Central Vermont Medical Center (CVMC) is the primary health care provider for 66,000 people in central Vermont.The medical staff numbers 121 physicians including nine community-based medical group practices. CVMC provide 24-hour emergency care, with 122 inpatient beds. CVMC is accredited by the Joint Commission on Accreditation of Healthcare Organizations. CVMC includes Woodridge Nursing Home.
Over the past several decades, federal laws have instituted sweeping antidiscrimination protections to foster inclusion for people with disabilities in education and employment, but substantial barriers remain to full and meaningful inclusion in the practice of medicine. In this position paper, the American College of Physicians (ACP) highlights the barriers to entering medicine and offers policy recommendations to improve the accessibility of medical schools, training programs, and the practice of medicine. ACP affirms that a diverse physician workforce, inclusive of disability, is a key component of reducing disparities in health and health care.
In the United States, people with disabilities experience disparities in health and health care. Disparities stem from inadequate insurance coverage, physically and culturally inaccessible health care facilities, pervasive harmful misconceptions about disability, and incomprehensive epidemiologic data regarding disability. In this position paper, the American College of Physicians offers recommendations to alleviate health disparities among people with disabilities through policy changes in areas such as health insurance coverage, accessibility of health care facilities, health professional education, research participation, and data collection.
The United States pays some of the highest prices for prescription drugs in the world, with drug prices and overall spending increasing year-over-year. Ballooning prescription drug costs can result in low rates of medication adherence, negatively affecting public health and straining national health care systems and resources. The 340B Drug Pricing Program (340B Program), which allows health care safety-net settings to purchase prescription drugs at deep discounts, has long sought to function as a bulwark against increasing drug prices for institutions serving those most vulnerable in society. Savings from the program have facilitated expanded access to health care services for low-income and uninsured patients. However, shortcomings in the program's design, implementation, and oversight obscure to what degree low-income and uninsured patients are realizing program benefits and create incentives for institutions to undertake profit-seeking behaviors at the expense of patients. To strengthen the 340B Program and ensure it is best serving its intended audience, reforms are needed within the program to promote transparency in how drug savings are reinvested into patient care and mandate demonstrated benefit to low-income and uninsured populations. Access to contract pharmacies-that is, the specialty or community-based pharmacies that 340B Program "covered entities" have an agreement with to distribute medications to patients-should be preserved, with appropriate guardrails to prevent unauthorized diversion. Federal regulators should be empowered with the resources and clear statutory authority necessary to engage in meaningful oversight of all program participants.
In the United States, dietary supplements are regulated as a subcategory of food and therefore are not required to undergo review and approval by the U.S. Food and Drug Administration (FDA). This inadequate regulatory framework has allowed adulterated and mislabeled products to repeatedly enter the market and poses a health threat to the public. In this position paper, the American College of Physicians offers policy recommendations to bolster the FDA's pre- and postmarket regulatory authority for dietary supplements, standardize dietary supplement terminology and data sharing, and implement changes within the health care system to improve care for patients using dietary supplements.
