Maull lashes out at those who ousted him

March 09, 1993|By Michael Hill | Michael Hill,Staff Writer

An article in Tuesday's editions incorrectly listed the number of Del. Lawrence A. LaMotte's bill to change the supervisory structure of the Maryland Shock Trauma Center.

It is House Bill 1476.

The Sun regrets the errors.

Dr. Kimball I. Maull told legislators yesterday that the Maryland Shock Trauma Center should not be handed over to the people who just forced him to resign as head of the state's emergency medical system.

Dr. Maull charged that the administration of the University of Maryland Medical System (UMMS) has been more concerned with its own bottom line than with maintaining the quality of care at Shock Trauma.

FOR THE RECORD - CORRECTION

"The UMMS has an excellent record of cutting costs to maintain their profitability," Dr. Maull said.

"But, sooner or later, reducing costs affects quality of care. In my judgment we are reaching that point."

Dr. Maull was speaking to a joint hearing of the Senate's Budget and Taxation Committee and the House's Appropriations Committee.

The committees are considering a proposal that would dramatically reduce the authority of Dr. Maull's former position as director of an institute that supervises not only Shock Trauma, but also the state's rescue network of MedEvac helicopters, ambulances and paramedics.

Senate Bill 686, which is supported by Gov. William Donald Schaefer, would prohibit one person from overseeing both areas.

Instead, the rescue network would be supervised by a new panel reporting to the governor. And the University of Maryland Medical System would be given even greater authority over Shock Trauma than it has now.

The committees also are considering House Bill 1222, a measure sponsored by Del. Lawrence A. LaMotte, D-Baltimore County, that would in effect enhance the authority of Dr. Maull's former post.

Under that bill, the Shock Trauma director would continue to oversee the rescue network. And the director would no longer have to answer to bosses at the medical system and the University of Maryland at Baltimore.

Instead, the director would be supervised by a board reporting to the governor.

Officials of the medical system backed the administration proposal yesterday, saying that taking away the rescue network would remove an apparent conflict of interest because Shock Trauma could no longer be seen as directing patients to its own facility.

"In today's competitive environment, there are concerns that have been expressed by other major hospitals and trauma centers over our presumed capacity to direct patients," said Dr. Morton I. Rapoport, president of UMMS.

"We have had this capacity for the past 20 years, but again in today's competitive environment our respected colleagues in other institutions are concerned about our control of the patient delivery system."

But Dr. Maull said he saw a greater conflict in giving the medical system, a private nonprofit company, even more control over Shock Trauma.

"When they have a financial problem on their side, do they put a job freeze in effect and by so doing cripple Shock Trauma's ability to respond to its statewide role?

"That's the conflict of interest that has to be controlled by having public accountability for Shock Trauma," he said after the hearing.

In his testimony, Dr. Maull detailed what he said was an attempt last year to manipulate Shock Trauma's bottom line in order to transfer funds to the medical system.

"We have to maintain the bottom line," Dr. Rapoport responded. "But we have always accomplished that while maintaining patient care levels."

Dr. Rapoport said that Dr. Maull's complaints are of the type that come from heads of various divisions of the medical system who can't always get everything they want. But that doesn't mean patient care suffers, he said.

Dr. Maull resigned under pressure late last month after a year in the $233,100-a-year job as director of Shock Trauma and the rescue network.

Though a number of doctors quit Shock Trauma during his tenure, and morale there was reportedly low, numerous members of the staff crowded yesterday's hearing and supported his testimony.

"We have no confidence that the Shock Trauma center will continue to have the necessary dedication of resources that the center needs to meet its emergency medical services mission," said Jim Estepp, fire chief of Prince George's County, speaking as head of the state's Fire and Emergency Medical Services Coalition.

"As the center becomes more consumed by the UMMS corporation, it is clear that the center will become a victim of the corporation's multiple clinical missions," he said.

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