Letters to the editor — The Courier-Gazette

Jun 12, 2014

Openness needed

There have been some interesting Letters to the Editor about impending changes to PBMC staffing. What sadly seems to be lacking is any truly illuminating comment from PBMC’s Board of Trustees, active Medical Staff, Administration, Mr. Frederick (COO) and Mr. Biscone (interim CEO). What has been stated is sketchy commentary concerning deficits and chronic “operating in the red” (not uncommon for a non-profit community hospital anywhere else). Apparently, the last CEO, Mr. Johnson has “flown the coop” back to Idaho in a cloud of deafening silence.

Like the Drs. Andersen, I am a retired physician who worked 33 years on the staffs of KCGH, CCH, and PBMC starting in 1974. Unlike the Andersens, I was dropped from the PBMC Incorporator roll in the early 21st century for failure to “re-apply” in a timely fashion. (I was recuperating from major surgery.) Never was I a PBMC trustee.

Nonetheless, I maintained an acute interest in the professional status of PBMC’s quality of practice and the success and advancement of its devoted and hard-working personnel. I was a member for decades of the Cancer Care Committee during which a Cancer Registry was established, connections to other treatment modalities not provided at PBMC, participation in research and clinical trials and earning program accreditation through the American College of Surgeons and the American Cancer Society. All of this was accomplished under the skilled leadership of Steve Ross, M.D., Karen Bachman, M.D. and currently Nadia Ramdin, M.D. Every month there is a multi-disciplinary meeting with participation of oncologists and radiation oncologists from Southern Maine Radiation Therapy Institute, Maine General Hospital and Eastern Maine Medical Center where difficult cases are presented and the best treatment protocol for the individual patient is discussed. I still attend these meetings as an observer — to learn.

The provision of medical care to the patients of Knox County was once a “three-legged stool”. One leg had been the incorporators representing the community (and “owners” of the hospitals). The second leg was the hospitals’ administrators whose job it was to provide a milieu in which good medicine could be practiced. The third leg was the medical staff who provided their skills, knowledge and technical input to both the Community representatives and the administrators to complete the triad…the main purpose of which was to provide good quality, reliable patient care.

What has changed? For one, the majority of PBMC’s doctors are hospital employees dependent on the institution for paychecks and perqs. As proven in the savage reprisals carried out by administrators against nurses who favored an attempt to unionization several decades ago, administrators favoring “benign dictatorship’ may have silenced voices of dissent with fiscal bullying….perhaps. Without input from physicians, the trustees may have relied too heavily on administrators’ input…. perhaps. Administrators no longer held to task have followed the business school teachings of the untouchable precepts of achieving The Bottom Line — something not entirely in keeping with a community nonprofit…perhaps. Furthermore, as revealed in Mr. Frederick’s (COO, PBMC) jargon, there may be an enshrinement of Wal-Mart corporate values i.e. “Lean Daily Management” and “associates” and “empowerment”. There may be absorption with managerial thinking to the detriment of humane patient care. Mr. Frederick, they’re called nurses, technicians, therapists and maintenance. They’ve undergone education and training to be where they are. They work hard every day and their dedication is to the well-being of the patients. They are honorable humans in honorable occupations. They most certainly are not associates.

Furthermore, while it is comforting to know that Mr. Biscone is committed to “caring for our community is at the core of all that we do," it might be helpful to provide a thorough fiscal accounting as to why PBMC is such an economic train wreck. There is rumor on the street that Maine Health is bleeding $2 million per year from PBMC in return for very little other than schlocky commercials. There is also rumor that a rather expensive Cancer Treatment Center to be situated in Lincolnville is in the works. Mr. Biscone, PBMC HAS an excellent Cancer Treatment Center under the management of Nadia Ramdin, M.D.

Finally, PBMC has had contracted radiology services with local radiologists for almost half a century…and they brought us the 2nd CT scanner in Maine and kept it technically updated, early availability locally of MRI and kept it technically updated, PET scanning locally and so many diagnostic and therapeutic services on the cutting edge. You canned them for absentee Spectrum Medical Group by Administrative fiat? Why?

There have been so many secretive deals cut between PBMC and private insurers involving reimbursement for services rendered... perhaps they have gone sour. Don’t blame it on Medicare, ACA, and Maine Care. Let’s see all the dirty laundry.

Times have been tough. No doubt! Perhaps it is time for openness with the community that is “at the core of all we do”.

C.F. Manning, MD, F.A.C.S

Rockland

Change is necessary

It is said that the only constant in life is change, and healthcare is no different than any other aspect of our lives. Healthcare is undergoing monumental change that will affect how we interact with and participate in it. Change can raise anxiety levels, but in the case of Pen Bay Healthcare the changes we’re making today will not change our commitment to our patients and their safety, and will position us better for the future.

