Nation Watches Doctor Walkout

From the Charleston Daily Mail January 3, 2003, Friday
Copyright 2003 Charleston Newspapers

WHEELING – The operating rooms in the Northern Panhandle may be quiet, but the halls of the hospitals here still are buzzing as the nation turns its attention to the region and the walkout its surgeons are staging.

From Connie Chung to “NBC Nightly News,” all the major networks and cable news channels are here to report on the 24 or so surgeons who are hanging their careers and potentially much more on a bold gambit they hope will make Gov. Bob Wise and the state Legislature listen to their concerns about malpractice liability and what one called “a tort cesspool.”

Producers dressed in black and talking intently into cell phones prowled the corridors at Wheeling Hospital as the parking spaces usually taken by doctors bound for surgery have been filled by satellite trucks ready to beam the latest news of the crisis from coast to coast.

“You never know who’s going to walk through the door today,” one nurse said. “But you get the feeling that anything could happen.”

While the nation may be looking to West Virginia for insights on a growing debate on tort reform and medical malpractice, the surgeons here have a nearer objective.

As the Legislative session is set to begin next week, the protesting doctors want attention for what they say is a legal system out of control and a business climate that makes even the most essential endeavors nearly impossible.

“As I understand it, Bob Wise has come to Wheeling on two occasions in the last several weeks to have dinner with two prominent plaintiffs’ lawyers … and talk about how to deal with the medical insurance crisis,” said Dr. Bob Zaleski, an orthopedic surgeon here for the last 22 years and one of the doctors who have vowed to lay down their tools until the current situation is resolved.

“But until now he hasn’t talked to a single surgeon here about it. He wasn’t asking the people who know the business and who are directly affected. He was asking the lawyers who stand to benefit every time a doctor is hit. So if any good has come of this, at least it got Wise to actually get involved.”

There is no definite timeframe for the surgical shutdown, though many in the health care community are confident that the walkout will end if Wise makes the subject a top priority in his State of the State address on Wednesday and the Legislature “comes out swinging.”

Wise spoke with the leaders of the walkout Thursday and has been involved with ongoing negotiations aimed at getting the surgeons back to work.

Dr. Donald Hofreuter, the CEO of Wheeling Hospital, said that he thinks the situation can be resolved if the state will agree to offer doctors who do risky trauma work insurance coverage through the Board of Risk and Insurance Management.

He said that in ongoing discussions with the Wise administration over the past two weeks the possibility of including Wheeling’s surgeons in the same kind of program now in place in Charleston, Huntington and Morgantown has been gaining momentum.

In those cities, the umbrella of state protection has been extended to private physicians, using the West Virginia University medical program as a vehicle.

“I think it at least begs the question of why these other areas would have access to something like that and we would not,” Hofreuter said. “I think that could be a very fruitful line of inquiry.”

The walkout surgeons say they want long-term relief via tort reform and a dose of immediate assistance in the form of reduced mandatory minimum insurance coverage required by the state.

Though none would say how long they would stay away from the operating table, many suggested that their decision was more one of whether to stay or go for good.

Hofreuter, like many in the local medical community, finds himself on the horns of a dilemma with the walkout. While he sees serious problems with the current system and has supported the political efforts of his fellow doctors in the last several years to affect a change, he still has a hospital to run.

“I understand their concerns and I understand their frustration,” Hofreuter said. “But I’m also concerned about patient care. We’re a non-profit community hospital and my first commitment is to our patients.”

But Hofreuter and his colleagues at the Ohio Valley Medical Center, Weirton Medical Center and Glen Dale’s Reynolds Memorial Hospital say they are satisfied they have done what they can to prevent the crisis from turning into a calamity.

Severely injured patients can be taken directly by air or ambulance to Pittsburgh or Morgantown. Urgent but not trauma-related surgeries still can be scheduled in the small hospitals across the river in eastern Ohio.

At Wheeling Hospital, one of the state’s leading employers, many staffers have been informed that they may be cut back to partial hours for the duration of the walkout, but that no layoffs are planned.

Some non-physician doctors quietly have expressed concern about what could happen if someone dies or is more seriously injured because they have to wait longer for surgery.

“We’ve been talking this through and trying the political thing for a long time with very limited results, so I hope this works” said one doctor on the job Thursday, who asked not to be identified. “But if something happens, it’s all over.

“If there is a loss of life as a result, we won’t have a leg to stand on. This is the big gamble.”

Zaleski said he and his fellow surgeons had thought those issues through and decided they couldn’t wait to act.

“You have to ask yourself if it’s better to have no doctors for the time being or on a permanent basis,” Zaleski said. “Should we keep shrinking and shrinking until we’re gone and then just vanish?

“This is my hometown and I made a decision in 1980 to come back and practice here and I want to stay here, so we’re not just going to drift away.”

Zaleski said he has watched his insurance rates increase 200 fold over the span of his career from $ 800 a year to his current annual bill of almost $ 160,000.

“For three years we’ve been using the political system – giving money to candidates, taking time to go to Charleston and there has been no real reform,” Zaleski said. “There’s been nothing done to shrink the bull’s-eye that every doctor wears on the back of their white coat.”