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Governor Paul LePage talks about his first year, his 2012 game plan, and the best part of being governor. . . 18
Inside MMCâ€™s simulation center . . . 28
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Roundtable: Leadership on Board 40
>> FEATURES BUSINESS UPFRONT
Transforming the ’Toon . . . 10
photo: mark wellman; illustration: m. scott ricketts
Jeff Kline created cool shows as a kid with his Super 8 movie camera. Now he does it with a team of 250 writers and animators from all over the world. BACKBONE
Tested and Approved . . . 16 Ever wonder where all the lifesaving 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 . . . 40 A quorum of nonprofit board members give thoughtful deliberation on board leadership.
Podium: Governor Paul LePage 18 November/December 2011 Maine Ahead >> 1
Share the spirits of the holidays. This year take the stress out of holiday gift giving. Itâ€™s easy, just go to your local agency liquor store. There youâ€™ll find all kinds of great presents. Learn more by visiting mainebeverage.com.
Old New England Egg Nog
Ketel One with 2 Glasses
Gifts may not be available in all stores. Visit mainebeverage.com for more information.
Baileys Irish Cream with 3-50mls Flavors
Kahlua with Glass Mug & 3-50mls Flavors
Photos: (left) courtesy of the jackson laboratory; (right) Sea Fantasy, Eli Sallualu Qinajua, Puvirnituq, 1975, soapstone, photo by Dean Abramson, courtesy of the peary-macmillan arctic museum, bowdoin college
worth the trip: Peary-MacMillan Arctic Museum 50
vantage point: Doug Coleman 53 LIFESTYLE
In Every Issue
WORTH THE TRIP
Northern Exposure . . . 50
Medical Mayhem . . . 62
Good for What Ails You . . . 9
Robert Peary was the first white man to reach the North Pole. See the sledge that took him there at this Bowdoin museum.
Everyone in Maine health care knows the big guys are gobbling up the little guys. Is it good? Is it inevitable? John Wipfler weighs in.
One Man’s Answers . . . 53
Doug Coleman, the celebrated Jackson Lab scientist, credits persistence and luck for his groundbreaking discoveries. Some special mice helped, too.
NIMBY Is an Attitude . . . 66
Pulling Rank . . . 68
Sonny’s One So True . . . 60
Yeah, yeah, we’re last on the Forbes business climate list. Perry Newman says it’s no reason for rash decisions.
Jay Villani, Portland chef and creator of Sonny’s and Local 188, is the real deal.
Orlando Delogu believes that “Not in My Backyard” is an attitude—a bad one— that needs to stop.
MEREDA . . . 70
CHCS . . . 64A
Bill Sullivan on the multi-family sector; historic preservation tax info.
A report from Community Health and Counseling Services.
What if you could buy cocaine and morphine at any corner drugstore? You could—in 1900.
A Kinder, Gentler Johnny . . . 12 Patricia 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 . . . 14 Theodore Scontras of The Bank of Maine gives expert counsel on the care and feeding of your nonprofit board. THE WAY WE WORK
Macintosh Medicine . . . 72 David Higgins put his skills at computer repair and his emergency medical training together to create a thriving “healthcare” business for Apple computers.
November/December 2011 Maine Ahead >> 3
meet and greet PUBLISHER
Mark T. Wellman
>> PUBLISHER’S NOTE
EDITOR IN CHIEF
Tori Britton Managing editor
The Life You Save May Be Mine If I was having a heart attack, what would you do? THEY SAY IT TAKES SEVEN YEARS for new medical knowl-
Sandy Flewelling BUSINESS EDITORS
Mike Woelflein Henry Garfield
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
illustrator in chief
grateful. But a newer method, using rapid chest compression
M. Scott Ricketts
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
Ashley Ray Administrative Team
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.
Irvin Serrano Kevin Couture
— Mark Wellman, publisher
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@example.com.
6 >> Maine Ahead November/December 2011
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 disabilities, 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. November/December 2011 Maine Ahead >> 7
“Our university is constantly growing and improving. Bangor Savings plays a key role in that.”
Dr. Robert Clark President - Husson University, Bangor
“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.”
Photo: courtesy of hubbard free library
>> Good for What Ails You circa 1900, Hallowell The next time you visit the pharmacy and wonder whether
Some of these feel-good remedies came with a price. Many
St. John’s wort can treat depression or ginkgo biloba will reverse
were laced with alcohol and cocaine, addictive substances whose
memory loss, consider patent medicine purveyor Henry Pope
use often required treatment. Medical centers discreetly located
Clearwater, PhD. In the early 1900s, Clearwater began earning a
in private homes began cropping up, promising to cure liquor,
fortune with his Hallowell-based Heart Cure Company, which he
tobacco, opium, and morphine habits.
started in John Hawes’ drugstore.
