Maine Medicine Weekly Update - May 7, 2018 (Print All Articles)
MMA Listening Session in Presque Isle on Tuesday, May 15 6-8pm
All Aroostook County physicians and their guests are invited to join MMA officers and executive staff at a Listening Session to be held on Tuesday, May 15th.
Join us at Cafe Sorpreso, 415 Maine Street in Presque Isle. Stop by for an appetizer and beverage on us and share with us your thoughts and opinions, including on topics such as:
- 2nd Regular Session of the 128th Maine Legislature
- Physician-Assisted Death
- MMA Statement on Reform of the US Health Care System
- MMA member engagement and leadership development
Jeffrey Barkin, MD, DFAPA Receives MAPP Lifetime Achievement Award
Dr. Jeffrey Barkin was awarded the Dr. Ulrich B.
Jacobsohn Lifetime Achievement Award for “providing and advocating excellent
treatment for Maine citizens with psychiatric disorders” at the
Maine Association of Psychiatric Physicians' (MAPP) 12th Annual
Spring Program on April 27 in Freeport.
The award was presented to Dr. Barkin by
Dr. Dylan McKenney who is the current President of MAPP. In his comments, Dr. McKenney remarked, “For
many years, Dr. Barkin has worked with state agencies, independent contractors
and industry stake holders to negotiate policies that govern some of the
fundamental aspects of our practice and provide sustainable benefit to our most
vulnerable patient populations.” “He has served more years as president of
Maine Association of Psychiatric Physicians than anyone else in the
organizations history and has been a driving force for many years, contributing
to the vibrant and dynamic life of our district branch.”
Dr.
Barkin is a Yale trained, Board Certified general and geriatric
psychiatrist with specific expertise in neuropsychiatry and psychopharmacology,
specializing in mood and anxiety disorders. Dr. Barkin serves as Associate
Medical Director of Change Healthcare, which is a large Healthcare IT
(information technology) as well as Medical Director of Cornerstone Behavioral
Health. He practices both forensic and clinical psychiatry in Portland, Maine
and has extensive expertise in health care policy analysis which he frequently
presents and lectures about nationally. His practice includes consultation to
various businesses as well as government affairs including multi-stakeholder
efforts in the health care. Dr. Barkin is immediate past-President and current
Treasurer of the Maine Association of Psychiatric Physicians, on the board of
the Maine Medical Association, President of Tri-County Mental Health Services,
and is a Distinguished Fellow of the American Psychiatric Association.
The award is named after Dr. Ulrich B. Jacobsohn who was a
well-respected individual and physician who had a long and distinguished career
in psychiatry, over 50 years. He also served as President of the Maine
Medical Association.
Update Will Change Buprenorphine MME Display in Most State PMPs
The
AMA and American Society of Addiction Medicine (ASAM) worked with Appriss
Health, the developer of more than 40 state PDMP platforms, to ensure that
buprenorphine for the treatment of opioid-use disorder has been removed from
all displayed morphine milligram equivalent (MME) calculations throughout its
system.
Appriss
Health reported that it deployed a full system update on April 11, 2018, that
clearly separates buprenorphine from opioids that are used for the treatment of
chronic pain. The company also strengthened guidance to exclude medications
used for medication-assisted treatment from Centers for for Disease Control and
Prevent-recommended MME limits (i.e. 90 MME per day).
New Scrutiny for an Old Drug
With a significant drop in opioid prescriptions (32% in
Maine from 2013-2017), doctors and other prescribers are looking for other ways
to treat pain…and people are finding new ways to get high. That means the government gets involved.
The latest drug to come under FDA scrutiny is the generic gabapentin,
the 9th most prescribed medication in the US. Commissioner Scott
Gottlieb has stated, “I don’t want to be sitting here 5 or 10 years from now
lamenting that we didn’t take more aggressive action.” Many physicians are not
aware that people are using gabapentin, often mixed with opioids and other
substances, to achieve a modified mental status. The AP
reports that, according to medical journal articles, 15 to 25% of opioid users
also use gabapentin. While it is not considered addictive, it has featured in a
rising number of overdoses.
Some states are adding gabapentin to their tracking
databases, and Kentucky has classified it as a “scheduled substance.” It appears that increased prescribing levels originated at
a time when the drug’s original manufacturer began aggressive marketing. In 2004
the company, Warner-Lambert, pleaded guilty to charges of promoting gabapentin
for a wide range of uses not approved by the FDA and paid over $430 million in
settlement of the charges. Warner-Lambert was purchased by Pfizer in 2000.
New Interactive Online Course Ups Physicians’ Nutrition Knowledge, Supports Patients in Diabetes Prevention
An important part of preventing type 2
diabetes is lifestyle changes. Research conducted by the Centers for Disease
Control and Prevention (CDC) revealed that people with prediabetes can reduce
their risk of developing type 2 diabetes by nearly 60 percent when they
participate in a structured lifestyle change program.
