May 30, 2016

 
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MMA Board Meets Wednesday; Agenda Includes Marijuana Referendum

The Board of Directors of the Maine Medical Association will hold its regularly scheduled meeting on Wednesday, June 1st at 4:00 pm at the Association offices in Manchester.  The Board is expected to make a decision whether to take a position on the referendum question regarding legalization of the recreational use of marijuana. 

Any MMA member is welcome to attend any Board meeting.  The Board is currently chaired by Jabbar Fazeli, M.D. Dr. Fazzeli is a geriatrician practicing in the southern Maine area.  

In addition to the marijuana question, other items on the agenda include the following:

  1. Update on 163rd Annual Session being held in Bar Harbor September 9-11, 2016.
  2. Consideration of instituting a mentoring program for pre-med students, medical students, residents, and/or young physicians in practice.
  3. Activities of the Maine Opioid Collaborative including implementation of the recommendations of the three Task Forces organized around the topics of Treatment, Prevention/Harm Reduction, and Law Enforcement.

Any MMA member interested in being considered for a Board position by the Nominating Committee should contact Executive Vice President Gordon Smith at gsmith@mainemed.com or 207-215-7461.  The Nominating Committee is chaired by Kenneth Christian, M.D.

Nominations being Sought for MMA's Annual Mary Cushman, M.D. Humanitarian Award

Nominations are being sought for MMA's Mary Cushman, M.D. Award for Humanitarian Service for this year.  A new committee has been formed to review applications, chaired by Lawrence Mutty, M.D., M.P.H.  Other committee members include former Cushman Award recipients Paul Klainer, M.D., Connie Adler, M.D., and Alice Haines, M.D.    

For further information, contact Susan Kring, Outreach Director at MMA at skring@mainemed.com.

 
 
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Christopher Pezzullo, D.O. Named Chief Health Officer at Maine CDC

The Bangor Daily News recently has reported two promotions at the Maine Center for Disease Control & Prevention (Maine CDC) by DHHS Commissioner Mary Mayhew.  Christoper Pezzullo, D.O. has been named Chief Health Officer.  Sheryl Peavey, a DHHS employee since 2004, has been named Chief Operating Officer.  The two apparently will share the leadership role at Maine CDC recently vacated by Kenneth Albert, R.N., J.D. [return to top]

House and Senate Approve Differing Funding Levels to Combat Zika Virus

Two weeks ago, both the House of Representatives and the Senate passed funding measures to address the Zika virus.  The House approved the Zika Response Appropriations Act (H.R. 5243), to provide $622 million in Zika virus funding through September 30th. 

The Senate approved a compromise amendment sponsored by Sens. Roy Blunt, R-Mo., and Patty Murray, D-Wash., to provide $1.1 billion in Zika funding through September 2017 as part of the Transportation, Housing and Urban Development, and Related Agencies Appropriations Act (H.R. 2577).

The Senate also voted down an amendment offered by Sens. Bill Nelson, D-Fla., and Marco Rubio, R-Fla., to provide $1.9 billion in Zika funding as requested by the Obama Administration.  President Obama has signaled that he would accept the Senate-passed Zika funding provisions but has issued a veto threat against the House bill, stating that its funding level is "woefully inadequate."

While there is widespread agreement on the need to provide federal funding to help prevent the spread of the Zika virus, there continues to be significant disagreement on the amount required, the duration of funding and whether such funding should be offset.  The Republican leadership in the House and Senate have stated their intention to work together expeditiously to reconcile the differing funding bills in a final piece of legislation that could be sent to the President.  

On May 26th, the AMA sent a letter to both the Democratic and Republican leadership of the House and Senate urging Congress take immediate action to provide the necessary resources to combat the spread of the Zika virus and address this growing public health threat.
 

For further information on the Zika virus and efforts to contain it, please visit the AMA Zika Virus Resource Center.

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FDA Approves Implant to Treat Addiction

The U.S. Food & Drug Administration (FDA) last week approved a drug-emitting arm implant to treat addiction to heroin and other opioids.  The implant, called Probuphine, contains buprenorphine.  Four implants are inserted into the upper arm at one time, providing six months supply of the medication.  Representatives of the manufacturer said the implant would cost less than $6,000 for a six month supply.  The most common side effects of the drug include pain, itching, and redness at the site of the implant, as well as headache, depression, and other issues, the FDA said.