As Stewart H. Holbrook explains in his book, The Golden Age of
By 1933, his mail order business , which also peddled prod-
Quackery, a 1905 Colliers Weekly series titled “The Great American
ucts claiming to cure rheumatism and stomach ailments, had
Fraud” prompted creation of the Federal Pure Food and Drug Act,
ballooned to the point where a new post office was built to handle
which required patent medicine manufacturers to list ingredients
as many as 25,000 letters a day, some from Great Britain and Africa.
on the label and to make no unproven claims. But companies still
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
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
the oddly-named Rhubard and Nux tablets from their horse-drawn
herbal nostrums, the public still clamors for unregulated, official-
wagon. And in Fryeburg, a Kickapoo Indian Medicine Company
looking products that promise to raise the libido or lower choles-
show employed Native Americans to sell Indian salve that suppos-
terol. Ecclesiastes got it right when it stated there is nothing new
edly cured fever sores, cancers, piles, and ulcers.
under the sun. —Richard Shaw
November/December 2011 Maine Ahead >> 9
>> mogul of the MONTH Transforming the ’Toon Jeff Kline has been blazing trails in animated TV since the mid-’90s. Now he’s showing LA how to commute. jeff kline is not a household name. But the cartoons he has turned into gold, from Transformers: Prime and G. I. Joe: Renegades 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 highlycompetitive 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, While his 50/50 time split between L. A. and Maine has been a
and sent it off. “I later read in the trades that Jumanji was going to In the 15 years since, Kline has codeveloped or produced 15
success, it does have one drawback. “Here in Maine,” Kline says, “my workday is longer because it starts three hours earlier and it
animated series—among them Men in Black, Jackie Chan Adven-
doesn’t end until the ‘kids’ in L. A. go home.” Still, with DigiDe-
tures, and My Friends Tigger and Pooh—while still keeping his
livery of clips, real-time conferencing with iChat, and a hand-
finger in the live action pie. Last year he signed a four-year
picked creative team he trusts, Kline is able to steer the studio
contract to create a new animation studio for Hasbro and conjure
ship from 3,000 miles away “and still take my daughter to karate
up content for The Hub TV network.
• Number of episodes of animated TV Kline has codeveloped and/or executive produced.
• Kline’s Daytime Emmy nominations, for Dragon Tails. Transformers: Prime earned 6 nominations.
2008 • Year Kline and his family decided to move 250 • People Kline currently manages across
to Maine for a “change of life.” 10 >> Maine Ahead November/ December 2011
multiple continents to produce two animated shows.
Illustration: m. scott ricketts
be UPN’s first kid show and that I was producing it.”
I always feel that the next person’s skeleton and mine will look about the same. —Wesley McNair
MA I N E
W A V ES
>> Twin Wins HISTORY 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
PHOTOS: (top) courtesy of sunday river; (CENTER) courtesy of the university of alabama; (bottom) samuel cousins photography
so they can legally drink their winnings.
>> Satellite Sleuth Who 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.
>> FTW 2.0
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.
if 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.
THOMAS REAGAN, a Maine-based personal chef, was crowned Maine Lobster Chef of the Year 2011 at Portland’s annual Harvest on the Harbor event in October. Reagan was named the winner at a cook-off competition in front of a live audience.
November/December 2011 Maine Ahead >> 11
>> Maine goods 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 .
Can 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. Sometimes adversity, not necessity, is the
johnny, with a useful life per garment of 40 to 50
mother of invention. In 2008, Patricia Royall was
washings. All told, the cost per johnny over its
undergoing radiation treatment for breast
entire life cycle can run from $500 to $700.
cancer, and selected her requisite hospital
Royall’s Jazzy Johnnys, when purchased at $64
johnny from the bin—pulling out a soft,
and given to the patient to care for over their
brightly-colored johnny with the name of a
course of treatment, save the hospital time and
Haitian hospital on the back. The other patients
money, and save patients’ self-esteem.
in the waiting room all admired it, and collec-
The higher initial price tag of Jazzy Johnnys
tively wondered: “Why can’t hospitals come up
comes in part from the special properties of the
with something better for patients to wear?”
fabric Royall uses, called TENCEL. Made from
In 2009, Royall launched Jazzy Johnnys, her
wood cellulose, the TENCEL in Jazzy Johnnys is
answer to the skimpy, ill-fitting hospital gown.
not only eco-friendly (it’s organic, and, unlike
As she researched designs and fabrics, she
polyester, breaks down in landfills)—it is also
found out there are more negative aspects to
antibacterial, helps regulate body temperature,
current patient wear than meets the eye.
wicks away excess moisture, and doesn’t irri-
While the typical hospital johnny costs as
tate sensitive skin.
little as $3, it is often made with cotton that is
In 2010 and ’11, Jazzy Johnnys was awarded
treated with pesticides in the field, and sprayed
two seed grants through Maine Technology
with formaldehyde to prevent shrinkage—“not
Institute. The initial grant allowed the company
the kind of material you want sick people
to conduct its first pilot program at MaineGen-
wearing,” Royall says. She cites a study funded
eral, where Patricia Royall was first inspired to
by the Robert Wood Johnson Foundation calcu-
create a kinder, gentler johnny. Pilot no. 2 is now
lating an average cost of $1.45 to wash each
going on at New England Rehab in Portland.
12 >> Maine Ahead November/ December 2011
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 doubling previous records.
