Editor’s Note: This is the fifth and final blog 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 , the third was about Bishop DeGoesbriand, and the fourth was about the University Health Center.
The past four blogs in our heritage series have hinted at the complex histories of our four clinical founding institutions: Mary Fletcher Hospital, Fanny Allen Hospital, DeGoesbriand Memorial Hospital and the University Health Center. In this one, we talk about all the mergers and meldings that have created what is now The University of Vermont Medical Center.
The concentration of medical facilities in Burlington has been large for a community of this size. It became a hub for referrals and collaborations, from telemedicine to reference lab capabilities and, more recently, to formal business and administrative partnerships. The concentration of medical institutions has also led to inevitable competition (for patients, staff, and for philanthropic dollars), which has, in turn, driven a series of mergers, affiliations and the associated discontinuance of some independent entities as they melded with others to create new entities. The process has inevitably led to some losses, but overall the community has accepted and embraced this evolution. When we consider the entire span of events from the creation of the medical school in 1822 to the present, we can appreciate the incremental moves that have consolidated the precious elements of our history into the current shared academic medical center.
In addition to the health care they offer, these hospitals and the University of Vermont have also long provided an array of educational programs for many categories of medical professionals – from physicians to physical therapists, from nurses to radiological and nuclear medicine technologists, from clinical laboratory scientists to cytology technologists, and so on. Each program and each institution enjoyed its own growth and unique history, cooperating – and sometimes competing – with each other, while also reaching out to the rest of Vermont and upstate New York.
The Need for Nurses
The mergers and meldings have been many. For example, take the Mary Fletcher Training School for Nurses, which was established in 1882 as a four-week program with six students. By 1885, it ran a two-year course, and by 1902, a three-year diploma program. In 1896, the first nurses’ home was erected. When it burned in 1948, the Burgess Residence was built. Across town, at the Fanny Allen Hospital, their own school of nursing opened in 1899 with eight students, offering an eight-week course. By 1902, the program spanned two years and expanded to three in 1911. When the Bishop DeGoesbriand Hospital (later DeGoesbriand Memorial in 1956) opened in 1924, it was not considered duplicative to begin a nursing school of its own (1927). Indeed, the school was badly needed to meet a nursing shortage in both the Catholic hospitals. Twenty years later, in 1946, the DeGoesbriand and Fanny Allen nursing schools were merged into a “Central School,” which became the Jeanne Mance School of Nursing in 1953, named for the nun who established the Hotel Dieu in Montreal in 1642, the origin of the Religious Hospitallers order that started Fanny Allen Hospital. The last Fanny Allen students graduated in 1955, but a School of Practical Nursing (a one-year program) was established in 1957, with Sister Chaloux as director, which continued until 1997. By 1971, both the Mary Fletcher Hospital School of Nursing and the Jeanne Mance School ceased to operate as separate entities and were absorbed into the new two-year associate’s degree program at the University of Vermont, which had a four-year Bachelor of Science degree program since 1943 under Director Faye Crabbe.
Hospital mergers were in the wind as well, after decades of expensive medical advances and growth of the individual hospitals. As early as the 1950s, Bishop Robert F. Joyce began to express concern that Diocesan resources were being stretched to keep two hospitals running. His inclination seemed to be to close the Fanny Allen Hospital, but the Joint Commission on Accreditation of Hospitals instead suggested a merger of the DeGoesbriand and Mary Fletcher hospitals in 1965. Negotiations were complex and intense, but Bishop Joyce, who enjoyed great respect in the community, became an important advocate for the merger, and in 1967, the Medical Center Hospital of Vermont (MCHV) was born. The Catholic Diocese then shifted its full support to Fanny Allen Hospital. In 1966, there was a major fundraising campaign for building the new Fanny Allen Hospital, resulting in $1.25 million. The new hospital was built in three phases in 1968, 1973 and 1976.
Changes at the Medical School
Throughout all these developments, the relationship of the medical school to the hospitals also shifted and adjusted. Even the relationship of the medical school to the University of Vermont itself changed over time, from relative independence to becoming a university department, and then moving back to partial autonomy as the College of Medicine.
The financial fortunes and academic rigor of the medical school have also evolved over time. After 14 years of existence, the medical school was closed from 1836 to 1854, and then resurrected with new faculty. The ensuing 50 years were often rocky; admissions standards were not always high, and most faculty were only part-time. By the turn of the 20th century, the American Medical Association Council on Medical Education and the Carnegie Foundation for the Advancement of Teaching were investigating the state of medical education nationwide. The resulting “Flexner Report” in 1908 threatened to close our medical school, among many others. The dean, Henry C. Tinkham, fought back and reorganized the college, setting the stage for the medical school in existence today.
Setting the Stage for a Medical Center
Gradually, the area hospitals grew, offering more specialties, and full-time faculty were hired. By 1945, UVM Medical School Dean William Brown arrived, and he began to speak of the need to create a “medical center,” though an undercurrent of suspicion persisted with local physicians who thought the UVM faculty was taking over their turf. It would be several decades before Brown’s dream matured enough for fulfillment.
In 1976, the MCHV began planning for upgrades of the physical plant, which no longer met federal standards. The 1982 Redevelopment Project led to the building of the McClure building in 1985. Meanwhile, the Vermont Health Foundation was established in 1983 as a parent company for MCHV. In 1987, Fanny Allen Hospital affiliated with the Covenant Health System. The creation of Fletcher Allen Health Care in 1995 was the next merger, blending MCHV, Fanny Allen and the University Health Center, in affiliation with the Larner College of Medicine at UVM. The name was chosen to preserve the legacies of Mary Fletcher and Fanny Allen. The creation of Fletcher Allen was also partially a response to expansions occurring at Dartmouth-Hitchcock in Hanover, New Hampshire. The regional reach of these two flagship institutions was proceeding along geographical lines.
The Foundation for the Future
The 2014 renaming of the institution as The University of Vermont Medical Center solidifies the intrinsic bonds of clinical care, research and medical education which have existed here since World War II. The simultaneous establishment of The University of Vermont Health Network formalizes our relationship with the hospitals in Plattsburg and Elizabethtown in upstate New York, and Berlin, Vermont. One Care Vermont is another cooperative venture that establishes an Accountable Care Organization to collaborate on quality, wellness and affordability for Medicare patients across Vermont and at Dartmouth-Hitchcock.
Mergers, meldings, affiliations and collaborations have made our history complicated, but the goal has always been to meet patient needs in increasingly better ways. There is nearly 200 years of our history, and we honor all the people who have played their part in moving us along the path to the place we are today.
Sarah L. Dopp has been an employee at the Fletcher Allen 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.
- “A Century of Modern Medical Care – MCHV,” Robinson Book Associates, Burlington, VT, 1985
- “FAHC: Providing High –Quality Care to Our Community and Region,” Fletcher Allen Health Care, Burlington, VT, undated pamphlet (~2005)
- “The Heritage: A History of the MFH School of Nursing, 1882-1971,” Muriel Campbell, MCHV, Burlington, VT, 1971
- “Larner College of Medicine at UVM,” Martin Kaufman, UPNE, Hanover, NH, 1979
- “UVM Medical Center CEO Dr. John Brumsted Looks Ahead,” Burlington Free Press, Burlington, VT, Nov. 20, 2014
- “Walking in the Spirit: Fanny Allen Hospital 1894-1994,” Michael J. Healy, FAH, Colchester, VT, 1993