ELLSWORTH — Doctors don’t make many house calls anymore, but Maine Coast Memorial Hospital is trying to bring in doctors to meet its patients halfway. Starting today, a Boston-based spinal surgeon will bring his expertise to the Ellsworth hospital two days a month to offer specialized treatment for spinal problems, treatment not now available anywhere in Hancock of Washington counties.
The agreement means that orthopedic patients now can have a herniated disc replaced without traveling to Portland or Boston.
The periodic visits by Dr. Louis Jenis of New England Baptist Hospital are one more step in Maine Coast’s effort to import part-time specialists when the hospital doesn’t have enough patients to invest in a full-time practitioner and advanced equipment in the field.
Paul Barrette, Maine Coast president and chief executive officer, said having specialists available prepares for the day when health maintenance organizations in Maine turn to a system of “capitated dollars,” meaning they reimburse hospitals a fixed amount per patient and the hospital would have to pick up the cost of transporting patients for surgery.
“Right now, [doctors] are centralized,” Barrette said. “We’re trying to decentralize.”
Since last fall, cancer specialists from Eastern Maine Medical Center have been coming to Ellsworth every week to treat patients who previously had to travel to Bangor for chemotherapy. Maine Coast is negotiating to borrow specialists from Massachusetts General Hospital in Boston. The hospital looks first to Bangor, then turns toward Boston if Bangor can’t supply the specialists or if those doctors already have monthlong waiting lists.
According to orthopedic surgeon Dr. Paul Denoncourt, EMMC has two pediatric orthopedic surgeons on staff, but there is no one to do adult spinal surgery unless it falls into the domain of a neurologist.
“Neurosurgeons in Bangor will take out discs but they don’t do it in Ellsworth …,” said Denoncourt. “It’s been very hard to get surgeons to take the tough cases.”
Denoncourt, who did part of his training at New England Baptist Hospital, initiated the arrangement by which Jenis will work out of his office every month. About a dozen patients are scheduled to see Jenis this week, and one is scheduled for surgery Friday.
For highly specialized surgical procedures, such as treating spinal fusion, patients still may have to travel to New England Baptist Hospital because Maine Coast doesn’t have the necessary equipment or specially trained nurses. But Denoncourt said the new agreement means that those patients may have to make one trip to Boston instead of several, since diagnostic consultations and follow-up care can be provided in Ellsworth and the Boston surgeons will be on call 24 hours a day.
“This type of working together is not going to be unusual,” Denoncourt said. “We’ll probably be seeing more of this in the future.” For instance, Denoncourt said, there is a shortage of dermatologists in northern and eastern Maine, and only two rheumatologists, who can treat complicated forms of arthritis.