Brian Pierce MD

09/20/2025

New England Direct Primary Care Alliance

The MAFP has collaborated with local groups to host an advocacy-based happy hour! This series is the chance to be part of shaping the future of healthcare. Each night is open to all healthcare clinicians by RSVP.

Brewer: https://bit.ly/4nw1UH1
Freeport: https://bit.ly/4naDxyg
Augusta: https://bit.ly/424zBqA
Lewiston: https://bit.ly/3HE8Suf

09/20/2025

Glad to see MAFP is meeting at the Samoset Resort this year.

We’re excited to invite you to the 34th Annual MAFP Medicine Update! This year’s update promises a dynamic blend of clinical education, professional development, and networking opportunities.

Please mark your calendars and stay tuned for registration details and the full agenda.

09/19/2025

The 20% uninsured and 50% high deductible plan patients in my panel will be surprised that Maine Health thinks they're "upper middle class and wealthy patients."

Am curious if they refer their uninsured and high deductible patients out to lower priced test facilities or if they'll keep these in-house at much higher out of pocket costs.

The new system is based on monthly fees and aims to improve access to health care providers.

09/13/2025

Easy and inexpensive to make POCUS phantom.

It's a bit beyond our Tufts University School of Medicine second year CAP student's competency requirements but fun for her as well.

Family Medicine at Tufts University School of Medicine

08/20/2025

A lot of Midcoast Maine docs fled to VAMC Togus when independent insurance based practices were failing and PenBay was becoming part of Maine Health.

I considered it because my military years would count towards retirement but glad now I didn't join them. Now 4 in 10 docs turn down VA job offers per the article.

Medical care if we were injured on active duty or did our 20 years was part of the deal when we signed up.

Amid concerns about the stability of the agency, records show nearly 40% of the doctors offered jobs at the VA from January through March of this year turned them down — quadruple the rate of rejections for the same period a year earlier.

08/04/2025

Prior to the development of the measles vaccine, families feared measles and wished there was a way to protect their children from this highly contagious disease. Decades later, most children are now protected by the measles vaccine, but we now have to combat the increase in misinformation around this vaccine despite the evidence proving the safety and efficacy of our modern-day MMR vaccine. We can’t let up on pro immunization efforts to protect our children!

Learn more about the measles vaccine here: https://www.aap.org/en/news-room/fact-checked/fact-checked-the-measles-vaccine-is-safe-and-effective/?srsltid=AfmBOoqNAm2_BqZ8g4BGrKheaRl_OMpaARP0xuApRZC59ALIErql6sAX

07/26/2025

07/20/2025

Thanks again Susan Collins for voting to confirm him. The deaths he's causing are on you too.

The Vaccine Injury Compensation Program stabilizes the nation’s childhood immunization system while paying those harmed by rare side effects. If the program topples, it could threaten access to vaccines.

07/13/2025

https://www.thebulwark.com/p/rural-hospitals-are-the-first-to

John Avlon and Jonathan Cohn dive into the GOP’s renewed push to slash Medicare, exposing the real-world consequences of proposed $1 trillion cuts.

07/11/2025

Important. We'll need to work on restoring trust, countering disinformation for decades to come.

In our latest Substack, we discuss lessons learned from people who have changed their minds about vaccines. Through a brief anonymous survey and interviews with people who were willing to speak with us, we've discovered that meaningful change takes time, that acknowledging vaccine adverse effects builds rather than undermines trust, and that bedside manner can be just as important as medical facts. We explore how "doing your own research" means different things to different people, why maternal attitudes have such lasting influence, and above all, why listening without judgment is essential. This work feels especially urgent as we face the highest number of measles cases since 1992, with 92% occurring in unvaccinated individuals or those with unknown vaccination status. These conversations about meeting people where they are have never mattered more.

Link to the article:
https://theunbiasedscipod.substack.com/p/seven-things-we-learned-from-people

You can find a link to the anonymous survey in our Instagram bio! Also linked below:
https://docs.google.com/forms/d/e/1FAIpQLSeCcBlKSGxT_AcBlROsGNTrfIa_MegHdhuw0zeOidRCbzX7oQ/viewform

07/07/2025

Thanks to DPC News for a nice summary of the history and current state of Medicaid and Direct Primary Care (DPC). This may seem like a trivial discussion after MAGA just gutted Medicaid but Medicaid using lower cost, efficient DPC practices could help extend care to more patients.

Contrary to expectations, we have a small but significant number of Medicaid ("Mainecare") patients who pay a monthly fee for primary care in our DPC practice. Most seem to value the convenience and access compared to the big hospital network's clinics, especially those with multiple chronic illnesses. Mainecare has been great for us to work with to get their other medical services covered.

While we continue to offer charity care via local nonprofits, that's been ineffective and I'd be very interested If Mainecare could offer something similar to Mending Health Insurance (formerly called Taro Health) does here in Maine and Oklahoma, a relatively simple, no or few strings attached, monthly fee for primary care. For it to work with low cost, small staff DPCs, it needs to be as simple as SNAP clients paying via EBT.

Maine could be one of the best states to try this since we now have a significant, growing number of DPC practices and a good local relationship with Mainecare.

Thoughts?

New England Direct Primary Care Alliance
Consumers for Affordable Health Care
Maine Academy of Family Physicians
Maine Chapter of the American College of Osteopathic Family Physicians
Maine Chapter, American Academy of Pediatrics
Maine Medical Association

Every so often DPC and Medicaid gets brought up. The conversation is predictable and people fall into three camps: “government is evil, stay away,” “we need better access for those who can’t afford…