The factors affecting our nation’s healthcare system are numerous and are continuing to evolve. One of the largest impacts is the movement toward Accountable Care Organizations. This federal initiative for a new payment and quality model of healthcare is based on providers being paid for how they care for the whole patient and for keeping patients well.

Many other factors are influencing changes in healthcare:

— Downward pressure on reimbursement from Medicare and Medicaid programs continue to reduce the amount they reimburse physicians and hospitals for services.

— Regionalization strategies provide comprehensive care for patients in a region that wouldn’t be available without working together; some examples include oncology services and cardiac care.

— Employing physicians means healthcare systems can ensure the needed primary care and specialty services are available in a given area, and employed physicians are able to focus on their patients and not on running a business.

— Electronic medical records are powerful tools for physicians and other healthcare providers, but they come with a significant price tag and a learning curve for users.

These initiatives, and many more, are being undertaken by healthcare organizations across the country, including Pen Bay and MaineHealth, to develop a patient-centered system with a goal of achieving the best outcomes at the lowest costs, and all while remaining focused on our core values of high quality, safe patient care.

The announcement of a couple of such efforts at Pen Bay have led to some misunderstandings in our community, which I feel important to speak to.

Pen Bay Healthcare and Waldo County Healthcare are working together to right-size cancer care offered in our region and to provide patients the experience they desire and the care they expect. Cancer care patients, whether they are in the Knox or Waldo County service area, will continue to receive exceptional care. Full-time coverage will continue in both locations through board-certified physician Betsy Connelly, DO, and the nurse practitioner staff. The number of staff and their hours of availability will not be reduced nor will the number of patient visits. Patients will see caregivers in the location that is convenient for them, and they won’t need to travel for comprehensive cancer care, including their treatments. We regret the decisions were made public before we shared it with our cancer patients.

The decision to select a new organization to provide professional imaging services for Pen Bay Healthcare was carefully considered by a committee of three administrators and 14 medical staff. The current provider group provides professional imaging services to Pen Bay under a contract agreement set to expire this coming December. As part of the contract review process, that began months ago under the former CEO, proposals were solicited, presented and reviewed and the review committee’s recommendation to interim the CEO was to select Spectrum Medical Group for professional imaging services. Our new relationship with Spectrum, which begins in January, will provide Pen Bay Healthcare patients with increased access to sub-specialties provided by fellowship-trained physicians, offering services 24 hours a day, which is not something available at this time.

Joining the MaineHealth system has allowed Pen Bay and Waldo to offer numerous community wellness programs, such as Let’s Go! 5-2-1-0 and AH! Asthma as well as initiatives that improve care, including having registered nurse chronic care managers in physician practices. Support from the MaineHealth system has enabled Pen Bay to fund 24-hour pharmacy coverage and our critical care remote monitoring program. In addition, by collaborating Waldo County Healthcare and Pen Bay Healthcare are able to share specialists and offer services we wouldn’t otherwise be able to offer in our area, including urology, nephrology, vascular surgery and infectious disease care.

Membership in MaineHealth also saves money. For example, Waldo and Pen Bay realized combined savings of nearly $800,000 in our last fiscal year through a variety of MaineHealth contracts. That savings doesn’t take into account the considerable discount enjoyed as part of MaineHealth on the purchase of major equipment, which can be $200,000-$300,000 on an MRI or CT scanner.

As the fourth-generation leader of my family’s 114-year old business, I know change. I know change is about adapting and positioning for the future. I know it’s not always easy and at times it’s quite difficult, but I know it’s necessary to stay relevant to our customers. I bring this same understanding with me to the Pen Bay Healthcare board meetings. Our Board of Trustees has a responsibility to ensure the sustainability of our community’s hospital, and it’s clear that we must continually adapt to ensure a future of high quality patient-centered care for our patients.

In closing, I would like to express my gratitude to the talented Pen Bay staff that care for us so well, and is committed to providing their neighbors with safe, effective quality care, compassionately. As chair of the Pen Bay Board of Trustees, I know that the entire Pen Bay organization is focused on ensuring the best outcomes for our patients — now and into the future. I am honored to work with this group of dedicated clinicians and administrators who are working together and will work even more closely in the future to adapt to the changing healthcare landscape.

Everett L. Spear III

Chairman, Board of Trustees, Pen Bay Healthcare

President, E.L. Spear, Inc., Lumber & Hardware

Rockland

Thank you for supporting 4-H

4-H in Knox and Lincoln counties, a program of the University of Maine Cooperative Extension, would like to thank the Tractor Supply Store in Thomaston for participating in the Paper Clover Fundraising Campaign April 23 to May 4. Twice a year, the 4-H Paper Clover Campaign raises funds for 4-H youth development program activities statewide and in communities where stores are located.

Thanks also go out to customers who purchased paper clovers for $1 at the store at 38 Thomaston Commons Way during the campaign, benefitting 4-H programming in Knox and Lincoln counties.

