Baltimore doctor calls on Carroll Physician chairs gubernatorial panel

January 26, 1993|By Donna E. Boller | Donna E. Boller,Staff Writer

The chairman of a gubernatorial commission that recently recommended a new oversight board for Maryland's emergency medical services spends part of his time in the emergency room at Carroll County General Hospital.

At 41, Dr. James A. D'Orta wears half a dozen hats. One of them is senior partner in Professional Emergency Physicians, an eight-member Baltimore-based physicians group that contracts to provide emergency room physicians at Franklin Square, St. Agnes and CCGH.

The group is also to provide emergency room physicians for the new Atlantic General Hospital, scheduled to open in Berlin in May.

Dr. D'Orta usually spends two or three days a month in the CCGH emergency room.

One of his most recent hats was medical director for President Clinton's inauguration, which won him an invitation to review the inaugural parade from the presidential box and a chance to return to the White House after the parade.

Dr. D'Orta was able to talk briefly with Mr. Clinton about health care.

"The president is so one-on-one," he said. "He talks to you and with you, the quintessential politician talking with you, not to a dot on your forehead."

His inaugural duties came one month after the Commission on Emergency Medical Services called for a permanent board with authority over all medical rescue services in Maryland.

That recommendation followed a year of turmoil in Maryland's emergency medical system. Critics charged that patients were being diverted from other hospitals' emergency rooms to the Maryland Shock Trauma Center, and rescue personnel complained that they were shut out of decisions on issues such as the use of a device that opens patients' clogged air passages.

The proposed oversight board will bring accountability to a system that spends $26 million a year in state money and has not been accountable in the past, Dr. D'Orta said.

He sees the board as having a role in holding down health-care costs.

If the existing system of different organizations can be streamlined into one effective board, "it will reduce the number of duplicities -- duplicating and to fool."

Statewide, Dr. D'Orta said, the board can coordinate transportation of patients to appropriate treatment centers, "eliminating needless referral costs to the patient."

The chairman said the commission found "incredibly strong sentiment" for change among the approximately 30 witnesses, including both volunteer and career paramedics, who testified during hearings.

The commission also recommended charging for medical care given during helicopter flights and expanding the use of helicopters from accident victims to other medical emergencies. The proposed changes will require approval of both the governor and the General Assembly.

Dr. D'Orta, a friend of Gov. William Donald Schaefer, said the feedback from the State House has been that the oversight board is a good idea.

Joseph L. Harrison, the governor's deputy press secretary, said the commission's recommendations will go into a legislative request this session. "The administration will support it all the way," he said.

If the oversight board becomes law, it will replace the 19-member emergency medical services commission.

At Carroll County General, Dr. D'Orta serves on an emergency department task force in addition to his duty rotation.

The task force doesn't have a formal chairperson. But Dr. Michael Stang, another partner in Professional Emergency Physicians, explained that the task force's job is "to look at ways we can improve the service we give the community."

Dr. Stang said the task force looks at issues such as occasional delays in getting patients admitted to hospital beds, which forces them to wait longer in the emergency room.

An emergency room visit naturally produces anxiety in a patient, and one of the sources of anxiety is not knowing what the problem is, Dr. Stang observed. To ease the stress, the staff is working on getting test results as fast as possible, he said.

Dr. D'Orta's physicians group offers its members the opportunity to rotate onto movie sets as medical directors.

On the set of "The Abyss," he had a chance to advise the moviemakers on how to make a cardiac arrest scene look authentic. "But mostly, we're there for the real-time emergencies," he said.

Dr. D'Orta founded Washington-based International Medical Consulting Inc., which provides emergency medical services in various countries.

He was a medical relief coordinator in Mexico after a 1985 earthquake, triage director at Franklin Square after the 1987 collision between Amtrak and Conrail trains, medical relief coordinator in Jamaica and in Armenia in 1988, and a consultant after the 1989 San Francisco earthquake. He led Maryland's health-care relief team to Kuwait after the Persian Gulf war.

A native of Long Island, N.Y., Dr. D'Orta became interested in emergency medicine in 1969 when his volunteer fire company asked him to take the new medical training program for firefighters.

Volunteer firefighters were his role models. He went on to become a physician, decided to practice emergency medicine and completed a residency training program in emergency medicine.

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