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MICHAEL SANDLERPinellas' medical director questions changing where heart attack patients go.
CLEARWATER - Pinellas County's medical director is prepared to change the county's long-standing policy that determines where people with acute heart attacks go after they call 911.
But she's not ready to do it on the spot to please a group of local cardiologists.
Dr. Laurie Romig told county commissioners Tuesday that she still has concerns about acting on an urgent request made last week by local doctors. They think paramedics should pass by closer medical facilities and take patients suffering from acute heart attacks to one of four Pinellas hospitals south of Gulf-to-Bay Boulevard that have specialized cardiac care units.
The county's current policy is more flexible. Patients who can speak are often asked where they prefer to go. Unstable patients are often taken to the closest hospital or to hospitals with specialty units on a case-by-case basis.
Last week, four cardiologists and doctors appealed to the County Commission to change that policy. They said the county's medical control board had stonewalled them for nine months. Lives were at stake, they said.
On Tuesday, Romig told county commissioners that the medical control board has acted properly. She said she's concerned about the county's liability if an ambulance passes a closer hospital and the patient dies. She also worries about the county's ability to monitor those hospitals offering angioplasty.
By county ordinance, the board of hospital administrators and emergency room physicians has traditionally had the authority to set and change policy regarding where ambulances take patients. But after researching state law, county attorneys this week discovered that the ultimate responsibility rests with Romig.
"Looking back, I think the medical control board has been very wise," Romig said. "We may not like it, but in terms of protecting our patients and the county, liabilitywise, it's a smart move."
Romig, who is trained as an emergency room physician, acknowledged that angioplasty is accepted by many studies as the best alternative for treating a heart attack caused by severe blockage of a coronary artery.
But she wants to wait until recognized medical organizations such as the American Heart Association and the American College of Cardiology issue some standard of care for treating those patients with angioplasty. The American Heart Association is currently working on coming up with a position on the issue.
Romig also wants agreements drawn up between her office and the four hospitals - Morton Plant Hospital, Largo Medical Center, Northside Hospital & Heart Institute, and Bayfront Medical Center - allowing the medical director to monitor how quickly patients are being treated and when those hospitals offer services.
- Michael Sandler can be reached at 445-4162 or sandler@sptimes.com