March 24, 2014

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PLEASE COMPLETE: The Physicians Foundation's 2014 National Physician Survey

All Maine physicians are invited to complete the 2014 National Physician Survey sponsored by The Physicians Foundation, a non-profit organization focused on tracking and improving physician satisfaction.  This survey will be the third national survey the foundation has conducted.  It presents an opportunity for your voice to be heard.  A link to the survey can be found below.

It is a pleasure to announce that The Physicians Foundation a non-profit group of physician and medical society leaders, is conducting its third national survey of America’s physicians.

This landmark survey, which you may have read about in The Wall Street Journal, USA Today and many other publications, is intended to give physicians a voice, and we greatly urge your participation. 

Take the Survey

All participants who include their email address will have the full survey report emailed to them, and will be entered in a drawing for a $10,000 travel voucher, a $2,000 Apple voucher, and multiple iPad Airs.  MMA also has an opportunity to earn a $5000 honorarium if Maine has the highest percent of physicians completing the survey.

Most important, this survey has been instrumental in conveying how physicians feel about the current state of the medical profession, and for that reason we believe it is important that you participate.

Thank you for your consideration and your time.

POLITICAL PULSE: Floor Action Heats Up - ACA Medicaid Expansion and Budget

Athough a few new bills were printed last week, including the first supplemental budget bill, the deadline for committees to complete their work on bills was Friday, March 14th.  This means that the focus of legislative activity moves to the floor of the House and Senate where unanimous bills will make their way through the process and divided reports will accumulate on the calendar as the 126th Maine Legislature aims towards an April 16th adjournment.

House Passes Medicaid Coverage Bill by Veto-Proof Majority 

On Tuesday, March 18th, the Maine House passed the first of three bills seeking to expand Medicaid coverage to an additional 70,000 uninsured Mainers through federal funds made available to states under the ACA (L.D. 1487).  L.D. 1487 includes a proposal to institute a managed care approach to the MaineCare program and other concessions aimed at garnering sufficient Republican support to override a gubernatorial veto.  The roll call vote in the House was 97-49.  The initial vote in the Senate last week was 22-13, short of a veto-proof majority.  Late Thursday, the bill was enacted in the Senate and sent to the Appropriations table.  If your legislators voted in favor of the bill, please take a minute to drop them a note of thanks.  If your legislators voted against the bill, please ask them to reconsider their vote when the opportunity to override the Governor's veto comes about.  You can find your legislators here.  You can find data and talking points on the issue on the Cover Maine Now web site.

Appropriations Committee Reports Out, Legislature Enacts, Initial Supplemental Budget 

Early last Thursday morning, March 20th, the Appropriations Committee reached unanimous agreement on an initial supplemental state budget focusing mostly on FY 2014 items.  The bill was printed as L.D. 1843 and was quickly enacted by both chambers on Friday, March 21st.  The vote was 33-1 in the Senate and 121-6 in the House.  There were few controversial health care proposals in this bill.  The Appropriations Committee will tackle the more difficult FY 2015 situation beginning today.

Criminal Justice Committee Receives Governor's Bill to Combat Drug Abuse 

On Monday morning, March 17th, the Criminal Justice & Public Safety Committee held a public hearing on L.D. 1811, An Act To Appropriate and Allocate Funds To Strengthen the State's Efforts To Investigate, Prosecute and Punish Persons Committing Drug Crimes.  MMA Associate General Counsel Jessa Barnard spoke "neither for nor against" the bill, putting in a plug for continued funding for the diversion alert program, but also asking the legislators to remember that addiction is a disease and to not forget funding for treatment in the midst of the Governor's prosecutorial zeal.  The Committee held several work sessions on the bill last week and has scheduled another for today.

Insurance & Financial Services Committee Finalizes Single Payer Study Bill 

After many hours of work in repeated work sessions during the course of the session, last Thursday afternoon, the IFS Committee reported out L.D. 1345, a bill to conduct an updated study on the feasibility of implementing a single payer health care reform program in Maine.  As expected, the vote was largely along party lines with Democrats in support and Republicans opposed, but freshman Rep. Peter Doak (R-Columbia Falls) did vote in favor of the bill.  A gubernatorial veto is likely.

