Independent physicians and health care providers continue to press state health officials and hospital system administrators about when they can get inoculated against COVID-19 as vaccines begin trickling into Maine.

Some doctors who work outside Maine’s large hospital systems contend that Maine’s thousands of independent health care providers were left out of initial plans for Maine’s vaccination rollout. Many of these medical professionals – from primary care physicians to dentists and oncologists – regularly see individuals potentially infected with COVID-19 as well as Mainers most at risk of severe or fatal complications from the virus.

“It’s just a shame. It really feels like the private practice physicians who sometimes serve the most rural patients, we feel like we have been neglected,” said Dr. Cortney Linville, who employs nearly a dozen direct caregivers and other staff who have daily contact with patients at Wiscasset Family Health.

Compounding those frustrations, Linville and other doctors say, is seeing others get their first COVID-19 shots from the hospital systems that employ them even when they have less potential exposure to the virus or to highly vulnerable patients.

“The hospitals are being very exclusive,” said Dr. Lisa Lucas, who runs her own private practice, Fulcrum Family Health in Freeport. “They are moving down the line to people who rarely have exposure to people with COVID.”

It is another example of how demand for COVID vaccine far outstrips the current supply, even among highest-priority groups.

Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, said Monday he hopes vaccinations for that group of frontline workers will begin within two weeks. But Shah cautioned the timeline depends on supplies of the two approved vaccines, which have already been smaller than anticipated, as well as figuring out the logistics of getting vaccines to smaller, dispersed offices.

Shah also noted that not all top-priority workers – such as emergency room staff, EMS providers or staff at long-term care homes – have received the first of the two-shot regimen for COVID-19.

“I absolutely hear, understand and agree with the concerns that independent medical providers have expressed,” Shah said during Monday’s briefing. “I absolutely do and I don’t quibble with it one bit. It is just a question of how quickly we can race through that inner circle so we can start expanding outward.”

As of Monday morning, just over 17,000 people in Maine had received vaccination shots for a virus that has sickened more than 19 million Americans and killed over 334,000, including 326 in Maine.

Consistent with federal guidance, Maine CDC has directed that the first wave of vaccinations be given to workers or individuals at highest risk of either contracting the virus, spreading it or developing severe complications. Most of the estimated 26,000 doses expected in Maine by the end of this week will be distributed to large hospital or health care systems carrying out initial vaccinations.

But there are an estimated 130,000 individuals included in the first phase of vaccinations, including privately employed doctors and health care providers. The professional organizations that represent such workers said they are being bombarded with calls and emails from frustrated or concerned members.

“It’s been nonstop for the last week,” said Dan Morin, director of communications and government affairs with the Maine Medical Association, which advocates for physicians in dealings with state government. “They’re not taking a holiday break, COVID doesn’t take a holiday break and they are looking for some answers. And unfortunately we can’t give it to them.”

Morin estimated that there are at least 1,000 doctors, nurses and other staff at independent practices statewide who should be vaccinated during the initial phase. Morin said his organization and members have been looking for equity from the beginning of the vaccine distribution plans – “and we haven’t seen equity.”

“When the CDC scheduled the distribution of vaccines to the hospitals, I don’t believe there were any parameters that were set,” Morin said.
In a statement, officials at MaineHealth, the state’s largest hospital and health care network, said the company is awaiting guidance from the Maine CDC on vaccinating private practitioners and other workers from outside the network.

“At this time, MaineHealth is vaccinating members of its clinical teams, working through the various tiers of eligible care team members in accordance with guidelines set by the Maine CDC,” the statement read. “MaineHealth has not yet begun to offer vaccination appointments to support staff or the medical staffs of its hospitals.

“In order to assure that vaccinations continue apace, appointments are offered to the next tier of eligible care team members as a given tier is wrapping up,” the statement said. “Further, when clinics are winding down for the day, a small number of routine clinic volunteers and other hospital staff working in clinical areas may be offered a vaccination so that doses of the vaccine – which have a very short shelf life – are not wasted. These are rare exceptions made so that no vaccine spoils for want of a recipient.”

But Lucas, the Freeport primary care physician, described seeing “infuriating” and “heartbreaking” posts on social media from non-clinical hospital employees displaying their vaccination cards. As the solitary doctor in her office, Lucas personally swabs patients for COVID-19 but noted that her efforts to reduce pressure on emergency rooms will be for naught if she is forced to shut down because of exposure.

Lucas said she fully supports providing the first vaccines to emergency room personnel, nursing home workers and other frontline staff but is frustrated with the lack of information. And unlike other states with county-level public health agencies, Maine lacks the basic infrastructure to allow independent primary care physicians to even schedule a vaccination.

“They just volley us back and forth and say that they are waiting for guidance,” Lucas said of her calls for assistance.

Likewise, Linville noted that public health officials instruct people to contact their primary care doctor first if they are feeling symptomatic or fear exposure to COVID-19. Yet Linville said she has been met with “silence” when she inquired about a vaccination schedule for the staff in her Wiscasset practice and lamented what she described as a lack of oversight in how hospital systems are administering vaccines.

“We shouldn’t have to compete with other people in the community for a vaccine, but it does seem like the order of distribution is somewhat skewed,” Linville said.

Darcy Shargo, executive director of the Maine Primary Care Association, said there are an estimated 800 high-risk staff at federally qualified community health centers that serve many lower-income Mainers in rural areas of the state. She hopes that with the arrival of more doses, vaccinations will accelerate and extend to community health center workers who have also “been on the front lines since this pandemic started.”

“We understand that as of this moment, there is supposed to be a plan forthcoming (last I heard was 1-2 weeks), but meanwhile it’s been painful for the frontline FQHC staff to see other workers, some of whom may not be at high risk, receive the vaccine,” Shargo wrote in an email. “We have health center staff that act as emergency responders, as well as quite a few that service (long-term care) facilities, and many that are in daily contact with COVID positive patients.”

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