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Letter to the editor

Lack of neurosurgeons forces Bayfront Medical Center to divert trauma victims

By Lisa Greene, Times Staff Writer
Published February 28, 2008

Bayfront Medical Center sees 2,600 trauma patients and 45,000 emergency patients a year.
	[Cherie Diez | Times (2007)]

ST. PETERSBURG -- A shortage of neurosurgeons at Bayfront Medical Center has prompted emergency workers to take trauma victims to Tampa hospitals.

Bayfront had to temporarily suspend its state designation as a Level II trauma center from 7 a.m. Tuesday until 7 a.m. today.

It was the third time in 10 days that Bayfront has had to stop taking trauma patients. Unless the hospital quickly finds more neurosurgeons, which like many trauma specialists are in short supply, it's likely to do so again.

"We're managing this problem daily," said hospital spokeswoman Kanika Tomalin. "There's a shortage of neurosurgeons on our call schedule, and that's really dictating this problem."

Bayfront's troubles are just the latest sign of a statewide shortage of medical specialists willing to work emergencies.

"We don't have enough highly trained specialists in the trauma world, and the burden of that call goes on too few people," said Tim Eixenberger, Bayfront's vice president for patient care.

As a group, specialists are getting older and less willing to work on call. Many specialists say they fear they are more likely to get sued by emergency patients than by their regular patients, who know and trust them. Even when hospitals pay doctors for working on call, specialists often make less money working emergencies than they do caring for regular patients.

And, as fewer specialists work on call, the burden falls heavier on those who remain.

"You have to understand the risk that these people are taking, and the life balance issues they are facing," Eixenberger said. "There comes a time when everybody in their life has to say, 'Why am I doing this?'"

Around Tampa Bay, leaders at other hospitals listed neurosurgeons as among the specialists in shortest supply.

"In Florida and nationwide, the pool of neurosurgeons is shrinking," said Mark Vaaler, vice president of medical affairs for St. Joseph's Baptist Healthcare.

Bayfront has long struggled with keeping enough neurosurgeons for emergency calls. But the hospital was pushed into a crisis when two of its four neurosurgeons stopped working call.

Neither the hospital nor any of the four would say Wednesday why the two surgeons, Dr. Bushnell Clarke and Dr. Thomas Stengel, decided to stop being on call for emergencies. Tomalin would not say whether their decision was prompted by a pay dispute.

But the hospital already was actively looking for neurosurgeons, she said.

"This can be underscored by their departure, but this is really broader than any two physicians," Tomalin said.

At Bayfront, two other surgeons, Dr. Kirk Jobe and Dr. David McKalip, are still working on call. But that's not enough brain surgeons to cover 24 hours every day.

In the meantime, trauma patients -- victims of serious accidents, violence or other catastrophic injuries -- were diverted to Tampa General Hospital, a Level I trauma center, or St. Joseph's Hospital, a Level II trauma center in Tampa.

By late Wednesday, two patients had been diverted to Tampa instead of Bayfront, said Chuck Kearns, director of Pinellas County EMS.

"We're hopeful that they can work through this, that it's only a temporary situation," Kearns said. But he said emergency workers may have to call on medical helicopters more often to get trauma patients to Tampa.

One of the two patients was taken to Tampa General on Tuesday, Kearns said. EMS workers felt the patient's condition wasn't severe enough to need a helicopter, he said. Details on the other patient weren't available.

Bayfront also diverted trauma patients from Feb. 15 to Feb. 18 and from Feb. 19 to Feb. 21, according to the state health department.

Bayfront sees 2,600 trauma patients and 45,000 emergency patients a year. It is still handling routine emergencies.

Lisa Greene can be reached at greene@sptimes.com or (813) 226-3322.

[Last modified February 28, 2008, 00:20:08]