Editorial: Plan could save lives at hospital

Thursday, Feb. 21, 2002 | 8:38 a.m.

At University Medical Center's Trauma Center, where an average of 30 people a day were treated in 2001 and 10 a day were admitted with critical injuries, there is at least a temporary fix to the medical malpractice insurance crisis. The word crisis is appropriate. Moments can mean the difference between life and death, yet gaps of several hours in the staffing of trauma surgeons are looming, possibly as early as March 12. The head of the Trauma Center teaches at the Nevada School of Medicine, and thus is covered by state insurance that has a cap on jury awards for malpractice. But all of the other trauma surgeons are private practitioners who contract to work on an on-call basis. On March 5, the Clark County Commission will discuss the idea of ending the contractual relationship with the surgeons and replacing it with part-time employment status. This woul d allow all medical procedures performed for the county to come under its self-funded insurance plan, which protects employ! ees from being sued for more than $50,000.

The idea is not without drawbacks. Some doctors might not want to be county employees, they would be limited to 20 hours a week as part timers, and their fair-market wages might be more costly to the county than their contracts. But the proposal could be adopted immediately and stave off a life-threatening situation until longer-term solutions are found. Tort reform is likely the longer-term solution. People who do not feel they have received proper compensation for someone else's negligence that caused them injury or loss have the right to file a "tort" lawsuit. Critics say the courts are clogged with frivolous cases. And it's a fact that jury awards can be outrageously high, which is one reason why doctors' malpractice premiums are doubling and tripling. Many doctors say they are fleeing to states that have adopted tort reforms, such as caps on jury awar ds. Tort reform will be an issue for the 2003 Legislature. State Commissioner of Insurance Alice Molasky-Arman will hold a ! hearing March 4. But it's a long time between now and the reforms that may be adopted as the result of the hearings and legislative action.

While not perfect, the part-time employment idea is better than leaving a shift uncovered by a trauma surgeon. The center recently was contracting with 12 trauma surgeons. Now it is contracting with 10, and by May the number will be down to four, based on notices it has received from the surgeons. There is little hope of quickly recruiting new, qualified trauma surgeons. UMC Chief Executive Officer William Hale says the first uncovered shift could come as early as March 12. With a growing population -- 1.5 million and counting -- to serve, and with 32 million visitors a year to Southern Nevada, we say leaving a shift uncovered is intolerable. There has to be a better way, and the part-time employment idea may be it, for now.