The FDA approved Probuphine's use in patients who are already stable on a low or moderate dose of oral buprenorphine.  The agency noted that the drug should be used alongside counseling and other psychosocial support.  Physicians must complete a training program on inserting the implants before they will become certified to administer them. 

 
 
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New Antibiotic-resistant Bacterium Now in U.S.

We deal with MRSA, we deal with C. diff, we deal with VRE, we deal with CRE … and many others.  Now there’s a new challenge for medicine in the U.S.:  colistin-resistant Escherichia coli. This bacterium, and other enterobacteria, can carry a plasmid-borne colistin resistant gene, mcr-1.  According to a report[1] funded by the U.S. Army Medical Command and recently published in the journal Antimicrobial Agents and Chemotherapy, this antibiotic resistant strain of E. coli was found in April 2016 in the urine of a woman in Pennsylvania—a woman who had not traveled in the previous five months.  “The recent discovery of a plasmid-borne colistin resistance gene, mcr-1, heralds the emergence of truly pan-drug resistant bacteria,” wrote the Walter Reed researchers.  It appears, though, that this particular bacterium in this patient was not resistant to carbapenem.

This bacterium is being trumpeted by the popular media in an alarming manner:  “’Nightmare bacteria’ superbug” (NBC News); “a dreaded superbug” (CNN); “The superbug that doctors have been dreading” (The WashingtonPost); “specter of superbugs” (New York Times); “Antibiotic-resistant ‘nightmare bacteria’” (Boston Globe). Yet the media are not the only ones making such statements. Dr. Tom Frieden, Director of the U.S. Centers for Disease Control and Prevention, said, “The medicine cabinet is empty for some patients…It is the end of the road for antibiotics unless we act urgently.”

One troubling aspect of this situation is that colistin, an older antibiotic, is used only rarely now, as a last resort treatment for CRE, because of its serious side effects such as kidney damage.  Another concerning issue is raised in a letter in the journal Emerging Infections Diseases, to be published in September 2016:  “These findings suggest that mcr-1-producing E. coli can colonize companion animals and be transferred between companion animals and humans.”[2]

The issue is getting the attention of political figures as well.  Sen. Robert Casey, Jr. (D-PA) said recently that he supports legislation looking into antibiotic-resistant bacteria.  “(They) present an urgent public health problem that we must focus on intensively.”  Federal funding has gone to the CDC and other agencies, along with state and local public health agencies, to increase the ability to detect and prevent outbreaks of antibiotic-resistant bacteria, and the NIH has received funding for research into the issue.

As with many other infectious diseases, hand washing and other front line preventive measures are one of the keys to limiting the spread of new, evolving antibiotic-resistant organisms. Greater attention is also being paid to the widespread use of antibiotics in food production. This threat need not become an apocalypse.



[1] McGann P,, Snesrud E., Maybank R., Corey G., et al. Escherichia coli Harboring mcr-1 and blaCTX-M on a Novel IncF Plasmid: First report of mcr-1 in the USA, Antimicrob. Agents Chemother. doi:10.1128/AAC.01103-16, Posted online 26 May 2016.

[2] Zhang X-F, Doi Y, Huang X, Li H-Y, Zhong L-L, Zeng K-J, et al. Possible transmission of mcr-1–harboring Escherichia coli between companion animals and human. Emerg Infect Dis. 2016 Sep [May 26, 2016]. http://dx.doi.org/10.3201/eid2209.160464


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How New Medicare Payment System Intends to Help Small Practices

Draft regulations released last month outline sweeping changes to the Medicare payment system, and one of those eagerly anticipated changes is the Centers for Medicare & Medicaid Services' (CMS) stated intent to ease physicians' administrative burdens—including for those in small or rural practices.  A new fact sheet outlines flexibilities the agency is proposing for physicians in the new payment system.

