Hagerstown shock trauma center reopens

Washington County facility shut in June

Surgeons to be on standby

Taylor says hospital came up with $1 million

October 04, 2002|By Ted Shelsby | Ted Shelsby,SUN STAFF

More than four months after shutting down because it couldn't find enough surgeons to cover round-the-clock shifts, Washington County Hospital's shock trauma center has reopened, but at a lower staffing level.

After the Washington County Health System in Hagerstown closed the center June 1, seriously injured patients had to be transported to Baltimore or Bethesda for care.

Before the closing, Washington County Hospital was a Level 2 trauma center, which requires a trauma surgeon to be in the hospital at all times and other specialists, such as neurosurgeons, to be on call and able to get to the hospital in a half-hour. Now it will be a Level 3 center, required to have a trauma surgeon on call and able to get to the hospital quickly.

"We are very pleased that the center is back, even if it is at a Level 3," said Brigitte Heller, emergency medical services management specialist for the Washington County Volunteer Fire and Rescue Association. "The citizens in this area can truly breathe a sigh of relief."

Under the new arrangement, Heller said, "surgeons will have 30 minutes to get to the hospital. We anticipate the doctors will be waiting for us at the hospital when the ambulance arrives with a patient or that we all walk in together."

Hospital officials said patients will receive the same extent of care under Level 3 as they did under Level 2.

Maureen Theriault, a spokeswoman for Washington County Hospital, declined to discuss the financial terms or the amount of compensation to doctors to settle the dispute.

"Compensation is something confidential between the hospital and the doctors," she said.

House Speaker Casper R. Taylor Jr. said the hospital came up with "over $1 million to meet the anticipated shortfall and get the doctors back to work."

Taylor said the shutdown of the Hagerstown center has focused attention on the plight of the shock trauma system statewide.

"We at the state level need to come up with $15 million to $20 million to fix the system statewide," the Allegany County delegate said.

Taylor said the legislature is looking at higher automobile and motorcycle insurance premiums and surcharges on traffic tickets as ways to come up with funding to compensate surgeons who staff the state's shock trauma centers.

"We're very happy to have them back," Dr. Robert Bass, executive director of the Maryland Institute for Emergency Medical Services System, which oversees the state's shock trauma system, said of the doctors in Hagerstown. He said the closing put pressure on other centers and on the state police, who were forced to make many more emergency helicopter flights to take patients to Baltimore or Bethesda.

Bass agreed with Taylor that the state's nine trauma centers are operating under financial hardship.

"The reimbursement of shock trauma surgeons has been static or declining for the past 10 years," Bass said. At the same time, he said, the cost of malpractice insurance has been on the rise.

Bass said the shock trauma surgeons have private practices and it costs them money to be on standby.

"They have been in this situation for a long time," he said. "It's a legitimate issue and it's not unique to Maryland."

The Hagerstown center was staffed by some doctors who were not full-time employees of the hospital but who have private practices and agreed to take shifts at the hospital.

The main issue in the four-month dispute was the compensation those doctors should receive when they set aside blocks of time during which they cannot meet with their regular patients or perform non-emergency surgeries.

Bass estimated that it would take $1.5 million to $2 million in additional funding to help each of the trauma centers to compensate their surgeons.

The center at Washington County Hospital, which re-opened Wednesday, handled 659 of the state's 15,000 trauma center cases last year. It has been a part of the system since 1980.

The state's system of regional trauma centers and MedEvac helicopters was created to treat virtually all trauma patients within 60 minutes of injury, the so-called "golden hour" after which there is usually less chance of saving a badly injured patient.

Heller said there was increased pressure on settling the dispute in Hagerstown after a Glen Burnie man was critically injured in an all-terrain-vehicle accident Aug 2.

The accident happened eight miles from Hagerstown, but the victim had to be transported by helicopter to the Maryland Shock Trauma Center in Baltimore.

The flight took 90 minutes and raised concern in Washington County. Taylor said it was a factor in his decision to meet with legislators and shock trauma officials Aug. 22 to discuss ways to reopen the center.

Heller said the center's reopening "was the one good thing to come out of a bad accident."

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