NORWAY — Maine Medical Center of Portland may be the largest hospital in Maine but its rural partners, like Stephens Memorial Hospital in Norway, are critical to  MaineHealth system’s ability system-wide to provide care to Mainers across the state.

Recently MaineHealth’s CEO Andy Mueller and SMH President Andrea Patstone sat down with the Advertiser Democrat to discuss the evolving nature of community healthcare.

As a candidate for the healthcare system’s leadership role Mueller had the opportunity to tour SMH in December of 2020.

“(Stephens) made a big impression on me,” Mueller said. “It is not easy to run a community hospital, and a critical access hospital. It was apparent just what a great job this team was doing. I think the board felt it was a good example of a rural Maine community as well as a well-run hospital, that they wanted to make an impression on all (the CEO) candidates that MaineHealth is not just an urban healthcare system. That the rural component to MaineHealth is critically important to both how the system is today and to the future of healthcare of the organization and of healthcare in our state.

“With the exception of our two hospitals in Portland (MMC and Spring Harbor) and the ambulatory practice in Scarborough, most of our hospitals are outside of Portland. That rural footprint is really important to us.”

Just how material the relationship between MaineHealth’s flagship hospital and its eight partner hospitals is became obvious during the pandemic, as MMC struggled to care for patients who were sick with COVID-19. MMC relied on outlying facilities like SMH to take on patients when its wards were full.

“What we learned from that experience was that the outcomes of those patients were really good,” Mueller said. “And our patients appreciated being closer to home.

“Without question the care teams in places like SMH were tired and burned out by the pandemic, but they found some satisfaction in providing that higher level care. It’s kind of pushing us away from the notion that all patients need to be shipped to Portland for care. Increasingly, we have to challenge ourselves to….to keep our patients close to home (except in cases where they require the highest level of specialized care).”

The lesson from the pandemic for MaineHealth was a positive return by investing in community hospitals to provide a higher standard of care to patients from rural areas. Mueller also spoke of the importance community hospitals play in rural economies, pointing out that as much as 55% of MaineHealth’s workforce is employed outside of the immediate Portland area.

“The health of a community is largely influenced by its economic well being,” he said. “And to ensure we’ve got our rural hospitals doing well it will continue to be important to deliver care, but also have good jobs available.”

“We’ve increased compensation across the system roughly $150 million dollars over the last 18 months,” Mueller said. “That excludes physicians and executives.”

SMH President Andrea Patstone added that employee flexibility through the pandemic was also a priority.

“We did not furlough any workers,” she said. “If employees needed time to stay home and take care of their families….without fear of losing their jobs.”

Other investments in its workforce include mental health support through a partnership with Talkspace, an online behavioral health service available to staff members and their families for free, programs to help reduce student debt for employees, increased job flexibility and continued remote work for those not required to be onsite.

Patstone pointed to a rural residency program with MMC that has boosted SMH’s care team. To date four residents have gotten their training at SMH, with three of them opting to join the hospital as practicing physicians.

“You attract the right kind of care team members to a learning institution,” she said. “We want people here to want to teach. They came here to learn, and it’s a testament to the vision of MMC, investing in a rural residency here at Stephens. Lo and behold, here we have three physicians we probably wouldn’t have had” otherwise.

Another SMH physician, Dr. Lisa Miller, recently completed a fellowship at MMC in addiction medicine,  which is allowing the Norway hospital to launch a comprehensive outpatient addiction program this fall.

“She [Miller] went to high school here, spent her career here and is returning after her fellowship,” Patstone said. “It’s very exciting. Lisa will provide treatment for alcohol abuse and opiate addiction through this program. I feel like we are on the cusp of improving substance abuse and behavioral health support available in Western Maine.”

“It’s a huge team effort,” Mueller said. “My predecessor did a really good job of ensuring that MaineHealth’s local leaders have ways to make improvements in their communities. We recognize that as big as MMC is, it’s not big enough to take care of everyone in the state. So we will continue to make these kind of investments in our rural communities. That includes behavioral health and also primary care. There is huge demand for those services, everywhere.”

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