Responding to physician feedback
The proposed rule for implementing key provisions of the Medicare Access and CHIP Reauthorization Act (MACRA) has drawn concerns regarding its regulatory impact analysis, which projected that the quality and resource use components of the new Merit-based Incentive Payment System (MIPS) would have a negative impact on most solo physicians and small practices.

CMS has clarified in its new small practices fact sheet that the projections made in the analysis were "based on 2014 data when many small and solo practice physicians did not report their performance.  It also does not reflect the accommodations in the proposed rule that are intended to provide additional flexibility to small practices."

In particular, the impact analysis table in the proposed rule only offers a partial picture of physicians' potential success in MIPS because it fails to include participation in the categories of "clinical practice improvement" and "advancing care information"—formerly the electronic health record meaningful use program.

Another flaw in the analysis was that it did not provide the magnitude of how physicians would be affected.  For example, physicians who opted not to participate in quality reporting and meaningful use would be subject to an 11 percent payment cut in 2019 under previous law. Under MACRA, the maximum payment cut would be 4 percent. Unlike MACRA, previous law did not provide any partial credit for efforts that were not 100 percent successful.

The analysis looked at successful participation of "eligible clinicians" in the Physician Quality Reporting System (PQRS) and under the value-based modifier.  CMS' definition of "eligible clinicians" includes nonphysician health professionals such as chiropractors.  Many of these eligible clinicians could not participate in PQRS or the value-based modifier. Consequently, the subset of the physicians actually reflected in the analysis is relatively small.

Andy Slavitt, acting administrator of CMS, recently testified before a congressional committee, emphasizing that the agency is focused on providing the flexibility required for physicians in smaller practices to be as successful under MIPS as those in larger groups.

Here are some of the flexibilities that CMS says were included in the proposed rule to accommodate the unique needs and challenges faced by physicians in small practices:

 
  • Physicians with a low Medicare volume won't be subject to the MIPS payment adjustment.  To avoid unnecessary reporting burdens, clinicians or groups who have less than or equal to $10,000 in Medicare charges and less than or equal to 100 Medicare patients are excluded from the MIPS payment adjustment.

  • Physicians should not be held accountable to inapplicable categories.  If a MIPS performance category does not have enough measures or activities that are applicable for the practice, then the category would not be included in the practice's MIPS score.

  • Physicians will have fewer measures on which to report.  The agency is proposing to remove unneeded measures and reduce administrative requirements.  For example, CMS proposes to reduce the number of required measures in the quality and advancing care information categories.

  • Physicians can use a single reporting mechanism.  Three of the four categories will require reporting—all of which can be done through the same mechanism, instead of the distinct reporting options required under the current payment system.  Physicians also have greater choice regarding which reporting mechanism to use.

Easing the burden within performance categories
CMS has proposed additional flexibilities within MIPS performance categories to account for the unique circumstances of individual clinicians, small groups, and practices in rural or professional shortage areas:

  • Quality.  The total possible points would be 80 for a group of nine or fewer, while a group of 10 or more would be 90 points.  Also in an effort to reduce physicians' reporting burden, the quality category would require practices of all sizes to report only on six measures, rather than the nine current measures. In addition, physicians would receive partial credit for measures.

  • Clinical practice improvement activities.  Under this category, physicians and other clinicians would be rewarded for clinical practice improvement activities, such as those focused on care coordination, beneficiary engagement and patient safety.  A list of more than 90 options will be available for physicians to select activities that match their practice's individual goals.  For physicians in small practices located in rural or professional shortage areas, this category allows them to submit one activity of any weight to receive partial credit or two activities of any weight to receive full credit. Larger practices would be required to submit three to six activities.

  • Cost.  A cost score would not be calculated for physicians who don't have a high enough patient volume for the cost measures (generally defined as a minimum of 20 cases pertaining to a particular measure).  CMS would reweight the cost category to zero and adjust other MIPS performance category scores to make up the difference.

While these proposals are important changes for physicians, the agency will need to make additional improvements during the rulemaking process to best address things that have been getting in the way of physicians focusing on providing high-quality care to their patients.  The proposed rule is open for comment through June 27, and CMS has said it welcomes feedback from patients, physicians, caregivers, health care professionals and members of Congress, among others.

