Maine Medicine Weekly Update - November 5, 2018
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CMS Issues Final Medicare Physician Payment Rule

CMS released its annual Physician Payment Rule last week and several revisions made to the proposed rule responded to physician concerns about collapsing the Evaluation and Management Codes to just two codes. There will be three codes instead of two and the implementation of this change has been delayed until 2021, allowing for more analysis and comments.  

 

In addition to the changes to the proposal to collapse the E & M codes, CMS also proposed to minimize some administrative burden and expand Medicare coverage of virtual health visits via new covered codes for technology-based services including virtual care and remote patient monitoring. Changes were also made to the MIPS reporting requirements.  

 
The changes are effective for services furnished under the Medicare Physician Fee Schedule on or after Jan. 1, 2019.
 
For CY 2019 and beyond, CMS is finalizing the following policies designed to minimize the current administrative burden:
 
  • Elimination of the requirement to document the medical necessity of a home visit in lieu of n office visit;
  • For established patient office/outpatient visits, when relevant information is already continued in the medical record, practitioners may choose to focus their documentation on what has changed since the last visit, or on pertinent items that have not changed, and need not re-record the defined list of required elements if there is evidence that the practitioner reviewed the previous information and updated it as needed. Practitioners should still review prior data, update as necessary, and indicate in the medical record that they have done so;
  • Additionally, CMS is clarifying that for E & M office/outpatient visits, for new and established patients for visits, practitioners need not re-enter in the medical record information on the patient's chief complaint and history that has already been entered by ancillary staff or the beneficiary. The practitioner may simply indicate in the medical record that he or she reviewed and verified this information; and 
  • Removal of potentially duplicative requirements for notations in medical records that may have previously been included in the medical records by residents or other members of the medical team for E/M visits furnished by teaching physicians.  

VOTE!

You've heard it all many times. Please vote tomorrow, Tuesday, November 6th. Elections have consequences for those of us involved in health care.

 

Vote!!!

Signatures being Collected for Citizen Initiated Proposal on Physician Assisted Death

As Mainers vote on Tuesday, they may be asked to sign petitions authorizing an assisted-dying bill, modeled after Oregon's law, for presentation on a November, 2019 ballot. 

 

A political action committee has been established which has already gathered about 9,000 of the more than 60,000 signatures required to place a citizen initiated proposal on the ballot. The number of signatures required will be 10 percent of the gubernatorial vote on Tuesday. In an article published in the Portland Press Herald last week, it was reported that the proponents of the measure will have more than 130 volunteers at 100 polling places on Tuesday.

 
Proponents of the measure expressed frustration that the legislature has defeated similar proposals repeatedly, although in the past four years a physician assisted-death proposal has been enacted in the House and come within a vote of passing the Senate; however, these votes were seen as somewhat symbolic as Governor LePage had stated his strong opposition to the bill. Seven states and the District of Columbia authorize such action when a patient has less than six months to live with Vermont being the only state in New England with such a law.
 
The Oregon law was the first in the nation authorizing a terminally ill patient to ask their physician to write a lethal prescription. Since the law went into effect more than 20 years ago, nearly 2000 people received such a prescription with 1,275 patients having died from taking the medication, according to  February 2018 report by the Oregon Health Authority.
 
A survey of MMA members taking during the course of the 128th Legislature revealed that members were equally divided in their support and opposition to the proposal. Based largely upon that division, the Association withdrew its opposition and took a neutral position on the bill which was not enacted. In the year 2000, a previous publicly initiated referendum was defeated by voters and in that election Association took an active role in opposition to the proposal. The Association currently has a work group reviewing the issue. Charles Pattavina, M.D., immediate past president of MMA, chairs the working group.
 
 
 
 

New Web-based Decision Support Tool Helps With Chronic Pain Treatment

Patient–provider communication is critically important in pain management and predicts patient satisfaction better than actual decreases in reported pain. A new web-based decision support tool helps patients with chronic pain and their health care providers work together to better manage chronic pain. The tool is free of charge and can be accessed at ThePainAPP.com.

 

 

Patient–provider communication is critically important in pain management and predicts patient satisfaction better than actual decreases in reported pain. A new web-based decision support tool helps patients with chronic pain and their health care providers work together to better manage chronic pain. The tool is free of charge and can be accessed at ThePainAPP.com

Here’s how it works. Patients interact with PainAPP on their own (online) before seeing their provider, answering questions about their treatment goals and preferences, viewing videos of other patients dealing with chronic pain, and learning ways to manage chronic pain and improve communication with providers. PainAPP also walks patients through a comprehensive pain assessment, including risk for opioid misuse, psychosocial and behavioral factors, and attitudes towards different pain treatments. A summary report is generated that the patient can share with print out or send to their provider through a patient portal. This report includes the patient’s treatment goals, preferences, and a comprehensive pain assessment. This information can help providers better understand their patients, spend less time collecting data, and more time talking with patients about what matters to them.

