Trauma care crisis

August 14, 2002

HAGERSTOWN'S striking trauma surgeons should go back to work immediately.

But they do have a point. Several points, in fact. They do need to be adequately compensated for the critical work they do -- and for the fee-generating work they can't do while they're on trauma service call. Reimbursements from Medicaid and Medicare are inadequate. Medical malpractice insurance keeps going up. Doctors are squeezed.

So, apparently feeling frustrated, surgeons at Washington County Hospital have refused to work until their demands for higher "standby" compensation are met. They're asking for as much as $2,400 a day, depending on their specialties -- an increase of more than 50 percent over current pay. Hospital officials have said no to these demands -- so far. But they and state officials are signaling a willingness to solve the problem on a short- and a long-term basis.

While the strike continues, pressure builds on the rest of the emergency medical system.

Patients who would otherwise be treated in Hagerstown now are being flown to the Maryland Shock Trauma Center in Baltimore -- or transported there by ambulance. In either case, equipment goes out of service. Volunteers, such as ambulance drivers, have been forced to work longer hours and at times miss work at their paying jobs. Some might have to stop volunteering. Doctors in Baltimore work longer hours to serve patients who would otherwise be cared for in Hagerstown.

Care for critically injured patients could also be delayed. The fundamental concept of emergency trauma care is treatment within the "golden hour" after injury.

The striking doctors must return to work. They've made their point. And they've done it for their colleagues all over the state. Symptoms of the same unhappiness have been detected at other hospitals, so the need for a systematic fix is undeniable.

A task force of legislators, physicians and others will convene soon under the leadership of House Speaker Casper R. Taylor Jr. of Cumberland. Gov. Parris N. Glendening almost certainly will be asked to find cash to end the short-term crisis in Hagerstown. Clearly, he should respond to that request.

Longer term, the state will have to find a way to pay for the services its citizens receive. Marylanders are blessed by a trauma care system that everyone can rely on at some of life's worst moments. To preserve that system, they may need to be even more willing to pay for it.

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