The AMA is developing recommendations to further ease the burdens on physicians in small or solo practices to enable their success under this new payment system.

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Opioid Prescriptions Decline Since 2012; A New Drug Appears

The New York Times reports that opioid prescriptions in the United States have shown a sustained decline for the first time in twenty years—since the advent of oxycodone (Oxycontin®) in 1996.  After a peak in 2012, the decline has been evident in 2013, 2014 and 2015.  In those years, only South Dakota showed an increase.  With the new political awareness of and emphasis on opioid addiction issues, it is expected that this decrease will accelerate in 2016.  The largest decrease nationally has been in the prescription of hydrocodone, marketed under the brands Vicodin® and Lortab®.

Unfortunately, the decrease in prescriptions has not affected the increase in fatal opioid overdoses, with Maine seeing 272 such deaths in 2015.  In addition, some physicians wonder whether efforts to reduce prescribing are penalizing patients who need such medicines for pain relief and take them responsibly, without diversion or abuse.

Medical schools have made significant efforts during this time to teach students not only about the pain relieving properties of these medicines but also the risks involved.  One might wonder whether we will see a pendulum effect, with a large decrease in opioid prescription even for appropriate situations, followed by a damping of the swing while physicians and other health care providers focus on the variety of causative factors leading to substance use disorders and overdose deaths.

Meanwhile, the BangorDaily News reports a new drug from Canada is raising greater concerns.  "W-18”, patented in 1984, has recently been rediscovered by chemists looking for the next cheap and powerful high.  While it is being described in the popular press as a synthetic opioid, the drug has not been tested on humans and it is unknown whether naloxone, an opioid antagonist, would work to reverse its effects.

Maine police are warning people about the drug, considered to be many times more powerful than Fentanyl, but it has not yet been seen in this state.  If recent history is any indication, we probably don't have long to wait.

 


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Summary of May 25th SIM Steering Committee Meeting

Thanks to Rhonda Selvin, APRN for preparing the following summary.

SIM Steering Committee Meeting May 25, 2016, 9https://innovation.cms.gov/Files/x/cpcplus-faqs.pdf-11am

Site:  phone only

April’s meeting was cancelled due to work proceeding in separate committee (MPOC) on the recently announced CMS CPC+ opportunity.

An Additional Note:  CMS announced on Friday 5/27, that participation in a MSSP ACO would no longer restrict participation in CPC+ see the link to updated FAQ’s below.

https://innovation.cms.gov/Files/x/cpcplus-faqs.pdf

A multi-payer Medicare Alignment payment model Primary Care Proposal (MPOC) is under consideration lead by OMS, a draft proposal was written by a sub group and is under review by the Committee and stakeholder groups. A facilitator was enlisted to help with development.

Today’s meeting was primarily updates as per agenda summary below, we followed the agenda if not the time frames.

1- Welcome – Minutes Review and Acceptance

Randy Chenard

Approve Steering Committee minutes from previous Steering Committee meeting

10 minutes

9:00 – 9:10

2- Medicare Proposal Oversight Committee

Randy Chenard

Objective: Provide update on May Meetings and next steps. Discuss role of Steering Committee.

20 minutes

9:10-9:30

3-  Hanley Health Leadership Update

JudiAnn Smith

Objective: Sustainability to a statewide health leadership development plan

20 minutes

9:30- 9:50

4- SIM Evaluation Update

Jay Yoe

Objective:  Review updated SIM Dashboard and evaluation activities, and provide a brief update on the recalculation of the Fragmented Care Index.  Provide evaluation report summary.

20 minutes

9:50-10:10

5- Subcommittee Updates

Frank Johnson, Lisa Nolan, Lisa Tuttle

Objective: Provide feedback on SIM subcommittee work and next steps

20 minutes

10:10-10:30

6 –  Clinical Data Risk

Jay Yoe, Amy Wagner

Objective: Review the risk to the SIM evaluation due to the lack of clinical data

20 minutes

10:30-10:50


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CMS Publishes Billing & Payment Guide for Small Practices

The Center for Medicare and Medicaid Services (CMS) recently published a guide to help physicians in small practices with billing and payment issues.  Called “Flexibilities and Support for Small Practices,” it clarifies certain issues relating to CMS’s regulatory impact analysis raised in response to a proposed rule to implement the Medicare Access and CHIP Reauthorization Act (MACRA).  There is a full discussion of the guide and the new rule in the AMA Wire®.  Many of the concerns relate to the Merit-based Incentive Payment System (MIPS) and the Physician Quality Reporting System (PQRS).