Photo: courtesy of jazzy johnnys
a kinder, gentler johnny
BURGESS Advertising and Marketing of Portland won six major awards at the 20th annual Maine Public Relations Council’s Golden Arrow Awards ceremony. The company was recently named the Best Place to Work in Maine in the small/medium category.
November/December 2011 Maine Ahead >> 13
>> sticky business 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?
R ecruit before you need them
A: In a lagging economy, the
Recruit all the time, in all the right places.
demand for nonprofit service spikes
Recruitment efforts can be adjusted according
to fill community needs. Attracting
to the board’s current needs, but should never
the right leadership will strengthen
go dormant. Establish a pool of potential candi-
a board’s governance and opera-
dates ready to fill a vacancy or supplement a
tional efficiency. As stewards of
committee task. Reach out often to stake-
trust, nonprofits must develop
holders who already have a vested interest in
their board’s strategic counsel to optimize performance and instill public confidence.
the nonprofit’s success. All outreach strengthens board recruitment. Educate supporters about goals and
Know your goals and skill requirements.
accomplishments. Take advantage of the
Take inventory of your board’s long-term plan
group’s professional affiliations to reach key
to determine what type of expertise is critical
audiences. Use social media tools to showcase
to drive forward. What are the strengths of
growth and share success stories.
your board today? What roles will need to be refreshed due to turnover? Recognize that a
Take care of your existing board. It’s critical
range of skills and experiences will allow the
to keep members engaged and to remember to
group to quickly react to any situation. Diverse
re-recruit your board. Have a board perfor-
board composition will also yield perspective
mance process to set clear expectations and
measure progress. Promptly resolve issues to prevent burnout and disillusionment. Find
Use your mission to attract strong leader-
creative ways to recognize contributors who
ship. Does your organization have a clear value
step up and deliver on commitments. Your best
proposition? Determine what messages differ-
potential recruiters of board talent are current
entiate your cause and market them effec-
members—especially those who feel both
tively. State what is compelling about your
effective in and appreciated for their service.
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 represents the fifth generation of family members running the Bangor supplies company, founded in 1854. MARK ADAMS has been appointed president and CEO at Sebago Technics, a Westbrook-based consulting 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 covenants 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.
nonprofit’s purpose and where potential board members can add value. A strong identity will
Sticky business questions need answers.
attract the right talent to advance your goals.
Email yours to firstname.lastname@example.org.
This month’s expert: Theodore N. Scontras Executive 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 Education 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.
14 >> Maine Ahead November/ December 2011
NANCY MARSHALL, president of Augustabased Nancy Marshall Communications, was awarded the Edward L. Bernays Achievement Award by the Maine Public Relations Council at the organization’s annual conference, the highest honor bestowed by the council to a single practitioner.
November/December 2011 Maine Ahead >> 15
Robert Weiss, MD, founder of Maine Research Associates
Tested and Approved Through 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
16 >> Maine Ahead
he powerhouse organizations in the $100 billion business of medical research tend to be large, academic hospitals in major cities: Johns Hopkins in Baltimore, Boston’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 trials 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 Associates conducts studies and research that lead to the development and improvement of drugs and treatments for heart disease and related conditions. Trial participants, many of them patients at Androscoggin Cardiology Associates, the practice
Dr. Weiss launched in 1985, benefit through access to drugs and therapies well ahead of the rest of the market, as well as through stipends for participating 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 better 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 process 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 Medical Center, which will add CMMC physicians and
locations to MRA efforts. Eight new studies 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 expansion to CMMC-linked facilities in Rumford, 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 SanofiAventis—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 treatment 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, including effectiveness and side effects. Neither the doctor nor the patient knows whether a particular patient receives the medication or a placebo, but all are monitored for side effects and progress. Currently, 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 advance of most people. Others clinical trials, such as a multidecade NIH study seeking a gene that causes heart attacks, don’t offer immediate benefits to subjects. Yet local patients’ commitment to such studies is one reason
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. that, though Lewiston-Auburn lacks the population and medical schools of larger competitors, it’s well suited to medical research, according to Weiss. It’s an aging population with a lot of free time, and a good amount of hypertension, obesity, arthritis, 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 medicines, 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 assistants, 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.” November/December 2011 Maine Ahead >> 17
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
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 conservative 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 mathematics. Paul LePage is a fiscal conservative, a Reagan-loving free-market capitalist from head to toe. He believes in the creation of wealth, wants limited 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 coffers. 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 money 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 income 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. 18 >> Maine Ahead
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. 20 >> Maine Ahead
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 competitors to what is being promoted by the president, 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 implement 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
Photo: jim bowdoin
The official portrait of Maine’s first family, taken at the Blaine House.
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 anything; 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 speaking 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 certainly did not show the respect that the Office of the President needed and deserves. By the same token, the underlying 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 structure and decrease accidents. Most of them are suggestions for improvements. There is a major, major concern amongst Maine people about welfare; people are very interested in making suggestions 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 anything else; it’s like people who are alcoholics or drug addicts—you’ve got to wean them away from the program.
