Concerns Raised Over Policies at Meritus Health Affecting Patient Care Quality

HAGERSTOWN, MD News (7/8/2024) – A recent letter addressed to the Meritus Medical Board has sparked considerable discussion online. Authored by Dr. Mary E. Money, a respected physician in Hagerstown, Maryland, the letter critiques a newly implemented policy that limits patient encounters to 20 minutes. This policy, according to Dr. Money, has led to significant dissatisfaction among medical staff and subsequent resignations of key healthcare providers. Meritus, however, claims the policy does not actually exist.

Dated June 12, 2024, the letter begins with Dr. Money expressing her concerns over the policy, which she describes as having been established without adequate consultation with the providers. She notes that rather than addressing the limitations imposed by this policy, many providers chose to resign, which could have serious repercussions for patient care quality at Meritus Health.

Dr. Money argues that a 20-minute time cap on patient encounters is insufficient, especially for primary care providers who need to build long-term relationships with patients and manage complex medical issues. She states that the policy fails to recognize the unique needs of each patient, likening it to treating patients as uniform “widgets” rather than individuals requiring personalized care.

Highlighting the broader implications, Dr. Money points out that the loss of experienced providers can degrade the quality of healthcare delivered to the community. She emphasizes that primary care providers play a critical role in patient health by managing chronic conditions, coordinating care with specialists, and preventing hospitalizations. The policy, she argues, compromises the ability of these providers to perform their roles effectively.

The letter also lists several providers who have resigned, including specialists in urology, primary care, emergency medicine, and general surgery. Dr. Money stresses that the departures of these seasoned professionals could negatively impact patient care and the overall functioning of the healthcare system at Meritus.

To address the issue, Dr. Money suggests that the board conduct thorough exit interviews with the resigned providers to understand their reasons for leaving. She also recommends an independent body be brought in to evaluate the impact of the policy and the administrative decisions at Meritus. This, she believes, would provide a clearer picture of the situation and help in formulating strategies to retain experienced medical staff.

Dr. Money’s letter calls for the board to reconsider the policy and recognize the value of experienced healthcare providers. She expresses confidence that the board understands the importance of maintaining high-quality medical staff for the health and well-being of the community.

The letter has gained traction on social media, with many expressing concerns over the potential implications for patient care at Meritus.

In an interview, Dr. Mary Money elaborated on the situation, noting that she believes more than 20 providers have resigned due to the time limits for interacting with patients. She emphasized the difficulty of delivering quality care within the 20-minute limit, describing it as an attempt to fit patient care into a factory-generated time-slot.

Dr. Money expressed her frustration with the administrators, stating, “As providers, we all take oaths to do no harm, whereas administrators’ goal is to save money.” She highlighted the need for the board to take immediate action to prevent further resignations and to restore respect and cooperation between management and healthcare providers.

Dr. Richard Bryson, a urologist who recently resigned from Meritus and is mentioned in Dr. Money’s letter, shared his perspective with us on the corporatization of medicine. He explained that the increasing financial and contractual pressures on private practices are driving them towards being acquired by hospitals and venture capital groups. Bryson criticized the focus on corporate interests over individual patient care, leading to burnout among providers and a significant reliance on traveling practitioners. “The reasons most people work in the medical field – any job really, is for fulfillment. When corporate interests take over you start losing stuff that’s important,” stated Dr. Bryson. He informed us that there is likely no official policy limiting patient care to 20 minutes, but there are financial incentives and penalties in place to keep providers in line with that limit.

Dr. Bryson emphasized the unrealistic demands placed on providers, which prioritize patient quotas over quality care. He described the situation as detrimental to both providers and patients, ultimately reducing the fulfillment that many seek in the medical profession. Dr. Bryson, who has been with Meritus for around nine years, is now exploring opportunities with other local healthcare systems.

A local resident (anonymous for patient privacy concerns) who discussed the issue with Radio Free Hub City and has recently been treated in the Meritus healthcare system, expressed frustration with his recent encounter regarding the 20-minute limit as well as staffing changes at Meritus. He recently saw a Nurse Practitioner with Meritus Internal Medicine, and encountered the limit. Prior to this most recent visit, his primary care provider was one of the providers listed in Dr. Money’s letter to Meritus. Recounting his visit with the new Nurse Practitioner he saw instead of his previous provider,”she stayed in the room for 40 minutes and told me that she had to rush out because appointments can only go 20 minutes,” stated the resident.

Meritus Health provided the following statement to Radio Free Hub City regarding the concerns addressed in the letter:

• No physicians are being limited in their time to see patients. We have no such policy. To meet the needs of our community, increasing access to primary care is a major goal.
• When an appointment is scheduled, the system needs to estimate an amount of time to hold on the provider’s schedule. Several months ago, we standardized this scheduling estimate to 20 minutes, which has been the longstanding average appointment length for primary care visits.
• If more time is needed for a particular patient, that time is available, and the doctor’s office has several ways to accommodate.
• Doctors are never “timed out” at 20 minutes. Standardized appointment time slots are the norm in all in organized medical groups. The 20-minute appointment estimate only applies to most routine primary care appointments.
• We continue to expand care for our community and have recently opened a new urgent care center at Valley Mall, along with sports medicine and physical therapy practices there.

Regardless of the existence or not of Meritus’ 20-minute patient limit, the exodus of providers from Meritus should be cause for concern with Meritus and the community. According to “The value of relationships in healthcare” by Adrienne Sabety, “when a primary care physician-patient relationship is severed, patient mortality increases by 4%, emergency department visits increase by 4%, and hospital admissions increase by 3%.” Sabety also states that “adverse events increase with the length of the exiting primary care physician-patient relationship, suggesting that the loss of the relationship explains adverse impacts.” This means that not only is patient care being threatened by the 20-minute appointments, but patient wellbeing is at risk due to this exodus of primary care providers.

Patients and community members who have concerns regarding the current situation at Meritus should contact Meritus directly, and request your comments be forwarded to the board, whose upcoming meeting is this Wednesday.

Story by multiple RFHC contributors.

This story was updated on 7/16/2024 to better reflect that the patient we spoke with‘s recent encounter with the 20 minute limit was with a new provider.