October 1, 2012

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SAVE THE DATE: MMA Legislative Committee Will Meet on December 12th to Prepare for the 126th Maine Legislature

This organizational meeting of the Legislative Committee is particularly important for any physician who is interested in the MMA's advocacy agenda and for medical specialty societies because the MMA's legislative agenda for the next two years will be developed during this meeting.  The MMA urges medical specialty societies to send at least one or two representatives to the meeting.

The details for the organizational meeting of the MMA Legislative Committee for the 126th Maine Legislature follow:

Date:  Wednesday, December 12, 2012

Time:  Dinner available at 6:00 p.m.; meeting will take place from approximately 6:15 to 8 or 8:30 p.m.

Place:  MMA Headquarters, Frank O. Stred Building, Manchester, Maine

Agenda:  Will include a review of election results, preview of legislation anticipated in the First Regular Session of the 126th Legislature, and development of the MMA's legislative agenda; the Committee also will decide the day and time of the weekly conference calls during the session

RSVP:  All are welcome, but please contact Maureen Elwell, Legislative Assistant, if you will attend the meeting, so we can plan for the meal, at melwell@mainemed.com or 622-3374, ext. 219

If you would like to discuss a bill proposal with the MMA advocacy staff prior to the meeting please contact one of the following individuals: 

It is now five weeks from Election Day and the MMA encourages you to get to know the candidates in your State House and Senate races.  You can find a complete list of candidates plus items in the referendum election on the Maine Secretary of State's web site.

Finally, the MMA is pleased to announce that Amy Madden, M.D. is the new Chair of the MMA Legislative Committee, taking over the role from Lisa Ryan, D.O., who was elected to Chair the MMA Board of Directors at the Annual Meeting in Bar Harbor in early September.  Dr. Madden is board certified in family medicine and practices with HealthReach's Belgrade Regional Health Center.  Dr. Madden also served as the first resident member of the MMA's Executive Committee, now called the Board of Directors.

Meet Your MMA Officers, Beginning with the President

For the next few weeks, the Weekly Update will contain a profile on one of the current MMA officers elected last month during the association's 159th Annual Session.  We begin with MMA President Dieter Kreckel, M.D., who will serve as President until Oct. 5, 2013.

Dr. Kreckel is a family physician, practicing in Rumford at Swift River Family Medicine, which is owned by Rumford Hospital.  He has been with the practice for nearly twenty years.  He also is a Director of the Central Maine Medical Center Rural Tract Residency Program and is lead physician for the Patient Centered Medical Home pilot project in which the practice participates.  He also chairs the Board of the Western and Central Maine PHO.  He is Board Certified in Family Medicine.

Dieter grew up in Pennsylvania and was destined to become a wildlife biologist until fate intervened with an acceptance to Temple University School of Medicine in 1976.  Prior to entering medical school, he received a BS in biology from Edinboro State University and a Master's Degree in Wildlife Biology from Washington State University. Following medical school, he completed a residency in family practice at St. Joseph's Hospital in Syracuse and was on the faculty at the Malcolm Grow Medical Center at Andrews AFB.  He then served as a family physician in the Air Force in Bitburg, Germany for four years following two years in Limestone at Loring AFB.

In addition to his active involvement with MMA, Deiter has also been very active in the Maine Academy of Family Physicians, serving as President for four years.  He continues to serve as a delegate from the MAFP to the Congress of the AAFP.  

Dieter also is involved in his community, serving as Chair the Finance Committee for the town of Rumford for the past two years.  He also serves as a volunteer team physician for the local high school's athletic teams.  In the past he has served on the Board of Directors of the local Chamber of Commerce and he continues active membership in his church.

Dieter lives in Rumford with his wife Jennifer, an attorney.  They are the parents of two adult children and are proud grandparents.  Among their family interests are photography, hiking, kayaking, wildlife biology, birding and travel.

Dieter can be reached on MMA business at President@mainemed.com.  

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MMA Announces Pilot Membership Project for Small FQHCs

In August, MMA's Board of Directors approved a proposal to offer, on a pilot basis, a new category of membership to small federally qualified health centers (FQHCs). The program begins today, October 1st, and seven health centers have chosen to participate in the two-year pilot.  An additional two or three centers may also join before the end of the calender year.

To be eligible for the pilot, a health center must be a member of the Maine Primary Care Association (MPCA), have five or fewer physicians associated with it and it must agree to participate in the MMA's Office-Based Quality Improvement Program.   If a center meets these qualifications, it can participate in the project which offers the following benefits for an annual dues of $3000.


