(10/02/2002)
From the Charleston Gazette www.wvgazette.com

Tuesday October 1, 2002

By Joy Davia
Staff Writer

If Charleston Area Medical Center trauma doctors want medical malpractice coverage from the state, they will have to attend more quality-improvement meetings than they have done in the past, a state official said Monday.

"For them to get special insurance coverage, they have to do things that are required of a level I trauma center," said Dr. Bill Ramsey, medical director of the state Office of Emergency Medical Services.

CAMC lost its top-ranked trauma center Aug. 27 because it didn't have enough bone surgeons to staff the center 24 hours a day. And not enough of the hospital's trauma staff — including urologists, bone surgeons, plastic surgeons and neurosurgeons, among others — attended the meetings, which are mandated by the American College of Surgeons.

Today, CAMC will return to a level I center. Bone surgeons had returned to the trauma center because they could get coverage from the state Board of Risk and Insurance Management, the Wise administration would push for a cap on lawsuit damages against trauma doctors, among other promises.

But to get the insurance, more than 50 percent of a hospital's trauma staff has to attend the "performance improvement" meetings, where doctors work to improve their response times and quality of care, among other issues. This is one of 18 criteria set by the national surgical association.

"This was put in as a condition of the contract," Ramsey said.

Dr. Frank Lucente, chief of staff and medical director of the trauma center, has said trauma doctors were too strapped to attend the meetings. There aren't enough of them to do their job, so they're too busy to attend meetings, he said.

CAMC's orthopedic trauma surgeons can immediately apply for the BRIM coverage. So can CAMC's other trauma specialists, although they may not get coverage for their nontrauma patients, Ramsey added. Doctors at level I and level II centers in Huntington, Charleston and Morgantown are eligible for the insurance.

A task group headed by Ramsey will look at other trauma issues, including how patients are referred to hospitals and how to fund a statewide system. Gov. Bob Wise will appoint members to the committee.

"This is just beginning," Ramsey said. "We're going to look at the whole system, the whole state, how we're going to support all the centers and not just one," he said. "The CAMC solution may be used to develop a bigger plan."

A level I and level II trauma center must have specialists like bone surgeons on-call 24 hours a day. A level II center doesn't do the research of a level I. For more than a month, CAMC was a level III center, which means they just had to have a general surgeon within 15 minutes of the hospital at all times.


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