Maine Medicine Weekly Update - December 18, 2017
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Opioid Task Force Issues Final Report

The December 2017 Final Report of the Task Force to Address the Opioid Crisis in the State was issued this past week. The executive summary lists the 20 recommendations of the Task Force, and the full report includes Appendices A through Y. Recommendations include suggesting legislation on drug education and prevention, action by various state agencies to develop recovery housing and integrate treatment programs, and expressions of support for treatment programs in correctional facilities.

 

"The task force recognized that the final recommendations to address the opioid crisis needed to take an integrated and comprehensive approach. The recommendations are broken into three categories to reflect the work of the small groups and the approach of the MOC [Maine Opiate Collaborative]. However, in developing the recommendations, the task force did not lose sight of how the categories are interrelated."(from the report's Executive Summary)

The Task Force recommendations are divided into three sections: prevention and harm reduction; treatment and recovery; and law enforcement. The report also discusses the background of the crisis and the genesis of the task force and gives a summary of its meetings.

The full report is at https://drive.google.com/file/d/0B3PYp5sROj_1d3dTbmExWlpickwtcjI3OEpELVE2RUVmRTB3/view?usp%3Dsharing .

The Task Force's work is not without its critics.  Dr. Mark Publicker, an addiction treatment specialist, pointed out that there have been many other, similar task forces that have tried to address this issue. "This is...well meaning but resulting in the same recommendations that have been made multiple times before."

 

Opportunities for Year-End Giving at MMA

 As you consider your year-end contributions to your favorite charities and non-profit organizations, we hope that you will consider a gift to one of several funds at MMA.

 

In anticipation of year end gift giving, and knowing there are many competing requests for your support, we ask that you consider directing a gift to the Maine Medical Association, Maine Medical Education Trust, and/or the Maine Medical Education Foundation this year.  Donations help support the scholarship fund, our annual educational conference, the Tufts Maine Track Students, members attending the Hanley Leadership PELI program, and more! If you are already a sustaining member, or one who dedicates funds to one of our funds, we sincerely thank you! At our Annual Session this year, we kicked off the 2017 annual appeal and distributed ‘I Donated’ ribbons to those who gave that day – so thank you if you have already made a pledge or given a one-time donation.

Did you know that making a contribution to the Maine Medical Association will better the quality of health care, and the health and well-being of Maine citizens? The Maine Medical Association works diligently to provide assistance and guidance to physicians on health care policy issues, legislation and quality of care issues, and serves as a collective voice for the physicians in the State of Maine. We sincerely appreciate and rely on donations to support our mission, efforts, and sustainability. Thank you!  You can find out more information on these opportunities on the MMA web site here.  You also can contact Dee Kerry for assistance at dkerry@mainemed.com.

Maine Falls to #23 in America's Health Rankings

After reaching a high of #8 in 2010, Maine has now descended to #23 among the states in America's Health Rankings, a study by United Health Foundation based on US CDC data.

 

Maine did very well compared to the national average in violent crime rate, air quality, and number of mental health providers per 100,000 population. Maine is also better than average in the number of primary care physicians per 100,000. We did badly in smoking, pertussis, and number of dentists, as well as excessive drinking, cancer, and infant mortality. Maine is near the national average for diabetes and immunizations.

The complete Maine report may be found here. The full 2017 national annual report is also available here.

Online Links to Opioid CME

If you want to continue prescribing opioids in 2018, you must get your 3 hours of Category 1 CME on opioid prescribing before 12/31/17. Here's how.

 

You can get Category 1 credits for opioid related education from the following places:

Maine Quality Counts: Caring For ME (Safe Opioid Prescribing) https://qclearninglab.org/course-cat/caring-for-me/

Massachusetts Medical Society: http://www.massmed.org/Continuing-Education-and-Events/Online-CME/Courses/Opioid-Prescribing-Series---Module-1/Opioid-Prescribing-Series-(6-Modules)/ 

 American Society of Addiction Medicine (ASAM): http://www.asam.org/education/resources/Opioid-Prescribing

Remember that you need THREE credits, that is, three hours, to meet the statutory requirement.

