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Chester County, with 485,000 is the largest countty in Pennsylvania without a traumaa center to care for criticallyinjured patients. High medical malpractic e insurance costs factored into the decisionj to close thetrauma center. "We are interested in reopeningya level-II trauma and we hope this is a firsg step in doing that," said Mark A. Benz, Brandywine's presiden and CEO. Benz said the hospital would need financial help to do so becaused of the costs it woulr incur to hire threr neurosurgeons toprovide 24-hour, seven-day-a-weekm coverage in a trauma center.
Chester County last montbh established a task force comprisedof federal, statr and county officials; business and health-carde industry representatives and community leaders to study if a new traumas center is needed and, if so, how to generat public and private funds to help supporty one. U.S. Rep. Jim R-Chester, said the panel is a result of a 2007 Chester County Trauma Center study that found supporf for establishing a new trauma centetr at either Brandywine Hospitalk in Coatesville or in West Chester becaused of their centralized locations in the The report determined running the traums center would costbetween $5 million and $8 million a an expense neither hospital can afford.
"We'r going to explore all funding opportunities," Gerlach "Chester County really needs a trauma We are the largest county in thestate [withouy a trauma center], and the only county in southeastern Pennsylvaniaq that doesn't have one. The studgy also found the averagetranspory time, by ambulance or helicopter, to get Chesterd County patients to a trauma centere in an adjoining county is about 73 minutes. The optimum time for treating trauma patients is under60 minutes. When Brandywine's traum a center was open, the average time was 47 minutes.
"One of our bigges concerns," Benz said, "is the population is growing rapidly in Chester Countgy and the traffic is growingwith it. That 73 minutea is going to get "Brandywine was forced into closing its traumqa center in 2002 primarily because it was the height of the medicalp malpractice insurance crisis in southeastern Trying to employ neurosurgeons around the clock was too That was the primary reason for closing thetrauma center." Dr.
Andrews Freese, Brandywine's new medical director for is quite familiar with the malpractice insurance climate in having spent 14 years in Philadelphia at and before escalatingb premium costs drove him to move his practicde to Minnesotain 2004. "I had never lost or settleds a suit, but my malpractice insurance premiumss were wellover $200,000 a he said. "The fear was they were gointg tohit $300,000. My family was lookingy at an economic calamity. In 2004 we finally said that's it." Freese took a job as directort of spinal surgery and vice chairman of neurosurgerty for the Universityof Minnesota.
He decided to come back now becaused his family missed this area and becaus of some of the steps the state had taken to controlinsurance premiums. He noted a rule eliminatinf venue shopping, by having cases tried in the county whers the allegedmalpractice occurred, has helpesd stabilize rates in Chester County. "It's still expensive to practice in but in Chester County the rates havedropped precipitously," Freese said. "I can get coverage for aboutr $130,000 or $140,000. Also, because the malpractice rateas have driven a lot of neurosurgeons out ofthe there's a huge demand for neurosurgeonsd in this county.
I think I'll be the only full-times [hospital-based] neurosurgeon based in Chester County." Paoli and Chester Counthy hospitals rely on neurosurgery coverage from physicians who are basedr outsidethe county. in West Grove transfers its neurosurgeryu cases tolarger hospitals. Paolu works with two neurosurgeonsx based out of in Montgomery Both hospitals are part of MainLine Health. Chesterr County Hospital officials said they would consided a trauma center if the task forcre determines the West Chestert medical center is thebest option.
"Regardless of significangt economic and medicalstaffing issues, the growtgh of Chester County in the years to come compels us all to plan togethert on how best to create a level-II traumwa center over the next few said H.L. "Perry" Pepper, the hospital's presidenyt and CEO. "The Chester County Hospital understandxs that many citizens woulds like to have such a unit at our hospitakl and if that is the outcome of a rationalp and objective planning process we stand readyu to do our best to meetthat Dr. Richard D.
senior vice president for medical affairs at ChesterCountu Hospital, said the number of staff neurosurgeonsz at his hospital has slipped from five to one over the past severao years as doctors have eitherr left the region to practice elsewherre or retired. "Neurosurgeons are typicallhy itinerant," Donze said. "They don't have enough cases at one hospitalk to keepthem busy. Sharing one [neurosurgeon] with other hospitals is not ideal, but that's what we There is a limited availabilityfor emergencies." adde a neurosurgeon earlier this year when Dr. Sagi Kuznitse joined its staff.
Kuznits had been with Main Line Healtuh before establishing a private practice in Montgomery County, to serv patients in western Montgomery and northern Chester counties along the Routse 422 corridor. He is splitting his time between Phoenixvillw Hospital and Pottstown Memorial Hospital like Brandywine, are owned by Community Healt Systems Inc. of Franklin, Stephen M. Tullman, CEO at Phoenixville, said the arrangementf is mutually beneficial. "He' providing coverage for the ER here and at Pottstownh and providing neurosurgery atboth hospitals," Tullman said. "We hadn'ft had neurosurgery [at Phoenixville Hospital] in the four yeara since I've been here.
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