Maine Ahead magazine Nov/Dec 2011

m a i n e ’ s b u s i n e s s & e x e c u t i v e l i f e s t y l e m a g a z i n e

Doug coleman 53 | nonprofit boarD leaDership 40 | Jeff kline 10

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Inside MMC’ssimulation center . . . 28

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November/December 2011 Maine Ahead >> 1

Contents

Roundtable: Leadership on Board 40

Podium: Governor Paul LePage 18

B U S I N E S S

UPFRONT

Transforming the ’Toon . . . 10Jeff Kline created cool shows as a kid with his Super 8 moviecamera. Now he does it with a team of 250 writers and anima-tors from all over the world.

BACKBONE

Tested and Approved . . . 16Ever wonder where all the life-saving heart drugs get tested? It’s happening in L-A, at Maine Research Associates.

PODIUM | Cover story

The LePage Q&A . . . 18 Nineteen questions on 2011 and 2012: You’ll know where the governor is coming from after reading this indepth interview.

PRIvATE TOUR

Playing Doctor . . . 28 Walk inside Maine Medical Center’s simulation lab and meet the people—real and plastic —who are helping train Maine’s new physicians.

ROUNDTABLE

Leadership on Board . . . 40A quorum of nonprofit board members give thoughtful delib-eration on board leadership.

>> FeatuReS

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L I F E S t Y L E

WORTH THE TRIP

Northern Exposure . . . 50Robert Peary was the first white man to reach the North Pole. See the sledge that took him there at this Bowdoin museum.

vANTAGE POINT

One Man’s Answers . . . 53Doug Coleman, the celebrated Jackson Lab scientist, credits persistence and luck for his groundbreaking discoveries. Some special mice helped, too.

CHEF’s CHOICE

Sonny’s One So True . . . 60Jay Villani, Portland chef and creator of Sonny’s and Local 188, is the real deal.

o P I N I o N

J. DOE

Medical Mayhem . . . 62Everyone in Maine health care knows the big guys are gobbling up the little guys. Is it good? Is it inevitable? John Wipfler weighs in.

BULL PEN

NIMBY Is an Attitude . . . 66Orlando Delogu believes that “Not in My Backyard” is an attitude—a bad one—

that needs to stop.

Pulling Rank . . . 68Yeah, yeah, we’re last on the Forbes business climate list. Perry Newman says it’s no reason for rash decisions.

Contents cont.

I n E v e r y I s s u e

BACK THEN

Good for What Ails You . . . 9What if you could buy cocaine and morphine at any corner drugstore? You could—in 1900.

MAINE GOODs

A Kinder, Gentler Johnny . . . 12Patricia Royall has a dream: that one day, every hospital patient will be stylishly green in his or her own Jazzy Johnny.

sTICKY BUsINEss

Building a Better Board . . . 14Theodore Scontras of The Bank of Maine gives expert counsel on the care and feeding of your nonprofit board.

THE WAY WE WORK

Macintosh Medicine . . . 72David Higgins put his skills at computer repair and his emergency medical train-ing together to create a thriving “health-care” business for Apple computers.

vantage Point: Doug coleman 53

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woRth the tRiP: Peary-macmillan arctic museum 50

PROGREss NOTEs

MEREDA . . . 70Bill Sullivan on the multi-family sector; historic preservation tax info.

sPECIAL sECTION

CHCS . . . 64AA report from Community Health and Counseling Services.

PromotIoNaL coNtENt

meet and greet

6 >> Maine Ahead November/December 2011

>> PUBLISHER’S NOTE

PUBLISHer

Mark T. Wellman

edItOr In CHIeF

Tori Britton

managIng edItOr

Melanie Brooks

art dIreCtOr

Sandy Flewelling

BUSIneSS edItOrS

Mike Woelflein

Henry Garfield

COnSULtIng edItOr

Annaliese Jakimides

ILLUStratOr In CHIeF

M. Scott Ricketts

PHOtOgraPHy

Irvin Serrano

Kevin Couture

PrOdUCtIOn deSIgner

Ashley Ray

admInIStratIve team

Melissa Sherman

Intern

Marcella Britton

COntrIBUtIng WrIterS

Richard Shaw

Orlando E. Delogu

Perry B. Newman

John Wipfler

dIreCtOr OF SaLeS & OPeratIOnS

Christine Parker

SaLeS COnSULtantS

Christie Spearen

SUBSCrIPtIOnS

10 issues $29.95 online, by phone or mail

www.maineahead.com

PrOdUCtIOn OFFICe:

One Cumberland Place, Suite 316

Bangor, Maine 04401

207.941.1300

Maine Ahead is published by Webster Atlantic Corp., a

Maine-owned company. Newsstand Cover Date:

November/December 2011, published October 28, 2011,

Vol. 2, No. 9, Issue 18, copyright 2011. Advertisers and event

sponsors or their agents are responsible for copyrights

and accuracy of all material they submit.

ADDRESS CHANGES: To ensure delivery, subscribers must

notify the magazine of address changes one month in

advance of cover date.

Opinions expressed do not represent editorial positions

of Maine Ahead. Nothing in this issue may be copied or

reprinted without written permission from the publisher.

Maine Ahead is published 10 times annually. To subscribe,

call 207-941-1300 or visit www.maineahead.com.

COVER IMAGE: Irvin Serrano

Email Mark Wellman at [email protected].

The Life You Save May Be MineIf I was having a heart attack, what would you do?

tHey Say It taKeS Seven yearS for new medical knowl-

edge to become part of common practice. If I dropped to the

ground with a heart attack (god forbid), and a good Samar-

itan decided to give me CPr the old-fashioned way, I’d be

grateful. But a newer method, using rapid chest compression

alone, would actually increase my chances of survival.

Currently, 300,000 americans suffer out-of-hospital heart

attacks each year, and only 5% survive. I found out recently

that a friend of mine is one of those survivors because his

daughter knew what to do. His grateful wife wrote about it in

a recent email:

“You and I are totally dependent upon the person next to

us knowing what to do and doing it within a minute. Here’s

what to do when an adult collapses and is not responsive:

•Have someone call 911.

• Immediately start rapid chest compressions. Aim for

center of chest. Put the heel of one hand on top of the

other one, lock your elbows, and “fall” onto the chest

(rather than push, which would be too difficult).

•Try to do this 100 times per minute—about the pace of

the song “Stayin’ Alive” by the Bee Gees. Jab, jab, jab, jab.

•All you do is pump on the chest. You’re doing the job of the

heart. Do this even if the person is gasping. This pumping

action won’t hurt the victim; you can’t make it worse.

•Every minute you delay CPR, survival chances go down

10%. If another person is there, have them kneel opposite

you and switch off. Keep going until EMTs arrive.”

Life is precious. Let’s protect it. Here’s a video to watch on

this lifesaving technique: http://tinyurl.com/2fx8r59.

— Mark Wellman, publisher


Melanie Brooks

“My technophobe tendencies were thrown out

the window when my husband gave me an iPad2

this fall. I love it. This little tablet is not only helping

me do my job more efficiently, it’s helping improve

the lives of kids and adults living with disabili-

ties, such as autism. How awesome is that?”

Melanie Brooks, Maine Ahead’s managing editor,

was brought up in Orono. After leaving Maine for

college, grad school, and various journalism gigs,

including a stint at Inc. Magazine, she is happy

to be back in her hometown, living with her new

hubby in the house that once belonged to her

grandparents. Brooks is a graduate of Towson

University (BA) and New York University (MA). In

addition to her duties at Maine Ahead, she is editor

of both of its sister magazines, Bangor Metro and

Real Maine Weddings.

Sandy Flewelling

Sandy Flewelling, Maine Ahead’s art director, is

the youngest of seven siblings, a fact which has

lifelong advantages. In addition to her long career

in graphic design, Flewelling also holds a master’s

degree in counseling, making her a rock of wisdom

and stability amidst the tempestuous waves of

print production.

>> CONTRIBUTORS

1.877.BANGOR1 www.bangor.com

“Our university is constantly “Our university is constantly “Our university is constantly growing and improving. Bangor Savingsgrowing and improving. Bangor Savingsgrowing and improving. Bangor Savings

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Member FDIC

“Husson University relies on Bangor Savings for a full range of

commercial services – from checking through lines of credit.

Our Bangor Savings cash management system also helps

us better manage our resources. We’re more efficient. It helps

us keep tuitions down and standards up. Bangor Savings

really understands our business. Give them a call for yours.”

Dr. Robert Clark President - Husson University, Bangor

FORGE worldwide 142 Berkeley Street Boston, MA 02116 617.262.4800 contact: Kelly Lucadamo

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back then

The nexT Time you visit the pharmacy and wonder whether

St. John’s wort can treat depression or ginkgo biloba will reverse

memory loss, consider patent medicine purveyor henry Pope

Clearwater, PhD. in the early 1900s, Clearwater began earning a

fortune with his hallowell-based heart Cure Company, which he

started in John hawes’ drugstore.

By 1933, his mail order business , which also peddled prod-

ucts claiming to cure rheumatism and stomach ailments, had

ballooned to the point where a new post office was built to handle

as many as 25,000 letters a day, some from Great Britain and Africa.

Clearwater’s counterparts proliferated in turn-of-the-century

maine. in Abbot, D. h. Buxton ran a rheumatic cure company in his

general store. in nearby Guilford, the Genthner Brothers peddled

the oddly-named Rhubard and nux tablets from their horse-drawn

wagon. And in Fryeburg, a Kickapoo indian medicine Company

show employed native Americans to sell indian salve that suppos-

edly cured fever sores, cancers, piles, and ulcers.

Some of these feel-good remedies came with a price. many

were laced with alcohol and cocaine, addictive substances whose

use often required treatment. medical centers discreetly located

in private homes began cropping up, promising to cure liquor,

tobacco, opium, and morphine habits.

As Stewart h. holbrook explains in his book, The Golden Age of

Quackery, a 1905 Colliers Weekly series titled “The Great American

Fraud” prompted creation of the Federal Pure Food and Drug Act,

which required patent medicine manufacturers to list ingredients

on the label and to make no unproven claims. But companies still

pushed the limits, and well into the century, the FDA tackled issues

such as Geritol’s alcohol content.

While cocaine and morphine may be missing from today’s

herbal nostrums, the public still clamors for unregulated, official-

looking products that promise to raise the libido or lower choles-

terol. ecclesiastes got it right when it stated there is nothing new

under the sun. —Richard Shaw

>> Good for What Ails You circa 1900, Hallowell

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upfront p e o p l e | p l a c e s | p r o d u c t s | p r o g r e s s

10 >> Maine Ahead November/ December 2011

>> mogul of the moNth

cumulative reach

600 • Number of episodes of animated TV Kline has codeveloped and/or executive produced.

2008 • Year Kline and his family decided to move to Maine for a “change of life.”

3 • Kline’s Daytime Emmy nominations, for Dragon Tails. Transformers: Prime earned 6 nominations.

250 • People Kline currently manages across multiple continents to produce two animated shows.

transforming the ’toonJeff Kline has been blazing trails in animated TV since the mid-’90s. Now he’s showing LA how to commute.

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jeff kline is not a household name. But the cartoons he has

turned into gold, from Transformers: Prime and G. I. Joe: Rene-

gades to Dragon Tales, have made him a superhero in the

industry. this past year, kline also managed a deal that allows

him to work two weeks in los Angeles and two weeks from his

home in Cape elizabeth, Maine, elevating his hero status with

his wife and daughter. “i love being able to pick up Darby

from the bus stop and always being home for dinner.”

kline, who grew up on the east Coast, developed an early

interest in writing and moving images. “i was the first kid on

the block to save up for a super 8 camera,” he says. He went

straight to l. A. after graduating from Boston University, and

soon found out that feature film work was too slow-moving for

him. ”nothing happened,” he recalls. “i wanted to shoot myself.”

His first big break came when he was selected for a highly-

competitive tV executive apprenticeship at nBC, tapped by

Brandon tartikoff (the rainmaker behind Hill Street Blues, L. A.

Law, Cheers, and Seinfeld). kline worked primarily on soap operas,

moved to Columbia Pictures television to manage their live action

dramas, then partnered with writer/executive producer frank

lupo, and “loved it all.”

jeff kline’s segue into the cartoon world proves once again

that truth is stranger than fiction. During a plane trip, he whipped

up a tV series treatment for a friend, put the friend’s name on it,

and sent it off. “i later read in the trades that Jumanji was going to

be UPn’s first kid show and that i was producing it.”

in the 15 years since, kline has codeveloped or produced 15

animated series—among them Men in Black, Jackie Chan Adven-

tures, and My Friends Tigger and Pooh—while still keeping his

finger in the live action pie. last year he signed a four-year

contract to create a new animation studio for Hasbro and conjure

up content for the Hub tV network.

While his 50/50 time split between l. A. and Maine has been a

success, it does have one drawback. “Here in Maine,” kline says,

“my workday is longer because it starts three hours earlier and it

doesn’t end until the ‘kids’ in l. A. go home.” still, with DigiDe-

livery of clips, real-time conferencing with iChat, and a hand-

picked creative team he trusts, kline is able to steer the studio

ship from 3,000 miles away “and still take my daughter to karate

practice.”


BUSINESS PRESS

Maine biz announced its annual next List of individuals likely to impact Maine’s economy. This year’s honorees are: Marada and Leah Cook, co-owners, Crown O’ Maine Organic Cooperative; elizabeth Mitchell, CeO, Maine Health Management Coalition; Gunnar Hubbard, principal, Fore Solutions; Mike and Kyle Rancourt, president and VP of sales and marketing, Rancourt and Company Shoecrafters; Jon Christensen, CFO, Kleinschmidt associates; Josh broder, CeO, Tilson Technology Management; Michael aube, president/CeO, eastern Maine Development Corporation; and Graham Shimmield, executive director, bigelow Laboratory for Ocean Sciences.

THOMaS ReaGan, a Maine-based personal chef, was crowned Maine Lobster Chef of the Year 2011 at Portland’s an-nual Harvest on the Harbor event in October. Reagan was named the winner at a cook-off competition in front of a live audience.

m a I N e W a V e s

>> Twin WinsHistoRY RePeAteD itself in october when

Mainers Rocco Andreozzi and kim Wasco took

home the north American Wife Carrying

championship for a second year, once again

winning Wasco’s weight in beer and five times

her weight in cash. Held on an obstacle course

at sunday River ski Resort every Columbus Day,

the event does not require contestants to be

married, but they must be over 21—presumably

so they can legally drink their winnings.

>> FTW 2.0if YoU knoW that an early adopter is not a

person who takes in babies and toddlers, you

belonged at this fall’s 2nd annual social Media

ftW Conference in Portland. founded by

industry gurus Rich Brooks, Christy Corns (both

pictured), and jaica kinsman, the event was an

insiders’ look at facebook, linkedin, twitter, and

other forms of digital messaging. While a sellout

crowd of 400 got smarter in the flesh, hundreds

more watched it live over the internet.

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I always feel that the next person’s skeleton and mine will look about the same.

—Wesley McNair

>> Satellite SleuthWHo neeDs A stARsHiP to discover lost worlds?

Bangor native and egyptologist sarah Parcak is

using satellite imagery, viewed through infrared

light, to reveal vast areas of buried egyptian

settlements, tombs, and as many as 17 pyramids.

