Steven Lidofsky, M.D., Ph.D., Larner professor of medicine and pharmacology and director of hepatology at the UVM Medical Center

(JANUARY 13, 2025) In a recent commentary in VTDigger, gastroenterologist Steven Lidofsky, M.D., Ph.D., professor of medicine and pharmacology at the Larner College of Medicine and director of hepatology at the University of Vermont Medical Center, says the value of work performed by clinicians cannot be quantified as goods and services.

In 2023, Lidofsky writes, the Green Mountain Care Board (a state-authorized regulatory authority with a mandate to control health care costs) engaged a team from Oliver Wyman Management Consulting to examine the health burden in Vermont and to develop cost-effective solutions to reduce it. While the Wyman report did accurately diagnose systemic problems and contained a cost-conscious treatment plan to correct these ills, the reasoning behind the plan was based on assumptions that were not always correct, he states.

One of the key issues identified in the report was patient access to clinical care. Rather than focusing on problems with the supply and distribution of clinicians accessible to patients (and with sufficient personnel to support the infrastructure that coordinates appointments), the report focused on clinician productivity, which was judged to be inferior. The implication was that if clinicians could be harnessed to see more patients in a shorter period of time, that would improve access. The Wyman report has failed to recognize that the value of work performed by clinicians cannot be quantified as goods and services. Human health is priceless, and those who work to preserve it are not widgets. To be sure, the system of health care delivery is in sore need of improvement, but the way to start is to examine how it can function with greater creativity and efficiency.

The emphasis on improving health care should not be to drive clinicians to generate greater volumes of services in shorter periods of time, but to tailor these services to meet the health care needs of the population.