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Rewritten contracts cause unrest at MCMH



ELLSWORTH — Dissatisfaction among doctors has been a pre-existing condition at Maine Coast Memorial Hospital, according to two providers connected with the facility. That condition was exacerbated by recent changes made to practitioners’ contracts.

The two providers who spoke to The American said some physicians are leaving the hospital as a result of that feeling of dissatisfaction, though the president of Maine Coast Memorial said the contract changes have not resulted in the departure of any doctors so far.

“A few doctors have signaled their intent to leave the organization, but at this time all physicians are still employed and caring for patients at Maine Coast Memorial Hospital,” said MCMH President John Ronan, who is also the president of Blue Hill Memorial Hospital.

Ronan said Maine Coast Memorial recently made changes to contracts with its doctors in an effort to achieve consistency throughout the hospital’s parent organization, Eastern Maine Healthcare Systems (EMHS). Ronan said that a periodic review a few months ago found some of the contracts at MCMH were not consistent with other hospitals that are part of EMHS, which the Ellsworth hospital joined two years ago.

Though he declined to discuss specifics, Ronan said a “variety of things were looked at” by the EMHS legal team in the contract review process. He said “there were changes that were made” to the contracts, noting that EMHS has a standard template that covers issues including compensation and benefits.

“We have approximately 50 to 55 employed doctors that were part of that process,” Ronan said.

Dr. Craige Williamson, an orthopedic surgeon specializing in upper extremities, is not one of those doctors. He was formerly employed by Maine Coast Memorial but now has his own private practice, Maine Coast Hand and Shoulder. He works in both Bangor and Ellsworth. His office here is housed in the Maine Coast Memorial complex on Union Street.

Williamson came to work in Ellsworth 22 years ago because he saw MCMH as “a gem.” He said “bad blood” between providers and the hospital administration began to develop years ago but has “accelerated” since Maine Coast joined with EMHS. He cited a feeling of “a lack of respect for providers” as a root cause of that bad blood.

“I think the biggest problem is that they don’t understand the value of good people,” said Williamson. He left the employ of Maine Coast about a year and a half ago “out of disgust” and after being asked to make changes to the way his practice was run.

Williamson said that when Ronan attended a recent medical staff meeting, he “came into a room full of bees.”

Dr. Margaret Blom is an ophthalmologist who is affiliated with, but also not employed by, MCMH. Like Williamson, she spoke of dissatisfaction among members of the medical staff.

“I know a lot of unhappy people, people who are complaining that they’re losing their jobs because of the merger,” she said. “They’re heading for places where they can get better hours and more pay.”

Like Williamson, Blom said she believed Maine Coast’s joining with the larger, Brewer-based system made an existing problem worse.

“I don’t think the merger with EMHS made it any easier on the employees,” she said.

Williamson said the issue of staff leaving has manifested itself in two departments in particular, emergency and anesthesiology. Ronan said there were several departures from the latter department, one for personal reasons and a couple of others when people went to work at other EMHS member hospitals.

Ronan acknowledged those departures did create a “void” in the anesthesiology department but said the matter has now been addressed and resolved.

“As of yesterday we’ve got a plan in place to ensure we’ve got coverage for every shift,” he said, speaking Tuesday afternoon.

Williamson’s and Ronan’s accounts on the emergency department differ. Williamson said four doctors have either left or are soon leaving, naming them individually, and he said that would leave the department without doctors as of next month.

“Based on the knowledge we have, that is not the case,” said Ronan on Tuesday. “We have not had resignations from all of our providers.”

Both Williamson and Ronan said it can be difficult to recruit and retain doctors. Ronan said emergency department staffing is a particular challenge for all of the three dozen hospitals across Maine, and not just in Ellsworth.

“I know that every hospital president wonders how they’re going to keep their ER staffed over the next couple of years,” he said.

To that end, EMHS established two collaborative programs in the past couple of years (one for emergency medicine and the other for hospitalists) with the goal of creating a “pool” of “high-quality doctors” who can be called upon to serve any of its member hospitals. Ronan said that has actually been a helpful recruiting tool, in that the prospect of working in a system-wide collaborative is attractive to prospective doctors and allows them to build familiarity with multiple hospitals.

Ronan said the collaborative programs help “provide better coverage to the organization” as a whole. He said it also results in “increased access to clinical resources and better staffing coverage.”

Filling vacant positions or shifts sometimes requires the use of what are called locum tenens, or locums. The Latin phrase means “to hold a place.” Locums are physicians or specialists who fill-in on a short-term or long-term basis.

Williamson said the use of locums “does not allow the public to build relationships with their providers.” Ronan acknowledged that “generally a locum is more expensive” than having a doctor who is employed directly by the hospital, but said the long-term aim is to use the latter rather than the former.

“Our goal is to form the collaborative with all EMHS-employed physicians,” Ronan said, though “there may be times that locums are used to meet staffing needs during the building phase.”

Overall, Williamson said he thinks it is “unfortunate” Maine Coast chose to join forces with EMHS.

That is not an opinion shared by those running MCMH, including Board Chairwoman Debbie Ehrlenbach.

“Gaining access to expertise and processes that help Maine Coast’s operations and its compliance program were a big reason the board pursued an affiliation with EMHS that we completed in 2015,” she said in a written statement. “We are pleased with the plans that Maine Coast’s senior leadership has developed, working in partnership with EMHS, to ensure we will have sufficient physician coverage to continue to deliver high-quality care for residents of Ellsworth and other Down East communities.”

Reporter Jack Dodson contributed to this report.

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