An important part of preventing type 2
diabetes is lifestyle changes. Research conducted by the Centers for Disease
Control and Prevention (CDC) revealed that people with prediabetes can reduce
their risk of developing type 2 diabetes by nearly 60 percent when they
participate in a structured lifestyle change program.
"Early risk detection and educational interventions for diabetes have tremendous potential for engaging people more meaningfully in their own wellness and for reducing the risk of developing diabetes and all of its complications and costs," said Noah Nesin, MD, Vice President of Medical Affairs at Penobscot Community Health Care, and Physician Champion for MMA's diabetes prevention efforts.
Part of lifestyle changes include
learning how to eat properly to maintain a healthy weight, which is often a
contributing factor for type 2 diabetes. In fact, the CDC study found that
people could lose between 5 percent and 7 percent of body weight through
healthier eating. However, learning how to eat properly isn’t always intuitive
and requires education about nutrition.
Most patients usually look to their
physicians for help as a starting point. Unfortunately, many physicians may simply
not be armed with enough education and training on nutrition to provide
sufficient education. In turn, this makes trying to help patients challenging.
Although patients can work with health
coaches and be referred out to a CDC-recognized diabetes prevention program
(DPP) to help improve eating habits, physicians now have access to nutrition
tools as well. A new self-paced online course on nutrition helps physicians begin the conversation with patients at risk for
chronic disease such as type 2 diabetes and hypertension.
Nutrition
training through modules
Research reveals that medical schools
provide less than 20 hours of nutrition training, and very little continuing
medical education (CME) that’s relevant is offered. To fill in the gap, the
American Medical Association partnered with the Gaples Institute for
Integrative Cardiology to develop a three-hour interactive course called
Nutrition Science for Health and Longevity: What Every Physician Needs to Know.
The course provides evidence-based
information, encourages a team approach and offers tools necessary to make
referrals to nutrition professionals. Broken up into four modules of 45 minutes
each, the course addresses the following topics:
- Module 1: Why does nutrition matter to your
patients?
- Module 2: Dietary fats and patient health
- Module 3: Helping your patients understand
carbohydrates and protein
- Module 4: Making nutrition counseling work in
a busy practice
The first three modules address core
nutrition concepts while the fourth module offers practical tools for
implementation and then uses realistic patient scenarios to test your knowledge
and provide customized feedback. Links to the original studies are also provided,
which allows you to dig deeper in the materials, and all the modules offer a
printable summary sheet of each module to help you put the education into
practice.
Upon completion of the course, physicians
earn three hours of AMA PRA Category 1 credit.
Additional
tools to support patients
Screening tools can help you identify
your patients who have prediabetes. Once you’ve identified these patients, you
can begin the conversation on nutrition with them and help refer them to a DPP
to get the necessary support they need to make lifestyle changes.
Some tools physicians may find useful
include:
Most chronic diseases can in part be
prevented by eating a healthy diet. In fact, the No. 1 contributing factor to
premature death and disability in the United States is poor nutrition. Equip
yourself with the knowledge and tools you need to meet this challenge head on
and partner with patients on chronic disease prevention.
Consumer and Healthcare Groups File Suit for Medicaid Expansion Implementation
On April 30, 2018, Maine Equal Justice Partners (MEJP) held
a press conference announcing they have filed a lawsuit in Maine Superior Court
to require implementation of Medicaid expansion as enacted by Maine voters in a
2017 referendum.
Robyn Merrill, Executive Director of MEJP, announced the action
against the Maine Department of Health and Human Services by MEJP, Consumers
for Affordable Health Care, the Maine Primary Care Association, Penobscot
Community Health Care, and several individual plaintiffs who would be eligible
for coverage under the expanded form of Medicaid. The claim is based on “a simple
legal issue,” said Jamie Kilbreth, Esq., lead plaintiffs’ attorney on the case: the State’s failure to file a State Plan Amendment by April 3,
2018, as required by the referendum.
Ms. Merrill stated that the plaintiffs had waited for the
Legislature or the Governor to act on the issue, “but we couldn’t wait any
longer.”
Governor LePage’s office stated that he can’t comment on “active
litigation.”
Maine Physicians Participate in Regional State Medical Society Meeting in Connecticut Last Weekend
The meeting of New England state medical society delegations is a regular event in preparation for the AMA Annual Meeting in Chicago in June.
The Maine Medical Association's delegation to the meeting at the Mystic Marriott Hotel & Spa in Groton, CT included AMA Delegates Richard Evans, M.D. and Maroulla Gleaton, M.D., as well as MMA President Robert Schlager, M.D. and Deputy EVP & General Counsel Andrew MacLean.