“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.” 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 without 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 session, 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 Washington, 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 November/December 2011 Maine Ahead >> 21
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
“There’s nothing I’d like to see more than a growing economy where income tax wasn’t necessary.” 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 system, 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 unrealistic; 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 looking 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 teacher 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 better 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 going to grow Maine, both from a population base and a pros-
>> The LePage File Born: October 9, 1948, Lewiston, Maine Education: Lewiston High School, 1967; Husson University, 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,
22 >> Maine Ahead
1979–1983; director of financial administration, 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; Waterville 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 furniture making, softball, raquetball, ice hockey, and reading biographies of historic leaders.
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 experience, 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.
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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 massive 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 investment, 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 inhibiting economic growth. Without a
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November/December 2011 Maine Ahead >> 23
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 energy 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 commercially viable at the present.
“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.” 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 making 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 24 >> Maine Ahead
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 opportunity 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 looking at a whole mix. We are looking at what has happened to our energy since we deregulated. There are some startling revelations. Back when electricity was regulated, the generation portion of our usage was 35% of our bill. After 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 Affordable 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
Photo: courtesy of paul lepage
Paul LePage, in his mid-30s.
had is, by passing LD 1333, we are still focused on a private-sector-controlled industry 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 people can afford health care at a younger age, so they don’t wait till they’re 40 or 50 to enter the healthcare system so there are more people and more money in the system. I think the work we’re doing at the hospitals 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 going 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.
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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 working 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.
versally, they come back and say, “It’s too expensive to do business in Maine. You’ve got to lower your costs.”
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?
So is it safe to say your goals for 2012 are basically to continue to “get our ducks in order?”
That’s a moving target. I believe we have a really good solid plan of fiscal responsibility and some austerity going for-
“You won’t tax yourself to prosperity. It’s never been done. So we have to learn to do more with less.” 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 million. 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 uni26 >> Maine Ahead
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 processed 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 beautiful state. Sometimes I think we’re the best kept secret. Our motto is “Vacationland” and I agree with that. It’s a beautiful 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 pushing. 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 community 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 service 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.
Photo: dennis walsH, courtesy of Maine medical Center
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
November/December 2011 Maine Ahead >> 29
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 hospital 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 intravenous 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 until the spasms subside. Ethan stabilizes for a moment, 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, sweet30 >> Maine Ahead
heart,” she says. “You did great, Ethan,” says one of the doctors. His partner nods as a voice comes over an unseen 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 televisions. They, like the two young physicians, are residents at the Maine Medical Center-Tufts University School of Medicine (MMC-TUSM), and such simulations are an integral part of their curriculum. 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.”
Photos: (top) dennis walsh, courtesy of Maine medical Center; (opposite) Mark wellman
“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.”
November/December 2011 Maine Ahead >> 31
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.
Jeff Holmes, MD (bottom) is director of simulation education and attending physician at Maine Medical Center’s department of emergency medicine. Here he coordinates communication and clinical findings from the control room during an emergency room simulation.
32 >> Maine Ahead
Photos: (top) mark wellman; (center and opposite) dennis walsh, courtesy of Maine medical Center; (bottom) Melanie brooks
Virginia Eddy, MD (center), director of undergraduate surgical education at Maine Medical Center and professor of surgery at Tufts University School of Medicine, teaches using the sim center’s laparoscopic box trainers, which help residents practice with the instruments and procedures involved in laparoscopic surgery.
Learners are practicing a procedure called intubation, which is supporting a patient with a breathing tube when they are in respiratory distress.
MMC-TUSM students start doing simulations their first month as a resident, something Matt Delaney, a recent 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 contains 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, offices, 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 mission 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-
“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 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 benefit from the pioneering centers that opened at large university 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 Foundation. 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 reNovember/December 2011 Maine Ahead >> 33
Extremely Patient Patients The medical mannequins at Maine Med’s Sim Center “live” to help students hone their skills.
34 >> Maine Ahead
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 stethoscope 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 underlying 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 beginning 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.”
Photo: melanie brooks
search. We are looking at grants and funding, but we don’t have any commercial relationships or government relationships that pay for our operational costs. The faculty time is taken care of by the departments, 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 transparent 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 interested in medical simulation while serving in the U.S. Air Force. “There’s the wellworn 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 cardiovascular 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 important 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 specialist controls the mannequin while another manipulates the readouts on the instruments hooked up to the plastic patient. Any actors in the room have an audio feed
so that controllers can whisper instructions 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 actors 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 actresses, and a full team to train them to play patient roles,” Darby says. “These
actor/patients interface with medical students, nurses, and residents for interpersonal 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 writing the scripts for some ED-related sceNovember/December 2011 Maine Ahead >> 35
Faculty listen to and monitor learner interactions from the standarized patients control room.
