Penobscot Community Health Care Credit: Gabor Degre

One of the region’s major providers of health care to children, Penobscot Pediatrics of Bangor, has ended a decades-old arrangement in which its doctors delivered checkups and routine care to newborn patients at Northern Light Eastern Maine Medical Center.

When the group stopped sending pediatricians to the Bangor hospital’s newborn nursery at the beginning of February, it freed them up to provide more of the outpatient services that they regularly deliver at their office on Union Street and for which there has been an increasing need, according to Dr. Noah Nesin, the vice president of medical affairs at Penobscot Pediatrics’ parent organization, Penobscot Community Health Care.

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“There is a lot of demand for those services,” Nesin said. “Having the time that the pediatricians spend [visiting] normal, newborn babies in the nursery, having that time back can provide additional, really important access for the work that we’re doing in the office. We’d like to be able to continue both — anybody would. But in a time of limited resources, it comes down to, in some ways, a value judgment of what has more impact on our population of people that we serve.”

Penobscot Pediatrics, which has six pediatricians on its 40-person staff, provides a mix of services for children, including primary care, walk-in care, case management and psychiatric counseling, according to its website. It operates the Key Clinic, which examines kids who have recently entered foster care.

Maine is known for its low birth rate and older population, but Penobscot Pediatrics has generally seen the demand for its services increase in recent years. It had 23,164 patient encounters last year, up 10 percent from 21,080 in 2017, according to a spokeswoman for the organization. It’s growing out of its Union Street office and this fall will move into a new location more than double the size at the former Verizon Wireless call center at 6 Telcom Drive.

The need for Penobscot Pediatrics’ services has gone up partly because of the opioid crisis that has afflicted Maine over the last decade, putting newborns and young children at particular risk, according to Nesin.

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The recent change, which took effect around the beginning of February, means that physicians employed by Northern Light EMMC will have to do the checkups and other routine care of newborn babies that Penobscot Pediatrics providers once handled.

Before the change in February, Penobscot Pediatrics doctors who went to the hospital saw infants whose families previously arranged for them to become patients of the Bangor organization.

Other practices have also sent pediatricians to see infants in the newborn nursery.

The visits usually include a routine exam of the newborns, counseling parents on the basics of caring for an infant and arranging a follow-up appointment for the child. However, more serious health challenges in a newborn are generally handled by one of the hospital’s specialists, according to Nesin.

The Bangor hospital has several groups of physicians who can provide care to newborns, including pediatricians, neonatologists and family medicine doctors, according to Dr. James Jarvis, the hospital’s senior vice president and senior physician executive. The hospital does not have any immediate plans to hire more staff.

“I think we will have to see how things go,” Jarvis said. “Right now, we have several different avenues of coverage. … We think those groups should be able to absorb the volume.”

Jarvis and Nesin said it was disappointing that this particular partnership had to end, but both praised the cooperation between their two organizations. They also said the departure of Penobscot Pediatrics from the newborn nursery is part of an ongoing trend in which providers of outpatient health care are moving away from the hospital setting.

“It’s a difficult decision,” Nesin said. “We understand that it’s a loss for our pediatricians and a loss for our patients not to be able to continue doing this.”

However, the two organizations will continue to partner on other efforts, including the CHAMP Clinic, a collaborative outpatient service that helps newborn babies who have been exposed to opioids.