October 26, 2015

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Open Enrollment in the Marketplace Exchange Begins Nov. 1; Medicare Open Enrollment Began Last Week

Open enrollment in the Marketplace Exchange begins on Sunday, Nov. 1 and MMA is, once again, providing information to practices to share with patients who may qualify for subsidies in the Exchange.  The annual open enrollment period for Medicare also began last week and will continue until Dec. 7.  

The 2016 sign-up season for purchasing health insurance in the ACA Marketplace Exchange begins on Nov. 1. The enrollment period will last for three months, ending on Jan. 31, 2016. Patients who currently have a 2015 health insurance plan through the Marketplace should review their plans and either renew coverage or select another plan for 2016. The Obama administration recently announced that it expects only a small increase in enrollment this year. HHS Secretary Sylvia Burwell has set a target of 10 million people being enrolled and paying their premiums by the end of next year.  That is only a small increase from the number of individuals covered through the exchanges now.

Secretary Burwell stated that it will be more difficult to sign up the remaining uninsured as many are young, with limited resources, and many are not aware of their eligibility for subsidies available through the exchange. Depending on household income, consumers may be able to get lower costs on monthly Marketplace health insurance premiums and out-of-pocket costs.  Most people who apply will qualify for some kind of savings.

Outside of Open Enrollment, some people may qualify for a Special Enrollment Period (SEP) if they have certain life changes, such as having a baby, adopting a child, or placing a child for adoption; getting married; change in Immigration status; moving to a new coverage area; aging off a parent’s plan at 26; or losing health insurance (but not if lost due to non-payment or voluntarily dropping coverage).   

The Medicare Open Enrollment period runs from October 15 to December 7, 2015 for the 2016 calendar year. During this time one can switch from Original Medicare to Medicare Advantage or switch between Medicare Advantage plans.

MMA is assisting medical practices with Open Enrollment by providing informational materials that can be shared with eligible patients.  If you are interested in partnering with MMA in this important endeavor, contact Susan Kring at skring@mainemed.com.  These efforts are supported by a grant from the Maine Health Access Foundation (MeHAF).

Legislative Council Approves only 32 Bills for Second Session; Many Appeals Expected

On Thursday, October 22nd, the 10 member Legislative Council voted to allow into the Second Regular Session of the 127th Legislature only 32 of the approximately 400 bills submitted for introduction by legislators.  Another 18 bills were tabled.  However, legislators are able to appeal the denial of a bill for introduction, so many of the bills denied last week are likely to be approved at the Council Meeting in November.  In addition, 176 bills introduced during the First Regular Session were carried over into 2016 and the Governor can introduce bills at any time so there will be plenty of work for legislators during the second session.

MMA did not prepare any bills for introduction into the second session.  There are, however, several bills of interest pending among the 176 bills held over including L.D. 622 requiring mandated training of all mandated reporters of child abuse or neglect; L.D. 690 licensing Certified Professional Midwives who assist deliveries at home and at free-standing birthing clinics; L.D. 633 expanding Medicaid as authorized by the ACA; and L.D. 1305 promoting consumers' ability to shop for medical services.

You can find the lists of legislator bill requests along with the Legislative Council's most recent action here.

You can find the MMA's summary of action in the First Regular Session which includes the entire list of bills carried over to the Second Regular Session on the MMA web site here.


MMA Legislative Committee Chair Amy Madden, M.D. urges all physicians and others interested in the MMA's legislative advocacy work to mark your calendars for the evening of Monday, December 7th for an organizational meeting of the Legislative Committee in anticipation of the Second Regular Session of the 127th Maine Legislature.  In keeping with the agenda of recent such meetings, dinner will be available at 6 p.m. and the meeting will last from approximately 6:30 to approximately 8:30 p.m.  The meeting will be in the large conference room at the Frank O. Stred Building in Manchester.  Look for more information on the agenda closer to the date of the meeting, but if you know you will be able to join us, please RSVP to Sarah Lepoff at slepoff@mainemed.com.  As usual, we strongly urge physician specialty organizations to send a representative to the meeting.

