Report From the States

Ohio Physician Can No Longer Treat Injured Workers

Kenneth D. Christman, MD

I am a plastic and reconstructive surgeon. Yes, I perform cosmetic surgeries. But, I also take care of many seriously injured people. In the last 18 months, I have rebuilt countless fractured faces of every description, mangled hands, and even cared for two lovely young ladies who suffered total scalp avulsions.

The usual cause for total scalp avulsions is hair becoming entangled in a machine (usually at work) and then being torn off at the posterior neck to the upper eyelids, often including at least part of the ear, and sometimes even ripping off part of the face.

These are nasty injuries, and my heart bleeds for the victims whose entire scalp I hold in my hands, realizing that what lies ahead are many hours of tedious surgery under the microscope, in an attempt to reattach the small arteries and veins so that the scalp might be saved. Needless to say, these injuries NEVER occur at a convenient time, and sleepless nights are the rule.

For several years I have subsidized my care of work-related injuries by taking care of paying patients. You see, the Ohio Bureau of Workers' Compensation (BWC) will NOT pay me for the care of injured Ohio workers since I chose not to be "certified" by Ohio BWC. Although I am certified by the American Board of Plastic Surgery, which involves many years of residency following medical school, then passing rigorous written and oral examinations, Ohio BWC certification involves selling out physician and patient rights to the managed care of Ohio BWC. I cannot do that.

Some of my patients are denied care by Ohio BWC. With others, it is difficult to provide quality care within their parameters. For instance, a bright young man with a complex work-related degloving injury of his foot had to be hospitalized. Not only was I pressured to discharge him prematurely, but, upon discharge he was denied the extensive dressing supplies he needed. Why? Ohio BWC deemed he was drawing a salary! The reality was that his salary had been slashed due to his injury, and he could not afford the cost of his extensive dressings. He had already been discharged, and I was preparing to purchase his dressings myself. He had to have them. Fortunately, at the last minute, following numerous phone calls and appeals, Ohio BWC relented.

Ohio newspapers recently reported that Ohio BWC had a $6 billion surplus. They should be pleased. But, no. That's not enough. Ohio BWC went to a major hospital in my community and demanded that I be removed from the emergency call schedule. Unfortunately, this hospital has a very lucrative agreement with Ohio BWC, and no amount of persuasion could deter them.

One indication that truth and integrity were irrelevant was that a letter to the hospital's physician president of the medical staff went completely unanswered.

At a meeting with four of the hospital's physician leaders, it was unanimous that I promptly and competently cared for all my patients. In an attempt to coerce me into being an Ohio BWC "certified" provider, the hospital's medical staff president warned me that I had to work within the system. That, he said, was how slavery was ultimately abolished. At that, one physician became quite irate, "What do you think this is? Here is a physician that takes care of patients day and night and doesn't get paid by Ohio BWC. Is this not slavery?"

Actually, it's worse than slavery, because Ohio BWC has effectively prevented me from taking care of ALL emergency patients at this hospital, not just injured Ohio workers.

So then, where are the freedoms my forefathers fought so hard for? This is a "Christian" hospital. Yet, it is even a nonprofit institution for strictly financial motivation, it has not hesitated to yield to the demands of Ohio BWC.

My advice to Ohio workers: Don't Get Hurt!


Dr. Christman practices in Dayton, Ohio, and is a member of the Board of Directors of the AAPS.

Originally published in the Medical Sentinel 2001;6(2);71. Copyright©2001 Association of American Physicians and Surgeons (AAPS)