Parcak, an assistant professor of archaeology at

the University of Alabama, was featured in a

recent BBC special on the Discovery Channel,

and her work has archaeologists longing to fly to

the land of the nile and start digging.



soMetiMes ADVeRsitY, not necessity, is the

mother of invention. in 2008, Patricia Royall was

undergoing radiation treatment for breast

cancer, and selected her requisite hospital

johnny from the bin—pulling out a soft,

brightly-colored johnny with the name of a

Haitian hospital on the back. the other patients

in the waiting room all admired it, and collec-

tively wondered: “Why can’t hospitals come up

with something better for patients to wear?”

in 2009, Royall launched jazzy johnnys, her

answer to the skimpy, ill-fitting hospital gown.

As she researched designs and fabrics, she

found out there are more negative aspects to

current patient wear than meets the eye.

While the typical hospital johnny costs as

little as $3, it is often made with cotton that is

treated with pesticides in the field, and sprayed

with formaldehyde to prevent shrinkage—“not

the kind of material you want sick people

wearing,” Royall says. she cites a study funded

by the Robert Wood johnson foundation calcu-

lating an average cost of $1.45 to wash each

johnny, with a useful life per garment of 40 to 50

washings. All told, the cost per johnny over its

entire life cycle can run from $500 to $700.

Royall’s jazzy johnnys, when purchased at $64

and given to the patient to care for over their

course of treatment, save the hospital time and

money, and save patients’ self-esteem.

the higher initial price tag of jazzy johnnys

comes in part from the special properties of the

fabric Royall uses, called tenCel. Made from

wood cellulose, the tenCel in jazzy johnnys is

not only eco-friendly (it’s organic, and, unlike

polyester, breaks down in landfills)—it is also

antibacterial, helps regulate body temperature,

wicks away excess moisture, and doesn’t irri-

tate sensitive skin.

in 2010 and ’11, jazzy johnnys was awarded

two seed grants through Maine technology

institute. the initial grant allowed the company

to conduct its first pilot program at MaineGen-

eral, where Patricia Royall was first inspired to

create a kinder, gentler johnny. Pilot no. 2 is now

going on at new england Rehab in Portland.

BUSINESS PRESS

COFFee bY DeSiGn received this year’s Global Hero award from Portland buy Local, the fifth award it has given Coffee by Design. The company also received the Community Hero award in 2009 and 2010, the beacon of My neighborhood award in 2008, and the Resurgam Community impact award in 2008 .

bURGeSS advertising and Marketing of Portland won six major awards at the 20th annual Maine Public Relations Council’s Golden arrow awards cer-emony. The company was recently named the best Place to Work in Maine in the small/medium category.

Une (University of new england) has announced that its Masters of Public Health Program has received accreditation from the Council on education for Public Health, the first such program accredited in the state of Maine.

Maine PUbLiC broadcasting network’s Super Thursday one-day pledge drive raised over $252,719 in donations from 2,866 individuals in October, more than dou-bling previous records.

>> maiNe goods

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a kinder, gentler johnnyCan you think of any uglier garment to wear than a typical hospital johnny? Patricia Royall couldn’t, either. So she created some that are downright jazzy.



This month’s expert:

>> sticky busiNess

Theodore N. ScontrasExecutive Vice President, The Bank of Maine

theodore scontras is executive vice president of the bank of maine, where he oversees the government, educational, and nonprofit business sectors. scontras has served on numerous boards, including the maine compact for Higher educa-tion and New england association of schools and colleges (Neasc). He will be organizing a December statewide event for nonprofits featuring Newman’s own foundation called the bank of maine focus on Philanthropy 2011.

A: In a laggIng economy, the

demand for nonprofit service spikes

to fill community needs. attracting

the right leadership will strengthen

a board’s governance and opera-

tional efficiency. as stewards of

trust, nonprofits must develop

their board’s strategic counsel to optimize

performance and instill public confidence.

Know your goals and skill requirements.

Take inventory of your board’s long-term plan

to determine what type of expertise is critical

to drive forward. What are the strengths of

your board today? What roles will need to be

refreshed due to turnover? Recognize that a

range of skills and experiences will allow the

group to quickly react to any situation. Diverse

board composition will also yield perspective

and innovation.

Use your mission to attract strong leader-

ship. Does your organization have a clear value

proposition? Determine what messages differ-

entiate your cause and market them effec-

tively. State what is compelling about your

nonprofit’s purpose and where potential board

members can add value. a strong identity will

attract the right talent to advance your goals.

Recruit all the time, in all the right places.

Recruitment efforts can be adjusted according

to the board’s current needs, but should never

go dormant. establish a pool of potential candi-

dates ready to fill a vacancy or supplement a

committee task. Reach out often to stake-

holders who already have a vested interest in

the nonprofit’s success.

all outreach strengthens board recruit-

ment. educate supporters about goals and

accomplishments. Take advantage of the

group’s professional affiliations to reach key

audiences. Use social media tools to showcase

growth and share success stories.

Take care of your existing board. It’s critical

to keep members engaged and to remember to

re-recruit your board. Have a board perfor-

mance process to set clear expectations and

measure progress. Promptly resolve issues to

prevent burnout and disillusionment. Find

creative ways to recognize contributors who

step up and deliver on commitments. your best

potential recruiters of board talent are current

members—especially those who feel both

effective in and appreciated for their service.

Sticky business questions need answers.

Email yours to [email protected].

Recruit before you need them

BUSINESS PRESS

JOn eaMeS will take over as president of n. H. bragg at the retirement of longtime president John W. bragg in november. He rep-resents the fifth generation of family members running the bangor supplies com-pany, founded in 1854.

MaRK aDaMS has been appointed president and CeO at Sebago Technics, a Westbrook-based consult-ing engineering firm. He was the firm’s executive VP.

LanD FOR Maine’S Future’s board recently approved four separate awards totaling $854,000. The funds will purchase working waterfront cov-enants on four properties in beals, South bristol, north Haven, and eastport that will restrict any future development of the land that conflicts with fisheries uses.

nanCY MaRSHaLL, president of augusta-based nancy Marshall Communications, was awarded the edward L. bernays achievement award by the Maine Public Relations Council at the organization’s annual con-ference, the highest honor bestowed by the council to a single practitioner.

Building a Better Board

Q: Excellent board leadership is critical to our nonprofit’s mission and success. What can we do to improve our recruitment practices?


CONCEPT l PERMIT l PLAN l DESIGN l BUILD l MAINTAIN


backbone

he powerhouse organizations in the $100 billion business of medical research tend

to be large, academic hospitals in major cities: Johns Hopkins in Baltimore, Bos-

ton’s Mass General, and UCLA Medical Center. But Maine’s own L-A is also a player in the space, thanks to Maine Research Associates (MRA), perched above the Androscoggin’s Great Falls in Auburn.

Through more than 500 clinical research tri-als over more than two decades, MRA, founder/director Robert Weiss, MD, and thousands of local patients have played a role in the development of every heart-related drug of the last 15 years, and will for at least the next 10. Maine Research Asso-ciates conducts studies and research that lead to the development and improvement of drugs and treatments for heart disease and related condi-tions. Trial participants, many of them patients at Androscoggin Cardiology Associates, the practice

Dr. Weiss launched in 1985, benefit through ac-cess to drugs and therapies well ahead of the rest of the market, as well as through stipends for par-ticipating in the studies.

“We’re helping people today, by providing them with medications that may not be in the drugstore for four years,” Weiss says. “But we’re also looking to tomorrow. We’re helping to ask—and answer—the questions that will help define the shape of medicine, and help people live longer and live bet-ter in the years to come. It’s wonderful, for us and our patients, to play that role.”

MRA’s role is growing and expanding, along with the company, which had 45 different studies in pro-cess as of October. Launched as a one-man shop in 1987, MRA grew from five employees in 2008 to 14 in October, with two more expected by the end of 2011. In November, Maine Research Associates will announce a partnership with Central Maine Medi-cal Center, which will add CMMC physicians and

Tested and ApprovedThrough its clinical

research trials, Maine Research

Associates in Auburn is a rapidly

growing player in developing

the drugs of tomorrow—while

helping its patients today.

by Mike WoelfleiN

Robert Weiss, MD, founder of Maine Research Associates


locations to MRA efforts. Eight new stud-ies will begin almost immediately, and Weiss says the deal will pave the way for trials outside the heart arena, plus more revenues and jobs, with eventual expan-sion to CMMC-linked facilities in Rum-ford, Bridgton, and Brunswick.

“It’s exciting,” Weiss says. “We’re going to get a lot bigger, a lot faster. It’s exciting for the business, for our patients, and for all of us as scientists. We’re going to be able to ask more questions and get more answers.”

Maine Research Associates makes the bulk of its revenues from pharmaceutical firms—including titans such as Pfizer, Bayer HealthCare, Merck, and Sanofi-Aventis—through trials that are part of the Federal Drug Administration approval process. The National Institutes of Health (NIH) is another significant revenue source. NIH trials tend to focus on treat-ment strategies, answering questions such as what drugs or regimens to use for a certain condition.

MRA coordinators, mostly registered nurses, run the studies, which can focus on many different aspects of a drug, in-cluding effectiveness and side effects. Neither the doctor nor the patient knows whether a particular patient receives the medication or a placebo, but all are moni-tored for side effects and progress. Cur-rently, MRA is the largest U.S. enroller for a four-year, 15,000-subject study of GlaxoSmithKline’s Stability, a drug that purports to keep the plaque in arteries from rupturing, which can cause a heart attack. That—along with another current trial of a vaccine for high cholesterol—is the kind of trial in which subjects benefit from cutting-edge medication well in ad-vance of most people.

Others clinical trials, such as a multi-decade NIH study seeking a gene that causes heart attacks, don’t offer immedi-ate benefits to subjects. Yet local patients’ commitment to such studies is one reason

that, though Lewiston-Auburn lacks the population and medical schools of larger competitors, it’s well suited to medical re-search, according to Weiss. It’s an aging population with a lot of free time, and a good amount of hypertension, obesity, ar-thritis, tobacco use, and diabetes, and that helps. But it’s also a willing population.

“Some people do it because they’re sick, or they can’t tolerate the standard medi-cines, and these trials can help them,” Weiss says. “Some do it because their grandchildren could benefit. And some do it to be nice. They’re good people and they want to help their fellow man, in their neighborhood or around the world.”

MRA’s presence in the L-A community goes beyond the benefits to participants. Weiss also notes that several clients of

Maine Research Associates visit the area on a typical week, bringing business to area hotels and restaurants. (“They all love Baxter Beer,” he says with a laugh.)

Key to the company’s success, Weiss says, is the MRA staff of more than a dozen managers, coordinators, and research as-sistants, a staff he describes as caring and extremely competent.

“We’re really enthusiastic about this stuff, and I think that’s infectious,” he says. “Clients love to work with our staff, so we always have the people we need. That’s helped us build a reputation with some big companies and with NIH. We deliver.”

“But the best part is the science,” Weiss says. “Finding answers, and treating people with tomorrow’s drugs, today. We love it.”

Thousands of local patients have played a role

in the development of every heart-related drug

of the last 15 years, and will for at least the next 10.

podium

aine’s governor’s life story is nothing if not remarkable. The oldest of 18 kids, abused by an alcoholic father, a homeless runaway at age 11, Paul LePage would grow up to earn an MBA, steer companies, become a Republican mayor of one of Maine’s bluest cities, and, now, is Maine’s most conser-vative governor in 50 years.

You don’t plow through life like that by being indecisive. While Paul LePage is quick to acknowledge the role of caring and inspiring people along the way, colleagues on both sides of the aisle will tell you Maine’s governor is difficult to steer.

The way to reach him, insiders say, is through ideology and mathemat-ics. Paul LePage is a fiscal conservative, a Reagan-loving free-market cap-italist from head to toe. He believes in the creation of wealth, wants limit-ed government, and preaches tough love—not just because he thinks it’s the best way to encourage personal freedom and responsibility, but also because the math is much better. When people manage their own affairs and pull their own weight, it takes less money out of the government cof-fers. When they go beyond that to innovate and create profit, it generates more revenue. And Paul LePage has his eye on Maine’s piggy bank.

Talk to Maine’s CEO about how a new initiative will increase social justice, and you won’t get much traction. Talk about how it will save mon-ey or promote a more robust private sector, and you’ll get his attention. He’s made it clear: He’s out to exchange shortfalls with rainy day funds, debt with sustainability, low wages with better ones, and high state in-come taxes with none. Say what you will about PR faux pas or his frank demeanor, Governor LePage is doing exactly what candidate LePage said he’d do.

When Paul LePage was elected governor in November 2010, he won on the promise that he’d make government leaner and more friendly to business, and get Maine’s fiscal house in order.

Not everyone likes the changes, but no one can say that Governor LePage is not keeping his promises.

by tori britton & mark wellman • Portrait by irvin serrano

LePage Means

business

18 >> Maine Ahead november/December 2011


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In this rare full-length interview, Maine Ahead asked him about his first year in office and his plans for 2012.

After serving your first 10 months, what have you

learned about governing in Maine that you didn’t

anticipate before being sworn in?

Coming from the business world, I’m used to making decisions, sending the plan, and then moving forward. In government, you make plans, you select options, you make decisions, and you wait. (Laughs.) The wheels of government move much, much slower than I had anticipated. It takes a long time to get things done. My staff’s been very good at staying on things and pushing, but one thing we’ve learned is, you can’t push the legislature.

What do you consider your and the legislature’s

three top accomplishments during the first session?

Probably the largest one is, the attitude of state government is changing. I think in the short time we’ve been here, our red tape audits and our regulatory reform has probably been the single thing that has helped us jump forward to get the confidence of the business sector.

Then, I think, the tax reform bill was massive—the largest tax reform in the history of the state.

I take particular pride in that accomplishment. I was told during the campaign by my opponents I was lying to Maine people, that it couldn’t be done, and I was only talking about a $100 million tax cut. We’ve accomplished $400 million, and I think there’s room for more.

And finally health insurance: What makes me proud about LD 1333 is the Heritage Foundation is looking at it to see if parts of it may be good com-petitors to what is being promoted by the presi-dent, because we are basing it in the private sector. We are making it easier for our youth to get into the healthcare program and to get used to having health insurance and to help pay for the high cost of health insurance for our aging population.

Yet in some rural parts of the state, health

insurance costs are going to go up, correct?

Yes, but it’s not because they’re rural. There are several dynamics playing into it. One is, when the legislature passed LD 1333, they did not im-plement it all at once, they’re implementing it in three or four stages. Unfortunately, the first stage is the part of the bill that is affecting some of the smaller business carriers. They’re trying to say it’s all rural, but it really is the participants in the plan. If they are older or if they have had some high risk issues, until the entire plan is in with Ph

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: jim

bo

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The official portrait of Maine’s first family, taken

at the Blaine House.

november/December 2011 Maine Ahead >> 21

the coinsurance, they’re going to being paying higher rates. But that’s going to be mitigated next July in the next renewal, when the second part of the plan comes in. It’s unfortunate; I wish that it had been implemented in two steps instead of four.

Your first year included some controversial comments.

What are the pros and cons of being “plainspoken”?

