DATE: Friday, March 28, 1997                TAG: 9703280561

SECTION: LOCAL                   PAGE: B1   EDITION: FINAL 

SOURCE: BY DEBRA GORDON, STAFF WRITER 

                                            LENGTH:  100 lines

OFFICIALS TRY TO FIGHT MEDICAL CUTBACKS LAWMAKERS AND A MILITARY OFFICIAL VOICE CONCERNS ABOUT CUTS AT PORTSMOUTH NAVAL.

A top military official and the area's representatives in Congress are worried that a plan to cut back on services at Portsmouth Naval Medical Center might reduce the quality of care that service members' families receive.

Marine Corps Gen. John J. ``Jack'' Sheehan, the commander-in-chief of the U.S. Atlantic Command, has expressed ``strong concerns'' to the Navy's surgeon general about plans to eliminate seven of 12 residency programs at the center.

In a March 14 letter, Sheehan told Vice Adm. Harold M. Koenig, the Navy's surgeon general, that he's worried how such a move will affect fleet sailors, Marines and their families, said Capt. Craig Quigley, the general's spokesman.

About 425,000 people in Hampton Roads and northeastern North Carolina are eligible for care at the Portsmouth hospital.

Overall, the Navy is eliminating 122 training programs over the next five years, 87 of them at Portsmouth Naval. Most specialty training programs will be consolidated at Navy hospitals in San Diego and Bethesda, Md.

The Navy plans to cut its medical staff from 4,050 to 3,376 over the next five years and reducing training positions is part of that strategy. At Portsmouth, the obstetricgynecology, pediatrics, anesthesiology, pain management, psychiatry, urology and ear, nose and throat programs will be cut.

Several officials have questioned the decision to eliminate so many programs at the Navy's busiest East Coast hospital.

``They haven't made a strong enough case for moving the programs,'' said Rep. Norman Sisisky, D-4th District. ``Why should the OB-GYN and pediatric programs be consolidated at Bethesda (National Medical Center) when it seems to me that sailors and their spouses have babies, not admirals and generals?''

He and the rest of the Hampton Roads congressional delegation co-signed a letter to Koenig asking that no further action be taken regarding the military's graduate medical education program until they receive more information.

If their concerns aren't addressed, Sisisky said, he may use his power as a member of the House Armed Services Committee to keep the programs at Portsmouth. The committee will review the defense budget next month.

``I don't want to put it into law if I can help it,'' he said. ``That's micro-managing to a degree, but I'm not beyond doing that if they don't make a better case.''

Sheehan has also requested more details.

The training cuts, announced in mid-February, came just days after the surgeon general's Medical Education Policy Committee recommended Portsmouth's programs be reduced by only six residents in the anesthesiology division, according to minutes from that meeting.

But even as the committee was meeting, the surgeons general of the Navy, Air Force and Army were also discussing the issue. They decided, instead, to eliminate nearly half of Portsmouth's residency positions.

The decision was driven by the joint graduate medical education programs already in place between Bethesda and the Army's flagship hospital, Walter Reed Army Medical Center, said Capt. Sheila Graham, a spokeswoman for Koenig's office. If the Bethesda programs were cut, it would hamper the cooperation between the two hospitals.

``As a result of this integration, these GME programs are recognized as being among the strongest in the nation,'' Graham said in response to written questions forwarded to Koenig.

Rear Adm. William R. Rowley, commander of the Portsmouth medical center, said that although he ``didn't anticipate what was coming'' at Portsmouth, he understands the reasoning behind the recommendation.

``Even though I am disappointed that I had to be the bad guy to close programs here, I think the decision was very carefully thought out,'' he said.

But several on the staff at the Portsmouth medical center, including one doctor who declined to have his name used for fear of repercussion, were concerned that the changes at Portsmouth would greatly impact patient care and the overall quality of the medical staff.

Koenig, through his spokeswoman, disputed those concerns. The hospital, he said in a response to written questions, would continue to be ``a tertiary care, multi-specialty training hospital with primary emphasis on serving the fleet.''

Rowley said he understands firsthand his staff's worries, particularly the concerns of the residents, who are doctors in training. He was among the last residents trained at Philadelphia Naval Hospital before that hospital closed.

As a resident, he said, ``you basically sell your soul for two to five years, working 80 to 100 hours a week. Your entire future depends on the quality of the training and the skills you develop.''

That quality will not suffer as the Portsmouth programs are phased out, he promised.

One of his challenges will be to ensure that enough attending physicians remain at Portsmouth to continue the residency programs during the phase-out.

Some, he acknowledged, will probably leave the Navy. Others, who prefer academic medicine, will probably ask for transfers to San Diego and Bethesda as the Portsmouth programs wind down.

Eliminating the residency programs, he stressed, will not reduce the hospital's overall capacity. ``Even though residents do a tremendous amount of work, they require an amount of teaching, so they are not as productive as staff doctors.

``We anticipate that as the residents go away, we'll convert their spots into staff positions and make sure we have more staff physicians to replace them.'' ILLUSTRATION: [Color Photo]

Marine Corps Gen. John J. ``Jack'' Sheehan sent a letter to to the

Navy's surgeon general. KEYWORDS: MILITARY MEDICINE

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