BLUEFIELD — A shortage of surgeons nationwide, and locally, could result in a case of medical musical chairs for patients requiring emergency treatment.

While surgeons, both general and specialty, are on call as part of their duties, when there are not enough physicians to fill rotations 24 hours a day, seven days a week, some patients requiring emergency surgery or specialized treatment may be transported to other facilities — a situation which is occurring in Mercer County, and across and the state.

Bluefield Regional Medical Center typically has four general surgeons on staff. However, currently the hospital is short one general surgeon, hospital CEO Lynn Whitteker said. Each surgeon is on call one week a month but, until the fourth slot is filled, the hospital does not have a general surgeon on call one week each month.

If a patient comes in to the hospital’s emergency room during the week when a general surgeon is not on call, “we would transfer that patient to another hospital that would have that service available,” Whitteker said.

Due to the growing shortage of surgeons and specialists nationwide, this problem is not unique to southern West Virginia.

“It is becoming a problem across the nation,” Princeton Community Hospital Vice-president of Marketing and Public Affairs Deborah Griffith said.

“We’re very fortunate at PCH, at least at the present time. Our emergency room is staffed by a company called Team Health and they provide excellent ER coverage. And we have four general surgeons who have worked out full on-call coverage for PCH.

“When there is only one specialist on staff at any hospital, which is the case here in Mercer County with neurosurgery, it’s impossible to have full-call coverage in that particular specialty, and that’s when patients sometimes have to be transferred to other hospitals,” Griffith said.

Whitteker and Griffith said it can be challenging to recruit physicians to West Virginia. “And especially southern West Virginia,” Griffith said.

Many physicians in the Mountain State left due to the medical malpractice crisis, which drew bold headlines in recent year’s past. This also affected the ability of hospitals across West Virginia to attract new doctors.

While lawmakers did address the medical malpractice problem with legislation, it did not solve the problem overnight — and the state is still trying to rebuild its reputation in the medical community, BRMC Director of Medical Records Maggie Millsap said.

“Unless you are in a big metro area, it’s hard to recruit specialists,” she said.

In West Virginia, the state is facing a “double whammy” with regard to recruitment difficulties, Millsap said. “There’s not a lot of industry, and the population is declining.”

A recent Letter to the Editor to the Bluefield Daily Telegraph from Roger Lowman of Hampton, Va., expressed frustration at the current on-call situation in Mercer County.

In his letter, Lowman explained that a family member was taken to Bluefield Regional where he was diagnosed with appendicitis and informed he needed immediate surgery. However, there was no general surgeon on staff at BRMC and Lowman’s relative was ultimately transported to Raleigh General, where a surgeon performed the operation.

Federal privacy laws prevented BRMC and PCH officials from discussing this case, however they said a regional communication system is in place through which hospitals and emergency responders are aware of when hospitals do, or do not, have certain surgeons or specialists on call.

This system is particularly effective in cases where a patient’s condition may be obvious. For example, if an individual has a fractured leg rescue squad personnel can identify easily, they would know to transport the patient to a hospital where an orthopedic surgeon is on-call, Whitteker said.

However, in the case of stomach pain, there could be a variety of reasons for the underlying problem. In that case, she said, emergency response personnel would bring the patient to a hospital where his or her condition could be diagnosed. If it was then determined the patient needed a surgeon, and one was not on call, the person would be transported to the nearest hospital — or a specific hospital requested by the patient.

“We have a system in place where a patient would be treated as soon as possible,” Whitteker said. “And, likewise, we get transfers from other facilities.”

“All the hospitals communicate with one another and whenever a specialists isn’t on call at one ER, the staff will locate the next closest hospital that has that specialist available,” Griffith said.

“As a board member and chairman of the Quality Assurance and Inspection Committee, it is the charge of that committee to maintain and implement the quality of care,” James “Smokey” Shott said. “And it is of major concern if physician shortages prevent BRMC from providing adequate coverage in the emergency room.”

However, Griffith and Whitteker said patients should not panic about the on-call shortage, as measures are in place to make sure individuals are provided the care they need — even if it means transporting them to another facility.

And both said they are working to recruit physicians.

“We have a very active physicians’ recruiting program,” Whitteker said. “We are working diligently to recruit and retain specialists, and right now our most pressing need is a general surgeon.”

“We keep ongoing recruiting efforts in place so we can remain fully staffed and right now PCH is in good shape — and we hope to remain that way,” Griffith said.

Whitteker emphasized she did not want the public to think the hospital can not, or does not, provide surgical care.

“We don’t want people to think Bluefield Regional can’t provide this care, because we do — we provide surgeons every day. But you can’t expect surgeons to be there 24/7,” she said.

“It’s really and truly a nationwide problem,” Millsap said.

— Contact Samantha Perry at sperry@bdtonline.com

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