The tool was pilot tested in a prospective controlled pilot study. Participants were referred through providers or patient networks. Testing included 38 participants (68% female, 85% white), half (56%) referred by providers. Half (47%) of PainAPP users shared their summary report with their provider. Both PainAPP and the control website were highly rated in all areas, with PainAPP slightly outperforming the control website on most dimensions. All PainAPP users would recommend it to others with chronic pain; nearly all trusted the information and said it helped them think about my treatment goals (94%), understand my chronic pain (82%), make the most of my next doctor's visit (82%), not want to use opioids (73%), think about the pros and cons of opioids (71%), manage my chronic pain (65%), and want to stop using opioid medications (33%).  

In conclusion, PainAPP offers a new approach for patient education, comprehensive pain assessment and patient-provider communication. PainAPP appears useful in improving communication and chronic pain management and discouraging opioid use. If you have any questions or are interested in customizing the tool for your practice, please email PainApp@SDMR.us.

 

Health Insurance Marketplace 2019 Open Enrollment Now Through December 15, 2018

Open Enrollment for 2019 health insurance plans through the Health Insurance Marketplace began on November 1 and ends on December 15, 2018.

 

Health Insurance Marketplace Open Enrollment for 2019 began on November 1. Many people can get help with premiums or out-of-pocket costs for plans in the Health Insurance Marketplace.

2019 Open Enrollment ends on December 15, 2018.

AMA Urges FTC to Act on Insulin Prices

The AMA expressed strong concern to the Federal Trade Commission (FTC) in an Oct. 26 letter about the sharp rise in insulin prices among manufacturers. The AMA urged the agency to monitor insulin pricing and assess whether anti-competitive actions were driving higher insulin prices.

 

[from AMA Advocacy Update]

The AMA expressed strong concern to the Federal Trade Commission (FTC) in an Oct. 26 letter about the sharp rise in insulin prices among manufacturers. The AMA urged the agency to monitor insulin pricing and assess whether anti-competitive actions were driving higher insulin prices.

The AMA asked that the FTC recommend enforcement action against manufacturers that were engaged in anti-competitive practices to the U.S. Department of Justice. In the letter, the AMA cited lawsuits filed in 2017 against insulin manufacturers on behalf of patients that noted there were "rapid and lockstep price increases of more than 150 percent."  

In addition,Modern Healthcare (11/1, Luthi, Subscription Publication) reports that Reps. Tom Reed (R-NY) and Diane DeGette (D-CO) are asking Congress “to limit patent extensions which have allowed insulin manufacturers to stop new generics from entering the market” in order to address rising insulin costs. According to their analysis, “Experts predict that follow-on insulins could cost 20 to 40 percent less than their brand name equivalents, creating savings for patients.” The article says other proposed changes include a proposal for “PBMs and health plans to disclose how many rebates they receive and pass along,” as well as “banning the ‘pay-for-delay’ practice in which the expired patent-holding brand drug maker pays a generic manufacturer not to produce the off-patent drug.”

 

MaineGeneral to Offer X-waiver Course

MaineGeneral Hospital is offering a "half & half" opioid treatment course with Dr. RIchard Fein on Saturday, December 11, 2018. Get your DEA X-waiver and provide medication assisted treatment to your patients who need it.

 

Office-Based Treatment of Opioid Dependence Course
FOR: All physicians, NPs, PAs, MAs, other medical office staff
DATE: Saturday, December 8, 2018
LOCATION: MaineGeneral Thayer Center for Health
149 North Street, Waterville, ME
AAAP’s “Half and Half” Course
with Dr. Richard Fein (8am-12:30pm)
----------------------------------------------------------------------------------------------
AAAP’s “Half and Half” course with Dr. Richard Fein is a free American Academy of Addiction Psychiatry program that combines 4.25 hours of face-to-face/in-class instruction and 3.75 hours of online training. Those wishing to qualify for a waiver to prescribe buprenorphine (Suboxone, Subutex) must complete both components of this program.
Training will focus on clinical vignettes to help participants think through “real life” experiences in opioid dependence treatment. The online modules provide a background on the treatment of opioid dependence and substance use disorders. This program has been approved for a maximum of 8 AMA PRA Category 1 CMEs. Note that NPs/PAs can take this 8 hour waiver training and it will count towards their waiver application.
To register or for more information email shane.gallagher@mainegeneral.org
The  

Ten Takeaways from the Surgeon General's Opioid Report

In a new report on the opioid epidemic, Surgeon General Jerome Adams, MD, highlights the need for a cultural shift in the nation's perception of substance-abuse disorders (SUDs). He emphasizes that SUDs are chronic-but-treatable diseases.

 

In a new report on the opioid epidemic, Surgeon General Jerome Adams, MD, highlights the need for a cultural shift in the nation's perception of substance-abuse disorders (SUDs). He emphasizes that SUDs are chronic-but-treatable diseases.