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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 respiratory 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 debriefing can focus on a particular response to a particular 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 scenario, 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 backstage area, a large room where mannequins are readied and repaired. “We learned in the planning 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 simulations. “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 chemicals. “They actually have odor kits that can make
Photo: deNnis walsh, courtesy of Maine medical Center
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 wiring 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 hospital 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 simulated medical events without real patients. There’s no risk of harm, and residents are
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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 hospital, 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 results in real hospitals? The sim technology and practices are new and the results
Startup cost: $5.8 million Annual operating budget: Approximately $500,0000. Positions: Software engineers, production staff, information technologies specialists. Future challenges: Expanding training opportunities to include EMT/paramedic training, partnerships with nursing schools, travel training programs for rural healthcare providers. To learn more: http://simulation.mmc.org
data curve is correspondingly short. “I caution people about the science,” Darby says. “There’s no absolute proof that someone who performs well in a simulated 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 learning, in part because of the time pressures on the learning system.” Young doctors like Delaney, who now works in the emergency room at Portland’s Mercy Hospital, say the simulation 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 doing. 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 tuning your guitar; it’s nice to have that stuff be automatic.” The training is not all technical, however. “There’s a real risk of doctors becoming 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 traditional doctor-patient relationship. Sometimes 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 relationship with the community.” The center’s goal is to make simulated
training available to medical professionals throughout the state and in all departments of the hospital. Plans include providing 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.” November/December 2011 Maine Ahead >> 39
40 >> Maine Ahead
ON BOARD Nonprofit 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
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 secondguessing 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 directors to make sure the nonprofit is deserving of tax-exempt status. This requires thoughtful reviews of annual budgets . . . helping the organization 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. November/December 2011 Maine Ahead >> 41
P E R S O N AL
F I N A N CE
P A N EL I S T S
Eric Uhl Kenneth Spirer
Commissioner 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.
Owner 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.
Fisher and Phillips Partner Sandra Featherman spoke at Director of Marketing and Eric Uhl recently President Emeritus the annual Maine Human Development University of New England Resources Convention. Mayo Regional Hospital Dr. Featherman was president of Lizotte chairs the Maine UNE from 1995 to 2006. Her board Humanities Council and service includes the Samuel Fels Penquis boards, and serves on Fund, Girl Scouts of Maine, and Foxcroft Academy’s, and others. Maine Community Foundation.
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 unplanned. 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 assured 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-
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teacher organization at my children’s school, and soon found myself president of the citywide organization, serving the parents of 300,000 children, in Philadelphia. Cheryl Rust: I believe the first nonprofit board was Shoreline—a community mental health organization based in Brunswick. I was recruited by another Wiscasset community member who was retiring 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?
I care deeply about the quality 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-
volved education (both k–12 and higher education), women and girls, and philanthropy. 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 saying 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 responsibilities; the strength and character of the organization; its leadership at the staff and board level; and my desire to not overcommit my time and energies. I have found my involvement in the nonprofit community as a board volunteer to be personally extremely rewarding. The organizations with which I have been affiliated all have a focus that is appealing 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 retirement, that learning experience has been a strong motivating factor for my continued activity.
Cheryl Rust: Inevitably, board service provides 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 organizations—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 inspiring 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 management styles, in different board environments, 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.
I have become less impatient when seeking change that I believe Kenneth Spirer:
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 Foundation, 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 articulate 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 matriculated 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?
An effective board member really needs to believe in the organization’s mission, be willing to devote time to the cause, and understand that personal philanthropy in support of the organization 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 November/December 2011 Maine Ahead >> 43
“All new board members should be given a thorough orientation, so there is no misunderstanding over what they are getting themselves into.” —Tom Lizotte
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 unhelpful, 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 informed mission. An effective board member should be a good listener, an active participant in board and committee 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 participating, or worse, who miss more than one or two meetings. 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
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passion about the mission of the organization. Board members need to be well informed about the issues facing 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?
A diversity of professional skills is critically 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 attention in the board recruitment process are geographic representation, 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.
Frequently, attorneys, accountants, and investment professionals are asked to serve on nonprofit boards because of their professional backgrounds. While this can be helpful, not every lawyer 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, primarily 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 knowledgeable professionals is always desirable. The same goes for the investment function, since board members have a fiduciary obligation to oversee the organization’s endowment.
I believe that boards should be as diverse as possible. That means not just race, gender, and income levels, but professions, political orientations, and age. Where appropriate, students, clients, service users, and public members should be included. The more points of view and life experiences represented, 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 giving 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, including a session in person with counsel for the organization or the presentation of a set of written guidelines and expectations, receipt of which should be acknowledged in writing. The board chair should lead this effort. I’ve seen improvement in this area over the past decade, primarily 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 appropriate 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. My experience suggests that there is a broad range of “legal sophistication” 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 briefing on relevant legal matters. An ounce of prevention, as they say. And, it is seldom a happy occasion to be learning about legal 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 November/December 2011 Maine Ahead >> 45
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?
“ 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
Tom Lizotte: What drives me nuts is board members who don’t follow through on their commitments, and who often fail to attend meetings. 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 given 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.
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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 accessibility of the Sam L. Cohen Foundation’s staff and its board’s willingness to initiate grants to support new pilot initiatives is another example of “getting it right.”
