• Tick season is May through September.  Most ticks are harmless, but deer ticks (about the size of a sesame seed) are a source of worry for people because of the possibility of getting Lyme disease from them. Don’t worry, though; Lyme disease is eminently treatable!
• The risk for getting Lyme disease is not high.  In Maine in 2025, there were 4,257 cases of the disease, which means that there were only 300 cases of Lyme disease for every 100,000 Mainers (0.3%). However, this is up a little over 1,000 cases from 2024, and Maine is seeing more cases of other tick-borne illnesses like Babesiosis and Anaplasmosis. Mid-coast Maine has the highest incidence.
• It is extremely unlikely to get Lyme disease from a tick that has been attached to the skin for less than 48 hours.

• If you get a tick bite…
  • Remove the tick with a pair of fine-pointed tweezers by grasping the tick as close to the skin as possible and pulling steadily upward until the tick is out.  If a “part” of the tick is left behind, you can either leave it there (the body will push it out) or try to remove it as you would a splinter.  DO NOT DIG!
  • DO NOT use Vaseline, nail polish, kerosene or matches to remove a tick.
  • Clean the bite area with warm water and soap then apply a topical antibiotic.
  • Watch the area for the next month for a red rash that gets bigger in size and begins to clear in the center, looking like a “bulls-eye,” especially if you also have flu-like symptoms like fever and body aches with it.  Let your medical provider know if these occur. It is NORMAL to have some redness and irritation immediately around the bite for several days to weeks.

• Blood tests for Lyme disease are NOT recommended routinely because if everyone bitten by a tick were tested, most of the positive results would be in people who did not actually have Lyme disease (this is called a “false positive” result).  Testing is done in certain specific circumstances when the suspicion for Lyme disease is high based on the clinical history and physical exam.
• Antibiotics are NOT recommended “as a precaution” because of the low risk of disease and the high risk of problems from the antibiotics themselves, especially because treating actual Lyme disease requires 14-21 days of treatment. There is a small subset of people who should receive a single dose of doxycycline as a precaution and these would be someone with (1) a proven deer tick species in a highly endemic area of the state, (2) known to have been embedded in the skin for more than 36 hours, AND (3) only if the patient presents for care within 72 hours of removal of the tick.

• PREVENTION is everything; keep the ticks away…
  • Wear long sleeves and long pants outdoors in areas where ticks may be found. 
  • Tuck your pants into your socks.
  • Wear light colored clothing to more easily see a tick on you.
  • Use DEET or other insect repellent.
  • Inspect yourself daily for ticks and remove them promptly.

• For more information, visit https://www.maine.gov/dhhs/mecdc/diseases-conditions/insect-borne-diseases/ticks, https://medlineplus.gov/ency/article/001319.htm, http://www.cdc.gov/lyme/index.html, or https://rheumatology.org/patients/lyme-disease.

By Kathryn Galbraith, MD

In this era of high tech and high cost healthcare, it can be quite difficult to know what tests and treatments are most likely to be beneficial, are least likely to harm, and are most cost-effective.  For example, do you need an X-ray or MRI when you wrench your back digging compost into your vegetable garden?

We are excited to share the news about beneficial programs that Medicare has approved that we are fully implementing. Medicare or Medicare Advantage recipients are eligible to take advantage of the benefits of either a program called Advanced Primary Care Management (APCM) or Chronic Care Management (CCM), depending on their needs. The purpose of these programs is to meaningfully recognize the importance of the longitudinal doctor-patient relationship in helping folks get and stay healthy. Medicare has realized that the time and work that goes into the day-to-day operations of healthcare delivery between visits is valuable because, in the long run, quality care given by a primary care doctor who knows you well and is around for the long haul keeps you healthier and saves the medical system money.

Medicare is committed to this goal and as such is willing to pay primary care doctors like us to provide these services. Participating in APCM pays us a small amount per month to handle the increasing workload of specialty referrals, insurance approvals, and medication refills and prior authorizations that happen between office visits. Participation in CCM is especially for the Medicare beneficiary who has 2 or more chronic conditions that require extra monitoring. Medicare pays us to track and complete that extra monitoring–with the patient and “behind the scenes”–to keep the chronic conditions from becoming more dangerous and leading to a costly hospitalization. The ability to support our staff as they work every day to assess our Medicare patients’ needs, coordinate care among their providers, and support them in their healthcare needs is valuable to us as doctors. Medicare covers these fees, often with no co-pay or co-insurance (though some plans do require this especially at the start of the year when deductibles have not yet been met).

What patients gain with these programs is consistent access to and continuity of care, comprehensive care management of all health conditions, care coordination with specialists and allied health providers, and enhanced communication opportunities with our office. The sample consent form, found under the “Patient Forms” tab above, summaries the programs more fully and is a nice, but not mandatory formality that allows all to understand the benefits. Please sign it and bring it to your next office visit or drop it in the mail. Verbal consent is also valid. If you choose to opt out, please let us know that, preferably in writing.

Feel free to give us a call with any questions about the programs or anything else. We look forward to continuing to deliver great quality care to our Medicare patients!