Editor’s Note: This is the fourth in a multi-part blog series recognizing and honoring the women and men whose vision and hard work built the foundation upon which Fletcher Allen – now The University of Vermont Medical Center – sits. The first blog post was about Mary Fletcher, the second was about Fanny Allen , and the third was about Bishop DeGoesbriand.
UHC-Campus-Front-Entrance-Given-Burl_-300x225In my first three blog posts, I highlighted the inpatient facilities that came together, but an equally important dimension of what is now The University of Vermont Medical Center came from the outpatient side and practice groups. The people associated with the creation of the University Health Center (UHC) are every bit as important to our legacy, even though their names never graced a building.

It all started in 1967, when Dr. William Luginbuhl, Associate Dean and later Dean of the Larner College of Medicine at UVM, became convinced that the 10 specialty practice groups formed during the 1960s and staffed by medical school faculty would benefit by coming together in an association. This association could provide shared administrative services, medical records and billing, and could better coordinate the patient experience in a common location with shared services on site, such as laboratory, radiology, pharmacy and more. Dean Luginbuhl also saw the possibilities for robust teaching opportunities in an ambulatory setting, as well as in the research that would be facilitated by a large patient base.

In 1968, Dean Luginbuhl procured a $1.2 million grant from the John L. and Irene H. Given Foundation to set up such a system. The name Given was later enshrined in Given Comprehensive Care, the primary care group to first become organized under the UHC umbrella, and the Given Building at the medical school. It was years before the grant money could be deployed fully in a specific location. By 1971, the year that UHC was incorporated, the decision was also made to utilize the former DeGoesbriand Memorial Hospital building at 1 South Prospect Street in Burlington. In 1976, the University of Vermont purchased the building from the Medical Center Hospital of Vermont (MCHV) and provided UHC with a 20-year lease. Given Comprehensive Care was organized by Dr. Henry Tufo, eventual founding President and CEO of UHC, who recruited faculty/practitioners from the Burlington community. The approach recognized and accommodated the natural skepticism between “town” physicians and the “gown” doctors at UVM and led to a wider acceptance of the project. It still occupies a space at 1 South Prospect Street.

Dr. John Davis arrived at UVM from Case Western Reserve in 1969 to chair the Department of Surgery and to design the fledgling ambulatory care system envisioned by Dr. Luginbuhl. The Surgical Associates became the other original group within UHC. Other key figures in the early establishment of UHC were Dr. Ben Forsyth of medical school (and later UVM) administration, and Jim Reuschel, who developed the financial side of the operation and became Director of Operations in 1973. It was the diligence of the individuals named — and many others — who assured the continued evolution of the coordinated ambulatory service model, despite many challenges.

The decade of the 1970s saw the addition of other practice groups, including Orthopedics, Psychiatry, Medicine, Obstetrics and Gynecology, Family Practice, Pediatrics, Neurology and more. These years also focused on establishing a unified mode of billing, the problem-oriented medical record (first conceived by Dr. Larry Weed), quality systems, refining governance and management structures, central registration, and the inclusion of public representatives on the board, all while managing the natural tensions between the autonomy of the various groups and their commitment to the shared enterprise. There were controversies, including tearing down the former Bishop’s house for parking, but there were even more successes, and by 1980, the University Health Center was functioning well.

Other sites in adjoining communities were added. First, there was the Villemaire Health Center in Milton in 1973, and later, practices on Maple Street in Burlington, the Brickyard in Essex Junction, the Medical Office Building at the Fanny Allen campus, and others joined UHC. One of UHC’s first goals had been to incorporate “managed care” in its approach. The HMO model was explored. Partnerships moved from the Vermont Health Plan, later the Green Mountain Health Plan, and eventually Blue Cross/Blue Shield’s Prime Care.

The MCHV clinics in the Arnold building were eventually incorporated into the UHC practice groups. In 1987, automated medical records were being researched. When the McClure building opened in 1985, space became available for some MCHV functions to move up the hill, allowing the expansion of UHC services into vacated space at 1 South Prospect Street.

Dr. Davis expressed the sentiment that one day, “probably not in [his] active lifetime, …. UHC and MCHV will be one medical center supplying services of high quality for people of the region.” His dream was further realized in the formation of Fletcher Allen Health Center in 1995 and continued to evolve with the opening of the new Fletcher Allen Ambulatory Care Center in 2005. Dr. Davis died in 2012, and a large auditorium in the medical school/hospital connecting hallway was named in his honor.

Sarah L. Dopp has been an employee at The University of Vermont Medical Center Laboratory for 45 years. She is the past president of the Vermont Historical Society and is the current president of the Chittenden County Historical Society.  You can read more about our “meldings and mergers in Sarah’s next blog post.

Sources

“Hospitals to Share Services,” Maria Blackburn, May 6, 1993, Burlington Free Press, Burlington, VT

“A Short History of the University Health Center,” David Cavanagh , 1987, UHC, Burlington, VT

Obituary “John Herschel Davis, MD,” Jan. 22, 2012, Burlington Free Press, Burlington, VT

Executive Profile “Henry M. Tufo, MD,” Bloomberg Business Week, online

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