ROCKPORT — Doctors at Pen Bay Medical Center are concerned that a proposal by parent corporation MaineHealth to create a single board of directors could result in a loss of local control and potentially cuts in services at the Rockport hospital.

Those concerns were voiced in a Jan. 9 letter to employees by the president of the Pen Bay medical staff summarizing a Jan. 5 meeting of physicians.

The Pen Bay letter follows a similar letter sent out in November by the physicians at Waldo County General Hospital in Belfast.

MaineHealth has proposed creating a single board of trustees that would make decisions for all member hospitals and affiliated organizations, such as nursing homes and home health agencies. Currently, each member organization has a separate board.

When Pen Bay Healthcare became a MaineHealth member in 2010, the agreement stipulated that no service offered locally could be discontinued unless initiated and approved by the local board.

Pen Bay Healthcare and Waldo County — which became a MaineHealth member in 2009 — merged in 2015 into a single organization and board called Coastal Healthcare Alliance, which remains a member of MaineHealth.

“For clinicians at PBMC, we do not have a good recent history of alignment and confidence in the local administration, nor have we had good support from MH,” stated the letter from Dr. Stephanie Lash, president of the medical staff.

Lash stated that the medical staff recognizes the need for more regional planning for health care, but that there are meaningful differences between health care in the urban/suburban environment of Portland and in the vast bulk of rural Maine.

“The floated governance model of a single board, of which 50 percent is Portland-based raises real concerns about preserving a rural voice, as only one small hospital would have to vote with Portland to create a majority on any issue,” she said. “Moreover, as PBMC is now rolled into CHA, it appears there would be only one board member for both PBMC and Waldo, meaning in essence that PBMC, one of the largest smaller hospitals, would have a half vote on the proposed new board. How could this half person adequately and fully represent all of the needs/nuances of our hospital is not clear,” she stated.

The medical staff president also pointed out the concerns that physicians have about the finances at Pen Bay.

“And finally coming to the cost/financial issues, there is a deep sense of frustration and even anger re. the financial position of PBMC. While easy to cast blame elsewhere in any situation, the financial problem for this hospital is something physicians care about, but not something we can fix,” she stated.

Coastal Healthcare Alliance reported a $3.26 million operating loss in the 12 months ending Sept. 30. A source told the Courier-Gazette in December that the loss was due to Pen Bay, and that the Coastal Healthcare loss would have been greater if not for a surplus at Waldo County. The $3.26 million operating loss for Coastal Healthcare was out of a total annual budget of $228.5 million. This translates to a 1.4 percent operating loss.

MaineHealth confirmed in December that Pen Bay lost money in the most recently completed fiscal year, but said the final numbers had not been audited and a bottom-line figure was not available.

The last financial information available for PBMC separately was for 2013-2014, when it reported a $4 million loss out of an $111 million budget.

Pen Bay physicians would like to see much clearer evidence of how the unification would improve Pen Bay’s financial situation going forward and not solely allow MaineHealth to absorb an old loss from PBMC, which then would result in cuts or collapse of clinical services going forward, according to the letter.

The doctor’s letter also cited the problems with the installation of a health care computer software record-keeping system known as EPIC as an example.

“All of our struggles with the EPIC system have probably been the most disruptive and difficult direct effect on our practice we can remember. And this product, rolled out by MH, is still not working well in the ambulatory setting. It has also been vastly more costly than was originally promised,” Lash stated.

Lash’s letter stated that the medical staffs at both PBMC and Waldo need to and can continue to work together to make the physicians’ concerns adequately heard.

MaineHealth initially met with Pen Bay physicians at a Dec. 15 meeting. A Courier reporter went to that meeting, held at the physicians building on the Pen Bay campus, but was asked at the start to leave, since it was a private meeting and the first opportunity for doctors to hear MaineHealth’s presentation.

There have been no public meetings held in the region on the proposed unification.

“MaineHealth member organizations continue to discuss how the organization can better structure itself to meet the considerable challenges facing local community health systems in Maine and across the country,” said Mark Fourre, president and chief executive officer of Pen Bay Medical Center and Waldo General in a statement issued Tuesday. “With an uncertain future for the federal Affordable Care Act and Medicaid program, and with cuts to hospitals being contemplated by the State of Maine, we remain concerned that even profitable community health systems could face financial difficulty going forward.

“The goal of these unification discussions is to create a structure where each community is able to get the services it needs, backed by the strength of the entire MaineHealth system. We are confident that a balance can be struck where MaineHealth and its members are able to leverage the considerable advantages of having a single budget across the system while keeping intact local decision making with regard to the care delivered in each community.

“As ideas bubble to the surface and start to form a more clear proposal for this restructuring, our member organizations will engage their local communities in coming weeks in a dialogue about the best path going forward. At this time, community stakeholders on our local and system boards, our physicians and the staff leadership across MaineHealth are reviewing options with a focus on our vision of making our communities the healthiest in America,” Fourre concluded.

This story was updated at 5 p.m. Feb. 22 to include comments from MaineHealth.

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