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Prevention/Harm Reduction Task Force to Meet Thursday, Oct. 29, 9:00am to Noon at MMA
The Prevention/Harm Reduction Task Force recently established as part of the Anti-Heroin Initiative of the U.S. Attorney, Maine Attorney General and the Commissioner of Public Safety will hold its initial meeting this coming Thursday from 9:00am to noon at the offices of MMA at 30 Association Drive in Manchester.  The Task Force is chaired by Eric Haram and William Paterson.  

The Treatment Task Force met on Oct. 16 and is in the process of scheduling its second meeting for the end of this week.  The Treatment Task Force is chaired by Mark Publicker, M.D. and Pat Kimball.  This second meeting will also be held at MMA offices.
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The New EHR Rules: What Now?

The AMA Advocacy team reports that more than 1,300 pages of new regulations released earlier this month outline requirements for the electronic health record (EHR) meaningful use program, with several changes applying this year. These regulations are based in two new rules modifying the meaningful use program and setting out technological outlines for new EHR programs.

The good news is that the first rule eases and streamlines some of the requirements for Stage 2. Unfortunately, it also fails to hold off application of Stage 3 as requested by physicians and Congress, and it makes mandatory a previously optional public health and clinical data registry reporting objective.

Immediate improvements to Stage 2 include several that the AMA had urged the Centers for Medicare & Medicaid Services (CMS) to make:

  • Physicians have a shortened reporting period for 2015. Instead of the full calendar year, physicians will be required to report on any consecutive 90 days.

  • The overall number of measures physicians must report on has been reduced.

  • The measure threshold for the requirement for patients to view, download or transmit their records has been cut down from 5 percent of patients to just one patient in 2015 and 2016. (This threshold goes back up to 5 percent in 2017.)

  • The threshold for the secure messaging requirement has been scaled back from 5 percent of patients to simply having the capability to send secure messages in 2015 and doing so with at least one patient in 2016. (This threshold also goes back up to conducting secure messaging with at least 5 percent of patients in 2017.)

CMS has stated that a hardship exemption will be available for physicians who are unable to meet the meaningful use requirements due to a delay in publication of the regulations.

The AMA is encouraging physicians to apply for a hardship exemption under the “extreme and uncontrollable circumstances” category, even if they are uncertain whether they will meet the program requirements this year. The exemption application will be available early next year, and CMS has approved over 85 percent of hardship exemptions requested in the past.

All physicians will be required to meet Stage 3 requirements beginning in 2018. The new rule (in its current form) will require physicians to upgrade to EHR products that meet the new certification requirements.

The AMA is intensifying its efforts to engage lawmakers and other stakeholders to reset the direction of the meaningful use program. While CMS is allowing a 60-day comment period for feedback on the final rule, a groundswell of physician responses will be needed to change the proposal, given the complexities of the lengthy regulations already issued.

Physicians can visit BreakTheRedTape.org to easily submit their comments on the new rule to CMS and ask the agency to take action so that critical problems with the program are addressed before moving forward.

The AMA is also asking physicians to join their peers in sharing their stories about how meaningful use regulations are affecting the patient-physician relationship. [return to top]

MaineCare Seeks Medical Director

The Office of MaineCare Services (OMS) is searching for a new Medical Director.  This position will have a key advisory role on a variety of health care issues, policy development, utilization of resources, and clinical practice models. 

The Medical Director is MaineCare’s clinical representative with external partners, governmental departments, and stakeholders, such as pharmacy, dental, nursing, and other medical organizations and committees or associations. He or she will also play a critical role in furthering MaineCare’s value-based purchasing initiatives, which incent providers and community organizations to provide the right services, at the right time, in the right setting, with a focus on improving the health of Maine’s most vulnerable citizens.  

This position is contracted through the University of Maine and is based in Augusta. The annual salary is $181,800. 

