Nurse practitioner elected chief of medical staff, a first for EMHS

Sunlight poured into the waiting room as a young woman doted over her newborn, awaiting the child’s first checkup. “She’s holding her head up now!” the mother proudly informed two smiling strangers in the waiting room of Sebasticook Valley Health (SVH) Family Care in Pittsfield.

“This is what I really like about family practice—caring for the whole family,” explained Emily Cianchette, MSN, and board certified family nurse practitioner (FNP) at SVH Family Care. In the span of a day, Emily can see the entire spectrum of human life. “I could be doing a well child check one moment, and then see a 75 year old man about his high cholesterol and difficulty caring for his home as he ages. It’s dynamic and ever-changing.”

Emily is among a growing trend in Maine of nurse practitioners independently caring for their own group of patients—a role traditionally filled by physicians. However, the demand for primary care physicians nationwide is outpacing the supply with an expected shortfall of up to 35,600 physicians by 2025. The need is especially serious in Maine as the population ages and recruiting physicians to rural locations becomes more difficult. To help fill this widening gap, nurse practitioners have had the authority to practice independently of physician supervision in Maine since the mid-1990s.

“Maine has always had very advanced legislation for nurse practitioners, which is great,” said Emily, whose career began after the legislation was passed. “We collaborate well with our physician colleagues and all share one vision, to take care of the healthcare needs of the patient.”

It is that spirit of collaboration, and other leadership qualities, that led Emily to break another tradition in medicine as the first non-physician at EMHS to be elected by her peers as chief of a medical staff—an extremely rare occurrence in Maine and the US.

Jeff Doran, EMHS vice president of System Clinical Services, said of Emily’s appointment as chief, “It’s a big deal. It’s a reflection of the continued maturation and importance of the non-physician providers—how critically important and valued that expertise is. “

A hospital’s medical staff is an integral part of shaping policy, and clinical delivery and quality—it is also traditionally comprised of, and led by, physicians. Emily said, “Healthcare is shifting from being physician-led to an integrated team approach.”

Maine representative Anne Perry, FNP, president of the Maine Nurse Practitioner Association and member of EMHS’ Board of Directors, is personally aware of the struggle Maine faces recruiting primary care physicians. “I think, and I hope, we will see more NPs filling that gap. Even though there are still practice restrictions on NPs at the federal level, in Maine, it’s been a collaborative effort.” Anne said of Emily’s new role at SVH, “That there is enough sense of collaboration that she was elected chief of staff, that’s groundbreaking. It really is.”

Emily is deeply invested in her community and its wellbeing. Raised in nearby St. Albans, her parents owned a general store and her mother was also a nurse who spent part of her career at SVH. “It’s such a close knit community and people really work together—we care about the people—and that is so important to me.”

When asked what she hopes to accomplish come November when she assumes the role of chief, her goals are much like her focus at work: all about the patients. “The medical staff is really focused on increasing the quality of care, following standard best practices, and trying to increase access to healthcare for all patients. I would like to see our providers work together to advance these initiatives.”

Robert Schlager, MD, SVH chief medical officer and family medicine physician, works side-by-side with Emily at SVH Family Care, and knows all too well what patients think of her. “What is remarkable is how much her patients appreciate and love her. She sees some of our most medically complex patients and manages their care extremely well. She is widely respected by her patients and peers and is viewed as a true leader.”

From the moment she trained as a medical assistant in high school, Emily knew she wanted to make a positive difference in healthcare. As a leader, she brings together the entire team to give the best care to Maine patients, from babies and their families, to the elderly. “Being able to empower the people you work with is critical—we’re all working toward the same goal. And if everyone feels like they’re making a difference and have a say in that goal, our patients win out in the end.”

Is someone in your organization breaking tradition or trying something new to advance patient care? Email us at [email protected].