By Wayne E. Rivet

Staff Writer

Trying to “get ahead of the wave of impending financial pressures,” Bridgton Hospital cut two primary care and two specialty providers last week as part of a Central Maine Healthcare two-phase “rightsizing” effort.

Bridgton Hospital President David Frum said Tuesday that Bridgton avoided a layoff in February, which 40 staff-level employees at Central Maine Medical Center in Lewiston were let go.

Last week, Phase Two resulted in a reduction of 31 workers at practices and clinics system-wide, although 20 were “redeployed into other openings.”

This time, cuts did hit home as Bridgton Hospital parted ways with two physicians, a podiatrist and oncologist, Dr. Hans Boedeker. Frum said the two physicians are headed toward retirement by year’s end and remain on staff at this time, while oncology coverage was immediately transferred to three Central Maine doctors, who will spend time each week in Bridgton and Rumford. According to the Bridgton Hospital’s website, two oncologists “accepting new patients” include Nicholette Erickson, M.D. and Daniel Rausch, M.D.

Podiatry at Bridgton Hospital will be phased out in 120 days, Frum noted. The program’s elimination was based on costs of service provided to revenue received.

At this time, no other layoffs are expected.

Frum said the hospital does a yearly review of services provided to chart use and financial viability.

Dialysis is one service that the public has asked Bridgton Hospital to consider several times in the past, but it is both expensive to offer and requires significant amount of space to operate — two factors that make dialysis not feasible to add.

“Hospitals are in crisis in Maine,” Frum said. “There is significant national pressures tied to the repeal of the Affordable Care Act, as well as at the state level where some people will no longer have insurance or Maine Care, while others are going with higher deductible plans, which creates bad debt for us. We have to reduce costs, not only at Bridgton Hospital, but system wide.”

Frum explained that consumers purchasing medical insurance at “the market” often sign up for coverage with high deductibles to keep premiums affordable. With deductibles in the $5 to $7,000 range, Frum said studies show that many Maine residents carry an average of $2,000 in assets, thus hospitals oftentimes face absorbing shortfalls in patient payments resulting in rising debt. Bridgton Hospital has seen its debt rise from $2 million to over $5 million this year.

While the hospital will always treat patients in need of care despite financial standing, Frum said a “balance” needs to be in place to keep the facility open and operating. That balance is “providing quality service” while keeping operating costs manageable as the result of finding efficiencies — one area is staffing, and the other is how practices and clinics are operated.

One example is Urgent Care. With openings emerging in several local practices, Urgent Care will be scaled back to weekend hours only. Patients will be able to see primary providers during the week, and can use Urgent Care for matters that surface over the weekend, Frum said.

Since the staff shake-up, public concern has surfaced. While Frum has heard that “less than a handful” of patients will likely transition out of Bridgton Hospital care to other out-of-system providers — “something they have a total right to do, and we will help them with that transition to make it as smooth as possible,” he said — there is no indication of a “mass exodus.”

Plenty of questions have been raised, Frum said.

One issue has been notification to patients regarding physician changes.

“It all happened pretty quickly. I’ve already reviewed the letter and all patients should receive it this week,” Frum said. “It’s never comfortable changing physicians. It’s very personal. We understand that. Given the circumstances, I want to assure the public that we will continue to provide high quality oncology services here.”

If patients need assistance in finding a provider or how to transition from one physician to another, patient advocate Kathy Wohlenberg is the support person to contact at 647-6149.

Frum is also available to answer questions the public may have regarding the changes, and can be reached at 647-6032.

Some local residents expressed concern regarding physicians only spending 15 minutes with patients, thus enabling them to reach certain volumes expected by administration.

Frum clarified the scheduling question saying, “The amount of time scheduled is based on patient need. A patient needing a new prescription may only take 15 minutes, while someone who is a new patient to a practice may take 30 or 45 minutes. It’s not one size fits all. Yet, there is no question, there has to be a level of production in our practices to meet our financial goals.”

As Bridgton Hospital prepares to celebrate its 100th anniversary this year, Frum pointed out how the facility and its offerings have changed over the past couple decades.

“If a person has major trauma, surgery won’t be here, it will be in Lewiston. We have been and continue to be one of Maine’s top critical access hospitals. We do things that we can do well,” he said. “We can’t be everything to everyone.”

Frum believes Bridgton Hospital will continue to evolve as to what services — based on viability and sustainability — are provided. Bottom line, he sees the hospital adapting and remaining open to serve the community well into the future.

“We will continue to strive to provide high-quality services, in an appropriate manner, and in a financially viable way,” Frum said. “It’s just harder.”