Education Committee Approves Final Version of Epinephrine in Schools Bill 

The Education Committee last week approved final language of LD 1727, a bill that will allow trained, unlicensed school personnel to administer epinephrine to students who have not previously been identified as having an allergy. Physicians and primary care nurse practitioners will be able to enter collaborative practice agreements with school nurses to provide epinephrine, and school nurses will be allowed to designate unlicensed school staff, who have been trained, to also administer the medication in an emergency.    [return to top]

Latest on Effort to Repeal Medicare's SGR Payment Formula: Senate Votes this Week

The United State Senate is expected to vote this coming week on legislation that would eliminate the flawed Medicare SGR physician payment formula.  The Senate bill is expected to be voted without any budgetary offsets to pay for it, an approach most recently recommended by the Wall St. Journal editorial staff.

The House of Representatives on March 14 passed a separate SGR repeal bill which included a budgetary offset paid for by a five year delay in the individual mandate included in the Affordable Care Act.  The House bill is expected to be rejected by the Democratic controlled Senate and, in any case, President Obama has stated he would veto the bill.

If the Senate and House do not agree on how to pay for the bill, another temporary patch is likely and a golden opportunity to permanently repeal the formula will have been lost.

As reported last week, Congress was in recess last week, so there was no legislative activity on the SGR issue.  On March 19th, the Congressional Budget Office (CBO) estimated that a new Senate bill to permanently replace the Medicare SGR physician payment methodology (S. 2110) would cost $180.2 billion for the period from 2014-2024.  The score for this bill includes the extension of other Medicare programs set to expire that was not included in an earlier Senate bill on SGR replacement (S. 2000).  This figure is based upon the $138.4 billion cost of the SGR replacement plus $41.8 billion for the "extenders."  

Physicians face a 24% cut in Medicare reimbursement on April 1st unless Congress passes a permanent fix, unlikely because of continuing disagreement about the "pay fors," or a "patch" or short-term fix likely to be either 9 or 12 months. But Maine Senators Susan Collins, Angus King and many others are still working toward a positive fix and lightening could still strike this coming week.

Thanks to all MMA members and others who have communicated to the Maine Congressional delegation the urgent need to permanently repeal the SGR formula and replace it with the substantive provisions agreed to on a bipartisan basis by the three major committees with jurisdiction over Medicare. [return to top]

Happy Doctor's Day: March 30, 2014

Each year, Doctor's Day gives people an opportunity to say a simple "thanks" to their physician.  This year Doctor's Day is being celebrated on this coming Sunday, March 30.  A special thanks to our MMA members who work hard all year to provide quality care to Maine patients.  We appreciate all you do.

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Only 1 Week Left to Enroll in Health Health Insurance Marketplace - Resources for Patients and Staff

Affordable Care Act Resources for Patients and Staff 

Do your patients have questions about Maine’s Health Insurance Marketplace and the Affordable Care Act (ACA)?

The 2014 Open Enrollment period ends on March 31, 2014.  Patients can visit or call 1-800-318-2596 to:

  • Find a Certified Application Counselors to answer questions and help them apply. 

  • Find dates and locations for walk-in sessions where they can get in-person assistance . 

Interested in resources for staff or patients and families? 

Susan Kring is the new ACA Outreach Coordinator at the Maine Medical Association, and can provide your practice, unit or office with information, resources and training about the health insurance Marketplace and the ACA.  Call 662-2364 or email Sue for more information. [return to top]

Hanley Center Physician Executive Leadership Institute Participants Recognized

Twenty-five physician leaders from Maine, New Hampshire and Vermont - including three current MMA Board Members - completed the Hanley Center’s Physician Executive Leadership Institute Advanced Course on March 15 in Brunswick.   Participants in the Advanced Program are named McAfee Fellows in honor of Robert McAfee, M.D., the only Maine physician to have served as President of the AMA.  Dr. McAfee addressed the graduating class in Brunswick and has attended many of the six two-day sessions since the class began in May, 2013.  A five member faculty team from Brandeis University, led by Jon Chillingerian, PhD., delivers the course along with Maine-based faculty assembled by the Hanley Center.

The Hanley Center currently is building its third class of McAfee Fellows.  There are still open seats available for the course, which begins May 1.  Physicians completed the course receive 80 Category One CMEs.  Physicians interested in learning more about the course should contact the Hanley Center’s Executive Director, Jim Harnar at   Information about the program can be found at

