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Trauma center meltdown should never have reached critical stage

June 09, 2002|by TIM ROWLAND

Washington County Hospital's loss of its trauma center is troubling for several pretty obvious reasons. Ambulance crews across the county are waving red flags, and they should.

Ambulances with seriously injured patients will now have to bypass Hagerstown and travel to Bethesda or Baltimore. That will cost the patient lots more money and it will keep valuable ambulances and crews tied up longer, unable to respond to other emergencies.

But of course the greatest cost is time. If this continues, it won't be long before someone dies in the back of an ambulance on I-270, simply because he didn't get to the emergency room soon enough.

In a nutshell, the problem is a shortage of neurosurgeons (to quote the doctors), or a shortage of trauma surgeons willing to fill out the schedule (to quote the hospital).

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Part of the trouble is that two of the hospital's five neurosurgeons retired, making it difficult to keep a doctor ready at the emergency room 24 hours a day - as the state requires for certification of a high-tier trauma center.

Some see this as a power struggle between the hospital and the surgeons, which it may very well be.

But when lives are at stake, high ground loses its relevancy.

What the hospital should know is this: It's taking a beating in the eyes of the community, and at a time when it's talking grandly of plans to build a new hospital - probably with the community's support.

That's bad publicity the hospital cannot afford.

Its position is more precarious, coming on the heels of an incident in which it told a highly popular and effective diabetes physician he had to change the way he practiced or leave, because he wasn't bringing in enough revenue.

Many diabetics need help with nutrition, something the doctor rightly preferred to do over the phone - at a great savings of time and money for the patients.

But phone hours are not billable hours, as are office visits. And the hospital wouldn't cover the $300,000 annual loss that occurred simply because the doctor wanted to do the right thing by the patient.

In a day and age when one single patient can quite plausibly rack up $300,000 in expenses for a serious malady all by himself, the hospital's decision struck the community as particularly miserly and uncaring.

And don't get nurses started on the conditions, hours and pay of their jobs at Washington County Hospital.

Community perception is likely to be that the hospital, given its track record, is trying to strong-arm fewer surgeons into performing the same amount of work as a cost-savings measure. That may be entirely untrue - the hospital may simply have a real problem trying to recruit new surgeons to the area.

But no matter what the full story is, it seems fair to say that this is a crisis the hospital administration should have perceived and somehow, some way, found a way to avert.

Are we to believe that the hospital didn't know about the retirements? That the hospital is on such shaky financial footing that it's impossible to make offers to new surgeons that they can't refuse? Those are melon-sized pills for the public to swallow.

This isn't to say the doctors are completely blameless in the loss of trauma-center status; it's definitely a story with two sides. But the hospital administration should consider that the public will believe here that the bean counters rule the roost, the well-being of the people of the community be damned.

In these days of one health-care fiasco after another nationwide, it would be inadvisable to write off community unrest as "misperception" or "a PR problem."

The community deserves an answer to these questions: If it can afford to build a new hospital, why can't the administration afford to subsidize a highly effective doctor? If it can afford to build a new hospital, why can't it afford to keep its emergency room staffed 24 hours a day? If it can afford a new hospital, why can't it afford to be generous with nurses and staff who are in touch with real people and offer up real care on a daily basis?

In short, the public will need to be assured that the old hospital is run with compassion, with the health of the community at the forefront, before it runs off and builds something new.




As a lawyer, Carl Disque recognizes that an attorney should never represent himself in court. As a blues man, Disque recognizes that it is absolutely essential to grab his sax and represent himself in the blues festival that he and his compatriots founded seven years ago.

Disque and his band members will pick out a little out-of-the-way niche, such as in front of the art museum in City Park, and begin to jam, sort of like an accessory to the main event, complementing the way a sapphire would a diamond broach.

And it's a jewel the Western Maryland Blues Fest has become, a three-day shindig that casts the city of Hagerstown in the best imaginable light and sends thousands back to their homes in other counties and other states remembering us with fondness.

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