To remedy the problem, Dr. Adams, an AMA member, suggests that physicians and policymakers focus on evidence-based treatments— both medications and behavioral therapies—that can save lives and restore people's health and wellbeing. The AMA agreed that there is a great need to recognize that patients suffering "require medical intervention, not moral judgment." Here are ten major takeaways from the report:

  1. Only 1 in 4 people, (28.6 percent) with opioid-use disorder (OUD) received specialty treatment for illicit drug use in the past year, 45.5 percent of people with a SUD also have a mental disorder, but only half (51.0 percent) receive treatment for either disorder.
  2. Individuals receiving buprenorphine with counseling have significantly lower total health care costs than individuals receiving little or no treatment for their OUD ($13,578 compared to $31,055). As of September 2018, 44,968 physicians and 8,825 nurse practitioners and physician assistants, are approved to prescribe buprenorphine.
  3. Research has found that, for every dollar spent on prevention programs, the program returns between $0.62 and $64.18 in reduced costs.
  4. Incorporating treatment for multiple SUDs can be beneficial and is associated with a 25 percent increase in the likelihood of maintaining long-term abstinence from alcohol and drug misuse.
  5. Evaluation studies have clearly shown that syringe services programs are effective in reducing HIV and HCV transmission and do not increase rates of community drug use. They help individuals engage in treatment to reduce, manage, and stop their substance use when appropriate.
  6. The introduction of illicitly manufactured fentanyl and other highly potent synthetic opioids to the drug supply makes immediate access to naloxone crucial to effective overdose death prevention. Although regulations vary, most states have passed laws expanding access to naloxone without a patient-specific prescription.
  7. Multiple factors create barriers to widespread use of MAT. These include provider, public, and client attitudes and beliefs about MAT; lack of an appropriate infrastructure for providing medications; payment policies; need for staff training and development; and legislation, policies, and regulations that limit MAT implementation.
  8. An abstinence-only philosophy that avoids the use of medications for opioid treatment is not scientifically supported. Research clearly demonstrates that opioid-agonist therapy leads to better treatment outcomes compared to behavioral treatments alone. Decades of research have shown that the benefits of opioid agonist therapy greatly outweigh the risks associated with diversion.
  9. A public health approach to the opioid crisis will also reduce other harmful consequences, such as infectious disease transmission and neonatal abstinence syndrome.
  10. Effective integration of prevention, treatment, and recovery services across health care systems is key to addressing opioid misuse and its consequences, and it represents the most promising way to improve access to and quality of treatment.

 

"Great American Smokeout" November 15th; "Tar Wars" Anti-smoking Education

For more than 40 years, the American Cancer Society has hosted the Great American Smokeout on the third Thursday of November.  The Great American Smokeout is an opportunity for smokers to commit to healthy, smoke -free lives – not just for a day, but year round. The Great American Smokeout provides an opportunity for individuals, community groups, businesses, health care providers, and others to encourage people to use the date to make a plan to quit, or plan in advance and initiate a smoking cessation plan on the day of the event.

 

For more than 40 years, the American Cancer Society has hosted the Great American Smokeout on the third Thursday of November. The Great American Smokeout is an opportunity for smokers to commit to healthy, smoke -free lives – not just for a day, but year round. The Great American Smokeout provides an opportunity for individuals, community groups, businesses, health care providers, and others to encourage people to use the date to make a plan to quit, or plan in advance and initiate a smoking cessation plan on the day of the event. 

Read more about the Great American Smokeout HERE.

 Another program, "Tar Wars", is a tobacco-free education program for fourth- and fifth-grade students. The program is designed to teach children about the short-term health effects and image-based consequences of tobacco use, and about being tobacco free by providing them tools to make positive decisions regarding their health and promote personal responsibility for their well being.

Tar Wars was developed by Jeff Cain, MD, and Glenna Pember of the Hall of Life, a division of the Denver Museum of Natural History, and Doctors Out to Care (DOC) in 1988. Since the development of Tar Wars in 1988, the program has reached more than 10 million children worldwide.

The program is owned and operated by the American Academy of Family Physicians (AAFP). The Tar Wars program is implemented in classrooms by volunteers. By utilizing a community-based approach to mobilize family physicians, educators, and other health care professionals, Tar Wars can accomplish its goals.

 

Webinar: The Changing Landscape of Retirement - Tuesday, November 13 5pm

The Changing Landscape of Retirement: Are You Correctly Allocated For These Financial Times? 
Webinar presented by Baystate Financial and the Maine Medical Association on Tuesday, November 13 from 5-6pm.

 

The Changing Landscape of Retirement: Are You Correctly Allocated For These Financial Times? 

Webinar presented by Baystate Financial and the Maine Medical Association

Tuesday, November 13
5:00 - 6:00 pm

To register for this webinar, please call Doreen Gay at (207) 770-2015 or email at dgay@baystatefinancial.com.

Topics include:

  • What is Asset Allocation?
  • Impacts of Social Security?
  • Creating Your Own Financial Plan
 

 

MMA Presentation on Healthcare Issues Considered by 128th Legislature Now Available

During the two sessions of the 128th Legislature, the Maine Medical Association advocacy team monitored well over 300 pieces of legislation involving some aspect of healthcare. With the session now nearly concluded, MMA attorneys are available to present a one hour CME talk on the new laws of which physicians need to be aware.

 

This is a one-hour, in-person presentation that will cover all bills that have become law related to health care over the last two years. Any last minute work the Legislature does this week will be added, so that a complete review will be available.

Medical practices, medical staffs or specialty societies interested in the presentation should contact MMA EVP Gordon Smith, Esq. via e-mail to gsmth@mainemed.com.

