Dr. Lisa: This is Dr. Lisa Belisle and you are listening to the Dr. Lisa Radio Hour and Podcast number 54, Kids’ Health, hearing for the first time on WLOB and WPEI Radio Portland, Maine.
On Today’s show, we will be speaking with Dr. Lynne Tetreault of Maine Medical Partners Pediatrics in Saco and also the medical director of Vax Maine Kids; Dr. Amy Belisle, medical director of the child health quality improvement projects at the Maine Quality Counts Program; Dr. Lisa Letourneau, executive director of Maine Quality Counts; and three representatives from the Girls on the Run Maine Chapter, Jen Rohde the council director, Sandi Sinclair program coordinator and Staci Olsen, outreach and events coordinator.
I first moved to Maine in 1977 as a fairly small child and have lived here for many of the years since. My family has 10 and I’m the oldest, so I had a lot of experience with kids’ health from the very earliest years of my life. I myself have three children and when it came time to be a doctor and raise them, I thought, “You know, what better place to live than Maine.”
Kids’ health has always been very important to me through my 10 years as a medical director at Maine Health, I worked for the learning resource centers and the Maine Health, works on wellness program and also the Raising Readers Program.
I also wrote for 10 years for the Parent and Family Newspaper in the Southern Maine area, so I know kid’s health and it’s important to me. I thought we’d bring together some of the thought leaders in kids’ health. Thought leaders that not only are doing good work now, but have been doing good work for a long time.
In fact, you’ll find as you listen along that some of these individuals are ones that I have trained with. Some are ones that I have known all my life and some are ones that have had an important impact on my life in public health over the last 15 years.
Then we also bring in a new group of individuals who are also very enthusiastic about kids’ health and these are the women from Girls on the Run, a new program which is encouraging girls to get out there and feel good about their bodies and themselves through running.
There’s a lot you’re going to get from this program and one of the topics that I know some of you may find controversial is vaccinations. But I hope you’ll give it a listen, because what we strive to do in the Dr. Lisa Radio Hour is to represent different points of view. We think that everybody has a right to live their own life and have their own health their own way, but it’s important to have as much information as possible in making good decisions.
Thank you for being a part of the Dr. Lisa Radio Hour and Podcast and listening in and having an open mind and being inspired in going out in raising your own kids and helping other children to be as healthy as possible in this great State of Maine.
The Dr. Lisa Radio Hour and Podcast is pleased to be sponsored by the University of New England. As part of this sponsorship, we offer a segment we call, “UNE Wellness Innovations.” This week’s wellness innovation comes from the University of New England itself.
According to the National Institute of Mental Health, anxiety disorders affect about 25% of adolescents aged 13 to 18 with close to 6% seriously affected and close to 40 million suffering well into adulthood. With a $404,000 research grant it has just received from the National Institutes of Health, the University of New England plans to investigate some of the neurological basis of this debilitating anxiety disorders in adolescents.
Michael Burman, Ph.D., assistant professor in the University of New England’s Department of Psychology and principal investigator of the grant says, “Although the neural systems involved in adult fear and anxiety are well-studied, how these systems develop and contribute to the occurrence of life-long anxiety is not well-understood.”
For more information on this wellness innovation, visit doctorlisa.org. For more information on the University of New England, visit une.edu.
Dr. Lisa: Today on the Dr. Lisa Radio Hour and Podcast, we have the theme Kids’ Health and we’ve had already some wonderful people talking about bringing health to the children of the great state of Maine. Today, I’m very fortunate to have in the studio with me two people who I’ve known for many years. One for her entire life and one for significantly less time but still I feel we’re all kindred spirits.
The first one is Dr. Amy Belisle who is the medical director for the Child Health Quality Improvement Projects at the Maine Quality Counts Program. And the second one is Dr. Lisa Letourneau who is the executive director of Maine Quality Counts. Thank you so much for coming in and joining us today.
Letourneau: Thank you Lisa.
Amy: Thank you very much Lisa. It’s good to see you.
Dr. Lisa: Yes good to see you. We were joking earlier about now another Dr. Lisa in the studio. So we have got two Dr. Lisa’s and we have a Dr. Amy. I think it’s really interesting that all of us were raised in Maine. We have chosen to raise our children here. We’ve chosen to come back and practice here.
Lisa, just tell me why would you choose to come back to Maine? Winslow that’s where you’re from?
Letourneau: That’s right Lisa. I am a Winslow native. I was one of four girls growing up in a working class family that grew up saying we couldn’t wait to get out of Maine. Sooner, I’ve been out for several years that I decided I wanted to come home because it very much felt like home and it felt like there were a lot of great opportunities for work here, so I actually came back after medical school.