Well, the pro is, there’s no doubt where I’m coming from. I leave nothing to the imagination. I don’t think I would do it any other way, because from the beginning of my life until now, it’s served me well. I think there are times I should think before I speak and maybe use different words, but for the most part I don’t think I’d change any-thing; I’d probably change the selection of my vocabulary, but I would still have the same message.

Is there anything you wish you’d said differently?

My comment about President Obama, when I was speak-ing to an angry bunch of fishermen—I should have been more levelheaded than that, been more careful about what I said, not recognizing that there were some trackers in the audience. That is the one time that I really got caught in the moment and it was not the right thing to say. It cer-tainly did not show the respect that the Office of the Presi-dent needed and deserves. By the same token, the under-lying message was, federal regulations are killing Maine business. That’s really what should have been said.

As governor, you’ve held open office hours for citizens on

the weekends. How’s that working?

Without a doubt, it’s the best part of being governor. Without a doubt. Strangely enough, when we started this, I thought that people would keep coming in and I’d be getting complaints every week and all week long we’d be trying to solve problems. It’s just the opposite. People are coming in with ideas; they’re coming in with suggestions on how to save money, how to change programs. This past Saturday, we were talking about lake trout in Moosehead Lake. We’re talking about ways to improve the road struc-ture and decrease accidents. Most of them are sugges-tions for improvements.

There is a major, major concern amongst Maine people about welfare; people are very interested in making sug-gestions on how we can curb welfare fraud. Now, that is an area that is very dear to me because there’s such limited resources and the welfare monies have got to be stretched, so we have no room for any fraud. I do be-

lieve we’re talking about a small number of people, but it probably has a big price tag to it.

Entitlement reform was something you campaigned on, of

creating a tiered system, but that hasn’t happened. Why?

We started to address that in the first session; that didn’t make it upstairs. But, yes, we’ve absolutely got to go back and have a tiered system. We have to have a program and a system that doesn’t take everything away once you’ve earned a dollar. You have to step them away. It’s like any-thing else; it’s like people who are alcoholics or drug ad-dicts—you’ve got to wean them away from the program.

Cold turkey doesn’t work. You stage it so that you keep a little bit more and you increase the standard of living. By increasing the standard of living, the incentive is to earn more, stay out there, get better jobs, improve your skills, instead of saying, “You earned $10, now you’re off welfare.” It’s just not working that way.

I don’t believe you can throw money at a problem with-out throwing education at it, so we have to convince our legislature that there’s plenty of money in the system; in fact, there’s too much money in the system. We have to convert some of that money to education so we can stretch the limited resources used to help those in need.

[Entitlement reform] didn’t have any legs in the first ses-sion, but I believe we’re going to make a lot more headway this time. We might even be able to introduce it in January. We’re certainly working on it. There are some challenges in DHHS that are both created and sent down from Wash-ington, and then there’s a culture that we need to change. It might be the second biennium before we have it fully implemented.

Can you share your other goals for 2012 in several key areas?

Please state what you see the main challenges, your plans

for improvement and how you measure success. Let’s start

with another big ticket item, education.

The education return on investment is all about reducing the number of dropouts and improving the number of kids that graduate. And eliminating, if at all possible, remedial

“There’s no doubt where I’m coming from.

I leave nothing to the imagination.

I don’t think I would do it any other way.”

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work. We may not be able to eliminate it in the next few years, but we certainly have to do better than one in five students going into the University of Maine and 54% of our kids going on to community college needing remedial work before they can start their college education. We need

to do a much better job in k–12 at promoting kids from one level to another once they reach a certain standard rather than when they’ve reached a certain birthday.

Why do you think our kids need so much remedial work?

Have we lowered our standards over time?

Here the federal government has a lot to atone for. No Child Left Behind says that every child has got to meet a standard by a certain date and that’s putting a time clock on how fast you’re going to learn. So what happens is, we teach to the test, we’re not teaching to a standard of knowledge. So the brightest and the gifted at the top, they get bored because we’re dumbing down our education sys-tem, and then we lose the kids at the bottom because they don’t have the time to get up to speed. So the top and the bottom, 20% let’s say, get dropped out and they teach to the middle. I think that is totally wrong. We need to teach to learning standards, to the kids’ ability to learn, and take whatever time it takes.

I think bringing in charter schools, bringing in what I call career academies, will give a broader scope of an educational curriculum so that kids have more opportunity. We have been going down a path of “all kids are going to go to college.” I think it’s unrealis-tic; I think it’s wrong. When I was going to school, you could either go the business track, the technical and vocational track, or the academic track. Now it’s all one and we’ve thrown out the others and we’ve got to bring them back. It’s critical. And, of course, if we’re look-ing towards new jobs in the 21st century, we’re talking about science, technology, engineering, mathematics, the STEM education. We’re going to be pushing in that direction.

The other thing that is going to be really important is making sure that our teachers have the opportunity to continue their education and their self-development and their professional skills so that we can get a better teach-er in the classroom. A better teacher in the classroom is the key to education, and it’s also a key to making sure we pay them well. So the third part of that is, they get bet-ter at their skills and I’m going to find a way to pay them more money.

How about tax policy. What are your challenges, plans,

and measurement of success?

Ultimately, I’d like to see the income tax go away. But there’s no possible way you can walk up and just take it away. So we’re going to have to stage it.

We’ve made some impact in the first session, very small. This time around, I think it’s very important that if we’re go-ing to grow Maine, both from a population base and a pros-

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>> The LePage File

Born:

october 9, 1948, lewiston, maine

Education:

lewiston high school, 1967; husson Univer-

sity, bs in business administration, 1971;

mba, University of maine, orono, 1975.

Career Highlights:

General manager, arthurette lumber

Company, new brunswick , Canada,

1971–77; finance director, maine state

housing authority, augusta, 1977–79;

controller, scott Paper Company, winslow,

1979–1983; director of financial administra-

tion, interstate Food Processing Corp., Fort

Fairfield, 1983–84; chief financial officer,

Forster manufacturing Company, wilson,

1984–85; president, lePage and kasevich

inc., 1983–1998; general manager, marden’s

surplus and salvage, 1996–2010; water-

ville City Council, 1998–2002; mayor of

waterville, 2004–2011; governor of maine,

2011–present.

Affiliations:

maine Forest Products Council, maine state

Chamber of Commerce, midmaine Chamber

of Commerce, toastmasters, elks lodge,

rotary international, and others.

Personal:

Governor lePage lives in the blaine house

in augusta with First lady ann lePage. he

has three daughters, lauren, lindsay, and

lisa; one son, Paul ii; and one adopted son,

Devon raymond. he also has a jack russell

terrier mix named baxter. he enjoys furni-

ture making, softball, raquetball, ice hockey,

and reading biographies of historic leaders.

“There’s nothing I’d like to see more

than a growing economy where

income tax wasn’t necessary.”


perity base, that we need to look at those who are on pensions.

The military people who retire after 20 years who still have a good 25 to 30 years to offer the workforce, I’d like to keep them in Maine, use their knowledge, their expe-rience, use that skill set to help grow the economy in Maine.

Those who leave for six months and a day to protect their nest egg from the tax man, we want to try to keep them in Maine as well. We need to attract capital for the job creators and the innovators. Who best then to go to than your family? So if our retired folk who have a nest egg stay in Maine, we have a better chance of interesting some of them in helping capitalize our growth.

Businesses sometimes say they have high

taxes to deal with in Maine, and it’s a

disadvantage to attracting new business

here. Are you addressing this?

I think we addressed a big part of that, both for the large companies and smaller companies, in the first session. Section 179, which we mirrored to the federal government, allows you to write off up to $500,000 of new investment every year. For a small business, I think that is a mas-sive benefit and a massive change in our tax policy.

For the larger businesses, we’ve allowed them to accelerate their depreciation and carry forward credits up to 20 years, so if they have any losses or any major invest-ment, they can write them off much faster. That allows whatever they’d be paying in taxes to stay as cash flow in the business.

Is there more to be done? As I said, there’s nothing I’d like to see more than a growing economy where income tax wasn’t necessary. And the only way you do that is by better jobs.

How about lowering energy costs? What

are the plans and challenges?

Energy is our single largest problem in-hibiting economic growth. Without a

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doubt it is the number one issue. We are currently paying 42% above the national average for energy. We have the 12th-highest energy costs in the nation.

There’s been a big move on renewable energies in recent years, and I don’t think there’s anything wrong with that, if you use it and you learn from it, as research and development projects, to refine the technologies so they can be brought to commercial realization and an affordable rate. Right now, wind, for instance, is highly subsidized; even with the subsidy, it’s still a high-cost energy. It’s not commercially viable. Solar’s the same way. As we’ve seen with a massive bankruptcy recently, Solyndra, that was caused by China getting into the deal and undercutting the panels, and now the cost of mak-ing them is $6 and they’re selling for $2. You just can’t do that and stay afloat. So we need to make sure that we have a long-term and a medium-term solution.

Medium-term, we need to take a large look at natural gas. In 2000, natural gas was selling at $5 per million BTU, as was oil. Now, in 2011, natural gas is selling for $5 and oil is $15. There have been more discoveries and technological

advances in natural gas. And there’s an abundance. There are two major pipelines in Maine; there’s an abundance in Canada; there’s been an abundance that’s been discovered in this country. I believe that 89% of natural gas that is being consumed in this country is from this country, and 11% is from Canada, and we have some LNG that comes from overseas.

So it’s a fuel that is here. We do not have to spend on foreign oil; we can spend it with a resource we have, and it’s a cleaner-burning fuel. We need to take advantage of that in the midterm, the next 10 to 15 years. Those are what are going to save us in the next one to two decades while all these other technologies are being refined and we find longer-term solutions. So I believe that for our en-ergy needs going forward, we need to concentrate on gas plants rather than large windmills and offshore wind and all the technologies that haven’t proven to be commercial-ly viable at the present.

Is there any chance that we will be getting cheaper

hydroelectric energy from Quebec?

I would say that there’s a chance, yes. We’re going to be meeting later this month with the province of Quebec and speaking to them about hydro energy. There’s op-portunity of maybe Maine being a transporter of energy to southern New England. But we’re also going to speak with New Brunswick and Nova Scotia, and look at work that’s being done in Newfoundland. So I would say that, yeah, there’s a real good chance that over time we will have large amounts of hydroelectricity, but I’m not ready to say that it’s all going to be Quebec, because I think we want to take a look at everyone, what they have to offer, maybe use a little leverage if we can.

We are also working with Emera and CMP. We’re look-ing at a whole mix. We are looking at what has happened to our energy since we deregulated. There are some star-tling revelations. Back when electricity was regulated, the generation portion of our usage was 35% of our bill. Af-ter deregulation, it’s jumped to 50%. So there’s a lot to be looked at on that end. They’ve been very willing to sit down and discuss ways we can drive the cost of energy down.

What are the key challenges, opportunities, and goals you

have for lowering healthcare costs?

One challenge is that we’re still faced with the Afford-able Healthcare Act. There are going to be many, many challenges there because Medicaid is going to be losing some monies at the federal level. The opportunity we’ve

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F Pa

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lePa

Ge

Paul LePage, in his mid-30s.

“We need to get rid of these two Maines.

And the quickest way to do that

is to bring prosperity . . . up to

some of the northern counties.”


had is, by passing LD 1333, we are still focused on a private-sector-controlled in-dustry and so our exchanges are going to be shaped to promote competition.

The biggest advantage we have in health care now is we’ve made it so younger peo-ple can afford health care at a younger age, so they don’t wait till they’re 40 or 50 to en-ter the healthcare system so there are more people and more money in the system.

I think the work we’re doing at the hos-pitals in approaching managed care for the less fortunate is going to bring the cost down. We’re adopting a lot of what we did in workers’ comp back in the ’90s. Some companies already have seen drops in premiums, but the real drops are go-ing to come when the whole program is in place in 2014. The challenge is going to be whether or not the federal government comes in and overrules us.

What is your transportation game plan?

That’s a major, major challenge and, to be frank, we don’t have all the answers right now. We do know that we are highly dependent on road transportation. We’re working with the federal government and the delegation to bring back the 100,000 pound limit, to make that permanent. It’s absolutely imperative. We need to get these trucks off secondary roads for safety, and for more efficiency and fuel savings. Also, it’s easier to maintain the interstate system than the 8,000 miles of secondary roads we have throughout the state. That’s one major thing we need to do.

We are looking very hard at the east/west highway right now, to try to make a combination with some ports, and work-ing with the provinces to try to open up and build in the northern part of the state. We need to get rid of these two Maines. And the quickest way to do that is to bring prosperity—the same prosperity we see in the two major southern counties—up to some of the northern counties. With a better transportation infrastructure, both

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rail and roadway, we can enhance our agricultural and our forest products industries up north.

It’s pretty unnerving to go from a balanced budget to a

billion dollar shortfall. What are your plans to maintain

more state budget stability?

That’s a moving target. I believe we have a really good solid plan of fiscal responsibility and some austerity going for-

ward at all areas of government on the state level. We need to prioritize the services that are needed, and we need to fund them properly. Frankly, a lot of the instability comes from the federal government. We know some massive cuts are coming and we’re going to have to deal with them.

The issue is going to become, do you do more with less or do you raise taxes? And you can’t build a strong economy if you tax yourself. You won’t tax yourself to prosperity. It’s never been done. So we have to learn to do more with less.

One thing I can say about the nine months we’ve been here: In January, there was no money in the Rainy Day Fund, and in nine months we have up to over $71 mil-lion. So if you pay attention to what you’re doing, you can make some adjustments and corrections.

Some members of Maine Ahead’s LinkedIn group were

upset at your decision not to attend the Brazil-Chile trade

mission in November. Doesn’t it send the wrong message?

I don’t think so; I hope not. We’ve looked at it long and hard and, frankly, I think it was premature, from the standpoint that I need to have my plan of energy improvements on ground before I can go to Brazil and do a trade mission and attract them to come here or sell products there. I think we’ve got to do the infrastructure work first.

The other side of the coin is, here we are trying to fill a billion dollar shortfall in the budget and the governor’s traveling to Brazil. So you have to weigh both sides of it. I just thought this year we should concentrate on solving the problems at home, our infrastructure, and then maybe reaching out. We’ve already reached out to companies in Japan, South Korea, to European companies, and uni-

versally, they come back and say, “It’s too expensive to do business in Maine. You’ve got to lower your costs.”

So is it safe to say your goals for 2012 are basically to

continue to “get our ducks in order?”

The big goals of 2012, we’ve spoken about it, are education, energy, and the economy. Education because we need to lower the dropout rate and better prepare our workforce for the future. Energy: Without it we can’t build the state. Right now, it is too costly to run sawmills, paper mills, processing plants. We have an abundance of marine and forest resources that we’re shipping to Canada to be pro-cessed because they have cheaper energy.

So energy is the number one issue going into January, and close behind it is education. With those two fixed, it gives us a fighting chance to really attract new capital to Maine, because if you get a prepared workforce and you have cheap energy, then it’s a lot easier to attract people who want to build in Maine because we have such a beauti-ful state. Sometimes I think we’re the best kept secret. Our motto is “Vacationland” and I agree with that. It’s a beauti-ful state, a great place to vacation. But we should probably adjust that a little bit, and say a state where you live, work, and play—so that even the people who live here can enjoy the vacations here. That’s an area that we need to be push-ing. It’s quality of life. It’s having a ready and well-trained workforce. It’s bringing our infrastructural problems like energy under control—then, get somebody with a little briefcase going around saying, “Come to Maine.”