  1. Participation in MMA's Office-Based Quality Improvement Program.
  2. Individual membership in MMA for any physicians employed in the practice.
  3. Annual HIPAA staff training (offered on-site) and up to two additional on-site education programs (including the cost of CME approval)
  4. Up to two external peer reviews at cost.
  5. Consultation with three MMA attorneys on practice related issues.
  6. Complementary registration (1) to annual Practice Education Seminar and to MMA Annual Session.
  7. Discounted registration to  First Fridays educational series.

This menu of services was developed by MMA staff following meetings with CEO's of several health centers and with the full support of the MPCA. The services offered are seen as enhancing the work of the MPCA and are not intended to compete with it.  MMA staff have been providing many of these services to the centers for several years, but have always struggled with the pricing of such services.  The pilot project is seen as an opportunity to experiment with a membership approach and after two years an evaluation will be conducted to determine if the program met the respective needs of the parties.  If so, it is anticipated that the program would continue indefinitely, with pricing to be evaluated on a regular basis.

Federally Qualified Health Centers in Lubec, Harrington, Pittsfield, Porter, Eagle Lake, Leeds and Patten have joined the pilot.  Other health centers meeting the requirements for eligibility and interested in participating should contact Gordon Smith, Esq., EVP of MMA at 622-3374 ext. 212 or via e-mail to gsmith@mainemed.com. [return to top]

Responses to Recent MMA Member Survey on ACA and Prescription Monitoring Program

In early September, MMA sent out through Survey Monkey three questions to all members for whom we have an e-mail address.  Regrettably, only 208 members took the brief time to answer the three questions but here is the result:


1.  Do you support the Supreme Court decision on the Affordable Care Act?     

Yes  73.9%  (150)

No  26.1%   (53)


2.  Do you think the State of Maine should expand Medicaid eligibility as proposed in the Affordable Care Act?

Yes  68.1%   (139)

No   31.9%   (65)


3.  Do you think that law enforcement personnel should have increased access to the data in the Prescription Monitoring Program?  

Yes  59.6%  (121)

No   40.4%  (82)


MMA intends to pose questions to the membership on a quarterly basis.  While the results of such surveys will not necessarily drive MMA policy, responses to such surveys are a quick way to gauge where the membership may stand on a given issue.  Thanks to those of you who did take time to answer the three questions.

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Affordable Care Act More Popular in Maine than Nationally

According to a recent statewide poll by Critical Insights, forty-seven percent of Mainers thought the Affordable Care Act would be good for the country and thirty-eight percent said they thought it would have a negative impact.  National polling during the same period of time showed Americans having the opposite view, fifty-one percent to thirty-seven percent.  The statewide poll was commissioned by The Portland Press Herald/Maine Sunday Telegram and was conducted approximately two weeks ago in the middle of September.

Not surprisingly, the overall support for the law tracked strongly the relative support for the Presidential candidates.  Eight-four percent of respondents indicating that they favored President Obama also supported the ACA while eight-six percent of Romney supporters opposed the law.  With the President leading Governor Romney in Maine fifty-two percent to thirty-six percent, the impact of the Presidential race on the public's view of the healthcare law is apparent.

As noted in yesterday's Maine Sunday Telegram article by staff writer John Richardson, support for the law among the candidates for federal office in Maine clearly falls along party lines.  Republican U.S. Senate candidates Charlie Summers and Republican House candidates John Courtney and Kevin Raye all favor repeal of the law.  Democratic Senate Candidate Cynthia Dill and Democratic House candidates Chellie Pingree and Mike Michaud (both incumbents) support the law.  Former Governor Angus King, the independent in the race, also has stated support for the law, while noting that there are aspects of it that need to be changed. [return to top]

First Fridays in October Moves to Third Friday, October 19th: Physician Compensation and Contracts

To accommodate conflicting schedules, the October CME program on the topic of Physician Compensation and Employment Contracts has been moved to Friday, October 19th.  Attorneys Michael Duddy, Gordon Smith, and Andrew MacLean will present the latest information on physician compensation in Maine and include a discussion of productivity incentives and other aspects of employment agreements.  The programs costs $65 and will be held from 9:00 a.m. to noon at the offices of the association in Manchester, Maine.  The program is also available via webex. 

Register now at www.mainemed.com or call 622-3374.

Watch you next issue of Maine Medicine for a list of First Friday programs for 2013.