MMA Legislative Committee's Organizational Meeting Scheduled for December 6

All are welcome to help the MMA determine its legislative agenda for the 129th Maine Legislature.

 The organizational meeting of the MMA Legislative Committee for the 129th Maine Legislature will take place on Thursday, December 6, 2018 from 6:00 p.m. to approximately 8:30 p.m. (dinner available at 5:30 p.m.) at the Frank O. Stred Building, 30 Association Drive in Manchester.  Because the Committee will be discussing the MMA’s legislative agenda for the next two years, medical specialty societies are strongly encouraged to have one or more representatives at the meeting.  Any interested member also is welcome.  Please RSVP to Sarah Lepoff at slepoff@mainemed.com or 622-3374, ext. 213.

The leadership of the Maine Legislature has set December 21, 2018 for cloture, the date by which new bills to be considered in the 129th Legislature must have sponsors and titles submitted.

While the date is not certain, since the newly elected leadership of the next (129th) Legislature can change it, this action makes it highly likely that cloture will not occur before that date. Any party or organization that wishes to have a bill considered in the 129th Legislature must have located a Senate or House sponsor and have at least a title for the bill, if not the whole language, in time for the bill to be submitted before cloture.

Upcoming Specialty Society Meetings

Below you will find an on-going list of Upcoming Specialty Society Meetings.  Any questions should be referred to the contact person listed for each specialty.

Below you will find an on-going list of Upcoming Specialty Society Meetings.  Any questions should be referred to the contact person listed for each specialty.

UPCOMING SPECIALTY SOCIETY MEETINGS

November 15, 2018
Maine Association of Psychiatric Physicians Executive Council Meeting

6:00pm – 8:00pm – Maine Medical Center, Dana Center
Contact: Dianna Poulin at 207-622-7743 or dpoulin@mainemed.com  

December 12, 2018
Maine Chapter of the American College of Emergency Physicians Meeting
Portland Regency Hotel – Portland, ME – 5:00pm
Contact: Cathy Stratton at 207-592-5725 or cstratton@mainemed.com

February 1-3, 2019
Maine Gastroenterology Society Meeting
Sugarloaf Inn - Carrabassett Valley, ME
Contact: Gail Begin at 207-588-6619 or gbegin@mainemed.com  

February 2-3, 2019
Maine & Rhode Island Urological Meeting
Sugarloaf Hotel & Conference Center - Carrabassett Valley, ME
Contact: Dianna Poulin at 207-480-4194 or dpoulin@mainemed.com  

February 9-10, 2019
Maine Society of Anesthesiologists Winter Meeting

Sugarloaf Hotel & Conference Center – Carrabassett Valley, ME
Contact: Lisa Montagna at 207-620-4015 or mesahq@gmail.com

April 3-6, 2019
27th Annual Family Medicine Update & Annual Meeting
Atlantic Oceanside – Bar Harbor, ME
Full brochure & registration available after Jan 15, 2019 at www.maineafp.org

Contact: Deborah Halbach at 207-938-5005 or maineafp@tdstelme.net

May 10, 2019
Maine Society of Eye Physicians and Surgeons Spring Educational Program & Business Meeting
Harraseeket Inn – Freeport, ME from 11:30am – 5:00pm
Contact:  Shirley Goggin 207-445-2260 or sgoggin@mainemed.com

May 17-19, 2019
Maine Chapter, American College of Surgeons
Harborside Hotel and Marina – Bar Harbor, ME
Contact: Cathy Stratton at 207-592-5725 or cstratton@mainemed.com

May 18-19, 2019
Maine Chapter, American Academy of Pediatrics 2019 Spring Conference
Point Lookout – Northport, ME
Contact: Dee Kerry at 207-480-4185 or dakerry@aap.net

 

 

 

 

  


 

Next Steps in Addressing Maine's Opioid Crisis: 11/7 Presentation Scheduled

This free presentation by the Maine Independent Clinical Information Service (MICIS) will be held in Portland on November 7 from 5:30-8:45pm. Advanced registration required. 

 

Next Steps in Addressing Maine's Opioid Crisis

Free Presentation - Advanced Registration Required

PORTLAND: Wednesday, November 7  5:30-8:45pm
Fireside Inn & Suites REGISTER FOR PORTLAND

Topics:

  • Opioid Use Disorder and Medication Assisted Recovery: Caring for Our Communities
  • Alternative Treatments for Chronic Pain
  • Recent Legal Changes Affecting Opioid Prescribing in Maine

Presenters: Elisabeth Fowlie Mock, MD, MPH and Peter Michaud, JD, RN.  Presented by MICIS.

This 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, and the similar requirement in the recent amendments to Chapter 1 of the Rules of the Board of Licensure in Medicine.

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 accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Maine Medical Education Trust and the Maine Independent Clinical Information Service (MICIS).  The Maine Medical Education Trust is accredited by the Maine Medical Association Committee on Continuing Medical Education and Accreditation to provide continuing medical education for physicians

The Maine Independent Clinical Information Service (MICIS www.micismaine.org) is a program of the Maine Medical Association.  For more information, contact Susan Kring at 480-4190 or skring@mainemed.com

Introduction to Lean in Healthcare Full-Day Workshop on Friday, November 9

Lean Healthcare East presents a full day workshop on Lean process improvement for hospital and practice leaders.

