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V O L . X X I V N O. X X S E P T E M B E R 1 7 , 2 0 1 8 14 P atient volume in the emer- gency department at Mount Desert Island Hospital in Bar Harbor spikes 400% in the summer and strains capacity, thanks to an influx of 3 million visitors and the island's summer community. e hospital deals with the spike by adding seasonal practitioners. Although year-round hiring can be just as chal- lenging here as it is nationally, sum- mertime hiring is easier, thanks to the hospital's location in a prime coastal community known for Acadia National Park, hiking and camping, yachting and water activities and tourist amenities. "e ocean's been helping us," says physician Nathan Donaldson, director of the emergency department. Last year, a physician who's an avid sailor literally sailed into Bar Harbor and cold-called the hospital for a summer job. A physician assistant did the same. Both were hired and lived aboard their boats for the summer. e physician returned this year. Being in Bar Harbor for the sum- mer is so desirable that the Perelman School of Medicine at the University of Pennsylvania, which sends third- and fourth-year residents to MDI Hospital for two-week training rota- tions, had to institute a lottery for those vying for spots. Traveling nurses, hired through staffing agencies, also ask for assignments in Bar Harbor. "So it's actually not hard to get people to come here in the summer," says Donaldson. Summer surge MDI Hospital's emergency depart- ment averages 300 patients in December and 1,200 in August. With six patient rooms, the ER in August operates at 150% of capacity, up to 10 patients at once. Two additional beds and two patient areas accommodate overflow, says Donaldson. When it comes to year-round staff, MDI Hospital has the usual hiring chal- lenges. It's an ongoing struggle to find certified nursing assistants and regis- tered nurses. MDI Hospital has been searching for a child and adolescent psychiatrist for two-and-a-half years and a general surgeon for a year. To compensate for staff shortages, MDI Hospital sends patients to other hospitals, asks staff to work extra hours and hires fill-ins through an agency (at a cost two to three times higher than staff hires), says MDI Hospital President and CEO Art Blank. Summer staffing is easier. Overall, Blank seeks a balance that accommodates the summer surge but doesn't add more resources than necessary, "recognizing you're going to have to sustain those resources year-round," he says. As with those sailors, he says, the area's attrac- tions make it relatively easy to find an additional ER physician, physician assistants and nurses for the summer, adding to the ER's year-round comple- ment of one physician, five physician assistants and nurses. Penn Med resi- dents fill out the team. Dealing with the surge is also aided by improved ER efficiency: "door to provider" time has been cut to less than 10 minutes throughout the sum- mer and is faster in the winter, says Donaldson. "In some city hospitals, you're waiting for hours. So if you're coming with that expectation and are seen within 10 min- utes, it's a pleasant surprise," he says. P H O T O / JA S O N PA I G E S M I T H H E A LT H C A R E F O C U S Art Blank is president and CEO of Mount Desert Island Hospital, where the hospital's roster of doctors grows in the summer to meet the demands of the island's 3 million visitors. ATTRACTION Physician Coastal hospitals rely on visiting doctors to meet summer demands B y L a u r i e S c h r e i B e r

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