During the first part of the meeting on Saturday, May 5th, Dr. Gleaton presided as President of the Council of New England State Medical Societies (CNESMS) which presents a regular opportunity for the New England state medical societies' leadership to share the highlights of their organizations' recent work. Dr. Schlager joined the Presidents (or their designated substitute) of the other societies in presenting reports. Dr. Schlager introduced himself to the group and commented about the MMA's advocacy work on Medicaid expansion, the opioid crisis, and the administrative hassles of prior authorization, as well as tasks assigned at the MMA board retreat in March on EVP succession planning, Stred building renovations, and board member and MMA member engagement. As usual, the Presidents' reports revealed a number of common themes - the importance of advocacy, responding to the opioid abuse crisis, and member engagement, for example.
During the latter part of the morning meeting, Dr. Evans presided as Chair of the New England Delegation to the AMA. The agenda for this part of the meeting began with review of proposed resolutions to the AMA House of Delegates on issues such as firearms safety (several in response to recent mass shootings), e-cigarette ingredients, payment methodology, and Direct Primary Care. The firearms resolutions prompted a lengthy and vigorous discussion. Following the resolution discussion, the group heard updates on various AMA Councils and Task Forces and noted several New England delegation members who are candidates for elected positions within the AMA.
The AMA Annual Meeting will take place at the Hyatt Regency in Chicago from June 9-13, 2018.
APM Set Forth for Opioid-use Disorder Treatment
The
AMA and ASAM jointly developed and released a concept paper detailing a groundbreaking alternative
payment model (APM) for use by teams of addiction specialists, primary care
physicians and other health professionals to manage the full array of medical,
pharmaceutical and psychosocial care for opioid-use disorder (OUD) patients.
The Patient-Centered Opioid Addiction Treatment (P-COAT) model is expected
to increase the number of OUD patients who are able to lead satisfying,
productive lives through successful management of their condition while also
reducing spending on preventable costs associated with addiction, such as
emergency department visits and hospitalizations.
P-COAT aims to broaden access to proven, effective treatment for OUD by
supporting coordinated care by multiple health professionals and ending the
fragmentation and service gaps that have often characterized addiction
treatment. P-COAT includes a number of innovative features, including an add-on
payment for participating treatment teams that make use of clinically validated
digital care management tools to improve patient adherence to treatment
plans.
ASAM and the AMA are now seeking physician practices and insurers interested in
pilot testing the new payment model, who can submit their contact information here. The
organizations are also working with the House Energy and Commerce Committee on
potential inclusion of a provision establishing a Medicare demonstration
project of an alternative payment model for OUD in the legislation the
committee is developing to address the opioid epidemic. A discussion draft of
such a measure was included in legislation that cleared the Energy and Commerce Health
Subcommittee April 25.
Read
more at AMA Wire.
The Honorable George J. Mitchell to Keynote MMA's 165th Annual Session
The Maine Medical Association will hold its 165th Annual Session Sept. 7-9, 2018 at the Harborside Hotel and Marina in Bar Harbor. Former U.S. Senate Majority Leader and Special Envoy, The Honorable George J. Mitchell will kick off the weekend with a keynote presentation at 6:30pm on Friday evening, Sept. 7. Registration materials are included with the current issue of Maine Medicine.
Members, guests and exhibitors can also register on the Association's website at www.mainemed.com. In addition to Senator Mitchell's presentation, the weekend will feature a gubernatorial forum featuring candidates for Governor, the annual presentation of 50 year pins and other awards on Saturday evening and the installation of a new President-elect. A new feature this year will be a champagne reception for MMA past presidents.
On the education side, programs will be presented on alternatives to opioids for pain, a panel discussing what more needs to be done to address the epidemic of drug overdoses in the state and a panel discussing leadership from physicians in the C-suite. Media training will be offered in an optional session, as will education on Chapter 488 on opioid prescribing and on the new Chapter 21 rules from the licensing boards (took effect for most boards on March 23, 2018). These optional sessions will qualify for the mandatory CME on opioid prescribing (3 hours CME).
Questions about the Annual Session can be addressed to Diane McMahon at the MMA at 480-4188 extension 216 or via e-mail to dmcmahon@mainemed.com.
We hope to see you in Bar Harbor in September!
Legislative Report: Is This a Wrap-up?
Veto day was held on Wednesday, May 2nd. Click through to find out which health-related vetoes were overridden and which sustained, along with a report on the day and the future of the 128th Legislature. Where do we go from here?
It was an interesting day at the Maine Legislature. Overall, out of 20 vetoes 11 were overridden and 9 sustained. Bills related to health care made up 8 of the 11 overrides and 3 of the 9 votes to sustain. It should be noted that when one chamber votes to override, the bill must go to the other chamber for a vote, whereas if one chamber votes to sustain a veto the other chamber need not vote, since a vote of 2/3 of each body is required to override. (See the list of bills and votes at the end of this article.)
The reader may remember that when the Legislature last met, on April 18-19, controversy surrounded the issue of whether the session should be extended. That controversy continued on Veto Day, and after the veto votes were completed the House moved to the matter of extension.
