Trauma surgeons issue new warning

Friday, May 31, 2002 | 11:03 a.m.

University Medical Center's chief of staff said he plans to meet as early as next week with surgeons who say they will be forced to sever their ties with the hospital's trauma center unless the medical malpractice insurance crisis is resolved.

Dr. John Ellerton said Thursday that as many as 15 surgeon specialists who assist the trauma center's general surgeons have told him they will no longer be available this summer unless they can get financial relief from skyrocketing insurance costs. Some of the general surgeons had already issued similar warnings.

Ellerton said one potential solution pitched by the surgeon specialists would be to have the county-run hospital place them under the same $50,000 malpractice liability cap that is available to all physicians employed by local or state government. Gov. Kenny Guinn has been considering similar relief for certain physicians who are not employed by government by making them temporary state employees.

But Ellerton and Larry Matheis, executive director of the Nevada State Medical Association, said they are not convinced that state or federal laws would allow physicians with private practices to qualify for those caps even if they perform work at a government-run facility such as UMC.

"I'm not convinced that would work from a legal point of view," Ellerton said. "The law is not written to be selectively applied. It's for people who work for the state or for a political subdivision."

Matheis said an increasing number of physicians not only in Nevada but nationwide have considered requesting that they be allowed to enjoy the same malpractice liability caps afforded government doctors.

"I don't think that that will be a useful option for most doctors because there aren't that many government positions and because it's a Band-Aid approach," Matheis said.

Instead, Ellerton said another possible option is for Clark County to provide emergency funds to help the surgeons pay their insurance premiums.

"One of the things being bandied about is that the county should provide financial aid specifically covering the trauma center," Ellerton said.

UMC has Nevada's only level one trauma center. Most of the 11,439 patients the center cared for last year were victims of serious motor vehicle crashes or other blunt injuries, gunshot wounds or stab wounds. Without the center, many of those patients would have to be transported out of state.

In March, six of the center's 10 general surgeons cautioned UMC that they may have to sever their ties by summer, when their insurance premiums must be renewed. One of those surgeons, Dr. Darren Soong, notified the hospital last month that he would only work at the center until August. Of the 10 general surgeons, eight have private practices.

On May 13, five surgeon specialists affiliated with the Western Regional Center for Brain & Spine Surgery wrote to Ellerton requesting that they be placed on leave of absence from UMC beginning Aug. 1 because of the medical malpractice situation.

"Unfortunately, the current medicolegal climate in Southern Nevada is such that we feel we absolutely have to reduce our liability exposure and UMC, particularly with regard to Emergency Room and Trauma Unit coverage, pose just too great a risk to us personally and professionally in this environment," the letter stated.

It was signed by Drs. Steven Agata, John Anson, Derek Duke, William Smith and Benjamin Venger. All five are neurosurgeons. Other specialists who have also warned they may leave include orthopedic and spinal surgeons.

"I don't see how we would be able to avoid disruptions in service at the trauma center if they leave," Dr. John Fildes, the center's medical director, said.

Fildes and Ellerton said they will do whatever possible to keep the center open, even though Ellerton conceded that it may be difficult to operate the trauma unit beyond the end of June if the malpractice insurance crisis is not resolved soon.

"I know that everyone is equally frustrated with the circumstances," Ellerton said. "I'm anxious to keep the trauma center open and I intend to do it because I believe in it. There are a lot of dedicated people who work there."