Local practice joins St. Joseph Healthcare

BANGOR – A longtime local physician practice, Gastroenterology Associates of Eastern Maine, announced this week that it has affiliated with St. Joseph Healthcare, the parent corporation of St. Joseph Hospital. Representatives of both the practice and the hospital on Friday heralded the transition as a good move for all concerned.

A spokesman for the Maine Medical Association, meanwhile, said it’s part of a sea change in American health care caused by the growing cost and complexity of running a private medical practice.

“Our whole crew is very happy with this change,” said Dr. Daniel Cassidy, one of the senior partners in the practice, which is the second-largest gastroenterology group in the state and serves the entire northern half of Maine.

Cassidy stressed that physicians from the group will continue to treat patients at both St. Joseph Hospital and Eastern Maine Medical Center, “honoring patient preferences as much as possible.”

All of the practice’s staff will retain their jobs, he added.

Cassidy said Thursday that the change would allow the six physicians in the practice to concentrate on treating patients without the distractions of managing the complicated business end of the practice. Recent changes in health care, Cassidy said – especially the complexity of billing dozens of private insurance companies and public payers such as Medicare and Medicaid – have made running the practice “a much more intense experience than it was when I started doing this back in the early ’80s.”

Other pressures include the difficulty of recruiting new young specialists to the practice and to the area as older physicians reach retirement age, Cassidy said; a task made more difficult by the heavy percentage of low-paying Medicare and Medicaid patients in the region it serves.

Approximately 240,000 of Maine’s 1.3 million residents are enrolled in Medicare, the federal health care program for people 65 and older. MaineCare, the state’s Medicaid program, covers about an additional 260,000.

“You’re trying to offer an attractive package to folks who have many other areas to choose from,” Cassidy said. But the prospect of lower payments, combined with the headaches and expense of running the practice, tend to discourage potential candidates.

The acquisition of the gastroenterology group will help guarantee that inpatients at St. Joseph Hospital have adequate coverage, said Sister Mary Norberta, president and CEO of St. Joseph Hospital and St. Joseph Healthcare. The physician group will enjoy administrative support and “economies of scale” when it comes to purchasing supplies, managing billing and payroll functions, complying with new reporting requirements, and recruiting new physicians, she said.

Sister Norberta said the future of medicine in Maine is likely to depend heavily on hospital-employed providers.

“Young doctors are looking for a professional network and the solidarity of the hospital environment, not just working in a group practice,” she said.

Across town at Eastern Maine Medical Center, Chief Medical Officer James Raczek said a number of formerly private practices have affiliated with that hospital in recent years, including several surgical specialty groups as well as the half-dozen primary care offices now known as the Norumbega practices.

Raczek said he is confident that other private practices in the area will join forces with EMMC in the future.

“The number of physicians who want to set up in private practice has gone down significantly,” he said. “Most doctors want to practice medicine, not be concerned about the business aspects of running a practice.”

Gordon Smith, executive vice president of the Maine Medical Association, said Friday that many private physician groups are moving to corporate employment. The transition is especially prevalent in rural states with small populations, he said.

Maine’s high percentage of Medicare and Medicaid patients “has made it nearly impossible to economically run a private practice,” Smith said. About half of the MMA’s roughly 2,000 members are employed now by hospitals or other corporations, he said.

For many doctors – especially recent graduates with college loans to pay off – the attractions of a predictable paycheck and the support of a corporate administration outweigh the losses, which include forfeiting the ability to purchase specific supplies and equipment, and to make decisions about hiring and firing staff, Smith said.

“You lose the ability to make those business decisions when you become part of a system,” he said.

Gastroenterology Associates of Eastern Maine was established in 1972 and is located at Evergreen Woods on Mount Hope Avenue in Bangor. The new name is Gastroenterology Associates of Eastern Maine -An Affiliate of St. Joseph Healthcare.