Speaker Sara Gideon passed the gavel to Majority Leader Erin Herbig so that she could assume a position as a rank-and-file member and move to extend the session for 4 days. She proposed a format whereby there would be a specific set of tasks for each day, with the Appropriations and Tax Committees meeting on the first day to vote on tax conformity, rate increases for home- and community-based services for children and people with developmental and intellectual disabilities, and "all remaining calendar items." The proposal for Day 2 would have required the Appropriations Committee to put together a package of bills from the Special Appropriations Table, while the Tax Committee would compromise on a tax conformity bill. Those matters would then be voted on by the House and Senate. Day 3 would be reserved for actions on line item vetoes by the governor regarding the financial bills, and Day 4 would be a second veto day for substantive bills. The "800 pound gorilla" in the chamber, the undiscussed issue upon which the controversy is based in large part, was the staffing and money necessary for Medicaid expansion.
Minority Leader Fredette stated, "While I appreciate the words...I can't agree with the proposal." He pointed out that the State is not currently in a fiscal crisis and said that his party had proposed a list of bills to pass. Then he stated that the path forward is through a special session, not an extension of the session, and he said that a special session would happen.
After some discussion, an amendment was proposed to extend the session by one day. That failed passage. Another amendment was offered to extend for 3 days. That amendment, which required only a majority vote, passed, setting the stage for a vote on the main motion (technically an "order") to extend the session by 3 days. The final vote was 82-66 in favor of extension, 19 votes less than the 2/3 needed to pass. The 128th Legislature then finally adjourned, "sine die", at 6:30 p.m.
There is still a chance that the Legislature will return for a special session before election day. That would require an action by the Governor or a call by Legislative leadership, with consent of a majority of each political party. In Maine that would mean a majority of the Republicans, a majority of the Democrats, and the consent of the one member of the Green party. If no special session is held, all pending bills including any on the special appropriations table will be dead.
For further discussion of the day's events and the chances of a special session, part reporting and part editorializing, see this article in the Bangor Daily News.
Vetoes Overridden
(Requires 101 votes in House and 23 votes in Senate):
LD 166: An Act to Increase Reimbursement for Child Care
Services (31-3, 119-29)
LD 1187: An Act to Amend the Child Protective Services
Statutes (34-0, 144-3)
LD 1388: An Act to Prohibit the Falsification of Medical
Records (34-0, 148-0)
LD 1719: An Act to Implement a Regulatory Structure for
Adult Use Marijuana (28-6, 109-39)
LD 1740: An Act Regarding Criminal Forced Labor, Aggravated
Criminal Forced Labor, Sex Trafficking and Human Trafficking (34-0, 136-12)
LD 1771: An Act to Stabilize Vulnerable Families (34-0,
148-0)
LD 1874: Resolve, to Ensure the Continued Provision of
Services to Maine Children and Families (34-0, 141-7)
LD 1892: An Act to Clarify the Prescribing and Dispensing of
Naloxone Hydrochloride by Pharmacists (34-0, 132-16)
Vetoes Sustained:
LD 1063: Resolve, to Reduce the Number of Substance-exposed
Infants (80-68)
LD 1587: Resolve, to Study the Feasibility of the
Establishment of Paid Family Leave in the State (80-68)
LD 1866: An Act to Increase Youth Mental Health Awareness in
Schools (82-66)
Introduction to LEAN in Healthcare: Full-Day Workshop on Tuesday, May 8
Are you frustrated by
poor communication and waste in your work processes? Lean has recently
transformed the way many hospitals and health systems operate. This full-day workshop on May 8 in Augusta provides those who
lead hospitals, health centers, practices, and related service industries with
an introduction to Lean thinking and process improvement tools.
The first half
of the day will cover the principles of Lean thinking and provide several
exercises so participants can compare traditional processes to Lean processes.
The second half of the day will share an overview of some of the important Lean
tools and challenge the class to identify applications for Lean in their
organization.
Lean Healthcare East has over 30
years combined experience in leading organizational transformation and have
many engaging exercises and examples to share from their experiences
implementing Lean improvements at hospitals and other healthcare related organizations.Click
here to learn more and register for the workshop. If you have questions or want to schedule a workshop at your
practice please contact
the Lean Healthcare East team.
MaineHealth MORE Conference - Managing the Opioid Response Effort - May 17th
The MaineHealth MORE Conference offers practical clinical approaches to combating Maine's opioid crisis. Join your colleagues and a host of content experts to explore non-opioid pain therapies and innovative opioid use disorder (OUD) treatment modalities.
The MaineHealth MORE Conference offers practical clinical approaches to
combating Maine's opioid crisis. Join your colleagues and a host of
content experts to explore non-opioid pain therapies and innovative
opioid use disorder (OUD) treatment modalities.
Breakouts will address cognitive and integrative pain management, perinatal OUD tratment, meeting the challenges of rural OUD treatment and effective strategies for patient and practice engagement.
