Miles and St. Andrews Patients Benefit from Surgical Pilot Program With Maine Medical Center
DAMARISCOTTA - When Surgeon Tom Lyons, MD, retired in April, Miles Memorial and LincolnHealth – St. Andrews Campuss found themselves with too few surgeons in the midst of a national shortage.
"As soon as we knew Dr. Lyons was going to retire, we started looking (for a replacement), but it's difficult," said Russell Mack, MD, Chief Medical Officer for LincolnHealth, the parent
company of Miles and LincolnHealth – St. Andrews Campuss.
Russell Mack, MD
For many community hospitals, finding a general surgeon is more than difficult. With newly minted surgeons gravitating to specialty practices in urban settings where the pay and hours are better, some rural hospitals are finding it is next to impossible to replace retiring general surgeons. Recently, ten Maine hospitals were searching for a surgeon, and the problem is expected to get worse, much worse, in the foreseeable future.
An Ohio State University study predicts a deficit of 1,300 general surgeons nationwide by next year and 6,000 by 2050.
For small rural hospitals like Miles and St. Andrews, the growing shortage is alarming. General surgeons play an indispensable role at small hospitals, performing everything from emergency c-sections to trauma surgery and routinely consulting with doctors on a wide range of other cases.
Using temporary or "traveling" surgeons is expensive and can result in unpredictable quality, but doing without can cause delays in patient care.
So when recruitment efforts initially came up empty, LincolnHealth turned to Maine Medical Center (MMC), the largest medical center in the state and, like Miles and St. Andrews, a member of the MaineHealth system.
The result is a pilot program that allows Miles and St. Andrews to maintain high quality care and, in most cases, keep patients in their home community.
Under the plan, Maine Medical Center surgeons take two out of every four days of on-call duty for Miles and St. Andrews surgeons. Using high speed data networks and sophisticated diagnostic imaging equipment, Miles and St. Andrews doctors, and surgeons from MMC, can discuss a case and determine if surgery is necessary.
Maine Medical Center surgeons work with Miles and St. Andrews doctors to keep patients in their local hospital whenever possible.
If surgery is required and a LincolnHealth surgeon is not available, the patient is transported to Maine Medical Center for emergency surgery.
Brad Cushing, MD, Chief of Surgery at Maine Medical Center, said the system means better care for patients and better use of scarce resources.
Too often, when a hospital somewhere in the state loses a surgeon or simply has more cases than they can handle, patients are shipped to Maine Medical Center with little warning on the assumption that the larger medical center can handle the extra load.
That means Maine Medical Center surgeons may have to cope with a sudden influx of patients with little forewarning.
"It stresses everybody in the system," said Dr. Cushing. "It's not always in the best interest of the patient to come down here, and it can also be more expensive."
By working together, Miles and St. Andrews doctors and Maine Medical Center surgeons can better determine which patients need surgery and, when surgery is required, insure the surgeon has the medical records and patient history he or she needs to provide the best quality care.
Since the pilot program began, several Miles and St. Andrews patients have undergone surgery at Maine Medical Center.
Because Miles and St. Andrews were able to recruit a new surgeon this summer, however, it is less likely that a Lincoln County patient will be transported south for surgery in the immediate future.
But while access to general surgery services is expected to improve when Matthew Zadrowski, MD, begins his practice, the pilot program will continue to be a valuable resource when LincolnHealth surgeons are not on-call and it will also provide valuable insight into the procedural and financial framework necessary to make future cooperative efforts a success.
"What we are trying to do is meet a need that is substantial and growing," said Dr. Cushing.
Dr. Mack said Miles, St. Andrews and other nearby hospitals have also begun initial discussions on the possibility of sharing general surgeons on a regional basis.
That sort of regional cooperation, as well as programs like the pilot program between Miles and St. Andrews and Maine Medical Center, is the key to coping with growing shortages of surgeons and many other medical providers, said Dr. Mack.
"These are problems that are not going to be solved by individual hospitals in the future. They are going to be solved by systems, hospital systems," said Dr. Mack.