Where I Stand — Mike O’Callaghan: Saving trauma center

Friday, July 26, 2002 | 9:43 a.m.

NEXT WEEK Nevada legislators will meet in Carson City in an effort to solve the medical malpractice insurance problems facing doctors, patients, lawyers and insurers. The forthcoming legislation must not be a mere Band-Aid that will fall apart after a few months.

I'm not sure that even the most reasonable law will encourage insurers to react in a reasonable manner. Most doctors have a close personal relationship with their patients and most lawyers have strong feelings about the welfare of their injured clients. Other than profit, I find little motivation for the insurers to be concerned about anything that will benefit patients, doctors or lawyers.

The legislators will have a difficult task in finding a fair law that will, in the long run, meet the needs of doctors and injured patients. There is little argument that resulting legislation will put a cap on non-economic awards. Along with this will most likely be a sliding scale for payment of lawyers and closer oversight of doctors by both government and professional boards and commissions. These are but a few of the problems legislators must attack and solve to the best of their ability and within constitutional limits.

When the 2003 Nevada Legislature meets, some deep thought must be given to preventing the UMC trauma center from closing. Its closing should never again be used as a weapon to gain political and/or monetary ends.

With this thought in mind, I asked the opinion of a very talented and respected physician who wrote the following:

"The one issue that has been overlooked in the debate regarding the closure of the UMC Trauma Center is the involvement of the University of Nevada School of Medicine with this entity. As I am sure you are aware, the vast majority of level 1 trauma centers around the country are staffed nearly exclusively by faculty from the partnering medical school. This approach to physician staffing at a level 1 trauma center negates the utilization of community physicians who are often motivated by secondary issues other than the dedication to the patient care. Unfortunately the University of Nevada School of Medicine has not been supported financially by the state of Nevada in a manner which would allow complete staffing of the UMC Trauma Center. The surgical faculty for the School of Medicine lacks several critical sub specialists as full time faculty members (which includes orthopedists). Additionally, some specialties have only one faculty member which makes it impossible to provide f! ull time coverage for a level 1 trauma center.

"As Bill Hale, CEO of UMC, has stated publicly, he has opened up UMC's pocketbooks in an effort to entice the community physicians back to the trauma center. A better utilization of these resources would be support of the School of Medicine in an effort to hire the needed specialists and sub specialists to provide consistent staffing of the trauma center. These full time medical school faculty would have the protection of the state employees liability cap of $50,000 as well as an unwavering devotion to the performance of this vital care for the Las Vegas community.

"I realize that there are always many facets of a complex issue, however the trauma center problem requires more than a temporary fix. The current approach of providing tort reform as the cure-all for this issue is unrealistic. I would predict that in the not too distant future, despite tort reform, there would be a reenactment of our current crisis. The care of trauma patients is time consuming; it interferes with individual physician's private practice; the financial return is frequently poor given the demographics of trauma patients; and the associated risks for acquiring a variety of diseases, such as hepatitis, is significantly higher. These issues would be minimized if not totally negated by strengthening the School of Medicine and providing a dedicated group of physicians who would willingly care for these patients based upon their desire to help th eir fellow man and share this knowledge with students and residents. ..."

These are ideas that must be given serious consideration at the 2003 Nevada Legislature. That's if we are really serious about continuing and improving the trauma services our residents and visitors deserve and should expect.