Pictured (left to right):  Jon Chilingerian & Jodi Hoffer Gittell, Brandeis Faculty; Daniel Loiselle, MD; Natania Piper, DO; Joseph Py, DO; Christopher Bowe, MD; Dervilla McCann, MD; Sara Freedman, MD; Kathleen Schwartz, MD; Roger Pelli, DO;  Joshua Plavin, MD; Heidi Decker, MD; Maroulla Gleaton, MD (MMA Board Member); Sarah Irving, MD; Timothy Pike, DO; Katarzyna Sadurska, MD; Dieter Kreckel, MD (MMA Board Member); Robert McAfee, MD; Robert Chagrasulis, MD (MMA Board Member); Dora Anne Mills, MD; Kathryn Vezina, Hanley Staff; Michael Bergeron, MD; Cyrus Jordan, MD; Michael Duffy, MD; John Alexander, MD; James Harnar, Hanley Staff. (Missing McAfee Fellows:  Kristen Martin, DO; Charles Radis, DO; Michael Rousse, MD; Douglas Wood, DO). [return to top]

Dr. Caper Comments on Health Care Reform Question in MMA Survey

The MMA recently released results from our January 2014 survey on payment reform. A total of 261 people completed the entire survey, representing a diverse selection of practice sizes, specialties, ownership and employment models, and geographic locations within Maine. Some highlights of the results include:

  • Most respondents (79%) agreed the current system should be restructured to align payment with optimal clinical care.
  • More than half (52%) said that they are prepared or are preparing for payment reform.
  • Nearly all respondents indicated that they understand most payment reform models, but – with the exception of pay for performance - fewer than half are currently participating in payment reform. Within 24 months though, respondents expected their participation to double. 

Complete results are available on the Payment Reform by clicking here.  MMA also recently released results of a survey question regarding physicians' views on a single payer health care system.  Dr. Philip Caper, a founding member of Maine AllCare, commented on those survey results in an opinion piece in the Bangor Daily News last Thursday. [return to top]

CME Opportunities and Consultations Available on Prescribing for Pain and Appropriate Use of the PMP

MMA has grant funds available through the end of June to assist members and practices with the difficult area of prescribing for acute and chronic pain and including specifically the appropriate use of the state's Prescription Monitoring Program.  These resources can include CME presentations or in-office consultations.  The funding is available through existing grants from the Offices of Substance Abuse and Adult Mental Health Services and the Maine Board of Licensure in Medicine. Contact MMA Executive Vice President Gordon Smith if you or your practice would like to take advantage of these free resources before the two grants expire. Gordon can be reached at 622-3374, ext. 212 or via e-mail to [return to top]

Medical Students Celebrate Match Day; All-Time High of nearly 30,000 Positions Offered

Medical students around the globe celebrated Match Day last week, with an all-time record of 29,671 first and second year positions offered.  This total represents an increase of 500 from 2013, according to the National Resident Matching Program.  More than half of the additional positions were in primary care positions in internal and family medicine.

Over 40,000 students participated in the Match with over 50% of match recipients receiving their first choice.  The most competitive specialties included neurological surgery, orthopedic surgery, otolaryngology, cosmetic surgery and radiation-oncology.

Congratulations to our many MMA student members who matched!  [return to top]

MMA Legislative Committee Weekly Conference Call, Tues., 3/25/14, 8 p.m.

The next MMA Legislative Committee weekly conference call will take place tomorrow night, Tuesday, March 25th at 8:00 p.m. 

Legislative Committee members and specialty society legislative liaisons are strongly encouraged to participate.  Any physician, practice manager, or other staff member who is interested in the MMA's legislative advocacy also is welcome to participate.  It is not necessary to RSVP for the calls.

Please use the following conference call number and passcode.  These will remain the same for every weekly call during the session:

Conference call number:  1-619-326-2772 

Passcode:  729-7185

The purpose of the weekly conference calls is to review and finalize the MMA's position on bills printed that week, to hear the views of specialty societies on the new bills or their concerns about any health policy issues, and to discuss the highlights of legislative action that week.  The calls rarely last longer than an hour and usually we can accomplish our business in much less time.  The MMA staff lists a suggested position for each bill and any medical specialty particularly affected by the bill.

If you have an opinion about any of these bills, but cannot participate in the call, please contact Andrew MacLean, Deputy EVP at or 622-3374, ext. 214.

The following are new bills for review this week and the MMA staff also will brief participants on the latest news from the State House.

LD 1829, An Act To Require the Department of Health and Human Services To Report Annually on Investigations and Prosecutions of False Claims Made under the MaineCare, Temporary Assistance for Needy Families and Food Supplement Programs (monitor)

LD 1840, An Act To Implement the Recommendations of the Substance Abuse Services Commission with Regard to the Controlled Substances Prescription Monitoring Program (support)

LD 1843, An Act To Make Supplemental Appropriations and Allocations for the Expenditures of State Government and To Change Certain Provisions of the Law Necessary to the Proper Operations of State Government To Address Supplemental Funding Needs Projected for the Fiscal Year Ending June 30, 2014 and To Adjust Funding for the Fiscal Year Ending June 30, 2015 (supplemental budget; monitor) [return to top]

Job Openings

Physician - Wound Care, part time

Mercy, a member of the Eastern Maine Healthcare System (EMHS), is the Greater Portland regional health care system representing the highest standards of clinical excellence and compassionate care.  We are seeking a Physician to join our Wound Healing Center. This is a part-time, 20 hour per week benefited position.