Most people have very busy schedules. When an organization acknowledges that fact by sending timely and informative materials, allowing a reasonable amount of time for you to review them in advance of the meeting, it is very much appreciated. Conversely, when they do not allow adequate time or materials to prepare thoughtfully for a meeting, 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 almost universally helped me organize what few talents I might have to feel that I can make a contribution to very important community work outside of my own professional career. They have very effectively created mechanisms to contribute to varied and vital missions, provided training to enhance my skills, guided my reading, challenged my thinking, broadened my understanding, and provided a forum through which to meet and come
November/December 2011 Maine Ahead >> 47
Here’s a tank full of thanks. 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?
One of the best leadership models I have observed was used by the late Bob Woodbury, my predecessor as Maine Community Foundation board chair and former chancellor of the University of Maine System. Bob included me in all important decisions and discussions in my role as vice chair for two years before I succeeded him. This model of leadership 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 other board members, with the obvious caveat 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 England, our board was faced with a difficult decision about the potential merger with Westbrook College. Faculty, staff, students, 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 university 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 DoverFoxcroft. Like many small-town libraries, 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 coming out, I feel a glow. It doesn’t get better than that. November/December 2011 Maine Ahead >> 49
>> Northern Exposure Arctic explorers Robert E. Peary and Donald B. MacMillan are still teaching us about the far north through their eponymous museum at Bowdoin College.
Getting there: • Take I-295 to Exit 28 • Merge onto ME-196 E/Lewiston Road toward Topsham/Brunswick. • Turn right onto Maine Street. Turn left onto South Street. The museum, located in Hubbard Hall, will be on the right.
50 >> Maine Ahead
very college appreciates highachieving 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 skillfully-designed clothing fashioned by an Inuit seamstress. (He also devised a stove
that would turn ice to boiling water in seven 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 collection, 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.
photos: (top) Qiviuk’s Journey, William Noah and Martha Ilumigayak Noah, Baker Lake, 1973, 23/50, stonecut and stencil, Courtesy of the peary-macmillan arctic museum, bowdoin college; (left) courtesy of the museum
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Coleman at The Jackson Laboratory in the 1960s.
One Man’s Answers 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 oug Coleman’s family was very poor when he was growing up in the ’30s. He remembers a horse and sleigh coming 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 prestigious 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, November/December 2011 Maine Ahead >> 53
but confines himself to the fitness center, which was recently named in his honor. You were born on October 6, 1931, in Stratford, 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 remember 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 rabbits and a couple of squirrels, things like that. My dad was a deadly shot; he could shoot a running rabbit through the head.
Yes, my dad was a very, very bright individual. 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?
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.
54 >> Maine Ahead
I guess I enjoyed it, but looking back, I was probably bored. I was most interested in history. I had my first taste of Shakespeare 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.
photos: (top left) courtesy of Doug Coleman; (others) courtesy of the jackson laboratory
Did your parents find work at some point?
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 interested in chemistry, biology, and geology, but I chose the chemistry route. I eased through elementary chemistry, and analytical 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 different than all the rest of the chemistry because of all the permutations and combinations that you can do with carbon 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 lecture. 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.
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-
“For years, obesity was thought to be a consequence of a behavioral problem, so when I showed this, people said, “No way.” 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 excellence. 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. Everybody 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 then spent your entire career at The Jackson Laboratory. What made you choose Jackson Lab?
You became famous for your research in obesity and diabetes,
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.”
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 appetite and body weight. Normal mice produced the facNovember/December 2011 Maine Ahead >> 55
“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.” 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 simple 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 enjoyment, doing things that we always wanted to do. Jeffrey Friedman at Rockefeller called up and said, “Are you going 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 Rockefeller, 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. 56 >> Maine Ahead
[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, “Everything 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, because, 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, different 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 factors 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 conservation 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.
Bigelow Center For Blue Biotechnology, East Boothbay, Maine. Rendering by Perkins + Will
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November/December 2011 Maine Ahead >> 57
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Once Bev got sick, we gave away a piece to the Small Woodlot Owners Association, and they’re doing everything 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 people 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 species of things, and they come back in wonderment.
I knew a few years ago that we had been nominated because 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.
As a scientist, you’ve won many of the world’s most important
Honors aside, you’ve made a place in the history of science.
honors and prizes, and many people thought you and Dr. Fried-
What are you hoping your legacy will be?
man might share the Nobel Prize this year. Your thoughts?
That I was persistent; that I did the best I could.
Tamera Edison, MBA Manager Group Customer Service Unum, Portland, Maine
November/December 2011 Maine Ahead >> 59
>> Jay Villani Sonny’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.
Opening Local 188. Places you’ve been to that inspire you as a chef: Au Pied de Cochon, Boqueria, Zuni Grill.
60 >> Maine Ahead
Favorite item on the menu: “Arepas. I love their simplicity.” Photos: Kevin Couture
Pivotal career move:
>> Sonny’s 83 Exchange Street • Portland www.sonnysportland.com
Hours: Lunch: Tuesday–Friday 11:30 am–2 pm Brunch: Saturday and Sunday 9 am–3 pm Dinner 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.