Please contact Stefanie Nadeau, Director of MaineCare Services, with any questions. She can be reached at (207) 287-2093 or by email: stefanie.nadeau@maine.gov. [return to top]

Maine Health Management Coalition and Maine Medical Association - 2015 Symposium Leading Change


MMA has combined its 25th Annual Practice Education Seminar with the Annual Meeting of the Maine Health Management Coalition.  In addition to the break out sessions for practice managers that members have come to expect from MMA, attendees will also have the opportunity to hear from plenary speakers, such as author Dan Heath.  Don't miss this rare opportunity to hear from one of America's most entertaining and insightful speakers. Heath will be keynoting the program, entitled, Leading Change: How to Make the Switch From Volume to ValueNot only is Heath a thrice-over New York Times best-selling author, he's also an educator, social entrepreneur, and one of the 50 most influential management thinkers in the US according to Thinkers50! The first 400 persons registering for the conference will receive a free copy of his book, Switch.   Learn More

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ACS Changes Mammogram Guidelines

The American Cancer Society has modified its breast cancer screening recommendations. The new guidelines, replacing those in place since 2003, recommend that women who are at average risk for breast cancer start annual mammograms at age 45 and continue until age 54. At that point screening frequency should be reduced to once every two years. That schedule should continue as long as a woman’s life expectancy is at least 10 years. The new guidelines also eliminate the recommendation that women receive manual clinical breast exams.

The new ACS guidelines now line up more closely with those of the U.S. Preventive Services Task Force. The task force recommends mammograms for women at average breast cancer risk every two years starting at age 50 and continuing until age 74. Both sets of guidelines state that women may request screening earlier than the recommended age.

The guideline changes are not expected to affect insurance coverage, at least in the near future. [return to top]

MMA/Baystate Financial Fiscal Fitness for Life Seminar

In our continued effort to provide members with easy access to information critical to making informed decisions regarding their financial well-being, MMA in conjunction with Baystate Financial will be hosting the third of our ongoing semi-annual Financial Educational Seminars on Tuesday, November 10th from 6:00 to 8:00 p.m. at the Saltwater Grille, 231 Front Street in South Portland. Refreshments will be served.

This seminar topic: Estate Planning 201- Beyond the Basics- is being presented in response to the previous seminar attendees, by almost unanimous request, for more information regarding Estate Planning issues. Issues addressed will include wills, revocable trusts, powers of attorney, health care proxies and "living wills."

Baystate Financial has years of experience developing personalized financial strategies for physicians. They help medical practitioners at all stages of their careers plan the financial futures of their practices and their families.

Please respond by November 3rd to Lawrence Perry, CLU, ChFC, CLTC at (207) 775-6181 or (@07) 770-2021, or by Email to lperry@baystatefinanical.com.

If you are unable to attend but would like to receive information on the seminar topic-Estate Planning 201 Beyond the Basics, please don’t hesitate to contact Lawrence Perry at lperry@baystatefinanical.com

The Maine Medical Association is pleased to be able to offer this continued service from Baystate to you, our members.

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Maine Awarded Federal Grant to Promote Colorectal Screening

After a competitive application process the U.S. Centers for Disease Control and Prevention has awarded over $22 million to a number of state health departments, six universities and one Native American tribe to promote and increase colorectal screening. According to the American Cancer Society, the Maine Department of Health & Human Services share is over $499,000.

“Colorectal cancer is the second leading cancer killer of both men and women in the United States, but most colorectal cancer can be prevented,” said Tom Frieden, M.D., M.P.H., director of the Centers for Disease Control and Prevention. “Screening saves lives and funds we are providing the states will support doctors, nurses, and others to save lives."

Each grantee must target its services towards the following:

  • Adults 50-75 years of age without symptoms;
  • Low-income, under- or uninsured, racial and ethnic groups disproportionately affected and/or with geographic barriers to screening;
  • At-risk populations.

CDC is requiring all grantee Colorectal Cancer Control Programs (CRCCP) to work with health systems partners to use a combination of evidence-based strategies to increase the number of people screened. These evidence-based strategies include patient and provider reminders, provider assessment and feedback as recommended by the Task Force on Community Preventive Services. They will implement these strategies considering the unique needs and situations of their health systems partners.

Since the program’s inception in 2009, CRCCP has provided almost 55,000 colorectal cancer screening exams and diagnosed 165 colorectal cancers and 8,441 cases of precancerous polyps. In program year 2014, CRCCP screened 13,425 people for colorectal cancer.

