the system. Frankly, it is maddening. We have to do it to stay in compliance and ensure that reimbursements are processed so we can stay in business, but the frustration of the effort it takes to make a change as straightforward as moving to a different address in the same town. My hope is, as healthcare reform advances in Vermont and across the country and we shift from fee-for-service medicine to a capitated, population-health system, that hoops like this can be reduced and costs can be avoided.

I appreciate and share Dr. Chiappinelli’s commitment to our greater Swanton community. We appreciate your understanding and patience with this change. We will continue to work on a sustainable approach that will allow us to bring you news of a renewed Swanton presence. Meanwhile, we look forward to caring for you in St. Albans.

— Jill Berry Bowen, RN, NMC’s Chief Executive Officer