Mercy's Wound Healing Center provides advanced wound healing techniques, two hyperbaric oxygen therapy chambers and state-of-the-art assessment, testing and treatment for people suffering from acute and chronic wounds. The successful candidate must be an MD, DO or DPM, eligible to be licensed in the State of Maine and board certified or eligible in the physician’s specialty. Broad and in-depth technical knowledge and skills related to the practice of medicine and wound care and relevant training and experience in hyperbaric medicine is desirable. 

Mercy offers a competitive salary and benefits package. The beautiful Greater Portland area is a community rich in cultural resources with an active, working waterfront, in a region that abounds in year-round outdoor recreation from the ocean to the mountains.  E.O.E.

FMI, and to apply for this position, please visit our website at or contact Alison Salerno, Provider Recruiter at , or 207-879-3804.


ED Provider Jobs

Challenging, Lucrative, ED Provider jobs in central Maine - honoring and serving Veterans.  ED Physicians are needed in Augusta. Must-have an unrestricted medical license (from any U.S. state), and current ACLS certification. This is your opportunity to use and develop your skills of diagnosing, treating, and managing patients according to standard, usual, and acceptable methods and techniques.

B/C or B/E specializing in EM, IM, or FP by the appropriate accrediting agencies (EM preferred).

This is the opportunity for you to receive a competitive salary, a generous leave package, excellent health & life insurance benefits, and retirement benefits. You'd be eligible to participate in a pension program as well as a matching Thrift Savings Plan which is similar to a 401K. If you are a veteran, you may be able to combine accrued military retirement credit with VA pension benefits.

Your salary will be determined by local Physician/Dentist Compensation Panel (commensurate with education, experience and qualifications). By law, U.S. Citizens will be given 1st preference but non-citizens will be considered in the absence of qualified citizens. A signing bonus may be available.  Equal Opportunity Employer. Disabled persons and/or veterans are encouraged to apply.

FMI, call John Poulin at (877) 421-8263 x6913, or email him at

To apply, go to


Medical Director - Scarborough, ME

We are seeking an experienced Medical Director with interest in occupational medicine for our clinic in Scarborough, ME. The Medical Director will be able to practice medicine in a supportive environment while providing oversight to mid-level practitioners.

The successful candidate must be board certified or board eligible MDs or DOs in Maine. Previous experience in Occupational, Emergency, Internal or General Practice Medicine is preferred.

About U.S. HealthWorks:

U.S. HealthWorks Medical Group is a leading national provider of occupational medicine and urgent care services. Operating close to 200 medical centers in 19 states with nearly 2,000 employees, including approximately 350 affiliated physicians; U.S. HealthWorks serves thousands of patients each day. At U.S. HealthWorks Medical Group, we offer programs and services that can help prevent illness, maintain health and provide early intervention and rehabilitation whenever injuries or health problems occur.

In addition to competitive salaries we offer: 

Occupational Medicine Focus

Incentive plans

Opportunity to grow and learn with an industry-leading healthcare organization

Flexible hours and excellent work environment

Benefits including, health, dental, vision, 401(k)

Apply Today!

Email: - Online: - Call: 1.888.770.8749 ext. 2659



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Upcoming Events

Free On Demand CME: Motivational Interviewing 

Basic Skills and Clinical Applications of Motivational Interviewing

This online activity consists of two-30 minute modules on using motivational interviewing techniques to help patients change health behaviors. Specifically, the program addresses four different problems that negatively affect health: non-adherence to treatment guidelines, poor eating habits, lack of exercise, and smoking. The activity also provides scenarios that demonstrate how MI is used in clinical settings.

Faculty: Michael Bierer, MD, MPH

Provided by Lunder Dineen Health Education Alliance of Maine - In Collaboration with Massachusetts General Hospital

Click here for more information or to take the course.


ICD-10 CM Training Session for Coders, March 25 & 26

Maine Medical Association Offices, Manchester, ME 

Registration fee: $545 per person and will include a training manual and a 2014 ICD-10 Manual.

For more information or to register, click here.

