ORONO, Maine — The Orono Medical Center, a health care landmark at the corner of Main Street and Kelley Road since the mid-1980s, closed its clinic permanently Friday afternoon.
Dr. Harry Peddie, who took over at the walk-in and primary care clinic in 1989, said he is losing money and cannot afford to keep seeing his patients, many of whom have come to feel like members of his extended family.
“I don’t want to leave these patients. I love these patients,” he said in an emotional interview. “I feel very guilty, but I have no option.”
For the next 30 days, the center will be open only to provide emergency care and to give patients copies of their paper records.
Peddie, 77, said the practice originally known as MedNow has been on a “downhill financial slide” for a long time, but that recent health care trends have made things worse. About half of his patients are elderly and covered by Medicare, he said, and reimbursements from that public program are not enough to cover the cost of providing care.
Over the past six months, he said, he has borrowed more than $80,000 from a home equity account to help keep the doors of the practice open.
“I’ve been hoping something would turn around, but it hasn’t. So I have to close up shop,” he said.
At the Maine Medical Association, General Counsel Andrew MacLean said independent practitioners such as Peddie are a vanishing breed in Maine.
With only marginal increases in Medicare for the past decade or so and Medicaid rates that have never covered the cost of providing services, he said, providers with a high percentage of patients in those programs are dealing with “an essentially flat revenue stream and ever-increasing expenses.”
Among those expenses are the basic costs of running a business, including rent, utilities, payroll and administrative costs. In addition, doctors must purchase medical liability insurance and comply with required quality improvement mandates, such as data reporting, and technology advances, such as electronic medical records — investments that can cost tens of thousands of dollars.
“All of this is great stuff from the point of improving the quality of health care, but it imposes significant costs on practices,” MacLean said. As a result, he said, more and more doctors are choosing to practice in large, multiprovider settings.
In the town of Orono, there is a medical practice owned by Sunbury Medical Associates, a private, multiprovider group based in Bangor, and another owned by Eastern Maine Medical Center in Bangor.
On the campus of the University of Maine, the Cutler Health Center is run by EMMC. Just up the road in Old Town, the Helen Hunt Medical Center is owned and operated by Bangor-based Penobscot Community Health Care, the largest federally qualified health center north of Boston. That’s a lot of local competition for a relatively small population of patients.
There is no electronic medical record at the Orono Medical Center.
“We just got touch-tone phones,” said Pam Peddie, Dr. Peddie’s wife and office manager. The practice’s austere budget has prevented keeping up with some emerging administrative and clinical technologies, she said, but never at the expense of patient care.
“I am old-school and proud of it,” Peddie said. Larger medical clinics pressure doctors to complete each patient visit in 15 minutes or less, he said, an approach he calls “treat ’em and street ’em.”
“There’s no incentive to provide quality care,” he said. “I can’t see a patient in 15 minutes.”
MacLean, at the medical association, said it can be hard for patients on Medicare and Medicaid to find a doctor willing to accept those payment sources, but that hospital-owned clinics and federally qualified health centers must accept all patients, even those without any insurance coverage.
Last week, the Maine Human Rights Commission voted in support of a former employee of the Orono Medical Center who said he was fired from the practice before he could report what he called illegal and unethical medical practices, including unnecessary testing to maximize profits. Peddie at the time called the charges “nonsense” and this week said the episode has no bearing on his decision to close his practice. The commission’s findings cannot result in disciplinary actions but may be referenced in future lawsuits.
About 12 employees will lose their jobs with the closing of the Orono Medical Center. Peddie said the building, equipment and lot will be put on the market, and he will look for a part-time job.
“I can’t afford to retire yet,” he said. “I’ve lost too much money.”
Peddie, who started Maine’s first family residency program at Augusta General Hospital in 1971, said he hopes to continue practicing medicine and perhaps teach.