Wednesday, Feb. 20, 2002 | 11:06 a.m.
University Medical Center's trauma center -- the only 24-hour center in the state -- could cut its hours as soon as March 12 unless doctors get relief from rising medical malpractice insurance costs, hospital officials said Tuesday.
In a presentation to Clark County Commissioners, who act as the public hospital's board of trustees, UMC Chief Executive William Hale said one of its 10 trauma surgeons is leaving because he can't afford malpractice insurance in the state.
"The way our schedule is working out (March 12) will be the first day that we will have a shift uncovered by a trauma surgeon," Hale said, noting the center would be closed for 12 hours that day.
In an effort to keep other doctors from leaving, the trustees unanimously voted to study offering part-time employment to trauma center surgeons, thus covering them under county insurance. They are expected to decide March 5.
"There needs to be a long-term solution, but in the short-term we need to have a response, or we can do nothing and hope the doctors stick around," Commissioner Erin Kenny said. "I'm uncomfortable with that because we're talking about people's lives."
Dr. Dale Carrison, head of the hospital's emergency room, said that the crisis could soon cause doctors to leave the state and necessary services, such as the trauma center, could be forced to close as a result.
"We're going to have someone who has been in a car accident and has internal bleeding, and there's not going to be a surgeon here," Carrison said. "Our staff will be resuscitating the patient, and I'll be on the phone with other trauma centers begging them to take my patient because he's going to die.
"It sounds dramatic, but it's not."
At issue for UMC is keeping open the only 24-hour trauma facility covering Nevada and parts of Arizona, California and Utah. The unit handles 11,000 critically injured patients a year, including victims of gunshot wounds, car wrecks and other serious incidents.
Critically injured patients cannot be expected to survive a plane ride to the next closest trauma center, said Dr. John Fildes, UMC trauma center's medical director.
But Fildes said the malpractice insurance crisis affects more than just the trauma center.
"This is a global issue," Fildes said. "This will affect how people are treated for heart attacks, get treatments for cancers, the care of their children and the delivery of their babies."
Doctors and hospital officials call the situation a crisis and say physicians are moving out of the state because of the rise in insurance premiums. Two insurance companies -- which together cover 60 percent of the state's doctors -- have pulled out of the state, citing the high cost of jury awards and settlements in malpractice cases.
Nevada, unlike other states such as California, has no limit on jury awards in malpractice cases.
Commissioners say hiring the trauma doctors part-time could work until there's a better solution.
At UMC, trauma doctors are now on contract and not employees of the hospital. County staff will study the viability of such a plan, but Kenny said the cost would be negligible because the county already pays the doctors' wages.
County and state employees are protected from being sued for more than $50,000, which makes the expensive malpractice insurance unnecessary for doctors working in public health facilities.
Gov. Kenny Guinn and lawmakers have been meeting with doctors and insurance companies, trying to find a solution to the bigger issue. State Insurance Commissioner Alice Molasky-Arman has scheduled hearings, to be attended by insurance providers, for March 4.
The Nevada State Medical Association recommended to the Legislature several years ago that the cap be extended to UMC's trauma specialists, said the group's executive director, Lawrence Matheis. The proposal was shot down following strong opposition from powerful lobbyists representing trial lawyers, Matheis said.
"We made our recommendation in anticipation of the kind of crisis we're seeing now," Matheis said this morning. "The fact that UMC is actually considering it now shows this is becoming quite a desperate time."
On "Face to Face With John Ralston," broadcast on Las Vegas ONE -- Cox Cable channels 1 and 39, Guinn said tort reform is likely the long-term answer and will be discussed during the 2003 legislative session.
Reporter Emily Richmond contributed to this story.
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