Keynote speaker Dr. Seddon Savage will draw on her experience directing Dartmouth's Center on Addiction Recovery and Education and serving as Medical Director of the Chronic Pain Recovery Center and Connecticut's Silver Hill Hospital to offer insights into pain treatment and addiction recovery.
This conference will fulfill the opioid CME requirement for the State of Maine.
WHEN: Thursday, May 17, 2018 from 8:00am - 5:oopm
WHERE: MaineHealth, 110 Free Street, Portland, ME
FEE: $75.00 Click
here for more details on the fees.
For more information and to register click here.
You won't want to miss this educational opportunity!
Maine Chapter, American College of Surgeons Annual Meeting in Kennebunkport, ME - May 18-20
The Maine Chapter, American College of Surgeons will hold their Annual Meeting from Friday, May 18 through Sunday, May 20 at the Colony Hotel in Kennebunkport, ME.
The Maine Chapter, American College of Surgeons will hold their Annual
Meeting from Friday, May 18 through Sunday, May 20 at the Colony Hotel
in Kennebunkport, ME. All surgeons are invited to attend this exciting program offering 12.00 Category 1 CME Credits.
For more information and to register online, click here.
Brochure (PDF)
Exhibit opportunities are also available and any questions regarding exhibiting can be addressed to Shirley Goggin at 207-445-2260, emailing maine@mainefacs.org.
Monday, May 21 in Brewer: Next Steps in Addressing Maine's Opioid Crisis
3-hour presentation from 5-8:30 pm at Jeff's Catering in Brewer.
Register Now This 3-hour education session will feature an update on Maine opioid prescribing laws and rules as well as clinical content with a compassionate, patient-centered perspective. The topics covered at this session will be:
- Opioid Use Disorder and Medication Assisted Recovery: Caring for Our Communities
- Alternative Treatments for Chronic Pain
- Recent Legal Changes Affecting Opioid Prescribing in Maine
This MICIS presentation activity qualifies for a maximum of 3 CME credits of the 3 CME credit requirement for opioid medication education found in P.L.2015, Chapter 488, Maine's recent legislation to address the opioid drug crisis.
Presenters: Elisabeth Fowlie Mock, MD, MPH and Peter Michaud, JD, RN
Monday, May 21, 2018 from 5:00 - 8:30 pm
Jeff's Catering, 15 Littlefield Road, Brewer
Check in begins at 4:30pm
FREE - advanced registration is required
Light snacks will be provided
The Maine Independent Clinical Information Service (MICIS) is a program of the Maine Medical Association.
The Maine Medical Education Trust designates this live activity for a maximum of 3 AMA PRA Category 1 Credit(s).TM Physicians should only claim credit commensurate with the extent of their participation in the activity.
This activity has been planned and implemented in accordance with the Essentials and Standards of the Maine Medical Association Committee on Continuing Medical Education and Accreditation through the partnership of Maine Medical Education Trust and the Maine Independent Clinical Information Service (MICIS). The Maine Medical Education Trust is accredited by the Maine Medical Association's Commitee on Continuing Medical Education to provide CME activities for physicians.
Inspiring Hope: How to Support Recovery Ready Communities - May 24 Conference
8am-3pm at the Hilton Garden Inn, Bangor.
Young People In Recovery - Brewer is grateful to be presenting their first ever YPR-Maine Statewide Conference, aimed at embracing change, inspiring hope and removing stigma.
Registration and Event Information
Thursday, May 24, 2018 8:00 am-3:00 pm
Hilton Garden Inn, 250 Haskell Road, Bangor ME
This event is sponsored in part by the Maine Health Access Foundation, Bangor Area Recovery Network, the United Way of Eastern Maine, and Penobscot Community Health Center.
One River, One Ocean: June 2-14, 2018
River Awareness fundraiser on the Androscoggin River.
One River, One Ocean: June 2-14, 2018
Androscoggin River Awareness Journey and Fundraiser
A River Awareness Journey down the Androscoggin, from Errol, NH to Topsham, ME
One River~One Ocean
When: Saturday, June 2, 8am – Thursday, June 14, 6pm
Where: Androscoggin River One woman’s river awareness journey down the Androscoggin~~~
I am a Registered Maine Guide, retreat leader and founder of Nurture
Through Nature Retreat Center, in Denmark, Maine, interested in
bringing a voice to the Androscoggin River, its history, heritage and
evolution in our culture. My intention is increase awareness about water
quality and raise money for an environmental non-profit organization
that includes in its mission and vision water and natural resource
protection. I grew up on this river and have a deep appreciation for it.
I am grateful to be in collaboration with MaineRIvers.Org whose mission
is to protect, restore and enhance the ecological health of Maine’s
river systems.
I will be paddling its length and sharing what is discovered along the way.
Please join me for the culminating celebration, where this
majestic river meets the sea, at the Sea Dog Brewing Company, 1 Bowdoin
Mill Island #100, Topsham, ME on June 14, 4-6pm. Special thanks to Sea
Dog Brewing for donating the space for this event.