This two day multi-specialty training session for coders will be presented by Laurie Desjardins, PCS, CPC-1 and others from CSI Coding Strategies.  The training will cover ICD-10 CM coding fundamentals and ICD-10 code assignment.


Free Webinar on the Disability Benefits Questionnaire

Hosted by the Department of Veterans Affairs, Benefits Assistance Service

March 28, 2014

9:30 am or 1:30 pm

The free webinar will walk through filling out and submitting Disability Benefits Questionnaires (DBQs) for VA disability claims applications. Learn how these downloadable, electronic forms can be filled out by clinicians with an active medical license to help VA determine disability ratings. 

Click here to register for the 9:30 am session or here for the 1:30 pm session.


Transforming Health Care:  Patients as Partners

March 31, 2014

5:30-7:30 pm 

On March 31st, Maine Quality Counts and its partners will present free “Health Care Town Hall Meetings” throughout Maine to discuss how patients and providers can Choose Wisely.  John Santa, MD, MPH will be presenting live at Maine General Medical Center’s Alfond Center for Health, Education Pavilion with live stream webcast out to the following locations:

Brewer - EMHS, Cianchette Auditorium
Lewiston - University of Maine campus
Machias - University of Maine campus
Presque Isle - University of Maine campus
Portland - University of Maine, Wishcamper Center
Waterville -Thayer Center for Health, Dean Auditorium

 For more information on the event and to register, click here.  Or call Judy Ward at 207.620.8526, ext. 106 or email:


Registration Now Open! 

Quality Counts 2014 Annual Conference 

Wednesday, April 2, 2014

Augusta Civic Center

Click here to register.

This year's conference, a collaborative effort of Maine Quality Counts, the Maine Primary Care Association, and the Maine Public Health Association, is titled, Innovation to Transformation:  What Will it Take?

As health care providers, payers, and consumers increasingly effectively work collaboratively as communities to bring together "medical neighborhoods" as private-public partnerships that align efforts to transform health care delivery and payment systems.  QC 2014 will help inform and advance these efforts.

More information can be found on the QC website.


Maine Harm Reduction Conference

Wednesday, May 14, 2014

9 am - 4:30 pm 

Kaplan University, Augusta, ME

Keynote Speaker, Jon Zibbell, Medical Anthropologist with the U.S. Centers for Disease Control will explore the intersection of culture, stigma, drug use behaviors and infectious diseases such as HI and hepatitis C. Jon's anthropologcial fieldwork immersed him in the subculture and lives of persons who inject drugs.

For more information, visit:


Maine's Health Workforce:  What Does the Data Tell Us?

Presented by the Maine Health Workforce Forum

April 15, 2014

8:30  – 10:30 am 

MaineGeneral Medical Center, Alfond Center for Health, Augusta,

Pre-registration not required

For more information, visit:


2014 Hanley Center Honors for Leadership in Health Equity & Health Disparities

Wednesday, April 16, 2014

 Reception & Dinner

 Portland Marriott at Sable Oaks, South Portland

The keynote speaker at the recognition dinner will be Dr. Lori Alviso Alvord, the first Navajo Woman Surgeon and author of "The Scalpel and the Silver Bear."


Maine Society of Eye Physicians and Surgeons Spring Educational Program and Business Meeting

Friday, May 2, 2014

12:00pm - 4:45pm

Harraseeket Inn, Freeport, ME

For more information, please contact Shirley Goggin at or 207-445-2260.


The Maine Public Health Association (MPHA) Tobacco Webinar Series  

Sex Sells: the Wild, Wild East—Emerging Tobacco Trends

May 15, 2014, 2:00 pm 

Register Now  


Inter Professional Collaborative Practice Summit 

May 28, 2014

University of New England Harold Alfond Forum, Biddeford, Maine

Funded by the Josiah Macy, Jr. Foundation and the Maine AHEC network, the summit will host national experts to address the relationship between health professions education, clinical practice, and national healthcare reform. 4.25 hours CME credit expected.

Click here for more information.


Maine Concussion Management Initiative Trainings 

June 13, 2014 in Waterville at Colby College (Date tentative)
October 21, 2014 in Portland in conjunction with the Maine Brain Injury Conference

All sessions 7:30 a.m. - 12:00 p.m. 

Includes An Introduction to Concussions and Concussion Management & Interpreting Neurocognitive Testing (including using ImPACT)

$100 for Health Care Professionals  (CEUs/CME available); $40 for school personnel and all other attendees

For more information or to register, contact Jan Salis,, (207) 577-2018

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