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By M. PAUL JACKSON michaelj@leader.net
Friday, March 07, 2003 Page: 1A
And, then there were two.
Only two neurosurgeons practice full time in Luzerne County as rising
medical liability insurance rates are forcing more specialists to abandon
high-risk surgeries.
The shrinking number of neurosurgeons is forcing patients to wait weeks for
appointments or to seek treatment out of the area.
And, because of the shrinking numbers, Mercy Hospital – which once had four
practicing neurosurgeons – has not performed neurosurgery in at least two
months.
“In Mercy, good luck finding someone to take care of you,” said Dr.
Benjamin Nakkache, a Kingston neurosurgeon who no longer performs surgeries at
Mercy. “Patients are going to suffer, sooner or later.”
Neurosurgeons typically treat injuries or diseases of the central nervous
system, including the spinal cord and brain.
Nakkache announced at the end of January that he would limit his practice
to consultations unless liability insurance premiums drop. His last Mercy
surgery was performed Jan. 9, although he still treats some patients at the
Department of Veterans Affairs Medical Center.
Because the VA hospital is a federal facility, physicians are not required
to carry liability insurance.
Wilkes-Barre General Hospital and Geisinger Wyoming Valley Medical Center
in Plains Township – the region’s other two general acute-care hospitals –
each have one full-time neurosurgeon. Dr. Eric Wolfson practices at Geisinger
and Dr. David Sedor practices at Wilkes-Barre General.
A fourth licensed neurosurgeon, Dr. John Presper, practices at the
Geisinger facility part time but limits the kinds of procedures he performs.
When Nakkache announced he would no longer perform surgeries, Mercy
officials said Wolfson and Presper were available to treat Mercy patients.
But, Wolfson said this week he has not performed neurosurgery at Mercy in
about a year. He used to practice at Wilkes-Barre General Hospital and Mercy
but became an employee of the Geisinger system in 2001.
“As far as I know, there’s no neurosurgery being done there,” Wolfson
said.
Mercy officials acknowledged Wednesday that the Wilkes-Barre hospital no
longer performs neurosurgery.
Because other facilities might be better equipped to treat neurosurgery
patients, the hospital has decided not to compete for those patients, hospital
spokesman Jeff Lewis said.
“We’re not going to compete from a facility standpoint with the larger
hospitals,” Lewis said. “Mercy Wilkes-Barre is really a community-oriented
hospital.”
Although a spokesman for the Pennsylvania Medical Society suggested that
hospitals that do not offer some services might lose out on sources of
revenue, Lewis said Mercy does not anticipate taking a financial hit.
Neurosurgery has “never been a major, major part of our services anyway,”
he said.
Patients may look elsewhere
Sedor and Wolfson say they are inundated with patients but have been unable
to recruit additional neurosurgeons.
Sedor – who stopped practicing at Mercy about five months ago – estimated
that his patient load has tripled in the past 18 months.
“If it gets worse, we may be at the point where we have no doctors,” he
said. “I hope that’s not the case.”
Patients who cannot promptly find a neurosurgeon must be transferred to
other facilities – but the wait time sometimes puts them at risk, Sedor said.
Some patients are going to New York and Philadelphia, both more than two
hours away, Sedor said.
“You’re talking about a delay in the ability to treat patients,” he said.
“It’s a Pennsylvania risk issue.”
The cost of medical liability insurance – which insures doctors against
malpractice claims – has increased more than 100 percent for high-risk
physicians since 2000.
Liability payments are higher for neurosurgeons than most other specialists
in Pennsylvania.
According to the medical society, neurosurgeons in Lackawanna County will
pay about $117,557 in premiums this year, compared to about $99,439 for
obstetricians, another high-risk specialty. Figures for Luzerne County were
not available from the society.
Wolfson said the high premiums are making it difficult to attract new
physicians.
“It’s a tough situation,” Wolfson said. “I’m hoping things change.
There’s got to be a turnaround at some point, but right now, I don’t see that
happening.”
Sedor said he is also considering leaving the state.
“I’m looking at my options. You can’t pay a high rate and not be able to
make a living here.”
He also is feeling the stress of being the only practicing neurosurgeon at
the county’s largest hospital.
“Continuously waiting for a page is a little tough on your family.”
M. Paul Jackson, a Times Leader staff writer, may be reached at 829-7134.
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