Any last words for the business leaders reading this?

I will say this: I believe in a very, very prosperous and strong economy for the state of Maine and I will put every ounce of my energy towards that. If the business commu-nity wants to grow enterprise and attract capital, then I need their help with my legislature. They need to call their legislators and their senators and tell them they have to prioritize the economy of Maine. If we make it a priority, it will happen. But if we have gridlock and we’re fighting among ourselves, then it won’t happen. So the only way this will happen is if the business community, the doctors, the lawyers, the manufacturers, the accountants, the ser-vice organizations, call their legislators and say, “Let’s get the economy moving.” Then we will get it moving.

I am the governor. I have a very strong bully pulpit, but I also have 180 people that we have to convince to go along on this path, this agenda of building the economy. It will only happen with the voice of the Maine people.

“You won’t tax yourself to prosperity.

It’s never been done. So we have

to learn to do more with less.”

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At the Hannaford Center for Safety, Innovation and Simulation at Maine Medical Center high-tech mannequins, convincing actors, and committed instructors work together to prepare

resident physicians for the real world. by Henry Garfield

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november/december 2011 Maine Ahead >> 29

30 >> Maine Ahead november/december 2011

than has a lump on his leg. He’s 5 years old, and his mother has brought him to

the emergency room because the lump has swollen and turned red and is causing the child considerable pain. Now he’s in a hos-

pital bed with his mother’s calming hand on his forehead, as two young physicians

talk to him and look at his leg.“Ow, ow, it hurts,” the youngster cries, as one of

the doctors examines the inflamed area.The doctors decide to sedate Ethan with an in-

travenous ketamine solution and to also give him a local anesthetic before they drain the abscess. An oxygen mask hangs near Ethan’s head. One of the physicians lances the lump and releases the pus beneath the skin. The procedure is going smoothly until Ethan begins to gasp and wheeze.

“What’s happening? What’s going on?” the mother wants to know, her voice pinched with anxiety.

One of the doctors offers a quick explanation that Ethan seems to be experiencing spasms of the vocal cords, a rare side effect of ketamine. But their attention is primarily on their patient. They need to clear his airway so that he can breathe un-til the spasms subside. Ethan stabilizes for a mo-ment, then goes into a set of renewed spasms. The doctors give him more oxygen. After several tense minutes, Ethan’s breathing returns to normal and he slowly returns to full consciousness. His relieved mother is at his side. “It’s all over, sweet-

heart,” she says.“You did great, Ethan,” says one of the doctors.His partner nods as a voice comes over an un-

seen intercom: “This ends your simulation.”The doctors aren’t practicing physicians—

not yet, anyway. Ethan’s mother is Susie Lane, an aesthesia technician and simulation specialist at the Hannaford Center for Safety, Innovation and Simulation at Maine Medical Center in Portland, where the faux procedure has just taken place. And Ethan isn’t human at all. He’s a mannequin. His voice, bodily functions, and vital signs are controlled from an adjacent room behind one-way glass. The pus that came out of the abscess on Ethan’s leg was made from a mixture of yogurt and honey.

In a classroom across the hall, some two dozen students and their instructor have just watched the procedure live on a pair of flat-screen televi-sions. They, like the two young physicians, are residents at the Maine Medical Center-Tufts Uni-versity School of Medicine (MMC-TUSM), and such simulations are an integral part of their cur-riculum. After each one, the class will participate in a debriefing session to discuss what went right, what went wrong, and why.

“The debriefing rooms are the heart and soul of the place,” says the center’s director, Dr. John “Randy” Darby. “We often spend two to three times as long debriefing an event as we do running the event.”

private tour

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“We spend a lot of time talking about how to

take 21st-century technology and inject it into the

traditional doctor-patient relationship.” —Randy Darby, MD“Mom” Susie Lane and emergency medicine resident Erik Angles, MD, discuss the upcoming procedure with 5-year-old “Ethan.”


private tour private tour

Job Descriptions

sim center director John “Randy” Darby,

MD (top) became interested in the power

of simulation as a physician in the air

force. darby oversees all aspects of the

medical simulation facility, which is

housed on a 18,000-foot complex on MMc’s

brighton campus in Portland.

Virginia Eddy, MD (center), director of

undergraduate surgical education at

Maine Medical center and professor of

surgery at tufts university school of Medi-

cine, teaches using the sim center’s laparo-

scopic box trainers, which help residents

practice with the instruments and proce-

dures involved in laparoscopic surgery.

Jeff Holmes, MD (bottom) is director of

simulation education and attending physi-

cian at Maine Medical center’s department

of emergency medicine. Here he coordi-

nates communication and clinical findings

from the control room during an emer-

gency room simulation.

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MMC-TUSM students start doing simulations their first month as a resident, something Matt Delaney, a re-cent graduate, found invaluable. “Being a doctor is a new sensation. You get to make all the mistakes here,” he says. “It takes a lot of the anxiety out of seeing real patients. It’s a great safety net.”

Maine Medical Center’s simulation center opened in October 2010 at the Brighton Avenue campus in Portland. It takes up one entire floor of the building. The center con-tains fully-equipped operating rooms, emergency room suites, patient rooms, as well as a number of classrooms and conference rooms, plus control rooms, a skills lab, of-fices, and storage spaces. Amazingly, it’s run by a full-time staff of just 10 people.

You’ll see a lot more people than that on any given day, however, because the sim center is busy. The primary mis-sion is to train future physicians attending MMC-TUSM, but it’s also used by a variety of Maine Medical Center clinical and surgical teams. Inquiries are already pouring in from hospitals and medical organizations throughout the state asking about future training opportunities.

The simulation center is on the third floor of what was once an osteopathic hospital, and still looks and functions very much like a hospital. There’s even an elaborate record-

keeping system for virtual patients, though safeguards are in place to ensure that virtual records never get mixed up with real ones.

Darby describes the center as part of a “second wave” of simulation centers, built in the past decade, that ben-efit from the pioneering centers that opened at large uni-versity hospitals in the 1990s. He and a committee from MMC spent three years looking at simulation centers all over the country during the planning process. The center’s startup cost was $5.82 million, made possible in part by a $500,000 grant from the Hannaford Charitable Foun-dation. It’s an in-house operation; Maine Medical Center does not rely on government or fundraising to cover the cost of running the center.

“Maine Medical Center built the entire thing,” Darby says. “We have a very strong interest in doing medical re-

“You get to make all the mistakes here.

It takes a lot of the anxiety out of seeing

real patients. It’s a great safety net.”

—Matt Delaney

Learners are practicing a procedure called intubation, which is supporting a patient with a breathing tube when they are in respiratory distress.


Harvey tHe Heart Mannequin doesn’t have any

legs. but that’s okay, because he doesn’t need to

get up and go anywhere. His job—at a cost of over

$100,000—is to lie on the table and mimic various

heart conditions in humans.

Harvey was built at the university of Miami, and

now spends his days at the Hannaford center for

safety, innovation and simulation at Maine Medical

center. He’s hooked up to an elaborate speaker

system and a control board, which instructors can

use to impart valuable lessons regarding the care of

cardiac patients.

The mannequin has sensors that can detect

where a student places a stethoscope and respond

accordingly. “you have to have the stethoscope in

the right place for it to transmit the correct sound,”

says dr. randy darby, director of the simulation

center. “an instructor can come in here and cover up

the control panel and ask a student to do an exam.

the mannequin senses where the bell of the stetho-

scope is and responds accordingly.”

Harvey is one of 12 sophisticated mannequins,

or “patient simulators,” in service at the simulation

center. two adult mannequins used in operating

room simulations can actually “breathe,” meaning

they take in oxygen and exhale carbon dioxide. a

mannequin named Hal (no relation to Harvey) comes

equipped with a synthetic lung.

“We can intubate Hal, and his lung functions can

be programmed to behave like he’s had trauma to

the lung, or he has pneumonia, or he has asthma,”

darby says. “we can use Hal not only to train

or ventilation issues, but we can put Hal over in the

icu room and have a respiratory therapist learn how

to use the ventilators to respond to certain under-

lying lung conditions.”

Perhaps the most complicated mannequins

are the two pregnant ones, the birthing simulators,

which can be programmed to represent a mother in

various stages of pregnancy and can simulate the

birth of a baby. the center also has mannequins that

stand in for newborns and premature infants, as well

as the pediatric mannequin featured at the begin-

ning of this story.

A fully computerized patient simulator can cost

as much as $300,000. but there’s also a low-tech

element to some of the training. the center employs

a number of sand-filled dummies that cost less than

$12,000 but weigh 250 pounds. darby points out that

nurses and other hospital personnel need practice in

getting inert patients from bed to gurney and back

again without injuring themselves in the process.

“Most patients who faint in the hospital collapse in

the bathroom,” he says. “you have someone who’s

curled up around a toilet on the floor, what do you

do? we’ll stick a mannequin behind the toilet and let

them practice. it’s a simple educational tool that’s

very effective.”

private tour

Extremely Patient

Patients The medical

mannequins at Maine Med’s

Sim Center “live” to help students hone their skills.

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search. We are looking at grants and fund-ing, but we don’t have any commercial re-lationships or government relationships that pay for our operational costs. The faculty time is taken care of by the depart-ments, but the support and equipment is provided by us, so they can run their courses here with no concerns about the transfer of money. It’s been a very trans-parent process and it makes the place work.”

Darby still works as an anesthesiologist at Spectrum Medical Group in addition to running the center. He first became inter-ested in medical simulation while serving in the U.S. Air Force. “There’s the well-worn comparison between administering anesthesia and flying,” he says. “People talk about hours and hours of boredom broken by seconds and minutes of sheer terror. When things go well it’s great, but when something goes wrong it tends to be really catastrophic.”

Susie Lane spent 20 years as a cardio-vascular technician, often working beside Darby on critical cases. “In my prior job, I was his right-hand person during very critical open-heart surgery, during the placement of all the lines that go into a patient. I would monitor those lines while the patient was on the heart-lung bypass machine. Now I get to set up a lot of the same equipment, but I set it up to run on the mannequin. Props are important in creating the environment as realistically as possible.”

The “suspension of disbelief” is as im-portant in medical simulation as it is in literature. To make the scenarios as real as possible, simulation specialists craft and rehearse what Darby characterizes as “intricate one-act plays.” These scripts become the blueprint for each teaching situation. In the control room, one special-ist controls the mannequin while another manipulates the readouts on the instru-ments hooked up to the plastic patient. Any actors in the room have an audio feed

so that controllers can whisper instruc-tions in their ears during the scenario.

And while some of the easier roles can be played by simulation center personnel, there’s also quite a bit of work for real ac-tors looking to broaden the range of their skills or to help train the next generation of Maine physicians. “We actually have a cadre of 70 or 80 trained actors and ac-tresses, and a full team to train them to play patient roles,” Darby says. “These

actor/patients interface with medical stu-dents, nurses, and residents for interper-sonal skills, delivering bad news skills, diagnostic issues, and how you go through things like informed consent. A lot of the actors we have are very experienced, and some of them are excellent at the end of the encounter at giving real-time feedback to the medical students and the residents.”

Dr. Jeffrey Holmes is in charge of writ-ing the scripts for some ED-related sce-


narios. (He also provided Ethan’s voice during the simulation.) Scripting a 15-minute procedure can take up to four hours. “We look at our monthly theme, whether it’s a cardiovascular or respira-tory month, and we try to figure out what some of the core topics would be, and some rare instances or complications that might happen,” he says. In each script, it’s important to limit the number of teaching points, so that students in the debrief-ing can focus on a particular response to a par-ticular situation.

“We give them a little bit of a heads-up about what topics might be covered,” Holmes says. “And then there’s no better motivation than being in front of all your peers in a scenario to study for that. They’ll read up on potential topics, do the sce-nario, and then right after that we’ll debrief it and go over those topics again. That repetitiveness and redundancy is really what makes it stick.”

It follows that a theater needs a prop room, and the center’s planners didn’t skimp on the back-stage area, a large room where mannequins are readied and repaired. “We learned in the plan-ning process that most sim centers underplan for storage space,” Darby says. “We always had a desire to use more of the space for clinical work. But we had to have places to repair and work on stuff and store it. It was one of the subtle, simple details that went into the planning that made a big difference.”

The room is used not only to store and service mannequins and medical equipment, but also to mix up messy concoctions used in the simu-lations. “My team is excellent at making vomit, blood, stool, diarrhea—you name it, they’re pretty good,” Darby says, standing in front of two large sinks and a closet full of condiments and chemi-cals. “They actually have odor kits that can make

Faculty listen to and monitor learner interactions

from the standarized patients control room.

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the oatmeal stuff smell like alcohol-laced vomit. They can make some foul-smelling colonic discharges, and all kinds of nasty human bile fluids, stuff that only adds to the realism of cases.”

In the skills center, which looks like a college science classroom, students can practice intubation on low-tech synthetic heads and throats; on the flip side, they can learn how to use a colonoscope. Again, repetition builds muscle memory, which prepares a nurse or doctor for doing the same procedure on a real patient.

Inside the simulation center’s ceilings and walls, approximately 24 miles of wir-ing keep all this technology humming. The center has 75 video cameras and 22 large television monitors. Anyone authorized to use the sim center’s computer system can access videos of the simulations—a boon to learning, but also a potential risk to privacy and security. For that reason, cell phones are not allowed.

“We can digitize every encounter, and we can look at it in real time, and we can digitize it for every provider in the hospi-tal who has password access rights to our database,” Darby says. “That info is tightly controlled. Most of it auto-destructs after 30 days. What happens here stays here. This is a sensitive training area and we take our mission very seriously.”

“There’s a large demand for this type of training,” he continues. “The public’s become much more aware that we need to take novice students and residents and get their skill level up to a much higher level of proficiency before we’re cutting them loose to go to the hospital and do things to you and me and everybody else. When I was a surgical resident years ago, they worked you 36 hours on and 12 off for weeks and weeks. You were working 110 hours a week. We’re not allowed to do that anymore, which is good. We can conduct simulated medical encounters and simu-lated medical events without real patients. There’s no risk of harm, and residents are

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private tour


Year founded: 2010

Employees: 11

Creation details: created by Maine Medical

center as a training center for students in

the Maine Medical center-tufts university

school of Medicine medical school program,

and to support ongoing training for MMc

staff. financed by Maine Medical center,

with a $500,000 gift from Hannaford.

Hannaford Center for Safety,

Innovation and Simulation Portland, Maine

at a higher proficiency level when they do start out.”

And the realities of modern medicine in the United States dictate that doctors must often work in a limited time window, or on an outpatient basis, with patients who would previously have stayed in the hospital for days at a time.

“We don’t have patients in the hospital as long as we used to,” Darby says. “We’re lucky if patients stay in the hospital for 23 hours. So, as you can imagine, there’s not as much teaching material around for residents to get their hands on.

“Simulated systems aren’t ever going to replace seeing patients in the hospi-tal, but what we can do is get their level of training quite a bit further down the road using these systems and not have to rely on time and chance. Part of the reason residents used to spend so much time in the hospital is that you had to be around the hospital enough times to see enough stuff to be trained. We now try to do that synthetically.”

