New hospital head sees telehealth and teamwork filling Aroostook health care gap

10 months ago

Presque Isle’s new hospital leader wants to see local medical facilities unite to solve Aroostook County’s unique health care problems.

Longtime Fort Fairfield doctor Jay Reynolds became president of Northern Light A.R. Gould Hospital on Aug. 21. Greg LaFrancois, who served seven years at Gould, left in July to become president at Northern Light Eastern Maine Medical Center in Bangor. 

About 26 percent of Aroostook residents are 65 or older, compared with 22.5 percent statewide, according to the U.S. census. Towns are widespread, with only four hospitals serving the area’s 68,000 residents. People often have to travel to Bangor, 70 miles south of the county line, or farther for medical needs, which for some is difficult.  

Rural hospitals can’t solve the challenges on their own, but need to work together to help patients get the care they need locally, according to Reynolds. 

“We’re not only rural, we’re distant rural,” Reynolds said. “Many patients are older, with more transportation issues, and have difficulty traveling to Bangor or Portland. For many of our patients, [appointments there] might as well be on the moon.”

Adding more telehealth and home visits would help, and Reynolds wants to do that. But some of those telehealth sessions will be provided by people who aren’t local, which is the wave of the future, he said.

It’s a challenging time in health care as facilities battle back from pandemic worker shortages, closing clinics or cutting services. A.R. Gould closed its Mars Hill Health Center a year ago, and Fort Kent’s Northern Maine Medical Center closed its obstetrics unit because birth rates declined and there weren’t enough obstetricians. 

Elsewhere in Maine, Eastern Maine Medical Center eliminated some eye care in March. Central Maine Medical Center in Lewiston closed its neonatal intensive care unit in 2021 and Rumford Hospital ended maternity services in March.

Northern Maine Medical Center, Cary Medical Center in Caribou and Houlton Regional are independent facilities that don’t belong to Northern Light Health. Reynolds sees them as partners, not competitors, who often share equipment and providers. 

During the pandemic, the facilities united to inform the public, share care resources and deliver vaccines. Each facility was too small to qualify for some pandemic-related federal assistance, but they combined as a region and succeeded.

That spirit of cooperation will drive local hospitals’ future success, Reynolds said. 

Aroostook’s medical community has a long history of sharing, according to Houlton Regional Hospital CEO Shawn Anderson.

“We share blood when necessary and other critical equipment or supplies that would otherwise cause a delay in patient care,” he said. That cooperation extended into the pandemic. No one hospital had all the answers, but they learned from one another and served patients together, he said.  

Anderson, too, sees hospitals uniting to bring care closer to Aroostook patients. Sharing medical staff is one option. For instance, each hospital may not need a full-time specialist, but the facilities could share one that would work a week at each site, he said. 

Some people blame hospitals for the lack of doctors, but it’s simply the nature of the work today. It isn’t just an Aroostook County phenomenon, Reynolds said. The idea of a doctor working at the same small practice for 30 years doesn’t exist anymore. 

This is due in part to poor reimbursement, including Medicare, and doctors seeking a better quality of life, according to the Maine Hospital Association.  

With technology, doctors in Presque Isle can collaborate with colleagues anywhere, Reynolds said. 

“Nobody wants to be the only ‘X-ologist’ in town,” he said. “Here they have colleagues in Bangor and systemwide. That helps draw them here.”

Because A.R. Gould is rural, it can recruit international physicians, Reynolds said. Some foreign students can remain in the country for a period of time if they work in underserved areas like rural Maine. 

More than a quarter of Gould’s medical personnel are foreign graduates, he said.

The hospital retains from 85 percent to 90 percent of its physicians yearly and has assets that are unusual for smaller hospitals, Reynolds said. He named its cancer care center, radiation oncology and a dialysis center that offers kidney patients treatment closer to home as examples. 

But by far, the facility’s greatest strength is its people, he said.  

Reynolds earned his medical degree from the University of Vermont and completed his family medicine residency at Maine Medical Center in Portland before starting as a family doctor in his native Fort Fairfield, according to Northern Light Health

He has worked for A.R. Gould during all of his medical career, including as chief operating officer and chief medical officer. He became interim president upon LaFrancois’ departure.

He lives in Fort Fairfield with his wife, Karen. They have two daughters who live in Florida and a son in Fort Fairfield.

It’s an honor to serve people he’s known his entire life, he said.

“There’s a great need for that human-to-human touch,” he said. “We’re over 100 years old, and likely we’ll be providing health care 100 years from now.”