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:
Your new favorite ingredient:
Wednesday. It’s a surprising night—sometimes
Precooked cornmeal for our arepas. Things you’d like to learn or study:
busy, an early start to the weekend, and sometimes it’s quiet. You never know.
Longtime favorite ingredient:
Saffron. What a perfect day off looks like:
What you would want your last meal to be: My grandmother’s pasta fagioli.
Memory of a great meal you had in Maine:
Me and the boy at the ballpark.
My Christmas Eve dinner at Local 188 for The last time you really impressed yourself
When I made island spiced pig jowl.
Something about you that people would find surprising:
in the kitchen: Pet peeve when visiting other restaurants:
I’m smart. November/December 2011 Maine Ahead >> 61
Medical Mayhem 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 personnel 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 target of frivolous lawsuits. Not many entrepreneurs would want a piece of that action, but this is the business model independent physician practices in Maine confront today. Consequently, increasing numbers of independent practices have closed up shop to join ever-growing regional healthcare organi62 >> Maine Ahead November/December 2011
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 Association, 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 unable 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 difficult to sympathize with highly compensated physicians. However, as more Maine physicians move to large medical centers, consumer choice and access will become more limited 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.
Illustration: m. scott ricketts
Every day, Maineâ€™s independent physician practices are being swallowed up by large healthcare organizations. Is resistance futile? BY John Wipfler
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 interesting options, Maine does not have a large enough population of independently wealthy citizens who can pay for healthcare 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 focus on clinical and service quality, and superior outcomes. However, physicians can’t do this alone. Insurance companies and self-insured employers 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% annually? As employers look for ways to provide quality healthcare benefits at reduced costs while maintaining service choices, employers can put pressure on insurance companies to keep the independent practice in the provider mix. Self-insured businesses are also wise to reach out directly and identify preferred providers to negotiate better value (high quality + lower cost = value) and provide incentives such as lower co-pays and reduced deductibles to encourage their employees to use preferred providers. Independent practices are ready to become more efficient and stay independent. If employers incentivize employees toward high value providers, it creates a win-winwin situation for employer, employee, and independent practice alike.
Want Want more more of of Maine? Maine?
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 specialty practices and make them integral to their internal service offering, the organization does not want to see patient volume removed from its system and referred to an outside practice. This ultimately limits patient choice and access to quality care in a timely manner, as the healthcare conglomerate creates a selfserving system. Still, for many private practices, the economic and logistical benefits of consolidation are overwhelming, and every month more physicians decide 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 Orthopaedics, Chest Medicine Associates, Portland Gastroenterology Associates, and Spectrum 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 primary 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 quality service experience for patients. With Maine physicians continuing to enter into employment relationships with hospitals, it is obvious that many practices
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John Wipfler is CEO of OA Centers for Orthopaedics, with headquarters in Portland. November/December 2011 Maine Ahead >> 63
>> Free Ink A complimentary listing of Maine businesses. To get yours listed (first come, first served), go to www.maineahead.com and click on Free Ink. Paws Applause Natural Pet Supply Scarborough Founded 2004 Full-service supplies for dogs and cats; salon grooming for dogs. Largest retailer of raw food in Maine and New Hampshire. 27 Gorham Road • (207) 885-0077 www.pawsapplause.com Beachstone south Portland Founded 2009 Manufacturer of recycled glass and seashell countertops, tabletops, and giftware for the residential and commercial markets. 192 Mussey Street • (207) 899-8109 www.beachstone.biz
Custom designed offices for work and home, tailored to your individual needs and budget. Call John at (508) 889-4008 or (207) 645-5375 or visit us at Groverwoodwork.com
Maine Bay Canvas Portland Founded 1979 Specializing in party tent rentals and accessories for weddings, festivals, fairs, sporting events, and backyard gatherings. 53 Industrial Way • (207) 878-8888 www.mainebaycanvas.com Occupational Medical Consulting Leeds Founded 1996 Provides worksite wellness programs and software solutions to promote healthy and productive workforces, and reduce individual risks for chronic disease and rates of medical plan cost growth. 306 Campbell Road • 1 (800) 575-6537 www.omcwellness.com Fluid Imaging Technologies Yarmouth Founded 1999 Manufacturer 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) 846-6100 www.fluidimaging.com Mid Coast Hospital Brunswick Founded 1991 A full-service, 92-bed, independent, not-for-profit hospital with an active medical staff of more than 160 physicians. 123 Medical Center Drive • (207) 729-0181 www.midcoasthealth.com
64 >> Maine Ahead
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THE BULL PEN
NIMBY Is an Attitude The spread of “Not in My Backyard” is making legitimate, lawful, necessary economic pursuits increasingly impossible. By ORLANDO E. Delogu
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 wellbeing, the economic and social needs of the larger community. This NIMBY attitude is growing. Population is also growing. The diversity and complexity of undertakings 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, aberration limited to a handful of activities that stir passions and justified fears, e.g., nuclear waste disposal facilities, a major oil refinery or chemi-
Sound regulation of the unwanted activity seldom satisfies NIMBYs— they want it to go away. 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 power66 >> Maine Ahead
generating facilities (including today’s wind, solar, fracking facilities) and transmission lines, hazardous 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 facilities, homes for handicapped individuals, homeless shelters, soup kitchens, low-income housing, elderly housing—the list goes on. The NIMBY attitude, in its focus on what an individual 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 community. 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 arguments 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 stringent but fair regulation of the activity in question. But sound regulation of the unwanted activity seldom 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 arguments, voiced only in unguarded comments, but
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 unacceptable. Though NIMBYism is bad policy, selfish, and dangerous in the long run, NIMBY 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 NIMBYs 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 activists. 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. NIMBYism 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 inconvenience, 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.