The big question is: Does it truly work? Does the training residents receive at the simulation center translate into real re-sults in real hospitals? The sim technol-ogy and practices are new and the results

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data curve is correspondingly short. “I caution people about the science,” Dar-by says. “There’s no absolute proof that someone who performs well in a simu-lated environment will perform well in a clinical environment. I think it’s here to stay, though. I think you’re going to see more and more technology-based learn-ing, in part because of the time pressures on the learning system.”

Young doctors like Delaney, who now works in the emergency room at Port-land’s Mercy Hospital, say the simula-tion center training is tremendously beneficial. “Almost everything that can go wrong I’ve seen go wrong,” he says. “When you see it for the first time in real life it’s nice, because you have that muscle memory and some idea of what you’re do-ing. You do it five or ten times in here, so when you treat a real person, it’s the same sort of thing: You plug your oxygen in, set the patient up the right way. It’s like tun-ing your guitar; it’s nice to have that stuff be automatic.”

The training is not all technical, how-ever. “There’s a real risk of doctors be-coming technicians rather than doctors,” Darby explains. “We spend a lot of time talking about how to take 21st-century

technology and inject it into the tradi-tional doctor-patient relationship. Some-times patients don’t like it when doctors are typing away on a computer and not looking at them. Medical schools in the past did not always select for people with good interpersonal skills. This becomes particularly important in rural areas where a doctor has a very intense rela-tionship with the community.”

The center’s goal is to make simulated

training available to medical profession-als throughout the state and in all depart-ments of the hospital. Plans include pro-viding remote electronic access to medical practitioners in rural areas.

“None of this would happen without the production staff, IT, engineers,” Darby says. “We were very lucky in terms of who we were able to convince to come join us and make the thing fly. It’s a great team effort.”

Startup cost: $5.8 million

Annual operating budget: approximately

$500,0000.

Positions: software engineers, production staff,

information technologies specialists.

Future challenges: expanding training oppor-

tunities to include eMt/paramedic training, part-

nerships with nursing schools, travel training

programs for rural healthcare providers.

To learn more: http://simulation.mmc.org


Roundtable


all them trustees, call them board members, just don’t call them backseat drivers. A nonprofit board of directors is charged with something much more important than second-guessing the staff or picking apart the new website. Their job is to create a nonprofit organization’s roadmap; to ensure

that it stays on course in fulfilling its mission; and, last but not least, to see to it that there’s enough fuel in the tank to keep up the good work.

The Internal Revenue Service requires 501 (c)(3)s to have a board of di-rectors to make sure the nonprofit is deserving of tax-exempt status. This requires thoughtful reviews of annual budgets . . . helping the organiza-tion create and maintain a sustainable income . . . hiring and supervising its chief executive . . . and, in most cases, pitching in with fundraising, both by soliciting donations and reaching into one’s own pocket.

Being an effective, responsible board member is not easy, and it’s not meant to be. But the four panelists in this month’s Roundtable will tell you that it is important, impactful, and rewarding.

Kenneth Spirer got charmed into board service by an enthusiastic friend; Cheryl Rust stepped up to fill a community need; Tom Lizotte helped create the organization he first served on; Sandra Featherman started with The League of Women Voters. All four have gone on to be instruments of positive change for many more nonprofit organizations. And all four have been changed by their service.

This Roundtable discussion was set up with two goals. One is to give leaders of nonprofits some honest feedback from four of philanthrophy’s loyal soldiers. They give some good tips, so you may want to take notes.

The other is to persuade business leaders who are hesitant to become involved in nonprofit service to dust off their copy of Robert’s Rules of Order and give it a go. To decide if you’re so moved, read on.

Leadership

ON BOARDNonprofit board service is not for wimps.

Nor is it for those who lack patience, generosity, or the ability to listen. Still in the running?

Kenneth Spirer, Cheryl Rust, Tom Lizotte, and Sandra Featherman will tell you what good

board service means and why it matters. by TORI bRITTON • IllusTRaTIONs by M. scOTT RIckeTTs

Roundtable


Roundtable

hat was the first nonprofit board you ever served on, and how did that come about?

Kenneth Spirer: My first nonprofit board was the LARK Society for Chamber Music,

the support group for the Portland String Quartet. My involvement was totally un-

planned. We were moving to Maine in 1995, and Judy Halpert, the co-owner of The Movies on Exchange in Portland, called me in New York and said, “You’re on the LARK board!” I had no idea what it was and hadn’t volunteered at any nonprofit organization since political activity in NYC during my law school days in the mid-1960s. She was a founding LARK board member and as-sured me that it would be fun, and based on that, I accepted.

She was absolutely correct, and during the 10 years I served on that board, including two years as president, I learned a great deal about serving on a nonprofit board.

Sandra Featherman: My first board was The League of Women Voters. As a young mother, I found that I needed intellectual stimulation. Coupling that with my interest in public affairs, I began going to League meetings, and got very active, over the next few years. I also got involved in the parent-

teacher organization at my children’s school, and soon found myself president of the citywide or-ganization, serving the parents of 300,000 chil-dren, in Philadelphia.

Cheryl Rust: I believe the first nonprofit board was Shoreline—a community mental health organiza-tion based in Brunswick. I was recruited by anoth-er Wiscasset community member who was retir-ing from the board and was seeking to maintain inclusive geographical representation and knew of my interest in community services.

Tom Lizotte: My first was the Piscataquis County Economic Development Council board. I was one of the founders of the council, and the need for people to work on economic development in our rural region was just so obvious that I had to step up and make a commitment.

You have since served countless hours as a board member. Why? What makes you keep saying yes?

Sandra Featherman: I care deeply about the qual-ity of life in my communities, at the local, state, and national level. While I have served on a great number of boards over the years, most have in-

Eric UhlFisher and Phillips

Partner

eric uhl recently spoke at

the annual Maine Human

Resources convention.

Kenneth SpirerCommissioner

Maine Commission

On Indigent Legal Services

spirer retired as assistant

general counsel of Merrill lynch

in 2001, and has since served on

several Maine nonprofit boards.

Tom LizotteDirector of Marketing and

Development

Mayo Regional Hospital

lizotte chairs the Maine

Humanities council and

Penquis boards, and serves on

Foxcroft academy’s, and others.

Cheryl RustOwner

Le Garage Restaurant

Rust is chair of the Maine

Health access Foundation. she

was given the 2009 community

builder award by the united

Way of Mid coast Maine.

P e R s O N a l F I N a N c e P a N e l I s T s

Sandra FeathermanPresident Emeritus

University of New England

Dr. Featherman was president of

uNe from 1995 to 2006. Her board

service includes the samuel Fels

Fund, Girl scouts of Maine, and

Maine community Foundation.


volved education (both k–12 and higher education), women and girls, and philan-thropy. I have occasionally served on arts, music, and environmental boards, but, in recent years, have only given my efforts to organizations in which I can contribute to policy decisions.

Tom Lizotte: I’m an easy touch—it’s a char-acter flaw. Seriously, someone has to serve, I’m at the point in my life where I can serve, and I have a desire to give back to my community and the institutions that have made a difference in my life. Service is a rewarding experience.

Kenneth Spirer: Frankly, I don’t “keep say-ing yes.” Because the need for volunteer assistance is so great for many nonprofits, opportunities to serve frequently arise. I try to be selective and attempt to balance my current board and other responsibili-ties; the strength and character of the or-ganization; its leadership at the staff and board level; and my desire to not overcom-mit my time and energies.

I have found my involvement in the nonprofit community as a board volun-teer to be personally extremely reward-ing. The organizations with which I have been affiliated all have a focus that is ap-pealing to me and strive to make this city and state a better place for its residents. Selfishly, I think that I learn more than I give, and as I transitioned into retire-ment, that learning experience has been a strong motivating factor for my contin-ued activity.

Cheryl Rust: Inevitably, board service pro-vides you with the opportunity to have an impact on various aspects of quality of life in your community. My particular interests have always drawn me to the work of human service agencies and orga-nizations—perhaps partially as the result of my restaurant work—exposing me to such a broad range of needs, through my engagement with both employees and guests. The opportunity to support the missions and the professionals who make a career commitment to improve the lives of our families and neighbors is both in-spiring and compelling.

In what ways have you become a better board member over the years? How did that come about?

Sandra Featherman: I have learned to be a better listener, and I still work at this. Also, I realized early how important it was to be able to read financial reports, and took some additional university training one summer to hone those skills.

Tom Lizotte: Exposure to a variety of man-agement styles, in different board envi-ronments, is a growth experience and that increases your confidence level. As you gain that experience and confidence, you become less bashful about speaking up to offer thoughtful, concrete suggestions.

Kenneth Spirer: I have become less impa-tient when seeking change that I believe

would be helpful to the organization. I believe that I work well in a collaborative environment and try to foster that in the organizations where I serve. When I have been in a leadership role, such as the board chair of the Maine Community Founda-tion, I have tried to suppress my natural inclination to give my opinion early in the deliberative process, choosing instead to let other board and staff members articu-late their views first. This enables me to see if there is some common ground upon which we can build.

Also, I decided to enroll as a matricu-lated student at USM’s Muskie School of Public Service in its master’s program in public policy and management. I found the experience of thinking about public policy and the role of nonprofits in an academic environment very rewarding and some of the readings and assignments allowed me to focus on subjects I had never considered in law school or business school many years ago.

What qualities do you believe are most critical to be an effective board member? Are there any attitudes or behaviors you’ve observed on nonprofit boards that are unhelpful?

Tom Lizotte: An effective board member really needs to believe in the organiza-tion’s mission, be willing to devote time to the cause, and understand that personal philanthropy in support of the organiza-tion is an obligation. The most unhelpful

“I realized early how important it was to be able

to read financial reports, and took some additional

university training one summer to hone those skills.”

—Sandra Featherman

Roundtable


Roundtable

trait I’ve seen is board members who don’t understand their role and try to take on management tasks. And I’ve never understood why someone would join a board, and then fail to make a financial donation. It happens, but it shouldn’t.

Cheryl Rust: Integrity of purpose and practice immediately emerge as the critical value to be embraced by each board member. Beyond integrity as the foundational quality, I would suggest a commitment to learn and listen, to be present and participate.

As to attitudes or behaviors that are particularly un-helpful, I would suggest the following: an unwillingness or inability to distinguish board and administrative roles; being unprepared for meetings; being closed to learning; and bringing an overly narrow “private agenda” to the table at the expense of a more broadly embraced or in-formed mission.

Kenneth Spirer: An effective board member should be a good listener, an active participant in board and commit-tee meetings, and an advocate for the organization. He or she does not necessarily have to be actively engaged in fundraising, but it should be clear to those members of the community who come in contact with the board member that there is a commitment to, and belief in, the mission of the nonprofit organization.

I have occasionally observed board members who merely “show up” at board meetings without partici-pating, or worse, who miss more than one or two meet-ings. This sends a negative message to those members who are giving their time to the organization and forces others to take on responsibilities that could ideally be shared equitably.

Sandra Featherman: Effective board members need to care deeply about the services and commitments of the boards on which they serve. There is no substitute for

passion about the mission of the organization. Board members need to be well informed about the issues fac-ing the organization, and attend all or almost all of the meetings. Members who cannot give the requisite time should resign, unless there are very special other ways in which they contribute to the organization. This does not include financial support, because board members should contribute appropriately to their organizations, where such support is sought. But board positions should not be for sale in good organizations.

In your experience, how important is it to have different professions represented on any given board? Are there certain professions that are particularly helpful?

Tom Lizotte: A diversity of professional skills is criti-cally important, and as an added benefit that provides a valuable variety of perspectives. Professions that are especially helpful include accounting, law, HR, public relations, education, management, and politics, but this really depends on the nature of the organization. At the Maine Humanities Council, where I am board chair, we also seek directors who are scholars in history, literature, philosophy, and culture. Other factors that need atten-tion in the board recruitment process are geographic rep-resentation, gender balance, minority membership, and, of course, philanthropic capacity.

Cheryl Rust: Having professional diversity is critical to ef-fective board leadership. The metaphor of the blindfolded people in a room each describing an elephant based upon the part of the elephant they were touching underscores the importance of bringing various perspectives and skill sets to the table. More perspectives, constructively contributing, results in a more robust and informed deliberation.

“All new board members should be given a thorough

orientation, so there is no misunderstanding

over what they are getting themselves into.”

—Tom Lizotte


Kenneth Spirer: Frequently, attorneys, ac-countants, and investment professionals are asked to serve on nonprofit boards be-cause of their professional backgrounds. While this can be helpful, not every law-yer wants to, or should, perform legal work on a nonprofit board. In my case, I eagerly sought responsibilities that moved me away from legal work, primar-ily because I wanted to learn new skills while helping the nonprofit organization. I was, however, asked to revise or write organizational bylaws from time to time, but always insisted that the organization retain experienced Maine counsel to give the final legal advice.

The finances of an organization need to be monitored carefully, and a board member who can help with budgeting and financial reporting is invaluable. Even if the organization has a financial officer, board oversight by knowledge-able professionals is always desirable. The same goes for the investment func-tion, since board members have a fidu-ciary obligation to oversee the organiza-tion’s endowment.

Sandra Featherman: I believe that boards should be as diverse as possible. That means not just race, gender, and income levels, but professions, political orienta-tions, and age. Where appropriate, stu-dents, clients, service users, and public members should be included. The more points of view and life experiences rep-resented, the better the organization will be able to shape its mission to the needs and desires of those it hopes to serve.

Do you believe Maine boards of directors, in general, are as legally sophisticated as they should be? If not, what kinds of issues do you believe need more attention?

Kenneth Spirer: I’m not sure I agree with

that suggestion that board members in Maine or elsewhere need to be “legally sophisticated.” They are usually not lawyers and are not expected to be giv-ing legal advice. Having said that, board members should be made aware of their responsibilities as fiduciaries. This can be accomplished in a number of ways, in-cluding a session in person with counsel for the organization or the presentation of a set of written guidelines and expec-tations, receipt of which should be ac-knowledged in writing. The board chair should lead this effort.

Tom Lizotte: I’ve seen improvement in this area over the past decade, primar-ily because more attention is being paid and more resources are available for board development. The sophistication level tends to be higher with regional and statewide boards that have the staff available to support development of ap-propriate policies and procedures.

There is truly nothing more boring than

a nitpicking debate over board bylaws, and it’s understandable why some smaller boards avoid that nitty-gritty work. Those are the ones at greatest exposure.

Cheryl Rust: My experience suggests that there is a broad range of “legal sophisti-cation” on the various boards on which I have served. I believe that it is always a good practice to have a thorough board orientation, which includes a sound brief-ing on relevant legal matters. An ounce of prevention, as they say. And, it is seldom a happy occasion to be learning about le-gal matters as the result of unanticipated problems. Smaller organizations may benefit by having board members attend some of the more broad-based leadership development seminars that occasionally become available.

Sandra Featherman: Boards do not need to be legally sophisticated, but they need to be sure they receive sound legal advice about some key issues. Those involve


Roundtable

conflicts of interest, legal requirements, and following the board’s own regulations. It is when boards make exceptions to their stated policies, without leaving adequate paper trails about the special reasons for those exceptions, that boards, and their members, are most at risk.

What frustrates you most about board service? What do the nonprofits you’ve worked with tend to get right?