CMS has proposed additional flexibilities within MIPS performance categories to account for the unique circumstances of individual clinicians, small groups, and practices in rural or professional shortage areas:

  • Quality. The total possible points would be 80 for a group of nine or fewer, while a group of 10 or more would be 90 points. Also in an effort to reduce physicians’ reporting burden, the quality category would require practices of all sizes to report only on six measures, rather than the nine current measures. In addition, physicians would receive partial credit for measures.
  • Clinical practice improvement activities. Under this category, physicians and other clinicians would be rewarded for clinical practice improvement activities, such as those focused on care coordination, beneficiary engagement and patient safety. A list of more than 90 options will be available for physicians to select activities that match their practice’s individual goals.

    For physicians in small practices located in rural or professional shortage areas, this category allows them to submit one activity of any weight to receive partial credit or two activities of any weight to receive full credit. Larger practices would be required to submit three to six activities.
  • Cost. A cost score would not be calculated for physicians who don’t have a high enough patient volume for the cost measures (generally defined as a minimum of 20 cases pertaining to a particular measure). CMS would reweight the cost category to zero and adjust other MIPS performance category scores to make up the difference.

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Job Openings

FALMOUTH ORTHOPAEDIC CENTER - Falmouth, Maine

Seeking a BE/BC general or fellowship trained surgeon to join our expanding group.  Falmouth Orthopaedic Center is a well respected private practice in a vibrant orthopedic community. You will be partnering with 3 experienced surgeons each with an outstanding reputation in the area.

Located in Falmouth Maine (approximately 10 minutes from Portland, 2 hours from Boston) we pride ourselves on our four beautiful seasons, unlimited recreation, and top-ranking schools all within 10 minutes of the magnificent Maine coast. Falmouth is an excellent place to raise a family and offers a great quality of life with easy access to all the cultural amenities of the city of Portland.

This opportunity offers minimal ER call at a Level 2 community hospital with a competitive compensation package.  Our ideal candidate is a well trained general orthopedist or an orthopedist who is fellowship trained in foot and ankle, hand, pediatrics, sports medicine or adult reconstructive surgery.

Please send cover letter, CV, and inquiries to: hsgentile@maine.rr.com.

5/16/16

Exciting Physician Leadership Opportunity in Maine

The Office of Child and Family Services (OCFS) within Maine’s Department of Health and Human Services (DHHS) is searching for the ideal candidate to be its Medical Director, serving as a senior leader and its clinical representative.

The selected candidate will play key advisory roles in improving the health of some of Maine’s most vulnerable citizens.   You will provide leadership in:

  • Policy development
  • Utilization of resources
  • Clinical practice models the guide the care and treatment of children known to child welfare and at-risk families.

Why Join Our Team?

Maine OCFS is:

  • Committed to reducing the number of youth in out-of-home placements by increasing the effectiveness of community-based services.
  • Working closely with Georgetown University’s Technical Assistance Center to guide us in Evidenced-Based and Promising Practice Models
  • Has multiple agencies and partners collaborating to address the social, medical and behavioral challenges impacting children and families.
  • Intensely focused on complex trauma.
  • Creating  new strategies to decrease the number of youth in custody on Psychotropic medication; 
  • Enhancing its family reunification practices.

Why Maine?

Maine is home to some of the finest beaches, lakes and mountains in the country.  For more information on why Maine is called vacationland all year, please visit the Maine tourism website at http://visitmaine.com/. 

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

6/9/16

HOSPITALIST - Brunswick, Maine

Mid Coast Hospital is seeking a full time Hospitalist to join its established hospitalist service, which is expanding due to growth. The candidate should be BC/BE in Internal Medicine or Family Medicine. Procedures are not required. Excellent Intensivist and subspecialist support is available. New graduates and experienced candidates are encouraged to apply. Part-time and per diem applications will be considered. 