“We are very pleased that the CDC has recognized the value of this type of preventive health program,” said Gordon Smith, Executive Vice President of the Maine Medical Association. “This grant should help physicians and other healthcare providers to impress upon the public the importance of colorectal screening in preventing cancer.” [return to top]

Job Openings


Inland Hospital Family Practice is seeking a full time Family Medicine Physician without OB to join the employed practice in Oakland.

The practice has been serving the greater Waterville/Oakland area for many years. The practice provides care for infants, pediatrics through geriatric care. A competitive salary with incentives, plus full benefits is offered along with assistance with medical education debt, paid time off, paid CME, and relocation allowance. Qualifications: Board Certified/Eligible in Family Practice. This site is not eligible to sponsor a J-1 waiver.

Inland Hospital is a dynamic healthcare organization that believes in putting the patient first in every way. We are a 48-bed community hospital in Waterville; Lakewood, a 105-bed continuing care center on the hospital campus; 18 primary and specialty care physician offices in Waterville and five surrounding communities. Inland has been a proud member of EMHS since 1998. Inland patients have seamless access to a higher level of care when needed.

For further information, please contact:

Sherry Tardy, Director Business Development/Provider Recruitment, Inland Hospital by email at: stardy@emh.org or by phone at: 207-487-4085.


Direct Care Boston Family Physician

Opportunity to join a solo practicing Family Physician in direct care, concierge practice in the heart of Boston with a founding physician trained and practiced in Maine 15 years before coming to Boston. Seeking a collegial physician with highest level skills. The Harvard-affiliated practice gives full conventional as well as integrative/functional medical care.

Job Details:

  • See 2-8 patients per day
  •  Medical care of children, adults, geriatric homecare and international patients
  •  Clinical practice and/or interest in both Functional and Integrative Medicine
  •   Share weekend and vacation call


  •              MA license
  •              Family Medicine Board certification
  •              Internal Medicine Board certification


  •             Competitive compensation
  •             Health and Dental benefits
  •             Medical malpractice
  •             CME compensation

We are located 3 blocks from the Boston Common near the best-ranked schools and colleges. Harvard CME conferences are walking distance. The area offers many cultural, educational and academic opportunities.

Contact: Meghan at office@personalhealthmd.com.

Website: www.personalhealthmd.com. We would look forward to discussing this position.


E.M. BC/BP Physicians

St. Joseph Hospital is recruiting E.M. BC/BP physicians for its dedicated group.  Collegial, nurturing workplace with latest technology and just-completed expansion.  Members support each other and know patient satisfaction is achieved through staff satisfaction.  Leadership development and participation in policies and direction available. 

Equitable scheduling based on 1440-1472 clinical hours per year; more flexible arrangements available. 

Staffing: 51 hours per day, mostly physicians, for 27,000 visits.  We have great E.D. nurses.   

Area offers many cultural attractions, including the University of Maine, natural and organic food producers, pleasant pace, low crime, friendly people, great public schools and affordable housing.  Acadia National Park, Baxter, scenic towns and harbors, Sugarloaf,  I-95 and Bangor International Airport are right here or close.

Highly competitive package includes relocation, signing bonus, loan repayment, retirement and protected vacation and CME time with allowance.

Contact: Charles F. Pattavina, MD, F.A.C.E.P., Chief, Emergency Medicine at 207.907.3350  or cpattavina@sjhhealth.com


BC/BE Family Practice Physician

Belgrade Regional Health Center seeks a BC/BE Family Practice Physician to provide primary care and preventive services to people from birth through retirement and beyond. As a NCQA-Patient-Centered Medical Home, we offer accessible, high quality healthcare with integrated behavioral health services focused on the patient’s care experience. Founded in 1977, we serve over 2,100 residents and travelers each year. We reside in the peaceful, picturesque, and welcoming Belgrade Lakes region in the heart of central Maine, renowned for its chain of seven sparkling lakes and abundant streams. We offer competitive compensation and malpractice coverage. Position is eligible for loan repayment. EOE. Contact: Recruiter, HRCHC, 10 Water Street, Suite 305, Waterville, ME 04901 | (207) 660-9913 | Fax: (207) 660-9901 | Communications@HealthReach.org | www.BelgradeCHC.org


Department of Psychiatry Faculty Position

The Geisel School of Medicine at Dartmouth, Department of Psychiatry, in a productive collaboration with the State of Maine, is seeking psychiatrists to join our faculty for inpatient responsibilities at the Riverview Psychiatric Center.