Tom Lizotte: What drives me nuts is board members who don’t follow through on their commitments, and who often fail to attend meet-ings. If you can’t attend, you shouldn’t agree to serve. Perhaps this is the fault of nonprofits who do not clearly state their expectations for board membership in advance. All new board members should be giv-en a thorough orientation, so there is no misunderstanding over what they are getting themselves into. The good nonprofits take care of all of that right up front.

“ I think that I learn more than

I give, and . . . that learning

experience has been a strong

motivating factor for my

continued activity. ” —Kenneth Spirer

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Kenneth Spirer: My pet peeves are board members who are not engaged and board members who believe the board should manage the day-to-day functions of the organization. The latter function should be reserved for the executive director. Of course, the board must exercise its oversight responsibilities vis-à-vis the executive director.

The Maine Community Foundation’s practice of holding board meetings throughout the state is an example of a statewide nonprofit reaching out to the communities it serves. And the accessi-bility of the Sam L. Cohen Foundation’s staff and its board’s willingness to ini-tiate grants to support new pilot initia-tives is another example of “getting it right.”

Cheryl Rust: Most people have very busy schedules. When an organization ac-knowledges that fact by sending timely and informative materials, allowing a reasonable amount of time for you to re-view them in advance of the meeting, it is very much appreciated. Conversely, when they do not allow adequate time or mate-rials to prepare thoughtfully for a meet-ing, it sends a message that one’s time and input are more perfunctory than meaningful. Also, when board members are slack in preparation and then expect a private tutorial during the meeting, it is very annoying and disrespectful of other people’s time.

My varied board experiences have al-most universally helped me organize what few talents I might have to feel that I can make a contribution to very impor-tant community work outside of my own professional career. They have very effec-tively created mechanisms to contribute to varied and vital missions, provided training to enhance my skills, guided my reading, challenged my thinking, broad-ened my understanding, and provided a forum through which to meet and come


to know many wonderful volunteers and professionals.

Can you give an example of something that has happened that gave you a great deal of satisfaction, as a board member, and that might inspire other businesspeople to get involved in nonprofit service?

Kenneth Spirer: One of the best leader-ship models I have observed was used by the late Bob Woodbury, my predecessor as Maine Community Foundation board chair and former chancellor of the Univer-sity of Maine System. Bob included me in all important decisions and discussions in my role as vice chair for two years be-fore I succeeded him. This model of leader-ship served me and the organization well, as there was continuity of leadership and no learning delay when I became chair.

From that experience, I would conclude that leaders in the business world can bring a great deal to the nonprofit world by building on developed skills while learning new ones, and by mentoring oth-er board members, with the obvious ca-veat that they should proceed slowly and recognize that they are also in a learning position in the nonprofit organization.

Sandra Featherman: Early in my tenure as president of the University of New Eng-land, our board was faced with a difficult decision about the potential merger with Westbrook College. Faculty, staff, stu-dents, and alumni of both schools were overwhelmingly opposed to the merger. After numerous meetings and a retreat, the board came together to approve the merger. Westbrook’s board did as well.

Both schools were small and struggling at the time. Now the combined university is flourishing on both campuses. The uni-versity has more than doubled in student size, its many new buildings are remark-

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able, and it has built a national reputation for the high quality of its programs. None of its constituencies would want to go back to a pre-merger state, because the merger has been so amazingly successful.

Tom Lizotte: I’m on the executive commit-tee of Thompson Free Library in Dover-Foxcroft. Like many small-town librar-ies, the Thompson was severely cramped for space and had talked about building

an addition for years, but the estimated cost of $800,000 seemed more than we could afford. We began in 2000 to plan a capital campaign, started writing grant applications and raising local funds, and we opened the new wing in 2006 after raising every penny we needed. Every time I drive by the library on Main Street and see all the patrons going in and com-ing out, I feel a glow. It doesn’t get better than that.

worth the trip


very college appreciates high-achieving alums, but few Maine schools can rival the prestige of Arctic explorer Robert E. Peary

from Bowdoin College’s class of 1877. While most of us know that Peary (left) is

credited as the first white man to reach the North Pole, a trip to the Peary-MacMillan Arctic Museum at Bowdoin will make the feat seem all the more awe-inspiring.

A permanent exhibition of Peary’s 1908–09 North Pole expedition sledge shows the explorer to be ingenious and open-minded. Peary wed the best of Western technology with the acquired wisdom of local talent, assembling dog sleds with lashings rather than nails to better absorb the relentless pounding, and dressing his men in skill-fully-designed clothing fashioned by an Inuit seamstress. (He also devised a stove

that would turn ice to boiling water in sev-en minutes.)

Visitors to the museum will also come home with a better appreciation of the physical realities of Arctic life, in part through the museum’s diverse collection of Inuit art. The unique focus of the collec-tion, in fact, makes it a destination for both art and Arctic scholars as well as tourists, undergrads, and schoolkids.

The museum is also named after Peary’s fellow Bowdoin alum Donald B. MacMillan (class of 1898) who made over 30 Arctic expeditions of his own—bringing back thousands of photos, along with films and specimens, which are foundational to the museum’s collection. MacMillan is also proof that the cold can be good for you: He took his last Arctic expedition at age 82, and lived to be 95.

>> Northern ExposureArctic explorers Robert E. Peary and Donald B. MacMillan are still teaching us about the far north through their eponymous museum at Bowdoin College.

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vantage Point

oug Coleman’s family was very poor when he was growing up in the ’30s. He remembers a horse and sleigh com-ing at Christmastime to take him and

his parents to a farmhouse, where they ate turkey and all the fixings. “Real food,” he says. “No rabbits and no squirrels.” Those, along with foul-tasting northern pike, were his usual sources of protein.

Interestingly, the boy who often went hungry would grown up to change how the scientific world looked at overeating and obesity.

In 1957, Coleman, a PhD biochemist with a young family, started his career at The Jackson Laboratory in Bar Harbor, back when mammalian genetics was still in its infancy. In 1965, a favor for a fellow scientist with a diabetic mouse on her

hands turned into a career segue that led him to discover the “satiety factor”—a chemical signal to stop eating that normal mice had and mice with the obese gene did not. He also found that obese mice would stay fat even if they ate only half the amount consumed by normal mice.

Coleman retired in 1991, but the implications of his findings, confirmed by scientist Jeffrey M. Friedman through cloning in 1994, have not yet been fully digested by either science or society. But they did earn Coleman some of the most pres-tigious prizes in science, including the Shaw Prize and the Albert Lasker Award (both shared with Friedman), Canada’s Gairdner Award, and election to the U.S. National Academy of Sciences.

He still visits Jackson Lab a few times a week,

Douglas L. Coleman is Maine’s most decorated scientist, but awards never motivated him. His goal was to find answers—with persistence,

luck, and some tiny assistants. by tori brittoN & Mark wellMaN

One Man’s Answers

Coleman at The Jackson Laboratory in the 1960s.


vantage Point

but confines himself to the fitness center, which was recently named in his honor.

You were born on October 6, 1931, in Strat-

ford, Ontario, Canada. Can you describe your

family life and formative years?

I grew up in the Depression. My parents were immigrants from England. They had jobs when they got married in 1929, and then they lost their jobs and there were no jobs at all. My first recollection was at about 3 years of age; I realized, basically, I was hungry and there was no food. I re-member at 6 years of age it was dry cereal six days a week; on Sunday I got milk on the cereal and a navel orange. I remember going down into the basement, and there was the meat for the week or as long as it lasted. There’d be about six cottontail rab-bits and a couple of squirrels, things like that. My dad was a deadly shot; he could shoot a running rabbit through the head.

Did your parents find work at some point?

Yes, my dad was a very, very bright individ-ual. He never had any education past grade eight, but he got interested in radios and started fixing radios for people and had a reasonable business. From there he started fixing refrigerators, and by the time I was in college, he was doing very well. When my parents died, I was the executor. I had no idea, but they had saved half a million dollars. They were Depression people right to the very end; they had a nest egg, in case something bad might happen again. I have that same tendency.

Did you enjoy school?

I guess I enjoyed it, but looking back, I was probably bored. I was most interested in history. I had my first taste of Shake-speare in school and I liked Shakespeare. High school wasn’t really science oriented, but one of my good friends who still lives in my hometown says the only way he got through chemistry was because I helped him in the labs. ph

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Top left: Beverly and Doug Coleman, in the 1950s. Top right: Coleman in 1998. Center: Doug Coleman and Jeffrey Friedman in 1994, after Friedman had isolated the satiety factor, which he named leptin.

(Coleman says the grimace on his face is because the mouse was biting him.) Bottom left: Coleman receives the 2008 Shaw Prize, also called “the Nobel of the East,” in Hong Kong. Bottom right:

Professor Bob Braun (left), Jackson Lab’s associate chair for research, and Mike Hyde, vice president for advancement, assist in the August 2011 dedication of the Doug Coleman Fitness Center.


You went on to McMaster University in Hamilton, Ontario, and

majored in biochemistry. Why McMaster and why biochem?

The University of Toronto turned me off because it had 10,000 students —which is not that big nowadays. So I went to McMaster, which was a school of 500. I was inter-ested in chemistry, biology, and geology, but I chose the chemistry route.

I eased through elementary chemistry, and analyti-cal chemistry and inorganic chemistry were alright, but they didn’t grab me as a career. My third year, I hit organic chemistry and I liked it. It was fun, and it seemed so dif-ferent than all the rest of the chemistry because of all the permutations and combinations that you can do with car-bon atoms.

Then my last year I took biochemistry. The professor was so good he was hypnotizing; you’d listen to every word. The eight of us who took biochemistry were always lined up at the door waiting for him to come in and start the lec-ture. He taught us to think like research scientists, to take data and interpret it. As long as you thought logically, you would get your points because there were many ways of interpreting data. I think that was what really turned me on to biochemistry.

You also met your late wife, Beverly, at McMaster, a fellow

chemistry major. What brought you together?

Talk about luck! It would probably be 1953. I was in my dorm, in another person’s room, and saw this picture of four people, two couples. I looked at this girl and I said to myself, “That’s the girl I’m going to marry.”

I knew Beverly vaguely because we ate together. She wasn’t strong in organic chemistry then, so I volunteered to tutor her a bit. In February of ’54, I proposed and she accepted, and we got married at Christmastime. So it was a whirlwind romance that worked out and we had almost 55 years together. We were bound at the hip. She was my biggest supporter, always right there for me.

After McMaster, you went on to study with Carl Baumann at

the University of Wisconsin, earning your master’s and PhD.

You then spent your entire career at The Jackson Laboratory.

What made you choose Jackson Lab?

My last year at Wisconsin, I went out looking for work. I interviewed with Esso, believe it or not, and Proctor and Gamble, and Parke-Davis in Detroit. Proctor and Gamble said, “If you come with us, you’ll have a million dollars when you retire,” and that seemed like a big deal, but I said, “I don’t think I’m interested in a million dollars.”

There were no opportunities in Canada. That’s where I tried first, to go back to Canada. A fellow who preceeded me in Baumann’s lab had come to The Jackson Laboratory and I knew him by reputation. He wrote a letter to Carl Baumann saying he would like to recruit a biochemist, and Baumann told me. I thought I’d like to learn some im-

munology and some genetics, and then maybe I could have a better opportunity of going back to Canada. So I came here, was interviewed, and was offered the job. I came on Halloween in 1957. My plan was to leave in a couple years, and I never left.

Did you have any mentors at the lab?

George Snell. He was a Nobel Laureate, but not when I met him. George was a Yankee, a Vermonter; he didn’t talk very much, but he took a liking to me. I wanted to learn immunology, and he was an immunologist par ex-cellence. Tibby Russell—Elizabeth Russell—taught me genetics and got me talking to the other geneticists, and I always looked up to her. Both Tibby and George got into the National Academy of Sciences. So they were two.

But the good thing about The Jackson Laboratory was almost everybody was a mentor in some fashion. Every-body had a different discipline. If you had a problem here, this guy could help you. I published with probably half the people in the laboratory; we had that much cooperation.

I went through the best part of science. I was at the bench all the time doing my own research. Today, you sit at the computer writing grant applications, and you have a postdoctoral student doing all the research. You don’t get your hands into it, and that was what the beauty of it was.

You became famous for your research in obesity and diabetes,

by discovering a factor that triggered satiety, which was

lacking in two fat strains of mice. What did you find out?

I conducted a series of experiments with the obese and the diabetes mouse models, and found a blood-borne factor, synthesized in the fat cells, that regulates ap-petite and body weight. Normal mice produced the fac-

“For years, obesity was thought to be a

consequence of a behavioral problem,

so when I showed this, people said, “No way.”


vantage Point

tor; the obese mice didn’t produce the factor and the diabetes mices were unable to detect it.

Another thing that was part of the restriction on the obese mice was a thrifty gene. If they ate a big amount of food, they would pack it away as fat; if they were limited to a little amount, they would still survive. They could eat 50% of what a normal mouse would and get along fine.

For years, obesity was thought to be a consequence of a behavioral problem, so when I showed this, people said, “No way.” Neurologists came up to me and said, “There’s no evidence for a factor that causes satiety.” Psychiatrists would say, “Look this is what it is, it’s behavioral; all I have to do is change their mind.”

Now people ask me, where were my Eureka moments, what I won these prizes for. I didn’t consider them Eureka moments at the time, because these, to me, were just sim-ple experiments that showed something controversial. So I struggled; I was determined to disprove it, if necessary. But I wanted to know.

Your findings were finally confirmed 20 years later, when

Jeffrey Friedman of Rockefeller University cloned the obese

gene and isolated the satiety factor, which he named leptin.

Did you know Friedman?

I’d decided I was going to retire early, which I don’t regret now, because Bev and I had an extra five years of enjoy-ment, doing things that we always wanted to do. Jeffrey Friedman at Rockefeller called up and said, “Are you go-ing to clone the obese or diabetic gene?” and I said, “No way, it costs too much money and takes too many people and it’s not the type of research I like to do.”

So Jeff asked me to collaborate with him. He said he’d like to have me help him identify the phenotypes, so I went down to Rockefeller University periodically and we’d go over the results. They gave me visiting privileges at Rock-efeller, and I’d take Bev and we’d go see a couple of shows and enjoy ourselves in the city for a weekend, and I’d do my two hours of consultation. He always invited me down, even though I was not contributing after the first couple years; I was just listening to what he did.

[In 1994] we went to dinner as we always did and he was walking on air. I said, “Okay, Jeff, which gene is it?” He said, “It was the obese gene.” He’d cloned it. He said, “Ev-erything you wrote and published is correct.”

He told me afterwards, “You didn’t look surprised.” I said, “Jeff, I had been working on it for 30 years, trying to disprove it. I knew I had to be right.”

What are some of the implications of those findings?

Leptin is one of the most important hormones that has ever been discovered. I think it will go down as that, be-cause, first of all, it’s synthesized in the fat cell. Nobody thought fat was good for anything; it was something to get rid of. When you look at marathon runners who have no body fat, they don’t go through puberty. Well, you give them leptin, they go through puberty. So you need to have a certain amount of fat to live normally.

Now we know there are a myriad of satiety factors, dif-ferent compounds that are coming from the fat that are working in the brain, synergistic with leptin. Leptin’s not really the satiety factor; it’s just turning on the satiety fac-tors which are coming from a whole lot of places.