 

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 November 9 in Portland 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.

Division of Disease Surveillance Annual Infectious Disease Conference - November 14

Since 1983, the Maine Center for Disease Control and Prevention, Division of Disease Surveillance, Department of Health and Human Services has organized an annual infectious disease conference targeting public health issues of emerging concern to medical practitioners throughout the state. Presentation topics will focus on a range of infectious diseases.

Since 1983, the Maine Center for Disease Control and Prevention, Division of Disease Surveillance, Department of Health and Human Services has organized an annual infectious disease conference targeting public health issues of emerging concern to medical practitioners throughout the state. Presentation topics will focus on a range of infectious diseases.

DATE: November 14, 2018

LOCATION: Augusta Civic Center, Augusta, ME

AGENDA:
  7:45 - Participant and Exhibitor Registration Poster Set-up
  8:15 - Welcome
  8:30 - Top 10 - Updates and Epidemiolog and STDs - Dr. Katherine Hsu, MD, MPH, FAAP
10:45 - Break / Visit Exhibits & Posters
11:00 - Antibiotic Stewardship - Minkey Wungwattana, PharmD, BCPS-AQ ID
12:00 - Lunch & Pump Handle Awards, Visit Exhibitors & Posters
  1:15 - Infectious Disease Hazards of Occupational and Recreational Needle Use - Panel Discussion
  2:15 - Tuberculosis Diagnosis - Prevention and Treatment - Elizabeth A. Talbot, MD
  3:15 - Break / Visit Exhibits & Posters
  3:30 - What About Rabies? - Rachel Fiske, DVM
  4:30 - Adjourn
Please check the event website for agenda updates and additional speaker information.

Continuing Education:

  • Nurse Continuing Education
  • Continuing Medical Education
  • American Osteopathic Association
  • American Academy Family Physicians Continuing Education
  • Pharmacy Continuing Education
  • General Continuing Education

Intended Audience:

  • Healthcare Providers - Immunization Program Staff, Clinicians, Hospital & Nursing Leaders, Health Policy Makers, Public Health Workers, Healthcare Administrators, Infection Control Practitioners, Pharmacists and Laboratorians.
  • Medical Office Staff - Practice Managers, Nurses, Case Managers, Medical Assistants, Health Educators, Pharmacy and Laboratory Staff.
  • Others interested in emerging infectious diseases of public health significance including public health educators, partners in public health, and students of public health, nursing or medicine.

Questions should be directed to 207-626-3615 or adcare@adcareme.org.

For more information and to register online visit:  http://www.cvent.com/d/4gqcxk

MICIS 3-hour Opioid CME Presentation - November 26 in Portland

All licensees of the Board of Licensure in Medicine must take 3 hours of CME on opioid prescribing every two years whether they prescribe opioids or not.

 

All licensees of the Board of Licensure in Medicine must take 3 hours of CME on opioid prescribing every two years whether they prescribe opioids or not.

Improving Opioid Prescribing and Patient Safety

This 3-hour presentation is an updated version of the broad clinical and legal review of opioid prescribing in Maine first presented by MICIS in 2017.

The Maine Board of Licensure in Medicine has established a new CME rule which is currently effective. All its licensees, whether MDs or Physician Assistants, must take 3 hours of CME on opioid prescribing every two years whether they prescribe opioids or not. No BOLIM licensee is exempt from this requirement.  

MICIS, a program of the Maine Medical Association, is scheduling five 3-hour presentations on opioid prescribing in different regions of the state which are designed to fulfill this requirement.  Registration is open for:  

PORTLAND: Monday, November 26 at Fireside Inn REGISTER HERE

Presentations were held in Brewer on August 21, Auburn on September 12, Augusta on October 16 and Wells on October 17.

Topics and Learning Objectives:

How Did We Get Here: (1) review 2016 CDC opioid prescribing guidelines, (2) understand morphine milligram equivalents (MMEs), (3) Assess alternative treatments for acute and chronic pain

Transforming Our Practices & Our Communities: (1) review best practices in opioid prescribing practice transformation, including team-based care, (2) understand benefits of buprenorphine prescribing, anticipate prescribing naloxone for all patients and families at risk

    Recent Legal Changes Affecting Opioid Prescribing in Maine: learn about recent changes in (1) Maine statutes related to opioid prescribing and safety and Substance Use Disorder recovery, (2) rules from licensing boards related to opioid prescribing and safety and Substance Use Disorder recovery, (3) rules from Maine DHHS relating to opioid prescribing and safety and Substance Use Disorder recovery

    The Maine Independent Clinical Information Service (MICIS) is a program of the Maine Medical Association. 

    This MICIS 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, and the similar requirement in the recent amendments to Chapter 1 of the Rules of the Board of Licensure in Medicine. 

    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 accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Maine Medical Education Trust and the Maine Independent Clinical Information Service (MICIS). The Maine Medical Education Trust is accredited by the Maine Medical Association Committee on Continuing Medical Education and Accreditation to provide continuing medical education for physicians.

    For more information, contact Susan Kring at 480-4190 or skring@mainemed.com.