Riverview Psychiatric Center is a 92-bed acute psychiatric facility located in Augusta, ME and is the flagship inpatient treatment center for Maine’s public mental health system.  Psychiatrists with expertise in general inpatient psychiatry or forensic psychiatry are encouraged to apply.

Academic duties can include teaching and supervision of medical students and residents. Research opportunities available and encouraged.

Candidates should be board certified or eligible in Psychiatry. This position will include a faculty appointment at The Geisel School of Medicine at Dartmouth at a rank and salary commensurate with experience. Curriculum vitae and three letters of reference, addressed to Dr. William Torrey, Search Chair, should be e-mailed to psychiatry.jobs@dartmouth.edu.  Please reference search number PS0314D.

Dartmouth College/Dartmouth Hitchcock Clinic/Geisel School of Medicine is an equal opportunity/ affirmative action employer with a strong commitment to diversity. In that spirit, we are particularly interested in receiving applications from a broad spectrum of people, including women, persons of color, persons with disabilities, veterans or any other legally protected group.



DFD Russell Medical Centers (DFDRMC) operates three community health centers in beautiful Central Maine.  We are seeking a full time physician for immediate placement.  A current unencumbered Maine license and proficiency with electronic medical records are required.

Our three health centers serve a multicultural, rural population of about 10,000 patients and have a family practice focus serving pediatrics to geriatrics.  We have integrated behavioral health, care managers, a patient assistance coordinator and an excellent clinical support staff to support the candidate in delivering excellent clinical care.

Excellent benefits, including medical, dental, life insurance, 401K retirement plan, flexible spending accounts, generous paid time off and an incentive plan.  Salary is commensurate with experience.

We are an equal opportunity employer committed to diversity in the workplace.  If you want additional information about this position, which combines making a difference in patients’ lives with a family-friendly work life, please fax (207-524-2459) or e-mail (Laurie.kane-lewis @dfdrussell.org) your resume as soon as possible to Laurie Kane-Lewis, CEO.



As a General Surgeon in the Air Guard, you’ll adapt the skills and knowledge you’ve gained in your civilian career to the military environment.  You’ll provide urgent treatment to Air Guard personnel sick or wounded during duty, and regular healthcare to personnel training in your unit.


The Air Guard gives you the opportunity to serve your community and country with pride, and help people in a whole new way. If you still have student loans, you may be eligible for the Student Loan Repayment Program, or you can potentially get money for college that transfers to your dependents through the Montgomery G.I. Bill.

Besides a monthly paycheck, as a member of the Air Guard you’ll receive low-cost life insurance, a military retirement plan, and eligibility for VA home loans. With more than 140 Air Guard bases in the United States, Puerto Rico, Guam, and the U.S. Virgin Islands you’ll be able to serve where you live, without interrupting your civilian medical practice. And as an Air Guard member you’ll have access to Base Exchange and Commissary shopping as well as free available air travel.

Learn More Today

Go to GoANG.com/HP or call 1-800-To-Go-ANG to find out how you can become an important member of America’s homeland defense in the Air Guard.


Orthopedic Surgeon

The Air Guard Orthopedic Surgeon examines, diagnoses, and treats diseases and injuries of musculoskeletal system by surgical and conservative means. In this role, you’ll manage orthopedic surgery services as well as oversee the administration of anesthetics and provide diet recommendations in addition to performing surgical procedures.


The Air Guard gives you the opportunity to serve your community and country with pride, and help people in a whole new way. If you still have student loans, you may be eligible for the Student Loan Repayment Program, or you can potentially get money for college that transfers to your dependents through the Montgomery G.I. Bill.

 Besides a monthly paycheck, as a member of the Air Guard you’ll receive low-cost life insurance, a military retirement plan, and eligibility for VA home loans. With more than 140 Air Guard bases in the United States, Puerto Rico, Guam, and the U.S. Virgin Islands you’ll be able to serve where you live, without interrupting your civilian medical practice. And as an Air Guard member you’ll have access to Base Exchange and Commissary shopping as well as free available air travel.

