Memorial finds short-term solution for lack of neurosurgeons

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However, state says two doctors on call not enough for the long term

Memorial Health System has devised a short-term solution that will allow the hospital to treat brain trauma patients in its emergency room.
The hospital had to divert its brain injury cases to Penrose-St. Francis Health Services during August because doctors at Colorado Springs Neurological Associates ended a long-standing contract with Memorial.
“We’ve hired Dr. John McVickers from Denver, and our pediatric neurosurgeon is going to take on adult cases,” said spokesman Chris Valentine. “So we have a short-term solution in place, and are working toward a long-term solution.”
Having two doctors on-call 24-seven isn’t “sustainable” in the long run, said Randy Kuykendall, chief of the emergency medical and trauma services section for the Colorado Department of Public Health. His office is responsible for certifying the state’s hospitals to take trauma patients.
“They gave us a plan Aug. 18 and updated it Aug. 26,” he said. “And they can take adult trauma patients Sept. 1.”
Kuykendall said Memorial is working hard to fill the gaps left when the neurosurgeons declined to renew their contract July 30.
“But, we understand and acknowledge that they will add additional surgeons to that list throughout September,” he said. “We’ve given them a deadline of Oct. 1 to have more people in place — but it isn’t a hard and fast deadline.”
Kuykendall said that the state understood that if Memorial hired neurosurgeons from out of state, it would take time for the doctors to receive state and hospital credentials. But, he said, Memorial would have to show that it is moving in that direction.
The state certifies acute-care hospitals for trauma cases, he said. The certification is voluntary, and the Pikes Peak region needs two Level II trauma centers.
“We have an unusually high rate of compliance in Colorado,” he said. “Of our 86 acute-care hospitals, 70 are certified to take trauma cases. There is not a financial incentive — unless you count the additional patient load.”
Kuykendall said the state offers grants to trauma-certified hospitals — but those grants are not guaranteed. The incentive to treat trauma patients reflects the hospitals’ missions.
“Of course, they can’t treat trauma patients if they aren’t certified,” he said. “State law says they have to get them out of there posthaste. So that’s an incentive to do it, but they certainly aren’t required to maintain a trauma certification.”
Memorial treated only nine neurosurgical cases during 2008, Valentine said, but the doctors are called in frequently to consult whenever there’s a head injury.
“If someone falls in Garden of the Gods, or is in a car accident, we call them in,” he said. “But they only operated in nine traumatic brain injury cases last year. They do other operations — strokes, that kind of thing — but only a few times do they operate in trauma cases.”
Andrew Staphopulos, attorney for Colorado Springs Neurological Associates, said the group terminated its agreement because of “issues we had tried to work out with hospital administration.”
“These issues were not related to compensation, or to insurance,” he said. “We were resolved to work them out, and termination was only a last resort.”
Staphopulos declined to cite specific problems with the hospital.
“I don’t want to air our grievances in the paper,” he said. “But they were significant enough to terminate our on-call coverage agreement.”
Colorado Springs Neurological Associates served as on-call providers of neurosurgical care to Memorial for the past 50 years, he said.