8 in 10 Doctors Have Experienced a Cyber Attack in Practice

Physicians, overwhelmingly, are finding themselves the target of cyberattacks that disrupt their practices and put patient safety at risk.

 

[from the AMA Advocacy Update]


A staggering 83 percent of physicians told AMA researchers that their practices have experienced a cyberattack of some type. The 1,300 physicians surveyed also said not enough cybersecurity support is coming from the government that will hold them accountable for a patient information breach. These and other findings are contained in a first-of-its-kind survey from the AMA and management consulting firm Accenture. The data (infographic) provide new depth—and an often overlooked physician voice—to the discussion on how best to protect patients in a complex health care system that is increasingly connected and vulnerable to cybercriminal exploitation.

"The important role of information sharing within clinical care makes health care a uniquely attractive target for cyber criminals through computer viruses and phishing scams that, if successful, can threaten care delivery and patient safety," said AMA President David O. Barbe, MD, MHA. "New research shows that most physicians think that securely exchanging electronic data is important to improve health care. More support from the government, technology and medical sectors would help physicians with a proactive cybersecurity defense to better ensure the availability, confidentially and integrity of health care data."

A June 2017 report by the congressionally mandated Health Care Industry Cybersecurity Task Force found "health care cybersecurity is a key public health concern that needs immediate and aggressive attention," and that, "most importantly, cybersecurity attacks disrupt patient care." The 88-page document underscores the risk to medical care delivered in smaller settings, which are especially vulnerable to attacks by cybercriminals.

Read more at AMA Wire.

Naloxone Research Shows Importance of Post-Administration Intervention

See information about a naloxone study published in the Annals of Emergency Medicine.


More than 84 percent of Massachusetts patients who received naloxone from emergency medical services were alive one year following the administration. The study abstract, published in the Annals of Emergency Medicine, reviewed data from more than 12,000 naloxone administrations between July, 1, 2013, and Dec. 31, 2015. The study's authors concluded that, among other things: "Patients who survive opioid overdose should be considered extremely high risk and should receive interventions such as offering buprenorphine, counseling and referral to treatment prior to [emergency department] discharge."

Read more about naloxone on the AMA opioid microsite.
 

AMA Statement on Proposed Aetna-CVS Merger

The President of the AMA, David Barbe, MD, MHA, issued a brief statement in response to CVS's announced proposal to acquire Aetna.

 

"This proposed $69 billion transaction—one of the largest merger deals in the history of American health care—would have long-term impact on the markets for health insurance and pharmaceutical benefit management services. These markets are already dominated by few participants with large market shares, including Aetna in health insurance and CVS in pharmaceutical benefit management. The AMA is committed to reviewing all issues triggered by this proposed merger to preserve the benefits of competition, including increased access and choice, lower prices and higher quality care for patients."

—David O. Barbe, MD, MHA, president, American Medical Association

Peer Navigation Program from Facing Our Risk of Cancer Empowered

Free program for those affected by hereditary breast and ovarian cancers.

 

The mission of Facing Our Risk of Cancer Empowered (FORCE) is to improve the lives of individuals and families affected by hereditary breast, ovarian, and related cancers.

The FORCE Peer Navigation Program helps match people facing hereditary cancer with support and resources.  This free program connects cancer survivors, people at high risk and their caregivers to support and resources personalized for them.

For more information visit the FORCE website at www.facingourrisk.org

 

Legislative Calls to Resume When Legislature Returns

The Maine Legislature is in recess at present. The Weekly Update will feature articles concerning aspects of that work of interest to medicine. Legislative report articles will resume, and Legislative Committee calls will begin, when the Legislature returns to Augusta in January 2018. The first call will be Tuesday, January 9th, at 8 p.m., so mark your calendars now.

 

Highlights of Recently Enacted Legislation: L.D. 593 (c. 63) Medical License Renewal

The general effective date for legislation enacted during the First Regular Session (2017) of the 128th Maine Legislature was earlier this month on November 2, 2017. For the next several months, the MMA will highlight one enacted bill each week in this newsletter. We hope this helps your organization's compliance efforts and please call the MMA legal staff with any questions you may have.