I did my residency right here in Portland at Maine Medical Center and have been working in the state ever since and feel very fortunate to have that opportunity because we often say it’s a state that’s just the right size to do this kind of improvement work. It’s just big enough to have an impact and just small enough to everybody and get everyone in the same room together.
Dr. Lisa: Amy, I know you obviously. Amy is my next younger sister, 19 months younger. Her twin is Dr. Adel Belisle and Amy went away and spent time overseas with the military but you chose to come back. Why did you decide to come back to Maine?
Amy: I think the reason that I came back first and foremost was our family, a large family, 10 children and our parents are close by. Like Lisa said, I did do residency in Portland and I trained at the Barbara Bush Children’s Hospital and had a very good experience there doing pediatrics and then was in the Air Force and went overseas. I actually lived in Japan for three years and Washington DC for a year before deciding to come back to Maine.
Ultimately, our decision was that we had small children and we want to be closer to our family. I was very interested in health care issues, health policy, health education and we felt like this would be a great state to come back and do that kind of work. Initially I came back and worked as a hospitalist and did work with kids who are in the hospital both newborn babies and older children and then got involved in some public health work; what we’re doing now.
Dr. Lisa: Let me take a step back. Both of you have been interested in public health related programs for a long time. I know Amy you did an educational program when you are a student at the University of Vermont where people went in, the students went in and were teaching health things in classrooms.
Amy: That’s right. We did what’s called the Smile Doc Program. When I was a medical student, we had the first and second year medical students go out into the Burlington community. We taught in about 10 schools in classes and really had them to go out to teach children about children’s health. That was a great way for medical students to learn and it was a great way for the 5th and 6th grade on children to learn.
They’re continuing to do that work. Actually, the Family Medicine Program in Portland has done a lot of work teaching in the Portland Public Schools around health education. So I think that that’s important. Part of being a doctor is to teach that’s one of our missions in life. It’s important to teach not only the medical students or fellow physicians, but also the families that we work with.
Dr. Lisa: And other Dr. Lisa across the microphone for me. You were an emergency room physician for many years. How did that translate into this interest in public health?
Letourneau: It has been an interesting journey. I’m actually trained as an internist and then did emergency medicine for my clinical life and it was a great experience, a great job. But I found myself getting a little bit frustrated with hearing a lot of the same stories over and over. People coming in with cough or infection and they continue to smoke. People who are having all kinds of health problems and clearly had not addressed root causes.
I remember one of the most dramatic was a middle-aged gentleman who came in clearly having a heart attack and I asked him before he could get his clothes off if he had a history of heart disease and he said, “No.” And he didn’t seem to know it was happening and then we took his shirt off and he had a great big zipper scar running down his chest.
He clearly had had bypass surgery and I looked at the scar and said, “I thought you said you didn’t have heart problems.” He said, “Well, they did surgery but they fixed that.” I remember thinking, “Wow, there’s a real need for education and for change here.” I saw some opportunities to get involved in quality work and sort of changing system sand it really had a lot of appeal.
Dr. Lisa: And you and I both went and got our masters in public health at different schools but around the same time, so I’m very familiar with this sort of seeing something clinically and then broadening it out and deciding to get more training. How has that translated into what you’re doing now and what is Maine Quality Counts?
Letourneau: The opportunities that I’ve had to get public health training have really been wonderful for my work. I first did that when I was working for Maine Health, the health system here in Portland. That includes Maine Medical Center and several other hospitals and really saw the public health training as a way to bring some discipline and additional tools to the kinds of work we were doing which is really I see about trying to bridge clinical practice in public health.
In the US environment for whatever reason, public health and clinical medicine seem to have grownup evolved into somewhat separate spheres. Often times when I ask my physician colleagues about interest in public health, they’ll refer to it as, “Well, that’s what other people do and that’s what people do over there at the state.”
I think since my early days at working in this area, it’s really been to try to bridge that gap between public health and clinical medicine and say they’re not two separate things. It’s about not just health care but about health. Both at Maine Health and now in my role at Quality Counts, it’s all about trying to bring together the difference stakeholders that are really critical to have an impact in changing our health care system with the ultimate goal of improving our health.
It’s not just about improving health care, it’s about having people grow up healthier as children, as young people to live healthier lives and then when they do need health care, to get better care as well. Maine Quality Counts is an organization that several of us actually helped to found about 8 or 10 years ago now. As people working in different arenas in health care, that saw some opportunities to share what was going on at the national level and at the state level about who is doing a good job in this area of trying to improve health and health care.
Since then, it’s grown from a very small sort of voluntary organization to a still small, but somewhat larger, slightly more formal organization. We are a separate non-profit, 501(C)(3) charitable organization with a mission of transforming health and health care in Maine by aligning, leading and collaborating in health improvement activity.
