Miller Participates in Ways and Means Health Subcommittee Hearing on Challenges of Independent Medicine

Washington, D.C. - Today,Congresswoman Carol Miller (R-WV) participated in a Ways and Means Health Subcommittee Hearing to discuss the economic and regulatory burdens that independent physicians face that can lead to closure or consolidation of independent physician practices.

Click here to watch.

Congresswoman Miller began her remarks by highlighting how patients in rural West Virginia and across the United States deal with the financial burden and timing that it takes to get to a hospital in order to receive the care they need.

"I live in West Virginia, a very, very rural state. Sometimes it can take from an hour to almost five hours to get to your doctor or to your hospital because our terrain is very challenging. It's critical that our local, rural, physician practices exist so that they aren't always burdened with a far drive and expensive visits to a hospital for something very minor. Today's economic environment with inflation through the roof, thanks to the reckless spending that continues to go on with this Administration, many independent physician practices simply cannot afford to keep their doors open. Frankly, the federal government doesn't reimburse well enough to make [staying open] feasible for you to do it at all. This is a huge issue for physiciansas well as patients," said Congresswoman Miller.

Congresswoman Miller asked Dr. Jennifer Gholson, a Family Practitioner, to describe the differences between physician-patient relationships in rural areas and physician-patient relationships in large health systems.

"Dr. Gholson, I was really disheartened to hear about your struggles you and your practice have endured because of bad federal policy. I know firsthand how devastating it is for rural communities to lose their local doctor. To help paint the picture for my colleagues that might not be from rural areas, can you go into detail about the different physician-patient relationship that happens in independent practices, particularly in rural areas compared to physicians in these huge practices?" asked Congresswoman Miller.

"To paint the picture of how rural my community is, we are a one stoplight town. My patients could walk to my practice to see me because we were right downtown. I was able to do home visits with my patients which gave incredible insight to what was going on in their life. I would see them at Walmart [or Church] and they would talk to me about their care. Even though I closed my practice in 2022, I still get those questions from my former patients even today. You really are part of the community. You're part of the fabric. You sponsor the local baseball teams. You're at the team events as team physicians. The whole community becomes like family," responded Dr. Gholson.

Congresswoman Miller continued by asking Dr. Gholson to explain what it felt like to compete with larger health systems.

"As much as I'd love to see every independent practice thrive, I know that there are tons of challenges out there that you all face that can drive you to close or sell your practice and move into a larger health system. Prior to having to make the impossible choice to close your practice, can you tell us some of the pressures that came with competing for workforce with larger health systems or if there was any pressure to consolidate your practice?"asked Congresswoman Miller.

"Competing with the local hospital was probably the biggest thing with my workforce that I could not compete with what they were able to pay my nursing staff. We already had a nursing shortage going into COVID-19, and COVID-19 exacerbated the nursing shortage. It was very difficult to compete, and the hospitals had an advantage because of the facility fees, they were able to garner from the care that they were receiving, so that made it very difficult to compete," responded Dr. Gholson.

Congresswoman Miller asked Dr. Timothy Richardson, an Independent Physician with Wichita Urology, if there were any Medicare regulations or reimbursement requirements that limited his practice's ability to provide high-quality care to rural patients.

"Dr. Richardson, in order for people to understand more of the business side of how Medicare reimbursement [policy] is simply not enough to even cover the costs of operating in a rural area, are there examples where Medicare regulations or reimbursement requirements have limited your practice's ability to provide high-quality services to your rural patients?" asked Congresswoman Miller.

"I think everything's more difficult when you're treating patients in rural areas unless you actually have a provider in that area. From a specialist standpoint, you're traveling. We get in our car, grab our staff, grab our equipment, our scopes, our drugs, put them in our trunk and drive to that community to run a clinic and sometimes do some simple outpatient surgeries at that local rural hospital and then drive back. It's a burden to your quality of life [and] to your practice at home. We have had the discussion of consolidating care and making patients drive to the Wichita Metro area because we are so overburdened there. We just haven't had the heart to do it because many of these patients simply cannot or would not make the travel. They don't have the social support or the resources to drive three to four hours. One of the good things that came out of the pandemic was telemedicine. There are so many of these patients in rural Kansas that need a five-minute appointment with me that could be easily done over telemedicine and so we've tried to take advantage of that," responded Dr. Richardson.

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