By Amanda Estes

Staff Writer

Vincent Conti, President and Chief Executive Officer of Maine Medical
Center (MMC), said he knew about MMC via its reputation long before he
knew anything about Portland or Maine.

    When Conti accepted the job nearly 11 years ago, he
wanted to build on MMC’s reputation. His vision called for the hospital
to be one of the best in the nation, not just the best in New England
or the best in the state.

    “People that were here were, I think, very satisfied
with the way the medical center was. They were comfortable,” he said.
“There was an accurate sense that this was a good place to get care,
that delivered high quality care, but there was a complacency probably
about it that I thought, there would be nothing wrong with, if we
wanted to be what we were.”

    The Cape Elizabeth resident came to MMC in 1997 when
the hospital was entering the Maine Health system, a partnership
between various health care agencies. For 20 years, Conti worked at
Yale-New Haven Hospital in New Haven, Connecticut. Prior to that he
worked at Day Kimball Hospital, a 149-bed center in Putnam,
Connecticut.

    Growing up in New York City, in a family of
pharmacists and physicians, Conti said his first job at 16 was in a
hospital laundry room. After positions in admitting offices and
cafeterias, Conti taught himself to be a scrub technician.

    “I learned how to pass the instruments, get scrubbed
in and assist with the surgeries as a college student and that’s when I
figured out I’d rather be in management than direct clinical care,” he
said.

    Turning away from his pre-med aspirations, Conti
finished college in New York City and after “a brief stint in the
army,” attended Cornell’s graduate school for hospital administration.

    Conti said the “culture changes” that took place
within his first four years on the job were aimed at improving MMC’s
reputation as a quality referral hospital and developing more research
and education initiatives, while ensuring the hospital maintained a
quality work environment that continued to attract new employees.

     “Some people were more able to deal with the vision
that I talked about than others so we had a fair amount of turnover at
the senior level and that’s not easy, but it’s also invigorating, I
think, to everyone involved,” he said.     

    The next changes came in the form of several
strategic plans designed to assess where the hospital would be in 10
years. Looking ahead has prepared the hospital to deal with increasing
demands on hospital resources.  

    “Despite most people’s thinking eight, nine, 10
years ago, demand on hospital services has increased,” he said.
“Everybody thought–including yours truly–with technology doing what it
was going to do, people would be admitted to the hospital much less
frequently.”

    Instead, Conti said, technology has given hospitals
the tools to expand patient services. In addition, he said the baby
boomer generation is hitting its “high hospitalization years.”

    Conti’s first plans focused on the hospital’s
facilities and finances. The results of the facility improvements can
be seen today as construction continues on the Women and Infants
Building and the Scarborough Surgery Center is scheduled to open on
Aug. 29. Construction is also underway on a new parking garage, a
helipad, a central utility plant and an emergency department expansion.


    Conti’s other long term plans addressed what he
called the “three legged stools of the mission:” clinical services,
research and education.

    Conti said MMC was able to hire two renowned
scientists, supported by National Institute of Health grants, who
helped to develop MMC’s Scarborough research program. Recently, Conti
said, MMC received approval for a 20,000 to 30,000 square foot addition
because of the program’s success.

    The recently completed education plan, focused
primarily on increasing education for physicians, Conti said. As a
result of the plan, the hospital increased the number of physicians in
training positions by 50 and expanded the graduate medical education
program.

    “The idea there was when you train physicians close
to home, they tend to stay close to home and Maine has a very
significant physician shortage right now, “ he said. “About a third of
the physicians that graduate from a locality, stay in that locality. I
think its been said that about 50 percent of the physicians, one out of
every two in the state of Maine, have had some contact of getting part
of their education here at Maine Medical Center so you put those two
facts together and its important to the state for us to expand.”

    As of Monday, Conti said the hospital is in
negotiations to expand its undergraduate program. Currently, third and
fourth year students from the University of Vermont College of Medicine
have the option to do their clinical rotations at MMC. Conti said the
hospital might pursue a relationship with another medical school in
order to enhance the program.

    “The theory there is if you have people come here
when they’re medical students, there’s a greater chance that they’ll be
interested in their medical residency here and if you get them as
medical residents, there’s a greater chance that they’ll stay in the
state of Maine.”

    Conti said a physician shortage is being felt across
the country. He said there was a decline in medical enrollment, which
has seen a reversal in the last three years, but due in part to long
and expensive hours of training and a decrease in reimbursement due to
rising health care costs, the career is not as attractive as it once
was.

    “We’re blessed here in Portland for a lot of reasons
in that we train a lot of our own physicians-plus Portland is a great
place to live so we don’t have nearly the physician shortage here in
Portland that most of the rest of the state and many parts of the
country do,” he said.

    The same can be said of MMC’s nursing staff, Conti
added. The hospital is in the fortunate position of having a committed
nursing staff while not having difficulty recruiting new
staff.    

    In communities across the country, Conti said, the hospital tends to be the largest employer in the area.

    “We are unusual in the terms of the size of Maine
Medical Center relevant to the population of Maine,” he said. “It isn’t
typical that a state of 1.2 or 1.3 million people could really support
the multiple missions and the size of Maine Medical Center, but it does
and it’s because the need is there.”

    Conti also said most people might not recognize that
MMC is one of the lowest cost hospitals on a unit basis in the state.
In a comparison of costs to 95 other hospitals across the country of
similar size and missions, Conti said MMC ranks in the top third.

    During the last three years, Conti said MMC has also
reduced its rates in order to comply with Governor Baldacci’s Dirigo
Health targets. The biggest issue for hospitals has been the program’s
limit on cost per adjusted discharge or CPAD, a measure Conti had
already established at MMC.

    Conti said a rise in medical inflation for
medication, equipment and salaries has made it difficult for some
hospitals to comply with the CPAD target.

    While keeping an eye on costs, Conti said the
biggest problem in health care is lack of coverage. He called
Massachusetts’ law requiring residents to purchase health insurance,
“probably the boldest and most innovative state level attempt to reform
the health care system,” but said it is more likely there will be
reform on a national level rather than state-by-state.   

    He said the American Hospital Association, of which
he is a board member, is working to develop a model to reform the
national health care system.