We specifically try to bring together the variety of stakeholders that are necessary to really change. It’s taken a lot to get where we are. It’s going to take a lot to change where we are and by that I mean bringing together people, consumers, patients, with providers, doctors, nurse practitioners, physician assistants, nurses with those who pay for care. So the employers, government, the health plans, public health and bringing them all around the table.
Ours I think is truly the one organization in the state that does that by bringing everyone together for this whole purpose of improving health and health care for everyone in the state. So there are a lot of organizations that do very good work in that area and tend to do it for a given geographic area or given group of providers or groups of patients. But ours is really about improving health of everyone in Maine.
Dr. Lisa: And that starts with the children of Maine which I know that’s the issue that has been your primary importance Amy. Tell me about, what is it that you actually are doing as the medical director of the Child Health Quality Improvement Project. Tell me what your role entails.
Amy: Well, we have a few things going on at Quality Counts. I think what Lisa was highlighting earlier is that we really are trying to build a partnership in the state so that we have a lot of different people working on children’s health and we’re trying to bring them together.
Ultimately, what we’re trying to build at Quality Counts is what’s called the Maine Child’s Health Improvement Partnership. Several states across the country have a Child’s Health Improvement Partnership and that’s bringing together both private and public organizations to work towards the goal of improving children’s health care and children’s health.
One of the first projects that we are actually working on right now is called First Steps. It’s a public health initiative to strengthen early preventive services for children. We are currently funded as part of a federal grant that’s come through Maine Care and we are working with the Muskie school, Maine Care, the Maine CDC and many state partners as well as health care systems on improving preventive services for children.
We actually have a three year project going on. The first project we’re doing is raising immunization rates. Our second project which were currently in the middle of is around developmental screening and autism screening and improving that at the practice level. Our third project next spring, we’ll actually be working with the Lets Go Program from the first two is to improve oral health and healthy weight.
Dr. Lisa: Two of the other programs you refer to were the Lets Go Program and also the First Tooth Program which I know has to do with dental health. How does Lets Go which Dr. Lynne Tetreault has discussed previously, how does that relate to adult health and why is it important to start early getting kids to be healthy so that they can have health adulthoods?
Letourneau: That’s a great question Lisa and really relates to what you’re saying which is we need to start early. We know in this country that we spend more on health care than virtually any other country in the world and don’t have as good outcomes while we also know that we have a very excellent health care system and that’s part of the problem is. We’re just applying lots and lots of health are instead of getting at these underlying issues of health.
This again is sort of chasm I described before between public health and health care creates this unfortunate gap in the middle that a lot of young people fall into. That is we need to address and prevent so many of these conditions that then turn into much bigger conditions and illness later on.
Kids that stay healthy are less likely to become overweight or obese are less likely to start smoking. Kids that stay more active, all those things that are being promoted through the activities of the state, Lets Go, the Healthy Maine Partnership, so many of the public health activities translate absolutely into better health in adult life and to lower cost.
It cost a heck of a lot more to take care of an adult with smoking, obesity, diabetes, all of the chronic illnesses that are associated with these underlying health behaviors that later in life are just so much harder to change.
Dr. Lisa: So how can people find out more about the vaccination programs your describing or some of these child health, some of the child health initiatives that you’ve been talking about Amy?
Amy: For health care providers, they could go to the Maine Quality Counts website and also the Maine Vaccine Board, but we’re really excited to be supporting the new website that’s come out, VaxMaineKids. It’s on Facebook. I think it’s the Twitter feed and there’s also a website that has a lot of parent education and materials for families around vaccinations.
This has been supported by the Maine Health Childhood Immunization Task Force. So there’s a lot of energy and passion right now around working with families in immunizations and I think that those are some great websites to look at.
Dr. Lisa: I can’t end the segment without talking about this award that I heard about from Dr. Lisa that Amy you were nominated for by the Maine Academy of Pediatrics, the Robert Wood Johnson Award. I think it’s called the Young Leaders.
Letourneau: Young Leaders Award.
Dr. Lisa: Young Leaders Award and truly I know that you are a leader along with Dr. Lisa, the other Dr. Lisa in the room, in public health and children’s health and the state of Maine. So it’s important that we have people who have gone away and come back to the state to be physicians at our community and to help us work on health from a systemic standpoint. So thank you for sharing the work that you’re doing and for being here today.
Amy: Thank you very much and we just want to say that although I was nominated, this is really a team effort from everyone in the state and all the people that we work with and we appreciate you having us today.
Letourneau: Spoken like a true leader. Thank you Lisa.