CARIBOU — Pines Health Services, established in 1981, plays a pivotal role in providing health care to central Aroostook residents.

Designated The County Community Health Care Services until it was renamed in 1985, PHS provides health care for area residents and also recruits physicians under contract for the Cary Medical Center. It is based about a mile from the hospital on the Access Highway (Route 89) in Caribou.

Brian Thibeau, the PHS chief executive officer, said that despite its affiliation with CMC, Pines Health Services “is not part of the hospital. We are a private, non-profit corporation under Maine law.” PHS “works in close collaboration with the hospital in those areas that would benefit the health-care community,” he said.

Pines Health Services has some 60 employees, including 11 doctors and four physician assistants, and stresses primary care. Its areas of specialization include:

Internal medicine;

Family practice;

Thoracic, vascular, and general surgery;

Obstetrics and gynecology;

Pediatrics;

Occupational health.

“We are probably the largest multispecialty practice north of Bangor,” Thibeau said. “We also have a medically supervised weight-management program.”

Besides seeing patients at the PHS offices, some doctors maintain offices at the Cary Professional Office Center, located near CMC. PHS physicians also provide health-care support for migrant workers under contract with the Rural Health Centers of Maine and run a pediatrics clinic two days per week at the St. John Valley Health Center in Van Buren.

Pines Health Services does some contract work with NYLCare, particularly emphasizing case management and provider relations for NYLCare programs. PHS provides school nurse services at the Limestone Community School and offers area schools and home-health agencies both occupational and physical therapy services.

The corporation has especially supported area health care in its physician-recruitment services. “We became aware a few years ago of the terrible shortage of physicians in the central Aroostook area,” Thibeau said. “We launched an intensive recruitment program.”

PHS contacted recruiting firms, placed advertisements in medical journals, and acquired the directories of medical students completing their residencies in the past several years. Those students received direct mail advertisements from Pines Health Services.

Thibeau said that PHS had been “successful in attracting doctors to the region.” No recruiting method has proved singularly lucrative; “a combination of those factors has made our work pay off,” he said.

Thibeau realizes that “rural areas are hard to recruit to.” Many doctors prefer urban centers and their access to patients, a well-established practice, and research hospitals. A doctor relocating to a rural region should prefer a less hectic lifestyle and want to practice a particular medical skill. Those are the predominant reasons “that come to bear for doctors coming here,” Thibeau said.

Ironically, the advent of managed health care has benefited rural Aroostook County. As HMOs and other health insurers squeeze costs to specialists, more medical students opt for family practice. With the cities saturated with primary-care physicians, many doctors look elsewhere to practice medicine.

PHS “has had reasonably good success in recruiting physicians who have a regional affiliation (New England and the Maritimes),” Thibeau said. Some Canadian doctors have moved to Maine after being squeezed from the nationalized health-care system in their country.

Doctors moving to Caribou have encountered minimal difficulties in establishing their practices. There was a pent-up regional demand for medical care, especially for primary health care, Thibeau said. He reasons that when there were few doctors available, “people who were not sick didn’t go to the existing doctors for checkups because their practices were full. Now the doctors are there, and people are responding.”

When contacting prospective physicians about coming to Caribou, PHS managers “look for a personality and a fit with the community. We are looking at the skills they’re bringing to the area. We know (that) not every doctor wants to live in Aroostook County. There’s always a tradeoff in moving here.”

Thibeau said that Pines Health Services attracts “a number of patients from Presque Isle and south of Presque Isle. It probably represents about 10 percent of our patient load. Another 5 percent are drawn from places farther north and south.”

Although County residents are accustomed to traveling far for various reasons, the decision to drive to Caribou “reflects an interest on part of some people to seek out the quality physicians they want,” Thibeau said.