Going Home at Any Price
Sherri B. Ross,
D.O.
As long as I have been interested in medicine, I have
always wanted to return to my home state of West Virginia
and practice. It is not a popular choice or a glamorous
one, but it is the place where I grew up and love,
and I cannot imagine living anywhere else. Even as
I am writing this article, I am in negotiation for
a job back in my hometown, and hopefully by the time
you read this, the ink will be dry on the contract.
It is a rare thing, especially now, for a physician
to want to practice in West Virginia. In fact, anyone
who has knowledge of medical politics might think
I am crazy for returning. Over the last year, my state’s
medical profession has taken a beating in malpractice
liability coverage. We are down to one commercial
insurance carrier, and now the state is having to
provide insurance for its physicians, or hospitals
are having to become self-insured. The estimated cost
of my full malpractice insurance premium is $36,000
a year. No, that is not a misprint: $36,000. This
would not be so shocking to me if it were not for
the fact that just nine miles down the road from where
I will be practicing is the Virginia state line where
anesthesiologists pay approximately $6,000 in malpractice
insurance. Why is there such a big difference? It
is tort reform… my state does not have any.
We also do not have any physicians in the state legislature.
Eight physicians, however, are running for office
this year to try to implement tort reform.
Currently the rate of physicians leaving our state
is so high that in our capital of Charleston, the
level 1 trauma center, Charleston Area Medical Center
where a part of West Virginia University’s medical
students and residents train, has now had to drop
back to a level 3 trauma center. Since the year 2000,
12 percent of the anesthesiologists have left the
state. I think another issue that deters physicians
is that West Virginia is not a specialty-friendly
state. If you did a primary care residency, you can
get loan forgiveness or help repaying your loans;
otherwise it is assumed that you will make so much
money that you won’t need help. In this era
of malpractice fees and Medicare/Medicaid cutbacks,
that just is not true. Today the cost of getting a
medical education is so expensive that it will take
me years to pay back my student loans and to begin
reaping the financial benefit for all the years of
hard work.
So what am I going to do? The same thing I would encourage
every graduating senior to do — take action
and get involved! We have to realize that most of
the problems that face the medical profession and
our specialty are state issues and can no longer just
be addressed on a national level. Therefore, it is
imperative that each one of us gets involved in our
state component society as soon as we know where we
are going to practice, and we need to ask what we
can do for them and find out the most pressing issues
facing our state. I have already contacted the West
Virginia Society of Anesthesiologists, and recently,
while in Chicago at the ASA Board of Directors meeting,
I sat in on the Mid-Atlantic Caucus meeting and met
several representatives from my area. We need to know
who our elected state officials are, where they stand
on issues that affect us and then start writing letters
and go see them in person. I also have called the
state insurance commissioner about the malpractice
situation and spoke with its legal counsel and plan
to keep calling them until this issue gets resolved
or at least until a better solution is found. We can
no longer afford to sit back and let someone else
take care of things that affect us. It is unacceptable
not to belong to ASA and not to be active in your
state component society. You cannot sit back and reap
rewards while not contributing yourself.
Of course I am sure while you are reading this, you
are thinking, “Then why would you ever go home?
Find somewhere else to practice.” If I do not
go back there, who will? If you did not grow up there,
the state probably does not hold much appeal for a
young physician. Who will be there to take care of
my friends and family? For all that West Virginia
does lack, it makes up for in other ways. It has beautiful,
four-season country weather, and many outdoor activities
can be found there. We have many hidden treasures
such as The Greenbrier Hotel, the “wild and
wonderful” New and Gauley Rivers for rafting,
some great little ski slopes — they are not
Vail, but they are still nice. Our most important
asset is not found in our coal mines; it is in our
people. You won’t find a friendlier or more
caring group anywhere than inside its borders. I guess
John Denver summed it up best in a song: “Country
roads, take me home to the place I belong…West
Virginia.” And that is where I am heading home…no
matter what the cost.
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Sherri
B. Ross, D.O., is ASA Resident Component and
Fellows Section Delegate, and a CA-3 resident
at the University of North Carolina-Chapel Hill,
North Carolina. |
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