    Enrollment Underway for Maine’s Physician Executive Leadership Institute - The Advanced Course - Deadline for Enrollment at Discounted Price: November 30th

     

    Enrollment is now under way for the Hanley Center's sixth cohort of its Physician Executive Leadership Institute - The Advanced Course.

     

    Enrollment is now under way for the Hanley Center's sixth cohort of its Physician Executive Leadership Institute - The Advanced Course.

    Physicians enrolling in the course are designated as McAfee Fellows, in honor of former AMA and MMA President Robert McAfee, M.D. Participants gain knowledge, skills and tools in the core competency areas of: systems awareness; strategic focus; key management/business skills; self-awareness; healthcare trends; and teamwork and collaboration, best enabling them to lead and transform our healthcare delivery system.

    Over the past 7 years, more than 150 physicians have participated in the Advanced Course. The sixth class will begin March 2019 at the Brunswick Hotel & Tavern in Brunswick and continue through January 2020. There are six two-day sessions, each running from Thursday evening through late Saturday morning. The class is expected to include 35 physician leaders from Maine, New Hampshire, and beyond. 

    A distinguished five-member faculty team from the Heller School at Brandeis University delivers much of the program content for the Advanced Course, joining with Maine-based subject matter experts and physician leaders.  McAfee Fellows receive 80 hours of Category One CME for their participation in the full program.

    Deadline for enrollments at a discounted price: November 30, 2018

    Ready to accept the challenge? For more information about the Advanced Course, the nomination and the enrollment processes, please visit www.hanleyleadership.org, or contact Judiann Ferretti Smith at judiannsmith@hanleyleadership.org or Kathy Vezina at kathrynvezina@hanleyleadership.org.

    To Enroll Go Tohttps://www.hanleyleadership.org/leadership-programs/physicians-executive-leadership/Advanced-Course 

    Identifying Substance Use Early Saves Lives! - SBIRT with Motivational Interviewing Training - 1-day Sessions Offered on Dec 8, Feb 2, Mar 2, Apr 6

    Maine continues to see deaths from opiate use increase. Rates of opiate use are highest in the 18-25 year old group and data from those entering treatment suggest that the majority begin using before the age of 17. Maine AAP is committed to helping practitioners identify youth on this path earlier and intervening earlier! SBIRT (Screening, Brief Intervention, Referral to Treatment) is one evidence based approach to doing this.

     

    Maine continues to see deaths from opiate use increase. Rates of opiate use are highest in the 18-25 year old group and data from those entering treatment suggest that the majority begin using before the age of 17. Maine AAP is committed to helping practitioners identify youth on this path earlier and intervening earlier! Screening, Brief Intervention, Referral to Treatment is one evidence based approach to doing this. Maine AAP will be offering several trainings throughout the state over the next 6 months. Please consider joining us to enhance your skills in identifying and offering brief interventions in the primary care settings for youth on the path to substance use disorders.

    The Maine AAP will be offering one day Saturday sessions in several regions of Maine, providing training and coaching to Pediatricians and Pediatric Specialists in SBIRT (Screening, Brief Intervention and Referral to Treatment) and effective conversational skills in Motivational Interviewing.

    Confirmed Dates for all sessions:

    Saturday, December 8, 2018 - Presque Isle/Caribou - REGISTER NOW

    Saturday, February 2, 2019 - Bangor - REGISTER NOW

    Saturday, March 2, 2019 - Farmington - Franklin Memorial Hospital, Allen Room - REGISTER NOW

    Saturday, April 6, 2019 - Biddeford/Saco - REGISTER NOW

    Instructor: Stephen R. Andrew LCSW, LADC, CCS, CGP is a storyteller, consultant, trainer, co-author of Game Plan: A Man's Guide to Achieving Emotional Fitness, and Chief Energizing Officer of Health Education & Training Institute. He maintains a compassion-focused private practice in Portland, Maine (USA) where he also facilitates a variety of men's, co-ed, couples, and caregiver groups. Stephen has been a member of the International Motivational Interviewing Network of Trainers (MINT) since 2003 as well as a MIA-STEP (Motivational Interviewing Assessment; Supervisor Tools for Enhancing Proficiency) trainer for the New England ATTC. Stephen has been MITI trained and has over 100 hours of training in Motivational Interviewing. He provides coaching and training domestically and internationally for social service agencies, health care providers, substance abuse counselors, criminal justice, and other groups.

     

    Physician – Leeds

    DFD Russell Medical Centers (DFDRMC) operates three community health centers in central Maine.  We are seeking a full time Physician, for our Leeds location.

    DFD Russell Medical Centers (DFDRMC) operates three community health centers in central Maine.  We are seeking a full time Physician, for our Leeds location.

    Our three health centers serve a multicultural, rural population of about 10,000 patients and have a family practice focus serving pediatrics to geriatrics. We have excellent clinical support staff.

    This position requires a high degree of flexibility, good clinical skills and commitment to team work and open lines of communication. It is a full-time at 4 days per week.

    This position combines making a difference in patients' lives with a family-friendly work life, please e-mail your resume to Laurie Kane-Lewis, CEO. (Laurie.Kane-Lewis@DFDRussell.org) EEO

    Requirements
    Current Maine license. Proficiency with electronic medical records.

