By BETTY ADAMS
Staff Writer Sunday, March 11, 2007

"There isn't any specialty position where someone couldn't go to another state and make more money," said George Hunter, vice president of administration at MidCoast Hospital in Brunswick. His responsibilities include recruiting and retaining doctors.

"Usually, people come to Maine because they get a reasonable salary and quality of life."

Getting them to stay here is another matter.

A "Physician Recruitment Agreement" made public after MaineGeneral Medical Center sued a doctor who left prematurely offers a rare glimpse of the efforts hospitals and others make to respond to community needs by recruiting physicians.

In its lawsuit, the hospital is demanding the physician, Dr. Eric L. Hensen, return a $375,000 advance.

Hensen, an osteopathic physician, was recruited to set up practice in MaineGeneral Medical Center's service area in Augusta and Waterville. The hospital offered a guaranteed income of $250,000 annually for the first two years, plus an additional $455,053 to set up a practice.

The hospital says Hensen, an ear, nose and throat specialist who closed his Augusta practice less than a year after opening it, left without making arrangements to repay the advance.

An affidavit by Dr. Stephen Sears, chief medical officer at MaineGeneral, said the hospital recruited Hensen and agreed to help him relocate to Maine from West Virginia.

Hensen has yet to file a response to the claim in court. Hensen is now practicing in New Mexico, according to his attorney, Michael Hodgins.

Those involved in the physician recruiting business say there's a lot of competition, too few doctors to go around, and the salaries are fairly standard, determined largely by the "Physician Compensation and Production Survey Report" published by the Medical Group Management Association.

The association conducts annual surveys of revenues and expenses for physician practices, analyzes it, and offers the data for sale. Currently, it offers "Physician Placement Starting Salary Survey Report: 2006 Report Based on 2005 Data."

Hospitals across Maine report a total of 204 physician vacancies, with the greatest need seen in primary care providers, followed closely by specialists. Match that with the fact that most other states are recruiting as well and with predictions of continuing shortages, particularly in certain disciplines.

Maine's openings, by practice specialty, are listed by the Maine Recruitment Center, a nonprofit arm of the Maine Hospital Association.

Jane Ham, recruitment center director, says the center forwards names of candidates to hospitals and private practices and then the hospitals or other employers conduct interviews and deal with contract negotiations.

"Using recruitment agreements is commonplace," Hunter said. "It's necessary because it's very difficult to recruit, particularly subspecialities."

Generally, doctors are recruited to meet specific needs in a community.

Salaries tend to be determined by region, and the survey by Medical Group Management Association shows that physicians generating a particular amount of revenue earn a certain salary.

"The report is the gold standard for data on physician compensation and production," according to the association's Web site.

Hunter agrees.

"Most people make market-based offers and most doctors are aware of what the market will bear," Hunter said.

In this field, as in many others, location matters.

"The more desirable the location, the easier it is," Hunter said. "On the coast, we're half an hour away from everything -- Augusta, Lewiston, Portland. Having a good location helps."

He said Maine competes on a national scale for ear, nose and throat specialists, urologists and orthopedists.

He said since salaries tend to be comparable -- because everyone is looking at the same survey -- a decision to relocate is based on other factors:

"Is this the place I want to live? Will I have colleagues to work with? If I'm the only ENT in town, I don't want to be covering every night and weekend."

Hunter said recruiting practices for physicians are limited by federal guidelines. The Stark Physician Referral law and Anti-kickback Statute prevent physicians from referring patients to entities in which the doctors have a financial interest.

Gordon Smith, of the Maine Medical Association, says low reimbursement rates for treating Medicare patients also contribute to Maine's physician shortage.

Betty Adams -- 621-5631

badams@centralmaine.com