 

All MD physicians should pay attention to this law. It eliminates the mail aspect of the renewal notification requirement for medical licenses, providing instead that the board must "notify" licensees at least 60 days before expiration of the requirement to renew. 

More importantly, the new law eliminates the grace period for renewal after expiration. DO physicians still have a 30 day grace period, but many other professions (nurses, for example) have none. That means one's right to practice is suspended on the expiration date if the license has not been renewed. Reinstatement is allowed within 90 days upon payment of a late fee and submission of "an administratively complete renewal application", but in the meantime the physician may not practice medicine in Maine. Failure to file within the 90-day period means that a lapsed licensee must go through additional administrative steps to be relicensed.

Online Learning Opportunities Offering CME Credits - from the Northern New England Practice Transformation Network

Take Advantage of Online Learning Opportunities Offering CME Credits - Available 24/7 now from the Northern New England Practice Transformation Network (NNE-PTN).

 

Take Advantage of Online Learning Opportunities Offering CME Credits - Available 24/7 now from the Northern New England Practice Transformation Network (NNE-PTN)

The Northern New England Practice Transformation Network, led by Maine Quality Counts in collaboration with the Citizens Health Initiative at the University of New Hampshire's Institute for Health Policy and Practice, and Vermont Program for Quality in Healthcare, Inc., is funded through the Centers for Medicare and Medicaid Services' Transforming Clinical Practice Initiative to provide technical assistance to support you, your practice, and your consumers in the transition to value-based payment. The QC Learning Lab has been designed to support health care practitioners and professionals, and practice teams with a wide range of continuing education offers including online courses, webinars, and learning sessions.

Topics include:

  • Improving Patient Outcomes with Cost of Care Conversation in the Clinical Practice
  • How to Transform Practice Finances for Success with Advanced Payment Models
  • Seamless Care
  • Get a Grip on Change
Click here to register for these no cost online learning opportunities, available 24/7 at your convenience.
 
This project is supported by FONCMS-1L1-15-003 from the U.S. Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services. The contents provided are solely the responsibility of the author and do not necessarily represent the official views of HHS or any of its agencies or the Maine Medical Association.

New Free CME on Alzheimer's Risk, Detection, and Management

Discussing memory concerns with your patients can be difficult. Alzheimer's and other dementias are complex, and patients often have many questions and concerns.

 

To help you prepare for these visits, the Alzheimer's Association® presents Challenging Conversations About Dementia. In this free course, you'll receive information to confidently approach the detection, diagnostic and care-planning process for your patients with cognitive impairment and dementia.

For more information and to complete this course, go to www.alz.org/FreeCME. Other tools on the website include the Cognitive Impairment Toolkit.

Chief Executive Officer - Pines Health Services

Pines Health Services, one of the nation’s top Federally Qualified Heath Centers and community-based physician practice in Aroostook County, Northern Maine is seeking a Chief Executive Officer.

Pines Health Services, one of the nation’s top Federally Qualified Heath Centers and community-based physician practice in Aroostook County, Northern Maine is seeking a Chief Executive Officer.

The chosen experienced professional will lead a team of more than 150 dynamic employees including 45 health care providers with multi-specialty medical staff.

The CEO will work with an engaged Board of Directors in collaboration with Cary Medical Center, a General Acute Care Hospital serving Aroostook County since 1924. 

Pines Health Services is a multi-disciplinary community health care center with services offered in Caribou, Fort Fairfield, Presque Isle, Washburn, and Van Buren.

Qualifications:  Minimum 5 years health care experience at the Senior Management level.  A Bachelor’s Degree in Healthcare Administration, Business or equivalent education is required, however, a Master’s Degree is preferred.  Prior experience working within the Federally Qualified Health Center system is a plus.

Interested candidates may forward a resume to:  Penny Wickstrom, Pines Health Services, Human Resources, P.O. Box 40, Caribou, ME 04736, or email pwickstrom@pineshealth.org.

1/8/17

Clinical Cardiology Opportunity

Maine Medical Partners MaineHealth Cardiology is seeking an invasive general cardiologist (non-interventional) for their practice located in their Augusta and Waterville, Maine locations

Maine Medical Partners MaineHealth Cardiology is seeking an invasive general cardiologist (non-interventional) for their practice located in their Augusta and Waterville, Maine locations.  Selected candidates will join a growing team of over 50 cardiologists who provide inpatient, outpatient and consultative services. 