So the solution isn’t as simple as giving obese people leptin.

No, leptin itself wasn’t the panacea that we hoped for. But I’m sure it’s coming, because it’s so remarkable in all the animal models. I think it’s a good shoehorn into the system, and it opens a whole lot of avenues which no one would have gotten to until they found out there were hormones produced in the fat. Now Jeff Friedman’s writing papers about how obesity should be treated like a handicap; he’s getting quite vocal about that.

So it’s opened up a whole new field. But I think I got the fitness center named after me because I’m the oldest of everyone working out there, and also because the pill that I thought might work didn’t. You still have to exercise and eat less; it’s the only treatment now.

After you retired 20 years ago, you and Beverly got involved

in land conservation and enhancing the woodlot around your

home, adding trails and gardens where young people can be

educated. What are some of the things you hope they learn?

I hope they learn about conservation, first of all, that you don’t have to develop every piece of land; I have a conserva-tion easement on both sides of the property. Why we saved it is, small woodlots are going out of style. Big companies are taking over, and I see it as a demonstration plot of how things used to be.

“No, leptin itself wasn’t the panacea that we

hoped for. But I’m sure it’s coming, because

it’s so remarkable in all the animal models.”


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the finish line may be closer than you realize


Once Bev got sick, we gave away a piece to the Small Woodlot Owners Association, and they’re doing every-thing I wanted to do. They put a box up with the trail map in it, and marked all the trails. There aren’t as many peo-ple using it as I’d like—though with too much use, it gets messed up, so maybe it’s a blessing—but you can walk dogs there without a leash. I insisted on that, and a lot of people have come up to me and said they love having the opportunity to run their dogs.

The other side of the property is to remain as it is now, except that I can clear it to keep the view. There is a lot of bird life and animal life; sixth grade kids have come here and gone down to the shore and seen all the different spe-cies of things, and they come back in wonderment.

As a scientist, you’ve won many of the world’s most important

honors and prizes, and many people thought you and Dr. Fried-

man might share the Nobel Prize this year. Your thoughts?

I knew a few years ago that we had been nominated be-cause I had received an email from Sven in Stockholm, and I don’t know any Svens, so I just trashed it. I didn’t even open it up. A couple weeks later, I got a call from Jeff, and he said, “Did you get that email from Sven?” I said, “I dumped it,” and he said, “Well, you’d better get it.” They were asking about a lot of particulars about my career, so that had to be the Nobel people.

But I get upset when I get these prizes. My wife would be very happy; my youngest son is very happy. My oldest son is like me, he knows how I feel. There are many people out there doing work that’s just as good or better, and they haven’t been recognized, and that makes me sad. There are a limited number of honors.

Honors aside, you’ve made a place in the history of science.

What are you hoping your legacy will be?

That I was persistent; that I did the best I could.

Tamera Edison, MBAManager

Group Customer ServiceUnum, Portland, Maine

chef’s choice


>> Jay VillaniSonny’s, Portland

Chef Jay Villani comes across as a regular guy, but

he certainly does not make regular food. Founder

and owner of Sonny’s, his second foray into the

highly-competitive Portland food scene (he also

is the man behind Local 188), Villani has a gift for

creating both plates and places that zing with

flavor. Sonny’s Restaurant and Bar, located in

what was once Portland Savings Bank, benefits

from Villani’s decision to save the best of what

was already there, including the original stained

glass windows and exposed bricks, and to layer it

with a hip, metropolitan visual palette. Likewise,

on the menu, local resources are mixed with

zesty treasures from away with combos like wild

Maine mussels with chorizo, jalapeno, and dark

beer from south of the border.

First or early food memory:

Smelling green bell peppers in the grocery

store.

Early cooking experiences:

I was washing dishes when I heard, “Hey, kid,

get over here.” The sauté guy hadn’t shown up

and suddenly I was a cook.

Family influences on your style and taste:

I come from a big Italian family.

Where you studied and/or apprenticed:

I was a wandering soul who bounced from

kitchen to kitchen.

When you realized you really were a chef:

When I had to make my first payroll.

Pivotal career move:

Opening Local 188.

Places you’ve been to that inspire you as a

chef:

Au Pied de Cochon, Boqueria, Zuni Grill.

Pho

tos:

Kev

iN C

ou

tur

e

FAvoritE itEM on thE MEnu:

“Arepas. i love their simplicity.”


things you do that keep you growing

professionally:

Surrounding myself with young talent.

Your favorite restaurant (besides your own):

Au Pied de Cochon.

other professionals you admire most:

My staff.

Your least favorite job:

Camp counselor.

Ways you’ve become smarter businesswise

over the years:

By letting people succeed or fail on their own.

Favorite night of the week:

Wednesday. It’s a surprising night—sometimes

busy, an early start to the weekend, and some-

times it’s quiet. You never know.

What you would want your last meal to be:

My grandmother’s pasta fagioli.

the last time you really impressed yourself

in the kitchen:

When I made island spiced pig jowl.

Your new favorite ingredient:

Precooked cornmeal for our arepas.

Longtime favorite ingredient:

Saffron.

Memory of a great meal you had in Maine:

My Christmas Eve dinner at Local 188 for

wayward souls.

Pet peeve when visiting other restaurants:

None.

things you’d like to learn or study:

Brewing.

What a perfect day off looks like:

Me and the boy at the ballpark.

Something about you that people would find

surprising:

I’m smart.

>> Sonny’s

83 Exchange Street • Portlandwww.sonnysportland.com

Hours:Lunch: tuesday–Friday 11:30 am –2 pmBrunch: saturday and sunday 9 am–3 pmDinner nightly 5 pm–close

Specialties: Arepas, house-made everything, excellent cocktails.

Restaurant accolades: Maine Sunday Telegram, four stars.

First-timer’s tip: Check out sonny’s live jazz on thursdays; half-priced wine on Mondays.

Sample menu item: Beef brisket enchiladas with house-made flour tortillas, mole roja, cheddar, rice and beans. $19

Directions:take i-295 to exit 7/Franklin street. At the top of the hill, take a right onto Congress street. turn left onto exchange street. sonny’s is on the left.


J. Doe

magine a business model where the consumer does not know the price of the service being purchased, but wants the finest money can buy. The customer rarely cares how much the service costs, because a third party

picks up the tab. The price paid is often less than the cost to provide that service. The service provider cannot raise prices to cover the high wages needed for the skilled per-sonnel to perform the service, not to mention the ongoing technology investments required to remain current and efficient. And, the business is highly regulated, competes with federally subsidized oligopolies, and is often the tar-get of frivolous lawsuits.

Not many entrepreneurs would want a piece of that action, but this is the business model independent phy-sician practices in Maine confront today. Consequently, increasing numbers of independent practices have closed up shop to join ever-growing regional healthcare organi-

zations and their hospital affiliates. Today, nearly 75% of all primary care doctors in Maine are in an employment relationship with a hospital or healthcare organization. Ten years ago, according to the Maine Medical Associa-tion, that number was less than 15%. The trend is similar on the specialty care side as orthopedists, neurologists, cardiologists, and other specialty groups find they are un-able to bear the burdens of running a private practice.

So, why should Maine businesses care? Because it will raise costs and limit access. On the surface, it may be dif-ficult to sympathize with highly compensated physicians. However, as more Maine physicians move to large medical centers, consumer choice and access will become more lim-ited as medical services are concentrated in the hands of a few large regional providers. And with fewer choices, there is less opportunity for competitive pricing, so patients and payers can expect to bear the burden of increased costs.

Every day, Maine’s independent physician practices are being swallowed up by large healthcare organizations. Is resistance futile? BY JohN Wipfler

Medical Mayhem

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This trend also creates a breeding ground for potential conflicts of interest. While hospitals obviously have a critical role in the healthcare system, it’s not to grow into monopolies or oligopolies. As regional medical centers gobble up spe-cialty practices and make them integral to their internal service offering, the or-ganization does not want to see patient volume removed from its system and referred to an outside practice. This ulti-mately limits patient choice and access to quality care in a timely manner, as the healthcare conglomerate creates a self-serving system. Still, for many private practices, the economic and logistical benefits of consolidation are overwhelm-ing, and every month more physicians de-cide to throw in the towel.

Despite the challenges, some southern Maine independent practices believe that the benefits to patient, payer, and practice of remaining independent far outweigh the allure of higher compensation and the promise of fewer administrative burdens. Earlier this year, OA Centers for Orthopae-dics, Chest Medicine Associates, Portland Gastroenterology Associates, and Spec-trum Medical Group of Portland formed Maine’s first specialty-only Independent Practice Association (IPA). Since forming the IPA, six more independent practices have joined the association.

Members of the Maine Specialty IPA are working together to compare their systems and resources to determine how they can work closely together to create operational “best practices” and efficiencies. The pri-mary objective is to maintain or increase clinical quality and service levels while decreasing costs. The IPA members are also sharing resources and expertise, and working to identify critical service metrics for all to adopt to ensure a consistent qual-ity service experience for patients.

With Maine physicians continuing to enter into employment relationships with hospitals, it is obvious that many practices

are not finding viable alternatives to stay independent. Examples of other models exist. These include: forming boutique practices which do not take commercial insurance and expect patients to pay for their care out-of-pocket, and practices choosing not to take public insurance like Medicare or Medicaid. Although in-teresting options, Maine does not have a large enough population of independently wealthy citizens who can pay for health-care services. Ultimately, physicians need to learn to provide higher value by creating new kinds of partnerships and providing better value for those paying for services. That value includes more efficiency, a fo-cus on clinical and service quality, and su-perior outcomes.

However, physicians can’t do this alone. Insurance companies and self-insured em-ployers can do more to assure that good independent medical practices stay in business. Why have hospitals consistently received on average 4% annual increases in reimbursement while independent medical practices are lucky to get 1% an-nually? As employers look for ways to pro-vide quality healthcare benefits at reduced costs while maintaining service choices, employers can put pressure on insurance companies to keep the independent prac-tice in the provider mix.

Self-insured businesses are also wise to reach out directly and identify pre-ferred providers to negotiate better value (high quality + lower cost = value) and pro-vide incentives such as lower co-pays and reduced deductibles to encourage their employees to use preferred providers. In-dependent practices are ready to become more efficient and stay independent. If employers incentivize employees toward high value providers, it creates a win-win-win situation for employer, employee, and independent practice alike.

John Wipfler is CEO of OA Centers for

Orthopaedics, with headquarters in Portland.

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IBE

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Paws aPPlause Natural Pet suPPlyscarboroughFounded 2004Full-service supplies for dogs and cats; salon grooming for dogs. Largest retailer of raw food in Maine and New Hampshire.27 Gorham Road • (207) 885-0077www.pawsapplause.com

beachstoNesouth PortlaNdFounded 2009Manufacturer of recycled glass and seashell countertops, tabletops, and giftware for the residential and commercial markets.192 Mussey Street • (207) 899-8109www.beachstone.biz

MaiNe bay caNvasPortlaNdFounded 1979Specializing in party tent rentals and accessories for weddings, festivals, fairs, sporting events, and backyard gatherings.53 Industrial Way • (207) 878-8888www.mainebaycanvas.com

occuPatioNal Medical coNsultiNgleedsFounded 1996Provides worksite wellness programs and software solutions topromote healthy and productive workforces, and reduce individual risks for chronic disease and rates of medical plan cost growth.306 Campbell Road • 1 (800) 575-6537www.omcwellness.com

Fluid iMagiNg techNologiesyarMouthFounded 1999Manufacturer of the FlowCAM imaging particle analysis instrument used to measure, count, image, and analyze cells and particles in a fluid medium automatically.65 Forest Falls Drive • (207) 846-6100www.fluidimaging.com

Mid coast hosPitalbruNswickFounded 1991A full-service, 92-bed, independent, not-for-profit hospital with an active medical staff of more than 160 physicians. 123 Medical Center Drive • (207) 729-0181www.midcoasthealth.com

>> Free InkA complimentary listing of Maine businesses. To get yours listed (first come, first served), go to www.maineahead.com and click on Free Ink.

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Specialists in retirement plan servicesSecurities and advisory services offered through Commonwealth Financial Network. TPA services by Norton

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THE BULL PEN

IMBY is an attitude and it does not reflect well on the values or common

sense of Maine people. Sadly, it’s not just a Maine problem—“NIMBYism”

is a national affliction with grave portent for the future. “Not in My Backyard” elevates “my,” “me,” an individual sense of “entitlement,” over the well-being, the economic and social needs of the larger community.

This NIMBY attitude is growing. Population is also growing. The diversity and complexity of un-dertakings in our economy/society (which must be located somewhere) is growing. But the quantum of land in Maine and the nation is not growing. All but the most foolish can see that NIMBY attitudes put us on a collision course with realities that will not go away. We must change the attitude.

If NIMBYism were a local, or an occasional, ab-erration limited to a handful of activities that stir passions and justified fears, e.g., nuclear waste disposal facilities, a major oil refinery or chemi-

cal plant, a tanning or rendering facility, we could probably live with it. A state or national search for safe and remote locations for these facilities would in most cases meet our needs.

But NIMBYs today are not focused on a handful of more or less distasteful, but necessary, societal undertakings. The list of things that NIMBYs do not want is long, and growing, e.g., most power-

generating facilities (including today’s wind, solar, fracking facilities) and transmission lines, haz-ardous or conventional waste disposal facilities (including green recycling facilities), wastewater treatment plants, most heavy industrial facilities (steel mills, railroad yards, etc.), prisons, big-box stores, right down to halfway houses, shelters for battered women, alcohol or drug rehabilitation fa-cilities, homes for handicapped individuals, home-less shelters, soup kitchens, low-income housing, elderly housing—the list goes on.

The NIMBY attitude, in its focus on what an in-dividual wants or doesn’t want, ignores the fact that all of these undertakings are an essential part of the economic/social order—locations must be found. They are all legal undertakings. They fulfill wants and needs that exist in the larger commu-nity. They provide employment, and often are a useful part of a municipal tax base.

At public hearings dealing with activities that have become difficult to locate, most NIMBY ar-guments are couched in benign concerns for the environment, traffic safety, noise, or some aspect of public health. To the extent that these issues are real, they can almost always be dealt with by strin-gent but fair regulation of the activity in question. But sound regulation of the unwanted activity sel-dom satisfies NIMBYs—they want it to go away.

More aggressive NIMBY arguments are based on junk science, unfounded fears, and/or worst case scenarios. This data and these tactics are often debunked by the developer of the unwanted activity. But the debunking data is seldom believed or accepted by NIMBY activists. NIMBYs live in a world of selective truth. The worst NIMBY argu-ments, voiced only in unguarded comments, but

The spread of “Not in My Backyard” is making legitimate, lawful, necessary economic pursuits increasingly impossible. By ORLANDO E. DELOgu

NIMBY Is an Attitude

Sound regulation of the unwanted

activity seldom satisfies NIMBYs—

they want it to go away.


often below the surface of public debate, reflect nothing more than latent racism or socioeconomic biases. I don’t want “those kind of people,” “that kind of activity or housing,” in my neighborhood. This is un-acceptable.