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Aroostook County Practitioners: MICIS Offering CME on Evidence-based Prescribing, Oct. 15-18

MICIS, the Maine Independent Clinical Information Service, a program of the Maine Medical Association, offers high quality, no cost CME on the evidence-based use of prescription drugs. Our academic detailers visit practice sites throughout the state to speak with individuals, small or large groups. Though any practitioner can request a visit from one of our academic detailers at any time, MICIS is currently scheduling its first-ever “County Tour” to reach out to Aroostook County practitioners. To that end, MICIS academic detailers will be present throughout the county October 15-18, offering educational modules on the following topics:

  1. Antipsychotic medications
  2. Management of chronic pain
  3. Management of atrial fibrillation 

Please contact Jennifer Reck, MICIS Program Manager, at jreck@mainemed.com or 632-5806 if you would like further information or to request a visit on a specific topic.  Not in Aroostook County but still interested? Please contact Jennifer Reck with any questions or to schedule a visit at your practice site.

Maine Independent Clinical Information Service (MICIS)

Academic Detailers:

Erika Pierce, MMC, PA-C

Elisabeth Fowlie Mock, MD, MPH, FAAFP

Advisory Committee Chairperson:

Noah Nesin, MD

More information can be found at: http://www.mainemed.com/academic/index.php

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MaineCare Redesign Task Force Reviews Enrollment Data, Cost Containment Measures

The MaineCare Redesign Task Force, charged by the legislature with coming up with $5 million in savings from the MaineCare program, met last Tuesday for the third time.  

The group received an additional briefing from Dr. Kevin Flanigan, MaineCare Medical Director, on the MaineCare caseload and who the high cost members are - and their conditions and providers.  The members who fall into the top 5% of spending for MaineCare most often have neurological disorders ranging from mild to severe mental retardation and their top expense is a per diem for residential care.  Mental health diagnoses are the leading expenses for the remaining MaineCare population.  

 Following Dr. Flanigan's presentation, the consultants hired by the task force to help in their work, Seema Verma, provided an overview of what other states are doing to contain costs in their Medicaid programs and how other states are managing high cost members.  Task force members agreed that they want to look at a combination of short-, medium-, and long-term strategies and that it would be helpful for Seema Verma to put together a list of where the state has already instituted cuts or other savings mechanisms. 

 The Task Force next meets on October 9th from 1-4 pm at the Statehouse in Augusta and all materials are available on their website by clicking here

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New England AMA Delegation Sets Stage for Nov Interim Meeting

The Council of New England State Medical Societies and the New England Delegation to the American Medical Association met last Saturday at the Massachusetts Medical Society Headquarters to share reports on state activities and prepare for the AMA Interim meeting being held this November in Hawaii. 

Maine's Dr. Richard Evans presided over the Council of the New England State Medical Societies portion of the meeting.   Each state medical society president delivered a report on society activities in the state.   MMA President Dr. Dieter Kreckel highlighted activities in Maine such as the MMA's growing Board and impact of the new bylaws, our pilot membership program for Federally Qualified Health Centers and our work at the legislature addressing proposed cuts to MaineCare eligibility. The states have a number of priorities in common, including being engaged with implementation of health care reform and working to increase physician leadership training opportunities.  

 The New England Delegation addressed several organizational issues in preparation for the upcoming AMA Interim Meeting.  They voted to support two resolutions for consideration by the House of Delegates, including one that advocates for state to expand Medicaid eligibility to 133% of the federal poverty level under the Affordable Care Act (very similar to the MMA resolution accepted by the MMA membership in September) and one calling on the AMA to urge Congress to develop a fiscally responsible alternative to the automatic budget sequestration cuts to health care and public health slated to take place January 2013.   The Delegation decided it was premature to support Dr. Joe Annis or Robert Wah for AMA President-Elect before hearing directly from the potential candidates.  [return to top]

Medical Profession in Decline, Says a Majority of Physicians Nationally

A physician survey commissioned by The Physicians Foundation and conducted March through June 2012 found that of the 13,575 doctors surveyed, more than 50 percent were planning to make changes that would likely reduce patient access, including:  cutting back on patients seen and/or hours worked, changing practice to concierge or become employed, retire or take other steps such as limiting the number of Medicare patients accepted.  Physicians cited patient relationships as the most satisfying part of their job.  However, an overwhelming majority of 77 percent were pessimistic about the future of medicine, citing concerns for liability or defensive medicine pressures, government regulations, reimbursement issues and uncertainly about health reform.  Over 84 percent felt that the medical profession itself is in decline.  

The survey also found that over 52 percent of physicians have limited the access Medicare patients have to their practice and 26 percent have stopped seeing Medicaid patients.  The survey report also breaks down responses based on age, status as practice owner or employed physician, gender, and primary care and specialists.  The complete survey results are available by clicking here.

MMA has asked the Foundation for the Maine data from the survey and it is expected to be available this week.  Watch for next week's Update for an article on the Maine specific data.