Maine Medical Partners MaineHealth Cardiology is a growing practice, with office locations in Augusta, Waterville, Lewiston, Rockport, and Scarborough, and is affiliated with the nationally recognized cardiac services at Maine Medical Center and its parent organization MaineHealth. 

This integrated practice includes Maine General Health, Maine’s third largest health care system.  The Alfond Center for Health, MaineGeneral Medical Center’s state-of-the art, 192-bed regional hospital, has a cardiac catheterization lab and full on site imaging, including echocardiography and nuclear testing.  The Augusta/Waterville practice consists of 9 cardiologists and 2 advanced practice providers.

For more information please contact Alison C. Nathanson, Director, MaineHealth Physician Recruitment Center at (207) 661-7383 or nathaa@mainehealth.org.

1/15/18

Primary Care Physician - Eastern Maine Medical Center

Eastern Maine Medical Center seeks a primary care physician, board-certified/board-eligible in internal medicine, to join our well-established, quality-driven, outpatient practice. 

Eastern Maine Medical Center seeks a primary care physician, board-certified/board-eligible in internal medicine, to join our well-established, quality-driven, outpatient practice. Husson Internal Medicine is one of seven primary care practices operated by Eastern Maine Medical Center. Our practice was the second in the nation to achieve “Patient-Centered Medical Home” status with NCQA. All physicians are NCQA-certified in diabetes and cardiac care. Our primary care network, largest in our area, has adopted a new practice model to include teams of one physician, one nurse practitioner, two registered nurses, and two medical assistants.

Eastern Maine Medical Center is a 411-bed, regional, tertiary care and level II trauma center serving the more than 500,000 residents living in central, eastern, and northern Maine We offer a collegial atmosphere, cutting-edge EMR, generous vacation and CME benefit, flexible work schedule, and reasonable call schedule. No hospital call required. We also offer a relocation bonus and sign-on bonus in addition to our generous educational loan repayment program.

Candidates in need of J-1 visa waivers welcome to apply.

For confidential consideration, please contact:

Amanda Klausing, AASPR, Physician Recruiter

Eastern Maine Medical Center

Phone: 207-973-5358

emmccvs@emhs.org

 
12/11/17

Relocate to Beautiful Southwestern Maine - Medical Director/Family Practice Physician

Sacopee Valley Health Center has a position available for a Medical Director/Family Practice Physician for our multi-service, progressive, rural federally qualified community health center located in a medically underserved area.

Sacopee Valley Health Center has a position available for a Medical Director/Family Practice Physician for our multi-service, progressive, rural federally qualified community health center located in a medically underserved area. This position allows for the medical director to apply leadership skills while partnering with health center staff and colleagues to provide optimal health care for our patients on a daily basis. 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. We are 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: Linda Watson, Director of Operations or, (lwatson@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.

12/25/17

Palliative Care Provider

Mid Coast Hospital is searching for a part-time (20 hours/week) Physician, Nurse Practitioner or Physician Assistant to join the Palliative Care Program.

Mid Coast Hospital is searching for a part-time (20 hours/week) Physician, Nurse Practitioner or Physician Assistant to join the Palliative Care Program. The successful candidate must be licensed in Maine. Experience in Palliative Care/Hospice preferred.  Must have or be willing to work toward certification in Hospice and Palliative Care.

The Mid Coast Palliative Care Program is a consultation service available to all hospital inpatients and functions in the role of supporting patients and families who are facing life-limiting illnesses or end of life, helping patients and families access resources in the hospital and after discharge, and providing education on care options when appropriate.

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.

12/25/17

Gastroenterologist - Brunswick, ME

Mid Coast Medical Group is seeking a full time BC/BE Gastroenterologist to join an established Gastroenterology practice with two Physicians and two Nurse Practitioners.

Mid Coast Medical Group is seeking a full time BC/BE Gastroenterologist to join an established Gastroenterology practice with two Physicians and two Nurse Practitioners. Position includes outpatient and operative work, conveniently located adjacent to Mid Coast Hospital and the state-of-the-art Digestive Health Center. New graduates and experience candidates are encouraged to apply.

