Samaritan weighs the costs, benefits of hiring a fourth general surgeon

Growing population and impending staff retirement increase pressure to find a solution

MOSES LAKE — Small town growth and impending retirement of general surgeons weighs heavily on the minds of the medical community its members consider the recruitment of a fourth general surgeon at Samaritan Hospital.

Back in April of 2002, a recommendation was brought forth to the hospital board of commissioners to increase general surgeon coverage. In October of 2002, general surgery and emergency room coverage was increased with what is known as a four in one cycle. This cycle rotates the three general surgeons currently on staff every fourth night and weekend, even if they are not scheduled to work that particular shift.

However, as the population continues to grow and medical staff near retirement, more surgery coverage is needed.

There are a number of issues to consider, such as increasing surgeon coverage beyond the one in four cycle, looking at whether or not the community can support a fourth surgeon and working to staff more hospital beds as building projects are completed, said Scott Campbell, marketing director at Samaritan Hospital.

Family practitioners such as Dr. Mathew Milligan of the Moses Lake Clinic, see full time surgeon coverage as an immediate concern for the well being of patients .

"Full time surgery coverage at the hospital needs to be a priority for the health and safety of the community," Milligan said.

While Milligan says he recognizes the some surgeons' concerns that hiring another surgeon could impact their clientele, he thinks alternative options need to be looked at.

One idea that Milligan has is to propose an economic cushion by which the general surgeons would be reimbursed for the percentage they lose by having a fourth surgeon.

"If it was found that there was a significant drop in income, the hospital in theory, would reimburse surgeons a percentage of that," Milligan said.

Reimbursement is one option that Dr. James Irwin, a general surgeon at Samaritan Hospital, believes needs to be investigated, but he also points out that the changing role of surgery due to advancements in technology is another factor to be considered.

"A much larger population is needed to support more surgeons as the tasks of surgery have changed just within the last 10 years," Irwin said.

According to a general surgery evaluation, one general surgeon can support the needs of 10,350 people. In Samaritan Hospital's coverage area which includes Moses Lake, Warden, Soap Lake, and Ephrata there are roughly 52,600 people which means the area could support up to six general surgeons.

Bringing in a visiting surgeon until a permanent placement is found is another option, but Irwin says the cost is high.

"When I was in Iraq, visiting surgeons took out three times what I did and can sometimes cost up to $1,200 for an eight-hour day," Irwin said.

The figures for the cost of bringing a visiting surgeon to this area are still being researched.

"The next step is to come up with a dollar amount for what it would cost us to bring in a visiting surgeon two weekends a month," said Phil Sandifer interim administrator at Samaritan Hospital.

Sandifer plans to present that information to the hospital board at the Oct. 18 meeting.

As of yet, no final decisions have been made as to when or if a fourth surgeon will be hired.

"At this point we cannot pursue a fourth surgeon," said Sandifer.

If the board decides to pursue recruiting a visiting surgeon, Sandifer says the hospital would look at recruiting potential candidates from the University of Washington, as well as military and local hospitals.

For Dr. Craig Hart, a general internist at the Moses Lake Clinic, his biggest concern is the issue of time.

"Hiring another general surgeon takes months and if a replacement isn't found as current surgeons begin retiring, we may find ourselves in a real bind," Hart said.