Part of the Mid Coast–Parkview health family of services, Mid Coast Hospital offers competitive benefits and compensation package, along with an excellent work environment. Please send CV to Melanie Crowe, Physician Recruiter, at mcrowe@midcoasthealth.com or call (207) 406-7872, for more information.

6/27/16

OUTPATIENT INTERNAL MEDICINE - Mid Coast Maine

Mid Coast Medical Group is seeking a BC/BE Outpatient Internis to join our multi-specialty group. Admitting is through a high-quality Hospitalist service.

The Coastal location, historic neighborhoods, superior schools, and Bowdoin College campus make this part of Maine a very desirable place to live.  

Part of the Mid Coast–Parkview health family of services, Mid Coast Medical Group offers competitive benefits and compensation package, along with an excellent work environment. Please send CV to Melanie Crowe, Physician Recruiter, at mcrowe@midcoasthealth.com or call (207) 406-7872, for more information.

6.27/16

FAMILY PRACTICE PHYSICIAN Sought In Oakland Maine!

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.

7/18/16

INTERNAL MEDICINE PHYSICIAN - Maine Medical Partners Internal Medical Clinic

Maine Medical Partners is seeking a PT BC/BE internal medicine physician for their Internal Medicine Outpatient Clinic at Maine Medical Center in Portland, Maine. 

The Clinic is the primary outpatient teaching site for Maine Medical Center’s Internal Medicine Residency Program and is the medical home for a culturally diverse population.  The ideal candidate will have an interest in residency education and international/immigrant patient care.  The clinical portion of the position involves a mix of direct patient care and the precepting of Internal Medicine Residents. 

Maine Medical Center has 637 licensed beds and is the state’s leading tertiary care hospital, with a full complement of residencies and fellowships and an integral part of Tufts University Medical School. 

For more information please contact Alison C. Nathanson, Director, MaineHealth Physician Recruitment Center at (207) 396-8683 or nathaa@mainehealth.org.

7/4/16

PHYSICIAN/MEDICAL DIRECTOR - Nasson Health Care 

Nasson Health Care is seeking a qualified clinical leader to work collaboratively with a team of health and administrative professionals to provide comprehensive primary care to patients while utilizing the Patient-Centered Medical Home model of care delivery.  

The Physician/Medical Director: 

  • Provides advice and counsel regarding a broad range of clinical, clinical policy, programmatic and strategic issues required to achieve the short and long-term strategies and objectives of Nasson Health Care; 
  • Provides direct clinical services and oversees physicians and advanced practice nurses; works in partnership with members of the practice team to manage the care of patients, assuring a high standard of medical care; 

  Qualifications include:

  • A minimum of three years’ experience as a Medical Director of a primary care medical practice;  A degree from an accredited medical school in the U.S.,
  • Board certification in Family or Internal Medicine;  An unrestricted Maine license to practice medicine, as well as a U.S. Drug Enforcement Agency license;
  • Working knowledge of the core concepts of evidence-based practice, social and behavioral determinants of health, population-based care, integration of medical, behavioral health and dental care, and Meaningful Use of health information technology.

Visit http://www.nassonhealthcare.org for an application. Completed cover letter, resume, and employment application will be accepted until position is filled.

6/27/16

Relocate to Beautiful Southwestern Maine - FAMILY PRACTICE PHYSICIAN

Sacopee Valley Health Center has a position available for a full-time family practice physician for our multi-service, progressive, rural federally qualified community health center located in a medically underserved area. Services on site include integrated primary care, dental services, family planning, mental health counseling, psychiatry, nutritionist, optometry, podiatry, social services support, sliding fee coverage, care management, radiology and lab services. NextGen EMR. Practice is outpatient only with no OB. On-call rotation is 4-5 times per month. NCQA Level III PCMH. Competitive salary and benefits package; physicians are eligible to apply for NHSC loan repayment.  Located in Porter, ME, between Portland and the White Mountains. Area is known for terrific four season recreational activities. Just two and one-half hours from Boston. Submit CV to: Nancy Buck, Human Resources Coordinator, (nbuck@svhc.org), Sacopee Valley Health Center, 70 Main Street, Porter, ME 04068. EOE. www.svhc.org. Sacopee Valley Health Center is an equal opportunity provider and employer. 