    Benefits
    Excellent benefit package: medical, dental, life, 401(k), flexible spending accounts and a generous paid time-off plan. Salary is commensurate with experience; there is also an incentive plan and a CME reimbursement.

    12/31/18


    Psychiatric Mental Health NP - Leeds

    DFD Russell Medical Centers (DFDRMC) operates three community health centers in central Maine.  We are seeking a full time PMHNP, for our Leeds location.

    DFD Russell Medical Centers (DFDRMC) operates three community health centers in central Maine.  We are seeking a full time PMHNP, for our Leeds location.

    Our three health centers serve a multicultural, rural population and have a family practice focus serving pediatrics to geriatrics.

    Responsibilities: Assessment of mental health needs for children or adults; Diagnosing mental health/psychiatric conditions; Developing and executing treatment plans; Providing primary health care; Prescribing medication (Suboxone waiver, required); It is a full-time 4 days per week.

    This position combines making a difference in patients' lives with a family-friendly work life, please e-mail your resume to Laurie Kane-Lewis, CEO. (Laurie.Kane-Lewis@DFDRussell.org) EEO

    Requirements
    Current Maine License. Proficiency with electronic medical records.

    Benefits
    Excellent benefit package: medical, dental, life, 401(k), flexible spending accounts and a generous paid time-off plan. Salary is commensurate with experience; there is also an incentive plan and a CME reimbursement.

    12/31/18

     

     

    Psychiatric Nurse Practitioner - 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. 

    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 Psychiatric Nurse Practitioner:

    • Provides diagnoses, conducts therapy and prescribes medication for patients with substance use disorder, psychiatric disorders and medical organic brain disorders.
    • Assures access for continuity of care through appropriate referrals for sub-specialty and inpatient services and prompt follow-up of patients discharged from inpatient settings.

    Applicants must have a Master’s degree in nursing, an unrestricted Maine license to practice as an advance practice nurse practitioner, Board Certification as a Psychiatric-Mental Health Nurse Practitioner as well as a U.S. Drug Enforcement Agency license.  Qualifications include:

    • A minimum of three years’ experience in a psychiatric or primary care medical practice required.
    • A 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.
    • Willingness to work some non-traditional hours and ability to travel between YCCAC/Nasson Health Care clinical sites. 

    Visit www.yccac.org for an application. Completed cover letter, resume, and YCCAC employment application will be accepted until position is filled.  York County Community Action Corp., 6 Spruce Street, P.O. Box 72, Sanford, ME 04073 - (207)324-5762 or 1-800-965-5762 - Fax (207)459-2811 - apply@yccac.org - EOE

    11/26/18

    Primary Care Physician

    Hometown Health Center, Newport, ME, seeks a doctor to serve as a leader within its patient centered medical home model.

    Hometown Health Center, Newport, ME, seeks a doctor to serve as a leader within its patient centered medical home model. This physician provides the full scope of primary care services including diagnosis, treatment, coordination of care, preventative care and health maintenance to patients, and  work with the Suboxone program.

    HHC is an FQHC that fosters a strong comradery among all staff and is family oriented with a positive atmosphere and connectedness where support for each other and for the patients is the primary culture.

    Join the HHC team and experience rural living near larger cities, an encouraged work/life balance, and the ability to develop deep relationships with your patients.

    Hometown Health Center is more than a medical office. It’s a way of life.

    Send cover letter and CV to:

    Robin Winslow, CEO,
    Hometown Health Center,
    118 Moosehead Trail, Suite 5,
    Newport, ME 04953.
    Or email robin.winslow@hhcme.org
    www.hometownhealthcenter.org

    11/26/18

    PCHC wants to add more Family Physicians at Multiple Locations!

    PCHC is recruiting Family Medicine Physicians for locations in Belfast, Old Town, and Bangor.

    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.

    12/3/18

    Outpatient Internal Medicine Physician – Bangor, Maine

    Northern Light 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.

    Northern Light 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. Our practice is one of seven primary care practices operated by Northern Light 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.

    Northern Light 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
    Northern Light Health
    Phone: 207-973-5358
    ProviderJobs@NorthernLight.org

    11/19/18

    OB/GYN Physician Opportunity

    Franklin Community Health Network is seeking a Board Certified/Board Eligible OB/GYN physician to join their hospital-employed practice located in Farmington, Maine. 

    Franklin Community Health Network is seeking a Board Certified/Board Eligible OB/GYN physician to join their hospital-employed practice located in Farmington, Maine. 

    The successful candidate will join a team of three physicians and a Certified Nurse Midwife, sharing a 1 in 4 call schedule.  This well-established practice offers a progressive laborist model.  Candidates will have the opportunity to work in a very collegial atmosphere at Franklin Health Women’s Care.  The practice has a 4 day work week with a mix of office and OR time in collaboration with an experienced team of physicians and highly skilled clinical staff.  The office is located on the Franklin Memorial Hospital campus, a 65-bed, acute care community hospital with a 40-member medical staff.  In addition to an annual base salary, physicians are offered significant additional income potential, as well as student loan repayment and relocation assistance.   