Learn More Today

Go to GoANG.com/HP or call 1-800-To-Go-ANG to find out how you can become an important member of America’s homeland defense in the Air Guard.


Winthrop Family Medicine Family Practitioner

Live and work amidst the beauty of scenic central Maine where you’re just a short drive away from ski resorts, lakes and rivers, award-winning golf courses, abundant hiking, and the beautiful Maine coast. The brand new, state-of-the-art, 192-bed MaineGeneral Medical Center at the Alfond Center for Health offers comprehensive inpatient and outpatient services for the surrounding communities. We’re located just an hour north of Portland, Maine’s largest city, and three hours from Boston.

MaineGeneral Medical Center, Central Maine's premier integrated health delivery system, is seeking a BC/BE Family Practitioner to join our nationally recognized Advanced Medical Home practice that delivers care in a team model.

Job Details and Requirements:

·        Join a collaborative group made up of 11 MDs, DOs, NPs and PAs

·        Provide a full range of care including: newborn and pediatric care, adult medicine, gynecology, geriatric and nursing home care

·        Outpatient opportunity

·        Technology includes an electronic medical record, online digital radiology program, and online hospital records and ordering

Benefits of practicing at MaineGeneral include:

·        Competitive salary

·        Loan repayment opportunities

·        Generous earned time program

·        Full health, vision and dental benefits

·        Relocation allowance

·        CME time and dollars

·        Retirement plans with employer match

For more information or to apply, contact Tiffiny Lamarre, Physician Recruiter at 207-621-4636 or tiffiny.lamarre@mainegeneral.org.


Family Medicine Physician

Oakland Family Medicine, a hospital-employed outpatient Family Medicine practice located in Oakland, Maine, is recruiting for an experienced Family Medicine Physician to join our growing team. Responsible for providing care for pediatric through adult patients while working in collaboration with our practice administrator, providers and senior management team as Oakland continues the transition to Patient Centered Medical Home. Join our team of four family medicine physicians and one physician assistant and collaborate with a unique mix of seasoned physicians who have practiced in the area over 10 years, and new team members who have recently joined our group. Weekly schedule will be 32 hours of patient contact time and up to 8 hours of administrative time. MaineGeneral offers a comprehensive benefits package. We’re located just an hour north of Portland, Maine’s largest city, and three hours from Boston. Contact Tiffiny Lamarre, Physician Recruiter at tiffiny.lamarre@mainegeneral.org.


BC/BE Family Practice Physician

HealthReach Community Health Centers seeks a BC/BE Family Practice Physician to provide primary care at both Strong Area and Mt. Abram Regional Health Centers. Both practices hold NCQA-Patient-Centered Medical Home certification and offer accessible, high quality healthcare with integrated behavioral health services to people of all ages. Strong also offers general dentistry. Strong and Kingfield which are 13 miles apart are located in Franklin County. They are close to Farmington with Sugarloaf and Saddleback Mountains nearby, and together serve 5,000 area residents annually. We offer competitive compensation and malpractice coverage. The sites are eligible for loan repayment. EOE. Contact: Recruiter, HRCHC, 10 Water Street, Suite 305, Waterville, ME 04901 | 207-660-9913 | Fax: (207) 660-9901 | Communications@HealthReach.org | www.StrongCHC.org | www.Mt.AbramCHC.org  



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Upcoming Events


Maine Concussion Management Coalition Trainings

The last Maine Concussion Management Initiative training program for 2015, will be held on October 20th as the Youth Concussion Track at the Brain Injury Association of America-Maine conference at USM-Portland campus. Level 1 – Introduction to Concussion and Concussion Management will be from 9:30am to1:00pm. Level 2 – Interpreting Neurocognitive Testing will be from 1:30pm to 4:30pm. Level 1 is a perquisite to taking Level 2.

To register, go to: https://secure.biasa.org and click on BIAA-Maine Conference (in menu on left).

MCMI training for 2016 will be held in March, June and October with a possible fourth training in Aroostook County in the spring. Details, when available, will be posted at web.colby.edu/mcmi.  

Any questions – contact Jan Salis, PT, ATC, MCMI Membership and Education Committee at jsalis@aol.com.






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