September 1, 2008

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155th MMA Annual Session this Week in Rockport offers Communications Skills Workshop

The Association's Annual Meeting opens this Thursday (Sept. 4) with an important Quality Improvement Symposium co-sponsored by the Maine Hospital Association with support from the Maine Quality Forum, Quality Counts and the Aligning Forces for Quality program.  Governor Baldacci and Edward Langston, M.D., immediate past Board Chair of the AMA will make concluding remarks at the conference.  Also see below information on the Communication Skills Workshop being held on Friday as part of the CME offerings at the Annual Session.  Registration for the meeting is still available through the MMA website at

Two tracks of CME are available on Friday afternoon, following the opening luncheon talk which features Greg Carroll, PhD of the Institute for Healthcare Communication.  One track is a Communications Skills Workshop offered by trained presenters from the American Academy of Orthopedic Surgeons and the Institute for Healthcare Communication.  The Workshop focuses on communication skills which are important in the patient/physician relationship for both understanding and trust.

The Workshop is limited to 24 persons so attendees knowing they wish to be included should call the MMA office to register.  Call 622-3374 and ask for Gail Begin at extension 210.

The Workshop will improve attendees patient communication skills which will lead to:

  • Less miscommunication and complaints
  • Better understanding and adherence to treatment
  • Improved practice quality and satisfaction
  • Reduced exposure to malpractice claims
  • Fewer follow-ups and increased clinical productivity

The fast-paced two hour workshop focuses on the 4Es of effective communication:

  • Engage
  • Empathize
  • Educate
  • Enlist

Led by a physician trained as a communicator skills mentor, the course follows a core curriculum based on scientific evidence.  It is designed to provide participants with opportunities to practice skills and techniques - not just hear about them.

John Tongue,M.D., will lead the workshop.  Dr. Tongue is the Chair of the American Academy for Orthopedic Surgeon's Communication Skills Mentor Program.  He has been in private practice of orthopedic surgery since 1978 in Tualatin, Oregon.  Dr. Tongue is a graduate of Saint Louis University.  On Saturday afternoon, Sept. 6, Dr. Tongue will lead a four and one-half hour communications workshop for orthopedic surgeons attending the MSOS meeting being held in conjunction with the MMA Annual Session.

Information on any of the programs and the Annual Session can be obtained through the MMA website at or by calling the MMA office at 622-3374 (Press O for assistance).


Law Prohibiting Smoking in Cars When Young Children Are Present is Effective Today

One of the most visible public health initiatives of the 123rd Legislature was L.D. 2012, An Act to Protect Children in Vehicles from Secondhand Smoke (P.L. 2007, Chapter 591, effective 9/1/08).  The bill prohibits smoking in a motor vehicle when an individual who has not reached age 16 is present, regardless of whether the windows are open or not.  The MMA Public Health Committee was active in supporting the bill and MMA EVP Gordon Smith was the lead witness during the public hearing on the bill.  The vision for this effort, however, came from Bangor pediatric dentist, Dr. Jonathan D. Shenkin.  The MMA salutes Dr. Shenkin's efforts on behalf of Maine kids!

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Congratulations to Medical Mutual Insurance Co. of Maine on its 30th Anniversary

Sept. 1, 2008 marks the 30th anniversary of Medical Mutual Insurance Company of Maine which formally began operations on Sept. 1, 1978.  The company held an anniversary event in Portland on Friday to commemorate the event.

In remarks to attendees Friday, company President Terrance Sheehan, M.D. noted that while the company has enjoyed great success over the years, when it began, that success was not guaranteed.  Many observers in the late 70's, particularly traditional insurance types,  referred to such efforts as "bedpan" mutuals and asserted that a group of physicians could never successfully operate a medical liability insurance company.  They could not have been more wrong.

Mutual liability companies organized by physicians in many states now insure the vast majority of physicians in the country.  While many companies have merged or been sold, Medical Mutual has stayed true to its roots.  It is still governed by a board with a strong majority of physicians and all the committees, including claims and underwriting are chaired by physicians.  While the company has expanded by writing insurance for physicians in New Hampshire and Vermont and the company now also insures hospitals in the three Northern New England states, the largest segment of business is with Maine physicians.

