It's not uncommon for tensions to flare between doctors and hospital management, but it's not often that such physician discontent ends up in the courts, as happened earlier this month in Virginia.
Carilion Health System, Roanoke, Va., is reviewing a lawsuit filed by two of its neurosurgeons who claimed they were overworked and wanted their caseloads adjusted so they could focus only on spinal cases.
"Our policy is if you have admitting privileges, you are required to take call duties in your specialty," Carilion spokesman Eric Earnhart said. "We understand they want to scale back their practice. We were a little surprised to see their request in a lawsuit."
The case, possibly the first of its kind, is of interest because physician workloads have recently become a national issue. The Accreditation Council for Graduate Medical Education adopted new guidelines in June that would restrict doctors-in-training to 80 hours of work per week, averaged over a month, beginning in July 2003. Hospitals also recently have begun turning to physicians to fill their top management jobs as a way to ease physician unrest (Sept. 30, p. 6).
Earnhart said Carilion's lawyers are "looking at the best way to respond." At deadline, the 10-hospital system had not yet filed a response.
In their lawsuit, filed in Roanoke Circuit Court on Sept. 30, Edgar Weaver Jr., M.D., and James Vascik, M.D., said their on-call obligations at Carilion's 520-bed Roanoke Memorial Hospital and 400-bed Roanoke Community Hospital have resulted in 100 hour workweeks and shifts of up to 72 hours straight. They've asked to be freed of head-injury cases and to have their admitting privileges limited to spinal cases which, they say, make up 95% of their practice.
The case illustrates the demands on neurosurgeons who juggle their practices and on-call duties at hospitals, said William Hazel Jr., M.D., president of the Medical Society of Virginia.
Physicians on the Carilion hospitals' medical staff are on call for 24 hours every third day. Weaver, Vascik and their partner at Neurosurgical Center of Southwest Virginia are the only neurosurgeons taking emergency cases at Carilion's Roanoke-area hospitals, their lawsuit said.
Carilion has refused the neurosurgeons' request, saying such a move would leave it with only one neurosurgeon for head trauma. The system is in contract negotiations with two additional neurosurgeons, Earnhart said.
Peter Leibold, chief executive officer of the Washington-based American Health Lawyers Association, said he knows of no other lawsuit similar to the Roanoke case but said the issue is a top concern in the healthcare industry.
"I know it is a constant area of conversation between doctors and hospitals," he said. "I am sympathetic to both sides."