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Upcoming Events & Conferences

Maine Public Health Association 2012 Annual Conference 

Community Connections: Building Creative Partnerships for the Health of All Mainers

October 17, 2012

Civic Center, Augusta 

Join us at Maine's premier Professional Public Health event, the 28th MPHA Annual Meeting. We will be partnering with many organizations across the State to bring the highest quality of education, innovation and inspiration to those that work in and around the field of public health.

For for information or to register, click here


Maine Cardiovascular Summit 

Best Practice: Cardiovascular Care in the Field, in the Clinical Practice, and in the Community

November 8, 2012

Samoset Resort, Rockport 

National  and local cardiovascular health experts will come together to discuss best practice in cardiovascular care. 

For more information, or to register, click here


Maine CDC Infectious Disease Conference 

November 13, 12012

Augusta Civic Center, Augusta, Maine

Presenting a review of emerging issues in the field of infectious diseases, particularly as they impact the Maine medical community. 

For more information or to register, click here[return to top]

Job Openings

MD/DO Position Available in Dexter, Maine

Sebasticook Family Doctors is accepting applications for a MD/DO at our busy Dexter location.  Ideal candidate will have two or more years experience in a busy community health outpatient setting delivering high quality care.  Exceptional clinical, interpersonal and EMR skills are required.   SFD offers  excellent compensation, benefits and working environment.   Join our growing team!  

Interested applicants should send resume and cover letter to:  Melanie Knowles, Human Resources, Sebasticook Family Doctors, 18 Moosehead Trail, Suite 5, Newport, ME 04953 or at mknowles@sfdchc.org


Family Practice Physicians

Katahdin Valley Health Center is recruiting dedicated Family Practice Physicians that are committed to providing quality health care services to the people in Central/Northern Maine.  Join our practice in one of the newly expanded facilities.  We are seeking physicians for our Millinocket, Patten and Houlton locations.  KVHC is a fully electronic medical record site and offers a competitive salary and benefits package which includes sign on bonus, generous amounts of paid time off, health insurance, life and disability insurance as well as Federal Torts Claims Act (FTCA) malpractice coverage.  No nights, no weekends, either limited or no inpatient care and limited call coverage.  Physicians who join KVHC are eligible to apply for NHSC Loan Repayment.
Physicians that join KVHC will be providing quality care in a dynamic, cutting edge environment, within a patient focused team of 11 Providers and 90 Staff Members.  As one of New England’s highest performing Federally Qualified Health Centers (FQHC), KVHC has a mission to provide community accessible, quality healthcare with compassion and dignity. 
To learn more about KVHC and Practitioner Opportunities, please contact Michelle LeFay at mlefay@kvhc.org or visit our website at www.kvhc.org.  KVHC is an equal opportunity employer.


Medical Director/Family Practice Physician

Katahdin Valley Health Center, established in 1974, is a high performing FQHC with a continuous track record of growth and stability.   KVHC seeks a Medical Director/Family Practice Physician to join our team and pursue our mission to provide community accessible, quality healthcare with compassion and dignity.   The Medical Director at KVHC will begin by providing patient primary care 3 days per week and performing administrative Medical Director Duties the other 2 days of the week.  This position will progressively move to a Full Time Medical Director Administrative role.  KVHC offers state of the art facilities and technology, electronic medical records, as well as a competitive salary and benefits package which include sign on bonus, generous amounts of paid time off, health insurance, life and disability insurance as well as Federal Torts Claims Act (FTCA) malpractice coverage. No nights, no weekends, either limited or no inpatient care and limited call coverage.  
KVHC has site locations in Houlton, Island Falls, Patten and Millinocket.  The Medical Director will work between the Houlton and Patten site, or the Millinocket and Patten Site.  Interested applicants should contact Michelle LeFay at mlefay@kvhc.org or visit our website at www.kvhc.org.  KVHC is an equal opportunity employer.


Psychiatric Nurse Practitioner

Sebasticook Family Doctors is a Federally Qualified Health Care Center currently accepting applications for a Full Time Psychiatric Nurse Practioner for our  Dexter location.  Position includes assessment, medical management, therapy and group work.  Ideal candidtate will have 3 or more years experience in a busy community health outpatient setting delivering high quality care.   Excellent compensation, benefits and working environment.

Send resume and cover letter to:  Melanie  Knowles, Human Resources,  Sebasticook Family Doctors,
18 Moosehead Trail, Suite 5, Newport, ME 04953  or by email at mknowles@sfdchc.org.

10/8/12 [return to top]

For more information or to contact us directly, please visit www.mainemed.com l ©2003, Maine Medical Association