MCMI Training Programs - Level 1 and Level 2 - June 22
The
Maine Concussion Management Initiative (MCMI) will to holding a training
program on June 22 in Waterville at Colby College. It is appropriate for
athletic administrators/directors, school nurses, coaches, athletic trainers,
physicians, nurse practitioners, and physician assistants.
The
Maine Concussion Management Initiative (MCMI) will to holding a training
program on June 22 in Waterville at Colby College. It is appropriate for
athletic administrators/directors, school nurses, coaches, athletic trainers,
physicians, nurse practitioners, and physician assistants.
MCMI Training Programs – Level 1 and Level
2
When and where
held:
June 22, 2018 in Waterville
at Colby College (Level 1 in the morning
and Level 2 in the afternoon)
Class
size limited to 40.
October 16, 2018 in Portland at
the Double Tree by Hilton Hotel in conjunction with the Brain Injury
Association of America-Maine Annual Conference
Class
size limited to 30
(Level 1 in the morning and Level 2 in the
afternoon)
(Registration
and fees will be through the BIAA-Maine for October 2017)
Training Programs:
Level 1 – An Introduction to Concussions
and Concussion Management
Speaker: Deb Nichols, CPNP and/or
Peter Sedgwick, MD and/or Jaclyn Tourtelotte, ATC
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:
Paul Berkner, DO
Level
of Difficulty: intermediate
Content:
Updates from Berlin 2016
Concussion Assessment Tools
Using ImPACT Testing in Concussion Management
Interpreting ImPACT Test Results
Concussion Case Reviews
Schedule:
June 22 – Level 1:
7:45am – 8:00am Registration
8:00am – noon Training Program
Level 2:
12:45pm – 4:00pm Training Program
CME: Level 1 – 3.5 hours Level
2 – 3.0 hours
CEU: Level 1 – 3.5 hours Level 2 – 3.0 hours
Registration Fee
for June 22:
$100 for Health Care Professionals taking
Level 1 or Level 2
(MD,
DO, NP, PA, Neuropsychologist, RN, PT, OT, SLP)
$175 for Health Care Professionals
taking Level 1 and Level 2
$40 for school personnel and all other
attendees taking Level 1 or Level 2 (Athletic
trainer, school nurses, coaches, athletic directors and administrators, parents)
$70 for school personnel taking Level 1 and Level 2
$20 for students currently enrolled in
a college program taking Level 1
$35 for students taking Level 1 and Level 2
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 a 100% return
no matter when you cancel – before, day of or after.
For more
information contact:
Jan
Salis, PT, ATC
MCMI
- Membership and Education Committee - Chair
jsalis@aol.com
(207)
577-2018
NATA CEU Statement
of Credit – June 22, 2018 – Level 1 and Level 2
MATA is recognized by the Board of Certification, Inc. to
offer continuing education for Certified Athletic Trainers. This program offers 6.5 CEUs. The MATA BOC
Approved Provider Number: P325
AMA Designation Statement – June 22, 2018 – Level 1 and Level
2
MaineGeneral Medical Center is
accredited by the Maine Medical Association’s Committee on Continuing Medical
Education to provide continuing medical education (CME) to physicians.
MaineGeneral Medical Center designates this
live activity for a maximum of 6.5 AMA PRA Category 1 Credit(s)TM. Physicians should only claim
credit commensurate with the extent of their participation in the activity.
Joint Providership – June 22, 2018
This
activity has been planned and implemented in accordance with the Essentials and
Standards of the Maine Medical Association Committee on Continuing Medical
Education and Accreditation through the joint providership of MaineGeneral
Medical Center and the Maine Concussion Management Initiative. Maine
General Medical Center is accredited by the Maine Medical Association’s
Committee on Continuing Medical Education to provide continuing medical
education (CME) to physicians.
REGISTRATION:
Registration can be done online at: https://mcmi-colby.org Payment still needs to be mailed.
Checks can be made
out to “Colby College-MCMI”. Note on
check for “MCMI Conference Registration”
Send check and completed
registration form to:
Jan
Salis, PT, ATC
MCMI
4
Cassie Lane
Poland,
ME 04274
If you need more
information: contact Jan Salis, PT, ATC, at jsalis@aol.com
or 207-577-2018
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.
Peer Navigation Program from Facing Our Risk of Cancer Empowered (FORCE)
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 http://www.facingourrisk.org.
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.
Northern New England Society of Addiction Medicine 2018 Annual Conference & Meeting - Nov 2-3
Save the date for the NNESAM 2018 Annual Conference taking place at the Trapp Family Lodge in Stowe Vermont November 2 & 3, 2018.
SAVE THE DATE
Northern
New England Society
of
Addiction Medicine
2018
Annual Conference & Meeting
November 2 & 3, 2018
(Friday evening, all day Saturday)
Conference registration forms will be available later
Trapp Family Lodge
Stowe, Vermont
www.trappfamily.com – please contact the Lodge for reservations
Conference rate: $187, rate
available for 11/4 and 11/5
Please request conference rate for NNESAM
Internal Medicine Outpatient Physician Opportunity
Western Maine
Primary Care is seeking a BC/BE Internist for their well-established outpatient
practice located in the Norway, Maine.