Though NIMBYism is bad policy, self-ish, and dangerous in the long run, NIM-BY individuals are good at unfolding their strategy. They band together; they hire competent lawyers; they understand and use the political process, particularly the politics of fear, to the fullest. They play the game at every level—local planning boards, boards of appeal, judicial review. If possible, they put in place restrictive, even prohibitory, ordinances. Striking these down will take the developer of an unwanted activity time and money. It becomes a game of attrition.

In some settings, the debate is moved to the state level of government. Here NIM-BYs play a similar string out—hearings, more hearings, calls for further review. If they don’t prevail, again there is judicial review. Time is on the side of NIMBY ac-tivists. They are in place. The developer of an unwanted activity seeks to gain entry. This is an inherently more difficult position.

In short, NIMBYism is not about sound regulation; it is not open to the debunking of myths. It is capable of embracing the worst types of discrimination. NIMBY-ism is little more than a selfish desire not to be intruded upon. What is really being said is: I do not want to bear any incon-venience, any portion of society’s need to find a suitable place for the very diversity that makes our economy/society whole.

These attitudes court disaster. They are unjust and economically ruinous. They are a type of tyranny that a minority has imposed on the larger society. At some point it must end.

Orlando E. Delogu is an emeritus professor of

law at the University of Maine School of Law.

Seeking a Bold, Dynamic Leader for the Maine Women’s FundThe Maine Women’s Fund is seeking a CEO who is passionate about

investing in the power of women and the dreams of girls and who will work with the Board to fulfill the Fund’s mission.

Visit www.mainewomensfund.org for full job description.


THE BULL PEN

ccording to Forbes magazine, Maine is the worst place to do business in the United States. The absolute worst! The

Capitalist Tool, as Forbes likes to call itself, ranked us 50th overall in its 2010 state-by-state comparison, giving us abysmal marks for business costs, labor availability, regulatory envi-ronment, and growth prospects.

It’s a good thing Guam, American Samoa, Puerto Rico, and the U.S. Virgin Islands weren’t included or we’d surely have finished 54th.

I know, I know. These rankings are highly sub-jective and they can be shaped in any number of different ways. Much depends upon the relative weight that is afforded a particular category or criteria used in the rankings.

But just like those rankings that drive universi-ty presidents mad, people read this stuff and many times they believe it. What’s more, as these rank-ings get repeated, the message gets reinforced and becomes an accepted part of the narrative until it is simply considered true.

Politicians then feel they have to make major changes in order to improve the business envi-ronment. Voters become convinced they’re liv-ing in a wretched place. Everyone walks around moping and wondering how the other half lives, and so we begin to muse: What would it be like

to live in a place that’s actually ranked best in the country for new investment? Maine is aging so quickly. Wouldn’t it be exciting to live in one of the places considered best in the country for young professionals?

Then we begin to gripe. If our energy costs weren’t so high, we’d be awash in new business. If our regulatory burden wasn’t so terrible, we’d be growing like crazy. If we would permit employers to keep more of their revenues and stop paying so much to the state, everything—everything—would improve.

Sorry to interrupt the rant, but it’s time for a re-ality check. There are rankings and there are rank-ings. While Forbes’ rankings may lend support to those who want to effect wholesale changes on our tax and regulatory infrastructure, other rankings suggest that Maine is one hell of a place to live and a fine place to do business. Ernst and Young recently completed a major study for the Council on State Taxation—a trade group that represents multistate corporations—and concluded that Maine offered the best tax environment in the en-tire country for companies interested in setting up corporate headquarters. And, interestingly enough, it was Forbes itself that recognized Port-land in 2011 as one of the best cities in the country for young professionals.

Look, no one’s going to deny it’s expensive to live and work in Maine, but the bottom line is that these rankings are distractions. To the extent that negative rankings become part of the narrative, they’re harmful. To the extent they’re positive, they need to be taken with a grain of salt.

We have to deal with rankings, but policy mak-ers shouldn’t make any rash decisions or fashion

Trying to move up in the Forbes business rankings is an understandable end goal. But we need to make sure the means don’t exact too high a price. By PERRy B. NEwmAN

Pulling Rank

We have to deal with rankings, but policy makers

shouldn’t make any rash decisions or fashion

entire legislative agendas based on them.


entire legislative agendas based on them.Case in point: There’s a move afoot to

reduce or eliminate Maine’s requirement that by 2017 some 40% of our energy be produced from renewable sources. The argument goes that renewables are too expensive and therefore keep the costs of doing business too high; by reducing or eliminating the 40% target, presumably we’ll lower the costs of energy and stimu-late investment.

That might be good news for some, but it probably wouldn’t be good news for the thousands of Maine people building access roads, producing composite ma-terials, trucking materials to job sites, erecting windmills, attracting research funding to our universities, designing floating wind platforms, deploying test sites, installing tidal power generators, and so on. Above all, eliminating the re-newables target would immediately end the flow of billions currently being in-vested in renewable power projects in the state. How is that good?

In the abstract, an agenda that lessens the regulatory burden and lowers the costs of doing business is a positive. Busi-nesses and their owners can keep more of the money they earn and will then be free to invest in the Maine economy, or not, as they choose.

Lowering the costs of doing business might also enable us to move up a few notches in the Forbes rankings.

But sometimes the cure is worse than the disease. Every medical student is ad-monished, first, do no harm. Cutting re-newable targets might allow us to inch up in the Forbes table next year, but at what price?

Do we really want to stake the future of Maine on something as fleeting as a fea-ture article in a business magazine?

Perry B. Newman is president of Atlantica

Group LLC, an international business

consulting firm based in Portland.

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70 >> Maine Ahead • SPECIAL PROMOTIONAL SECTION

What does the multi-family housing sector look

like in the Greater Portland area?

It’s a very strong niche in the real estate market cur-

rently. We’ve had a lot of clients that have taken money

out of the stock market to invest in housing. With a

multi-family building here in Portland you’re able to

see it, touch it, and feel it. I think investors feel a little

bit more secure being able to see their investment than

they are with the stock market going up and down.

Also, we have a lot of buyers right now because the in-

terest rates are so low.

Do a lot of people look at multi-family housing as

an investment?

Yes. The majority of buyers we see are investors and

first-time home buyers. Investors will look at three-and

four-unit complexes all the way up to 200 units. First-

time home buyers realize if they can afford $2,000 in

rent, they can afford to buy a two-unit multi-family

house and rent out one side for $1,000. The other unit

pays half of their mortgage. First-time home buyers

are usually able to get a loan for more money because

the bank will look at that $1,000 a month from rent-

ers as income. The more units you have, the better off

you are. First-time home buyers are often able to get a

much larger or nicer place because they have rent com-

ing in to help pay for it.

Becoming a first-time homeowner and a landlord

at the same time could be daunting.

We want our clients to be very successful landlords be-

cause that means they will purchase more property. We

conduct classes on how to be a good landlord, and I’m

on the board of the Southern Maine Landlords Associ-

ation. We also have a tool called the “Fast Pack,” on our

website to help people determine whether multi-fam-

ily housing works for them. It shows pictures, a brief

description of the building and basic information:

how many units there are, how many bedrooms/bath-

rooms are in each unit, what the current rent is, what

we see as a current market rent, lease information, and

expenses. If you add up all of the rent and then take

out all the expenses, that’s what is called “net operating

income.” With that information up front, they can see

if the building is making money.

Do you handle other sales besides multi-family?

Our specialty is multi-family homes, but we do meet

the needs of other clients with Sullivan Select which

specializes in single family homes. We have clients

who bought multi-family properties, lived in them

for several years, saved money in doing so, and then

were ready to move into a single family property. In

addition, we have a management company, Sullivan

Management, for our out-of-state buyers who want to

own properties but are too far away to manage them.

Have you seen any big changes in past years in

the multi-family sector?

We have. In Portland we have an old housing stock and

we see a lot of people come in and purchase a 10-unit

and re-do the whole building with green technology to

get a LEED certification. We are also seeing a lot of the

smaller buyers taking part in the government grants for

new windows, installation, and all those green-initia-

tive grants you see out there.

You have been busy; are you seeing a big upswing

in sales of multi-family units?

We’ve stayed pretty consistent. When the market is

great, everybody is buying property. Five years ago, be-

fore the downturn, first-time home buyers and small

investors were out buying up property. The big inves-

tors were sitting back, just waiting. They saw the cycles

and they knew something was coming. Now we have

less first-time home buyers and a lot more investors.

What drew you to the multi-family sector?

Eight years ago, I moved my family from San Diego

to Yarmouth. Prior to our move, I talked with a fam-

ily friend, Mac Macbride, who once owned a large

commercial firm in Portland. He noticed there were

no real estate companies specializing in multi-family

homes. So we filled a niche and Sullivan Multi is now

the leading multi-family real estate company in the

Portland Area.

Member Q&ABill Sullivan, owner of Sullivan Multi-Family Realty and MEREDA member, talks about

the multi-family housing sector in the Greater Portland area and what it means for

first-time homebuyers and investors. PRO

GRES

S NO

TES

Founded in 1985, MEREDA is a statewide organization of commercial real estate owners, develop-ers and related service providers, whose mission is to promote an environment for responsible development and ownership of real estate throughout the State of Maine through legisla-tive advocacy, educational programs and professional networking opportunities.

SPECIAL PROMOTIONAL SECTION • Maine Ahead >> 71

PROFESSIONAL EVENTSNovember 9, 2011LewistoN/AuburN AreA breAkfAst semiNArDeep Energy Retrofits

7:30 to 9:00 AMMartindale Country Club527 Beech Hill Road, Auburn

December 8, 2011PortLAND-AreA breAkfAst semiNArUrban Impaired Stream Regulations

7:30 to 9:00 AMClarion Hotel1230 Congress Street, Portland

JANuAry 26, 20122012 ANNuAL reAL estAte forecAst coNfereNce & member showcAseMEREDA’S SIGNATURE EVENT

This event brings together the largest gather-ing of commercial real estate professionals in Maine. This must-attend event attracts over 500 guests and offers a unique forum specifi-cally geared towards developers, brokers, architects, bankers, attorneys, accountants, and other professionals looking to gain valu-able insights on the state of the economy and what lies ahead in the coming months for the real estate industry. Topics to be covered include: An examination of current State

statistics and what they reveal about the future of Maine’s economy with an emphasis on real estate and a Market Overview by property type focusing on both Commercial and Residential Sectors

Supplementing the conference is MEREDA’s popular Member Showcase which provides an excellent opportunity for members to network and market their products and services.

For more information or to register, please visit www.mereda.org

9:00 AM to 5:00 PMHoliday Inn By the Bay88 Spring Street, Portland

In Maine, part of the 2008 stimulus package

included an amendment to the historic pres-

ervation tax credit, called An Act to Amend

the Credit for Rehabilitation of Historic

Properties. The bill changed the existing state

tax credit and added incentives for the cre-

ation of affordable housing projects.

“The benefits have been terrific. It can

mean putting a project over the top if it was

on the cusp of needing a little extra financing

equity to make the project viable,” said Drew

Sigfridson, a broker at CBRE | The Boulos

Company.

While the 2008 credit wouldn’t expire for

two more years, Maine legislators approved

extending the cutoff date until 2023 so devel-

opers and contractors can continue to take

advantage of the credit. The credit was essen-

tially obsolete this year because historic pres-

ervation projects take between two and three

years to complete. If a project was started this

year, it would have been difficult to finish pri-

or to the sunset date, according to Kevin Bun-

ker, MEREDA member and principal founder

of Developers Collaborative.

“Historically, the tax break wasn’t used all

that much, but when it was paired with the

affordable housing break, it becomes a very

powerful tool to redevelop historic build-

ings,” said Bunker. Bunker worked to extend

the life of the historic preservation incentive

because his company saw the benefits of con-

tinuing the credit. Developers Collaborative

has finished one project repurposing the his-

toric Gilman Street School in Waterville into

Gilman Place, which offers 35 affordable

housing units. Developers Collaborative has

two more similar projects in the works.

The legislation piggybacked the historic

preservation credit onto the federal afford-

able housing tax credit. Now, when a historic

building is repurposed into affordable hous-

ing, the historic preservation tax credit of up

to 20% is added to the affordable housing tax

credit of up to 30%, which could mean a tax

credit of 50%.

“It happened at the perfect time because the

historical housing market crashed along with

the economy. It’s very hard to make housing

deals work, but now we’re seeing a lot of his-

toric schools and other buildings turned into

affordable housing,” Bunker said.

The credit also helps commercial projects,

such as Portland’s Merrill’s Wharf project.

Law firm Pierce Atwood and other tenants

will be moving onto the wharf, where a win-

dow-less brick building sat empty until one

development company turned the building

into a sleek office complex with waterfront

and city views.

“The credit makes projects more afford-

able for the developer and for the tenants. It

helps preserve the historic nature of build-

ings because they have to conform to historic

standards in order to qualify. It’s a win-win,”

Sigfridson said.

For more information on the historic preserva-

tion tax credit, please visit the Maine Preserva-

tion Commission at www.maine.gov.

A recent amendment to extend the Maine historic preservation tax credit, passed in the last legislative

session, stimulates building projects during a time when development has dwindled. The credit gives

incentives to developers to repurpose historic buildings into qualified projects like affordable housing.

Tax Credit

The Way We Work


>> David HigginsComputer Repair Shop Owner

SOAKED KEybOArDS, peanut butter in the CD drive—Apple

Certified Macintosh Technician David Higgins has seen it all. One

of a handful of computer repairmen in Maine focused on Macs,

Higgins performs triage at his Hampden shop, Cybermall, to find

remedies for Mac owners with sick computers. between repairs

and phone calls, the former EMT also devotes time to keeping up

with the technical updates Apple publishes each day.

Why did you decide to focus on Apple computers?

I used to build and sell customized DOS and Windows-based

computers at my home after graduating from UMaine. After

working on a few Apple computers for a local service provider, I

realized how well-made Apple products were, and how easily the

operating system, applications, and hardware worked together.

There were no hardware incompatibilities or conflict errors that

were a constant burden with the PCs.

Do you work by yourself?

I am so very fortunate to have Jane Whinery, who is a registered

nurse, managing the business. both of us have previous medical

experiences, so it seems quite natural to operate the computer

business like a medical clinic. We triage the “patient,” then run

tests before diagnosing and administering “treatment.”

What are the most important tools you have on your bench ?

My antistatic mat, specialized screwdrivers and hand tools,

nonconductive probes, diagnostic software, and my iMac. The

mat and nonconductive probes keep any static electricity from

discharging and damaging sensitive circuitry.

What do you like least about your job?

Delivering bad news. Having to tell someone that their hard drive

has failed and there’s no way to recover their family photos, 80-

gigabyte music library, or doctoral thesis can be pretty unpleasant.

What do you like most about your job?

It’s very gratifying to be able to recover data from a failed hard

drive. I once had a young mother come in with her small daughter,

carrying her old Powerbook. She explained that it was her only

means of contacting her husband who was deployed to Iraq, that

her daughter’s delivery photos were in the computer, and that she

did not have a backup. I was able to recover the photos and, while I

was repairing her computer, I started an iChat session, on my iMac,

so she could visit with her husband. That was a great day.

The number one educator of health care professionals in Maine.

Biddeford and Portland, Maine | www.une.edu

Maine Ahead magazine Nov/Dec 2011

Documents

Transcript of Maine Ahead magazine Nov/Dec 2011