Seeking a Bold, Dynamic Leader for the Maine Women’s Fund The 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.
Orlando E. Delogu is an emeritus professor of law at the University of Maine School of Law. November/December 2011 Maine Ahead >> 67
THE BULL PEN
Pulling Rank 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 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-bystate comparison, giving us abysmal marks for business costs, labor availability, regulatory environment, 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 subjective 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 university presidents mad, people read this stuff and many times they believe it. What’s more, as these rankings get repeated, the message gets reinforced and becomes an accepted part of the narrative until it is simply considered true.
We have to deal with rankings, but policy makers shouldn’t make any rash decisions or fashion entire legislative agendas based on them. Politicians then feel they have to make major changes in order to improve the business environment. Voters become convinced they’re living 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 68 >> Maine Ahead
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 reality check. There are rankings and there are rankings. 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 entire country for companies interested in setting up corporate headquarters. And, interestingly enough, it was Forbes itself that recognized Portland 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 makers shouldn’t make any rash decisions or fashion
Call 773-8890 today. . . 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 stimulate 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 materials, 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 renewables target would immediately end the flow of billions currently being invested 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. Businesses 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 admonished, first, do no harm. Cutting renewable 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 feature article in a business magazine?
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Perry B. Newman is president of Atlantica Group LLC, an international business consulting firm based in Portland.
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Member Q&A Bill Sullivan, owner of Sullivan Multi-Family Realty and MEREDA the multi-family housing sector in the Greater Portland area and first-time homebuyers and investors. 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 currently. 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 interest 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. Firsttime 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 renters 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 coming in to help pay for it.
Founded in 1985, MEREDA is a statewide organization of commercial real estate owners, developers 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 legislative advocacy, educational programs and professional networking opportunities.
Becoming a first-time homeowner and a landlord at the same time could be daunting. We want our clients to be very successful landlords because 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 Association. We also have a tool called the “Fast Pack,” on our website to help people determine whether multi-family housing works for them. It shows pictures, a brief description of the building and basic information: how many units there are, how many bedrooms/bathrooms 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
Maine Ahead • SPECIAL PROMOTIONAL SECTION
member, talks about what it means for
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-initiative 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, before the downturn, first-time home buyers and small investors were out buying up property. The big investors 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 family 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.
Tax Credit A recent amendment to extend the Maine historic preservation tax credit, passed in session, stimulates building projects during a time when development has dwindled. incentives to developers to repurpose historic buildings into qualified projects like affordable housing. In Maine, part of the 2008 stimulus package included an amendment to the historic preservation 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 creation 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 developers and contractors can continue to take advantage of the credit. The credit was essentially obsolete this year because historic preservation projects take between two and three years to complete. If a project was started this year, it would have been difficult to finish prior 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 buildings,” said Bunker. Bunker worked to extend the life of the historic preservation incentive because his company saw the benefits of continuing the credit. Developers Collaborative has finished one project repurposing the historic 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 affordable housing tax credit. Now, when a historic building is repurposed into affordable housing, 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%.
last legislative credit gives
“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 historic 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 window-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 affordable for the developer and for the tenants. It helps preserve the historic nature of buildings 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 preservation tax credit, please visit the Maine Preservation Commission at www.maine.gov.
PROFESSIONAL EVENTS November 9, 2011 Lewiston/Auburn Area Breakfast Seminar Deep Energy Retrofits
January 26, 2012 2012 Annual Real Estate Forecast Conference & Member Showcase MEREDA’S SIGNATURE EVENT
7:30 to 9:00 AM Martindale Country Club 527 Beech Hill Road, Auburn
This event brings together the largest gathering of commercial real estate professionals in Maine. This must-attend event attracts over 500 guests and offers a unique forum specifically geared towards developers, brokers, architects, bankers, attorneys, accountants, and other professionals looking to gain valuable 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
December 8, 2011 Portland-Area Breakfast Seminar Urban Impaired Stream Regulations 7:30 to 9:00 AM Clarion Hotel 1230 Congress Street, Portland
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 PM Holiday Inn By the Bay 88 Spring Street, Portland
SPECIAL PROMOTIONAL SECTION • Maine Ahead
The Way We work
>> David Higgins Computer 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, 80gigabyte 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.
72 >> Maine Ahead November/December 2011
The number one educator of health care professionals in Maine.
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Published on Oct 19, 2011
Interview with Governor Paul LePage, Private Tour of Maine Medical Center's Simulation Center, profile of Jackson Lab scientist Doug Coleman...