Friday, December 23, 2005

Almost Heaven....
One of the great things about Grand Rounds is the exposure to health care blogs that I may not read on a regular basis. One is the Health Care Law Blog. Personally notable not only for the subject matter, but also because Mr. Coffield lives and works in Charleston, West Virginia. A city where I had the privilege to spend some of my formative years. But all is not well in the Kanawha Valley these days. From The Charleston Gazette:CAMC expects doctors on call
Seven heart surgeons who boycotted Charleston Area Medical Center General Hospital’s trauma center Monday will still get called in and are expected to show up if needed, hospital officials said Thursday.

The surgeons’ lawyer, Karen Miller, said the doctors won’t show up.

“They are sticking by it until they get their operating room because they feel they have to for patient safety,” she said.

The surgeons say the current facilities at General’s trauma unit are dangerous to patients, and have told the hospital they will not report to the trauma unit when called until administrators give them the equipment and trained staff they need to perform surgeries safely.
Nothing new there, I'm afraid. There was a cardiopulmonary bypass pump at the Gen Div, but I don't recall ever using it during my tenure. We always did what we could, and transferred the patients to Memorial of they needed the heart guys. As usual, money comes into the picture:
Hospital officials say the trauma center is safe, and the surgeons are upset because they don’t get as much pay as other doctors when they are on call for the center.
The heart guys were involved very rarely in the care of the trauma patient
In 2004, of the 2,557 trauma patients at CAMC, one patient was admitted for heart treatment, according to information from the National Trauma Data Bank maintained by the American College of Surgeons. The trauma center consulted with heart surgeons only 12 times that same year.
Other specialists are paid quite handsomely, but show up more often:
CAMC contends the issue is money. The doctors want $2,000 for every day they are on call, but CAMC says the doctors don’t come in enough. Furthermore, federal anti-kickback laws forbid the hospital from paying the surgeons that much for the work they put in, Witte said.

Some doctors in other fields make thousands of dollars for just being on-call for the trauma center. CAMC’s four neurosurgeons, including Schmidt, get $3,000 each day and were summoned to the trauma center 197 times and consulted 461 times in 2004, according to the trauma data bank.

The hospital’s 12 orthopedic, or bone, surgeons reported to the trauma unit 858 times and consulted 536 times that same year. Those doctors are paid $2,000 per on-call day, Witte told the Gazette in October.
After the recent struggles in West Virginia with liability issues, it's sad to see that things still haven't settled down.
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