Western Maine
Primary Care is seeking a BC/BE Internist for their well-established outpatient
practice located in the Norway, Maine. Experience the warmth of a small
town combined with a medical community working closely with colleagues
throughout the MaineHealth system to ensure the healthcare needs of patients
are delivered with the highest level of quality.
Come be a part of
our dynamic team of providers, which includes seven internal medicine
physicians and five nurse practitioners, working with exceptional support
staff.
Stephens Memorial Hospital is a 25-bed critical access
hospital. The position involves
teaching and mentoring residents and medical students from the Maine Medical
Center-Tufts University School of Medicine Medical School Program.
Norway is a scenic affordable community in the heart of a
four-season recreational area. Surrounded by more than ten lakes and ponds,
Norway is a haven for boating, swimming, and fishing. The nearby mountains
provide hiking with vista views of Mount Washington and the Presidential Range.
Competitive salary and benefits, including student loan
repayment. FMI contact Abbie
Graiver, Director of Physician Recruitment (207) 744-6049 or graiverab@wmhcc.org.
6/4/18
Ob/Gyn Physician Opportunity
Western Maine OB/GYN is currently seeking a BC/BE OB/GYN
physician to join our exceptional team of providers.
Western Maine OB/GYN is currently seeking a BC/BE OB/GYN
physician to join our exceptional team of providers. Come be a part of our
dynamic team, which includes board-certified physicians and a nurse
practitioner, working with exceptional support staff. Now is a great time to
join our team as we are currently relocating our practice to our brand new,
state-of-the-art suite in the fall of 2018.
Stephens Memorial Hospital is a 25-bed critical access
hospital. The position involves teaching medical students from the Maine
Medical Center-Tufts University School of Medicine Medical School Program.
Norway is a scenic affordable community in the heart of a
four-season recreational area. Surrounded by more than ten lakes and ponds,
Norway is a haven for boating, swimming, and fishing. The nearby mountains
provide hiking with vista views of Mount Washington and the Presidential Range.
This position is a four day a week position, weekday call
1:3 and weekend call 1:4. Competitive salary and benefits, including student
loan repayment. FMI contact Abbie Graiver, Director of Physician Recruitment
(207) 744-6049 or graiverab@wmhcc.org.
6/4/18
Outpatient Internal Medicine Physician – Bangor, Maine
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.
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
ProviderJobs@emhs.org
7/2/18
Family Practice Physician - Bucksport Regional Health Center
Bucksport
Regional Health Center, a Federally Qualified Health Center (FQHC) has a unique
opportunity in our small independent, community-based primary care facility
offering great quality indicators, team atmosphere and excellent working
conditions.
Bucksport
Regional Health Center, a Federally Qualified Health Center (FQHC) has a unique
opportunity in our small independent, community-based primary care facility
offering great quality indicators, team atmosphere and excellent working
conditions. Located along the Penobscot River, we are centrally located
along the beautiful coast of Maine, close to Acadia National Park and Bangor.
This
is a full scope of outpatient primary care services commensurate with his/her
field of training and State of ME licensure. Offers care to a diverse age
population. Optional 4/5 days/week schedule.
Candidates must have graduated from an
accredited medical school & completed Family Practice or Med/Peds
residencySheila, have a current State of Maine Medical License and D.E.A.
Certificate and at least 5 years of experience in the practice of family or
internal medicine. Submit resume and cover letter to: Danel Adams, Human
Resources, 110 Broadway, Bucksport, ME 04416, email dadams@brhcme.org
5/14/18
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.
7/2/18
Psychiatry Faculty, Division of Child & Adolescent Psychiatry
Maine
Medical Center (MMC) is seeking a BC/BE part/full-time Child & Adolescent
Psychiatrist clinician-educator or clinician-scientist to join the Department
of Psychiatry.
Maine
Medical Center (MMC) is seeking a BC/BE part/full-time Child & Adolescent
Psychiatrist clinician-educator or clinician-scientist to join the Department
of Psychiatry.
The position involves outpatient care in the child and
adolescent psychiatry clinic. It also includes a role as the clinician leader of the Child & Adolescent Psychiatry
Division’s Portland Identification and Early Referral (PIER) program team.
Maine Medical
Center has 637 licensed beds and is the state’s leading tertiary hospital and
Level One Trauma Center, and the position
involves teaching and mentoring Psychiatry residents, Child & Adolescent
Psychiatry fellows, and medical students from the Maine Medical Center-Tufts
University School of Medicine Program.
Just two hours north
of Boston, this is an exceptionally diverse and vibrant community.
For more information
please contact Alison C. Nathanson, Director, MaineHealth Physician Recruitment
Center at (207) 661-7383 or nathaa@mainehealth.org.