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

Mid Coast offers competitive benefits and compensation package, along with an excellent work environment.

For more information or to submit CV, contact Melanie Crowe, Physician Recruiter: mcrowe@midcoasthealth.com, Phone 207-406-7872.

Visit our website at www.midcoasthealth.com.

12/25/17

Hospitalist - Brunswick, ME

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.

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.

 12/25/17

DO or MD Physician - Augusta, ME

Maine-Dartmouth Family Medicine Residency (MDFMR), a community of allopathic and osteopathic physicians in Augusta, Maine who love to teach, is seeking a DO or MD Physician to join our faculty.

Maine-Dartmouth Family Medicine Residency (MDFMR), a community of allopathic and osteopathic physicians in Augusta, Maine who love to teach, is seeking a DO or MD Physician to join our faculty. Come teach and practice family medicine in a community and hospital system where you will be well supported! Ideal candidate has strong clinical skills and a passion for teaching. Must be willing to practice in both inpatient and outpatient settings and practice of full spectrum family medicine is a plus. We are looking for an enthusiastic, flexible candidate dedicated to high quality patient care. Maine-Dartmouth Family Medicine Residency is a successful and innovative dually accredited, community based, thirty-resident program. MDFMR is a mission-driven organization that provides healthcare to patients of all ages, with an emphasis on underserved and rural people. Our graduates go on to practice in Maine and across the country. Generous benefits package offered. 

Contact Michelle Bragg, michelle.bragg@mainegeneral.org

12/18/17

Outpatient Only - Internal Medicine with Loan Repayment & Sign-on Bonus

The Central Maine Medical Group seeks BE/BC Internal Medicine physician to join cohesive, well-established, hospital-employed practice in Lewiston, Maine. 

The Central Maine Medical Group seeks BE/BC Internal Medicine physician to join cohesive, well-established, hospital-employed practice in Lewiston, Maine.  We offer:
  • Up to $200K in medical student loan repayment
  • $50K sign on bonus
  • Up to $12K moving allowance
  • 4 day work week/generous outpatient call
  • Healthy work/life balance
Central Maine affords easy access to the coast and mountains where you can enjoy four seasons of outdoor activities.  We have a growing arts and restaurant scene in a very safe affordable area to live and raise a family.  To join our growing team, contact Gina Mallozzi, Central Maine Medical Center, 300 Main Street, Lewiston, ME  04240.  Email:  MallozGi@cmhc.org; Fax: 207/344-0696; Call:  800/445-7431; or visit our website:  http://recruitment.cmmc.org/.
 
3/26/17
 
 

Physiatrist - Brunswick, Maine

Mid Coast Medical Group is seeking a full time BC/BE Physiatrist to join an established practice of one Physician and one Nurse Practitioner.

Mid Coast Medical Group is seeking a full time BC/BE Physiatrist to join an established practice of one Physician and one Nurse Practitioner. The team approach to care also includes in office psychiatric consultations and an R.N. to assist with care plans. Call is 1:3 (phone call only). Successful completion of a residency in PM&R is required. New graduates and experienced candidates are encouraged to apply.

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

Mid Coast offers competitive benefits and compensation package, along with an excellent work environment.

For more information or to submit CV, contact Melanie Crowe, Physician Recruiter: mcrowe@midcoasthealth.com, Phone 207-406-7872.

Visit our website at www.midcoasthealth.com

1/8/18

Opportunities at the VA for Volunteer Physicians

Take advantage of this opportunity with the Veterans' Administration to thank our veterans in a concrete way for their service and their sacrifices.

The Physician Ambassador Program was created by the Department of Veterans Affairs as a best practice recruitment and placement initiative seeking fully licensed physicians and clinicians to enhance health care services for Veterans.

The Physician Ambassador Program is a without compensation program that provides civilian physicians and clinicians an opportunity to give back to the Veteran community by serving in a volunteer role to deliver health care services to Veterans. 

If you are interested in participating in this program at VA Maine Healthcare System, please contact Jonathan Barczyk at (207) 621-4886.