We would like to thank 4-H volunteers and parents Trina Havey, Billie Joe Flynn, Kim Krejsa and Michelle Seaman, and 4-H members Skye Havey, Isaiah Havey, Baylee Flynn, Isabel Flynn, Kaleb Flynn, Sean Krejsa, Gloria Seaman and Gabriel Seaman of the Jolly Farmers and Jolly Juniors 4-H clubs for representing 4-H at the TSC store on Saturday, May 3. The group showed their rabbits to the public and offered face painting and a bake sale. With the money they raised, they purchased paper clovers to help the campaign.

During the prior three years, the TSC 4-H Paper Clover Campaign has provided more than $2 million to 4-H nationwide; 70 percent of funds are returned to state and local 4-H programs for camps, after-school programs and scholarships that afford youth opportunities to explore interests in topics ranging from animal science to robotics. This is the first time that 4-H in Knox and Lincoln Counties has been able to participate locally.

Cindy Rogers

4-H Community Education Assistant

University of Maine Cooperative Extension

Knox and Lincoln counties

Preservation thanks

The North Parish Church Association of St. George wishes to publicly thank the Maine Old Cemetery Association for the remarkable work their members voluntarily performed by cleaning, resetting, and repairing stones in The Old North Parish Graveyard, the burial place for most of the first settlers in the northern part of St. George.

For four days as many as 40 volunteers showed up, coming from nearly all parts of Maine, and one from Baltimore, for MOCA’s annual workshop on cemetery preservation. Joe Ferrannini from Hoosick Falls, N.Y., an expert on the preservation of gravestones, provided appropriate equipment and instructions for the volunteers and they learned by doing. At least 50 cracked, fallen or tilting stones were saved from further deterioration.

Thanks also to the members of St. George Grange for providing a place for MOCA to gather and for providing a dinner for them on their first day here. Thanks also to the First Baptist Church for making their facilities available to MOCA and for keeping coffee available.

David Lowell of Tenants Harbor deserves credit for making the project possible. Having attended a similar workshop in another part of the state last year, David convinced MOCA to hold this year’s workshop in St. George. He also provided the sand and crushed stone for the project and enjoyed working all four days. Everyone had a good time. Thanks, David.

We look forward to seeing the good people of MOCA on Saturday, Sept. 27, when they will hold their annual meeting in the St. George Grange Hall.

Robert Karl Skoglund

North Parish Church Association

St. George

Thomaston Trek

On behalf of the Trekkers staff, students, families and the Thomaston Trek planning committee, I want to express my sincere gratitude to all the local businesses and individuals who helped make our June 7 5k/10k walk/run event such a success. With the community’s support at this recent event, we raised $1,800 to support our year-round programming and 15 Trekkers students raised money toward their program fees. The proceeds from the event will help these students participate in experiential learning programs this year— including life-changing expeditions, community service projects and adventure-based education.

We want to thank Scott Yakovenko and The Slipway Restaurant for providing such a wonderful venue for the post-event pancake breakfast, and for providing gift certificates to the prize winners. Special thanks also go to Lyman-Morse Boatbuilding Co., for providing the registration and parking area. We also want to thank Mike Leo and the Thomaston Fireman’s Association for the use of their tables; to Jim Leonard for providing the water containers; to Knox EMA for the safety vests; to the Thomaston Select Board and the Thomaston Police Department for allowing the event to take place on their historic village streets; to all of the volunteers who helped with set up, registration, route monitoring, timing, the pancake breakfast and clean-up duty.

Our sincere thanks go to the following area businesses who sponsored Trekkers’ 1st annual event: Epifanes, Maine Coast Petroleum, Inc., Bayview Press, Brooks Trap Mill, Fabian Oil, Mr. Tire Company, Scott Kingsley D.M.D., Strong Agency, Thomaston Boat & Engine Works, Inc., and Thomaston Grocery. Trekkers truly appreciates the generosity of all our sponsors. We encourage everyone to support these local enterprises.

And, of course, we want to thank everyone who participated in the event itself. Nearly 80 walkers and runners took part in the race. Several other folks came along and supported the post-run pancake breakfast. Thanks also go to all the student and parent volunteers, the Trekkers staff, and to the event committee who helped plan and organize this fundraising event: Alaina Ennamorati, Misty Start, Neal Young, Lindsey Evans, Chris Ferguson, Shari Closter, Bethany Yovino, and Jean Faustini.

As Trekkers celebrates its 20th year of mentoring youth from the midcoast area, we continue to be humbled and amazed by the outpouring of support we receive from the community. It is through the community’s support that we are able to achieve the Trekkers’ mission of connecting young people with caring adults through expeditionary learning, community service and adventure-based education. We can’t thank you enough for your continued support and for helping to make this first annual Thomaston Trek so successful.

Don Carpenter

Executive Director

Thomaston

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