5/28/18
Psychiatric Medical Director
Tri-County Mental Health Services has multiple
current and developing programs including Integrated Primary Care and
Behavioral Health Homes.
Change can make a world of difference. We offer
hope.
Tri-County Mental Health Services has multiple
current and developing programs including Integrated Primary Care and
Behavioral Health Homes. This is a true leadership position, where
understanding of healthcare systems is important and involvement in the
agency’s mission, clinical programs, and growth into new areas is key.
As the Psychiatric Medical Director you will:
- Oversee integrated
behavioral healthcare initiatives and programs across multiple settings.
- Build partnerships
within healthcare systems.
- Develop and implement
integrated and consultative models of care that enhance access to quality whole
health services.
State of Maine licensure, certificate in psychiatry
and DEA certificate required.
Located in Lewiston, Maine.
Contact Jessica Lachance at 207-344-1839 or jlachance@tcmhs.org for more information.
4/30/18
Maine's Largest FQHC in need of Physician for Geriatric Program
PCHC in Bangor, Maine is seeking Board-Eligible Internal
Medicine or Family Med Physician to join our team of doctors and advanced
practice providers in our Community Care and Geriatrics department!
PCHC in Bangor, Maine is seeking Board-Eligible Internal
Medicine or Family Med Physician to join our team of doctors and advanced
practice providers in our Community Care and Geriatrics department!
- Provide
care to seniors in post-acute care settings and in area long-term care facilities
and serve as Medical Director in those facilities.
- No
call, no holidays, no nights or weekends.
- Opportunity
to mentor PA, NP, and DO students through partnerships with multiple
university programs.
Penobscot Community Health Care is a nationally
recognized FQHC that focuses on patient-centered care, innovation and
collaboration. For you, for your family, for our community. For more
information, please contact Vanessa Sanderson, Recruitment Coordinator at
(207)404-8015 or vsanderson@pchc.com.
6/4/18
Multiple Family Med Opportunities in Beloved Community Health Centers
PCHC is recruiting Family Medicine Physicians for locations
in Belfast, Old Town, and Bangor. This is your chance to work for a nationally
recognized FQHC that is a leader in integrated primary care!
PCHC is recruiting Family Medicine Physicians for locations
in Belfast, Old Town, and Bangor. This is your chance to work for a nationally
recognized FQHC that is a leader in integrated primary care!
- Come
and join our team at Seaport Community Health Center and become a part of
a vibrant and active coastal community!
- Work
and play minutes away from the flagship university of the University of
Maine System by working at our Helen Hunt Health Center!
- Become
a part of the health center where it all began, Penobscot Community Health
Center located in the heart of Bangor, Maine!
We are the largest and most comprehensive FQHC in Maine and
the 2nd largest in New England. PCHC offers family medicine,
psychiatry, mental health, pediatrics, specialty services, physical therapy,
pharmacy, social work, lab, x-ray, and a large public health dental center --
all within our organization. If your passion is in community health, there is
no place else to be. Questions? Contact Vanessa Sanderson, Recruitment
Coordinator at (207)404-8015 or vsanderson@pchc.com.
6/4/18
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 Donna
Lafean, Central Maine Medical Center, 300 Main Street, Lewiston, ME 04240.
Email: Lafeando@cmhc.org; Fax: 207/344-0658;
Call: 800/445-7431; or visit our
website: http://recruitment.cmmc.org/.
7/2/18
Internal Medicine Outpatient Physician
Maine Medical Partners Internal Medicine Westbrook is
seeking a BC/BE Internal Medicine physician for their well-established
outpatient practice located in the greater Portland, Maine area.
Maine Medical Partners Internal Medicine Westbrook is
seeking a BC/BE Internal Medicine physician for their well-established
outpatient practice located in the greater Portland, Maine area. The selected candidate will join 4 internal
medicine physicians, 4 family medicine physicians and a geriatrician.
Maine Medical Center has 637 licensed beds and is the state’s
leading tertiary care hospital and Level I Trauma Center, with a full
complement of residencies and fellowships and an integral part of Tufts
University Medical School. The position
involves teaching and mentoring residents and medical students from the Maine
Medical Center-Tufts University School of Medicine Medical School Program.
Situated on the Maine coast, Portland offers the best of urban
sophistication combined with small-town friendliness. Just two hours north of Boston, this is an
exceptionally diverse and vibrant community.
For more information please contact Alison C. Nathanson, Director,
MaineHealth Physician Recruitment Center at (207) 661-7383 or nathaa@mainehealth.org.
5/7/18
Clinical Cardiology Opportunity
Maine
Medical Partners MaineHealth Cardiology is seeking an invasive clinical
cardiologist (non-interventional) for their practice located in their Augusta
and Waterville, Maine locations
Maine
Medical Partners MaineHealth Cardiology is seeking an invasive clinical
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.
5/21/18
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.
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