Starting in December, the number of trauma centers in Maine will drop from three down to two. Central Maine Medical Center in Lewiston says it's no longer seeking the designation for financial reasons.
Erin Clark, the medical director of the hospital's emergency department, says it costs the hospital about a half a million dollars a year to be certified as a trauma center through the American College of Surgeons.
"To be frank, CMMC doesn't have the administrative staff or resources needed to devote to maintaining record keeping for the designation, and we made a choice to allocate those resources to direct patient care elsewhere," Clark says.
The decision means that Maine Medical Center in Portland and Northern Light Eastern Maine Medical Center in Bangor will be the only two trauma centers in the state. But Clark says CMMC will continue to treat trauma patients, just as it did following the mass shooting in Lewiston in 2023.
"We would not just send all those patients down to Portland or Bangor," she says. "We would have the resources and capability to care for them, just as we did two years ago."
Maine's Emergency Medical Services says patients with more serious injuries should be transported to a trauma center if the travel time is less than 45 minutes. Otherwise, patients should be treated at the closest hospital. Under those guidelines, Paul Gosselin, the executive director of United Ambulance, doesn't expect much to change either. He says only patients in the southern part of Lewiston would be transported to Portland.
"For example, if we were out in Greene or Turner, or whatever, that probably wouldn't meet the criteria and we'd have to go to Central Maine Medical first anyway," he says.
But the director of Maine EMS, Wil O'Neal, says he's more worried by the change. He says emergency responders could face tough decisions about whether to transport patients longer distances or bring them to CMMC. And he says at a time when there's increased demand on ambulance providers, it could especially burden smaller services.
"There's an increased stress, I think, of the decision making on our stakeholders," says O'Neal. "There's going to be an impact on the system from these units having to potentially travel further and then return back to their communities."
At the hospital level, Maine Medical Center says its able to absorb more trauma patients. But some officials are expressing concern.
"I do think that this news is really a sign of, sort of an evolving and really worrisome trend that's sort of cascading across the state," says Dr. Charles Morris, chief medical officer for the southern region of MaineHealth, which includes Maine Medical Center. "Which is time and again we're seeing distressed hospitals and systems forced to make really difficult decisions given the really untenable financial pressures."
Morris says these decisions are often a reflection of the waning reimbursement rates from the state and from insurers that make it more challenging to provide care.
Officials at Northern Light Eastern Maine Medical Center agree that the reduction in the number of formal trauma centers, rural hospital closures, and the discontinuation of some labor and delivery services highlight a concerning trend. They're urging policy makers and other stakeholders to working to address underlying issues.
Central Maine Medical Center says this change isn't about removing a service- it's about preserving it. To underscore that point, hospital officials highlighted that they're currently recruiting for an orthopedic trauma surgeon.