Two physicians present at Friday's event have been leaders in the company since its creation,  current Board Chair William Medd, M.D. of Norway and Jeremy Morton, M.D. of Portland.  MMA congratulates Drs. Medd, Morton and all the physicians who have been involved with the company through the years.  It has been a remarkable journey.  Former company leaders including William Maxwell, M.D., Frederick Holler, M.D., and Patrick Dowling., M.D., also deserve recognition for their leadership during their respective terms as President of the company.

MMA, through the vision and leadership of Dr. Dan Hanley, at that time Executive Director of MMA, was instrumental in the effort to establish Medical Mutual in 1978.  MMA provided an important capital component, which was payed back to MMA in the 1980's through the authority of the Bureau of Insurance.  Along with a bank loan and subordinated loan certificates by the insureds, this loan helped to establish the company. Dr. Hanley went on to serve as an active Board member of the company until the time of his death.  MMA continues to endorse Medical Mutual as the preferred liability insurance carrier for MMA members.

"It is fair to say that MMA and Medical Mutual are the two organizations that Maine physicians rely upon everyday to maintain a reasonable liability climate in Maine and to protect their hard-earned assets." noted Gordon Smith, Esq., EVP of MMA.  "On behalf of the leadership of MMA, it is my honor and privilege to extend our heartiest congratulations to all those involved in the company's success during these past thirty years.  We look forward to to future anniversaries of what is, in our opinion, the most successful small market physician mutual company in the nation." [return to top]

FoCUS Conference, Building the Patient Centered Medical Home, October 15


Annual Friends Of the Center across the US [FoCUS]

Building the Patient Centered Medical Home On a Public Health Foundation

Creating a Roadmap for the Future with Key Healthcare & Public Health Stakeholders in Maine

Wednesday, October 15, 2008
Maple Hill Farm, Hallowell
9:00A -4:00P

The Maine Center for Public Health [MCPH] is very grateful to a group of national public health leaders who have a special connection to Maine, wish to share their wisdom and learn from Maine's groundbreaking work.  These individuals have become known as Friends Of the Center across the US [FOCUS members]. 

This year's FOCUS Conference is all about how to better link the health care system with public health in order to improve health status and health care quality. We are inviting state leaders in both public health and the health care system arenas to join this interactive, problem solving conference. Don't miss this chance to learn from two effective partnership models in North Carolina & Vermont, hear about emerging initiatives in Maine and share your thoughts with FOCUS members and key Maine stakeholders on next steps!

Why should you come? The following are just a few of the questions to be addressed during this day long conference. 

How can collaboration with Patient Centered Medical Homes (PCMH) improve and facilitate the work of community and public health? (e.g.  Physical  Activity, Nutrition, Substance Abuse Prevention; Community Health  Mapping and Data collection;  leveraging  scarce personnel  and financial  resources)  

How can community and public health resources support PCMHs improving both regional and personal health status and healthcare quality? ( e/g   chronic care coordination;  health promotion and preventive health outreach  and  information systems, community needs assessments and respective action items;  leveraging staff support with  public health nursing;  improving cost effectiveness;  and improving quality outcomes)   

What resources (personnel, financial, health informatics) can facilitate and sustain collaboration between PCMHs and community health coalitions?   

How do you evaluate/ measure effectiveness of community linked PCMH?  

What are national and state models of effective and sustainable community linked PCMH?

What is a roadmap for moving Maine ahead at state, regional, and local levels in assuring that healthcare system PCMHs can make and sustain mutually beneficial community health linkages?  

This year's conference promises to be useful and exciting. To register online, visit the Maine Center for Public Health website at: or fax the attached registration form to Melissa Chadwick at 207-629-9277 [return to top]

Report on Provider Payment Reform Committee Meeting August 28

The Provider Payment Reform Committee, organized by the Maine Health Management Coalition and staffed by  Gino Nalli from the Muskie School at USM met this past Thursday afternoon at the Augusta Civic Center.  Approximately thirty individuals representing a variety of healthcare interests and organizations are represented on the Committee which is chaired by David Howes, M.D., President of Martin's Point.  After reviewing minutes of the July 22 meeting and hearing an update from Lisa Letourneau, M.D. on the Working Group activity (Maine Multi-Payer Pilot Patient Centered Medical Home Working Group), committee members heard a presentation from Michael Bailit of Bailit Health Purchasing entitled, "Payment Models for the Patient-Centered Medical Home."  Mr. Bailit's presented seven payment models associated with the Patient Centered Medical Home (PCMH) and noted that all of the existing and emerging PCMH initiatives across the country include payment reform as a core component. 