    Please contact Donna Lafean, Recruiter, MaineHealth/Franklin at (207) 779-2185 or dlafean@mmc.org.

    11/19/18

    Franklin Health Behavioral Services is seeking a BC/BE Psychiatrist/Medical Director

    Tucked in the beautiful western mountains of Farmington, Maine, this full-time position with have an average of 14 patients per day and call is provided by our own local Evergreen Crisis Team, providing 24 hour crisis service coverage. 

    Tucked in the beautiful western mountains of Farmington, Maine, this full-time position with have an average of 14 patients per day and call is provided by our own local Evergreen Crisis Team, providing 24 hour crisis service coverage. The candidate would be the Lead provider for the Practice, IOP Program Director, Medical Director/Board member of our Crisis program, and Suboxone prescriber.

    Patient volume draws from a wide geographic region with 40,000 people.  This evolving practice now offers ECT treatment and has a shared medical record with primary care practices in a patient centered medical home model. The provider would work with 2 Nurse Practitioners and a team of clinical professionals in our Medical Arts Building attached to Franklin Memorial Hospital, a 65-bed, acute care community hospital with a 40-member medical staff offering exceptional benefits and compensation packages.

    Contact Donna Lafean, Recruiter, MaineHealth/Franklin at dlafean@mmc.org.

    11/19/18

    Internal Medicine MD or DO (BE/BC)

    Franklin Health Internal Medicine is an office based Internal Medicine practice tucked in the beautiful western mountains of Maine, and owned by Franklin Memorial Hospital, a member of Maine Health.

    Franklin Health Internal Medicine is an office based Internal Medicine practice tucked in the beautiful western mountains of Maine, and owned by Franklin Memorial Hospital, a member of Maine Health. FH Internal Medicine provides office based adult medicine services and preventive and diagnostic cardiovascular services and serves a population of approximately 40,000.

    FHIM providers average 15 to 18 patients with ages ranging from 18 to end-of –life. Expectation is 36 hours a week with 32 patient contact hours. The office is located on the Franklin Memorial Hospital campus, a 65-bed, acute care community hospital with a 40-member medical staff.  In addition to an annual base salary, physicians are offered significant additional income potential, as well as student loan repayment and relocation assistance.   

    Please contact Donna Lafean, Recruiter, MaineHealth/Franklin at (207) 779-2185 or dlafean@mmc.org.

    11/19/18

    Podiatrist (Non-Surgical)

    We are seeking a full-time, podiatrist to provide a full scope of general, non-surgical podiatric services to HAN patients in Lincoln, Maine.

    We are seeking a full-time, podiatrist to provide a full scope of general, non-surgical podiatric services to HAN patients in Lincoln, Maine.

    Competitive compensation / benefits package that includes: Sign on bonus; relocation expense reimbursement; loan repayment available; 100% paid premiums for health insurance for podiatrist and dependents; life, short-term, and long-term disability insurance; 401K plan available; generous paid time off; CME allowance; and Federal Tort Claims Act (FTCA) Malpractice Insurance.

    Candidate must hold a valid license to practice podiatric medicine in the State of Maine and a valid DEA license.

    Health Access Network is a federally funded community health center and an equal opportunity employer and program.

    Please forward cover letter and CV to:

    Sonia Maxwell, HR Director / Compliance Officer
    smaxwell@hanfqhc.org (preferred)
    Health Access Network
    P.O. Box 99
    Lincoln, ME 04457

    11/12/18

    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.

    12/3/18


    Seeking Medical Director for Family Medical Practice in Waterville, ME

    Elmwood Primary Care, a hospital-employed outpatient Family Medicine practice located in the lakes and streams region of Maine, is recruiting for an experienced Family Medicine physician as the practice Medical Director.

    Elmwood Primary Care, a hospital-employed outpatient Family Medicine practice located in the lakes and streams region of Maine, is recruiting for an experienced Family Medicine physician as the practice Medical Director.  We are looking for an individual with a commitment to providing care to an underserved population, as well as a strong interest in team building, mentorship, and collaboration.  The weekly schedule would involve 16 hours of direct patient contact, with the remainder of time dedicated to practice leadership and care coordination.  Elmwood Primary Care has considerable behavioral health support, including a psychiatric nurse practitioner, a licensed clinical social worker providing counseling services, and social work services within the practice.  We strive to improve the health and well-being of our patients and the community as a whole, and we wish to find someone who shares this desire.  Interested candidates should email Tiffiny Parker, Physician Recruiter at tiffiny.parker@mainegeneral.org.

    10/29/18


    Internal Medicine Physician

    Maine Medical Partners Internal Medicine is seeking a FT Board Certified/Board Eligible Internal Medicine physician for their well-established outpatient practices located in the greater Portland area. 

    Maine Medical Partners Internal Medicine is seeking a FT BC/BE Internal Medicine physician for their well-established outpatient practices located in the greater Portland area.  This is an exciting opportunity involving the teaching of medical students and residents, and includes the option to continue hospital care if desired. 

    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 successful candidate will have an academic appointment at Tufts University School of Medicine, and 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 Gina Mallozzi, Physician Recruiter at (207) 661-2092 or gmallozzi@mmc.org.

    11/12/18

    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.