Groups call for review of emergency services

November 03, 1992|By Jonathan Bor | Jonathan Bor,Staff Writer

ANNAPOLIS -- Several organizations of doctors and nurses are recommending that the state's emergency medical system be removed from the University of Maryland's orbit to erase the possibility of a conflict of interest.

As an alternative, they are calling for an independent board -- without direct ties to any hospital -- to oversee the system.

The groups told a gubernatorial panel Friday that they were troubled by the affiliation of Emergency Medical Services with the Maryland Shock Trauma Center -- both of which fall under the broad umbrella of the University of Maryland.

In an organizational structure resembling a sprawling family tree, an agency known as the Maryland Institute for Emergency Medical Services Systems oversees both the private Shock Trauma Center and the Emergency Medical Services.

Emergency Medical Services is the regulatory agency that sets policies for the ambulance corps and emergency departments. Shock Trauma is the hospital unit receiving the state's most critically injured patients.

While the speakers cited no evidence of irregularities, they said that the relationship presents the potential for the regulatory agency to rig the system to route a disproportionate number of paying patients away from other hospitals and into Shock Trauma.

"This conflict of interest issue is very real and has tangible manifestations," said Dr. Dan K. Morhaim, chairman of emergency medicine at Franklin Square Hospital. "It is of great concern to us and, sadly, tarnishes the reputation of our system and great work done in the past." Dr. Morhaim spoke for the Maryland chapter of the American College of Emergency Physicians.

Dr. Morhaim also said Emergency Medical Services, which is dominated by trauma surgeons, has failed to keep pace with the latest treatments for such medical emergencies as asthma attacks, poisonings and heart attacks.

Joining the chorus for an independent agency were the Maryland Trauma Network, which represents the state's regional trauma centers; the Medical and Chirurgical Faculty of Maryland, which is the state medical society; the Maryland State Council of the Emergency Nurses Association; and the Golden Hour Coalition, a citizens' group.

In August, Gov. William Donald Schaefer named an 18-member commission to look into troubles that began with the firing of three doctors at the Shock Trauma Center and evolved into a wide-ranging debate over alleged conflicts of interest and lapses in patient care.

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