The Joint Principles of the AAP, ACP and AAFP calls for "payment that appropriately recognizes the added value provided to patients who have a PCMH", with additional specifications.  However, most of the PCMH initiatives across the U.S. do not strictly adhere to the Joint Principles'specifications for payment.

Mr. Bailit, who is an acknowledged expert in provider payment, cited two rationales for payment reform in connection with the PCMH:

1.  infrastructure support.  Several initiatives have modeled the costs to a practice to deliver PCMH care and have found that it requires additional resources in the practice setting, including PCP time on non-billable activities, case management/care support, HIT, and space and equipment.

2.  incentive alignment:  Fee for Service drives how practices deliver primary care.  Many observers believe that only changes to the payment system that motivate and support the PCMH will generate practice transformation.

While there are a few different payment models that have emerged, even within those that have emerged there is significant variation.  The state of Pennsylvania was cited as one state that was moving forward quickly to restructure the payment system, with insurers covering most year one practice infrastructure costs, as well as supplemental practice payments. The project in PA is managed by staff in the Governor's Office of Health Care Reform and a consultant.  Staff and consultants support a Commission, its steering committee, five Commission subcommittees and three regional rollout steering committees.  The State is also funding practice learning collaboratives and evaluation.

Following Mr. Bailit's presentation, William Kassler, M.D. from the CMS Regional Office reviewed Medicare Medical Home payment initiatives and similar efforts in the states of Massachusetts and New Hampshire.

The charge and scope of work of the Committee is:  To develop a multi-stakeholder model for payment to Primary Care Practices that is endorsed by all stakeholders and can be implemented by the Working Group's pilot program which is planned to begin Jan. 1, 2009.  The Committee serves in an advisory capacity to the Maine Health Management Coalition and the Working Group.  Decision making will be reached by consensus of the organizations represented at the Committee meeting.

The Committee will meet monthly through the rest of the year and into 2009.

Earlier in the day, the PCMH Working Group met with most of the discussion centered on the issue of how many practices would be involved in the pilot project and what the make-up of these practices would be.   The Work Group will also meet monthly, with the next meeting scheduled for Sept. 24.

The Multi-Payer Pilot of the Patient Centered Medical Home is an important initiative that could have widespread implications for both primary care physicians and specialists.  MMA will continue to follow the work of the Committee and the Work Group closely and will report on their work through the Weekly Update and Maine Medicine.  [return to top]

Thomas Palmer, M.D., Author of Cracked Marbles, a Memoir

Retired Bangor Surgeon Thomas Palmer, M.D. has authored a delightful memoir entitled, Cracked Marbles, published recently.  Dr. Palmer will do a book signing at the Association's Annual Meeting on Saturday, Sept 6 around noontime.

The memoir is a compilation of stories of patients of Dr. Palmer's and of the many joys he experienced in his many years as a general surgeon in Bangor. 

"Many of our members have had success in getting their stories published, but Tom's is one of the best in his description of his experiences," noted Gordon Smith, MMA's Executive Vice President. "Although Dr. Palmer took appropriate steps to protect the identity of patients and others described in the book, his description of a fictitious rural county medical society will be pretty obvious to anyone who enjoyed the legendary hospitality offered by the Piscataquis County Medical Society in the last half of the 20th century!" [return to top]

Former Mainer Michael Katz, M.D., MBA Running for State Senate in Delaware

Former MMA member Michael Katz, M.D., MBA, a Wilmington, Delaware- based anesthesiologist, is running for the state senate in Delaware.  Dr. Katz is a graduate of Bates College and completed residency at the Maine Medical Center following medical school at Georgetown.  He also received an MBA from Georgetown.  He and his family (wife Trish and three children) are property owners in Maine and enjoy a seasonal home at Sugarloaf.

Many MMA members may remember Mike from his active years with MMA as a resident.  He also came back to an annual meeting a few years ago to speak on  behalf of the AMA's Physician Negotiating program.  He has continued to be very involved with the AMA and has received many awards recognizing his leadership in medicine.

He is running as a Democrat in an open seat and has one opponent in a Sept. 9 primary election.  If successful in the primary, Mike would then be on the Nov. 4th ballot running against the winner of a three-way Republican primary.

MMA members wishing to communicate with Mike may contact him at  Those wishing to learn more about his campaign or contribute should access the campaign website at [return to top]

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