5/23/16

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

7/18/16

FAMILY MEDICINE/OUTPATIENT INTERNAL MEDICINE PHYSICIAN  

The Maine Highlands offers great outdoor adventures, historic and cultural experiences, many culinary delights and unexpected entertainment opportunities.  KVHC’s newest clinic, Brownville, is located in the Maine Highlands and Katahdin Region.  As a result of this continuous growth, Katahdin Valley Health Center is recruiting a Family Medicine/ Outpatient Internal Medicine Physician that is committed to providing quality health care services to the people in the Brownville/Millinocket Maine regions.   KVHC’s clinics are outpatient only and offers a four day work week with a competitive salary and benefit package which includes: a 10% of first year salary sign on bonus, generous amounts of paid time off and $2500 annually toward CME. Physicians who join KVHC are eligible to apply for NHSC Loan Repayment.  

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.

5/23/16

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Upcoming Events
 

MCMI Training Programs – Level 1 and Level 2

General Information for 2016

When and where held:

                June 10, 2016 in Waterville at Colby College

              October 25, 2016 in Portland in conjunction with the Maine Brain Injury Conference

                                (Registration and fees will be through the Maine Brain Injury Conference for October 25)

               June and October programs will be Level 1 in the morning and Level 2 in the afternoon.

                               

Training Programs:             

              Level 1 – An Introduction to Concussions and Concussion Management

                            Speaker: Deb Nichols, CPNP or Peter Sedgwick, MD or Bill Heinz, MD

                           Level of Difficulty: beginner

                           Content: The Diagnostic and Return to Play Dilemma

                                           How Concussion Occurs and Pathophysiology            

                                           Concussion Signs and Symptoms

                                           Concussion Evaluation Tools

                                           Concussion Treatment

                                           Recovery Epidemiology

                                           Return to Function – Academics and Play

                                           Risk Factors and Protective Equipment

                                           Short and Long Term Sequelae

                                           Neurocognitive Testing

                                           Concussion Sideline Assessment

                                           Key Points

                                                      

              Level 2 – Advanced Concussion Management (Level 1 is a prerequisite for taking Level 2)

                           Speaker: Mike Rizzo, FNP-C, CIC or Paul Berkner, DO

                           Level of Difficulty: intermediate

                           Content: Updates from Zurich 2012       

                                           Using ImPACT Testing in Concussion Management

                                           Interpreting ImPACT Test Results

                                           Concussion Case Reviews

Schedule:

          

              June – Level 1:

                           7:45am – 8:00am           Registration

                           8:00am – noon               Training Program

                           Level 2:

                           12:15pm-12:30pm          Registration

                           12:30pm – 4:30pm         Training Program

                                                                    

Registration Fee:           

              For morning only training programs: March 11 and April 8

              $100 for Health Care Professionals (MD, DO, NP, PA, Neuropsychologist, AT, RN, PT, OT, SLP)

              $40 for school personnel and all other attendees

                           (School nurses, coaches, school athletic directors, administrators, parents, etc.)

              $20 for students – currently enrolled in a college program

             

              For morning and afternoon training program: June 10

              $100 for Health Care Professionals (MD, DO, NP, PA, Neuropsychologist, AT, RN, PT, OT, SLP)

              $175 for Health Care Professionals taking Level 1 and Level 2 - Only June 10

             

              $40 for school personnel and all other attendees                                                                                                              (School nurses, coaches, athletic directors and administrators, etc.)

              $70 for school personnel taking Level 1 and Level 2 - Only June 10

             

              $20 for students currently enrolled in a college program            

              $35 for students taking Level 1 and Level 2- Only June 10

CME/CEU contact hours: 3.50

Registration Confirmation will be sent by email.

Refund / Cancellation Policy: If you need to cancel contact Jan Salis, PT, ATC. You can choose to apply your registration fee to another training program or have your check returned.

For more information contact:

              Jan Salis, PT, ATC

              MCMI - Membership and Education Committee - Chair

              jsalis@aol.com

              (207) 577-2018

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