
DATE: Wednesday, April 30, 1997             TAG: 9704300500

SECTION: FRONT                   PAGE: A1   EDITION: FINAL 

SOURCE: BY DEBRA GORDON, STAFF WRITER 

DATELINE: PORTSMOUTH                        LENGTH:  121 lines

NAVY BACKS OFF HOSPITAL CUTS FOR NOW SERVICE WANTS MORE RESEARCH ON REDUCTIONS IN PORTSMOUTH

Physician training at Portsmouth Naval Medical Center will not be cut any time soon, a Navy official said Tuesday, reversing an earlier decision to slash seven of the hospital's 12 residency programs and enabling the Navy's busiest hospital to keep its reputation as a stellar training facility.

``People are relieved, they know a decision has been made, they know what's going to happen to their future,'' said the hospital's commander, Rear Adm. William R. Rowley.

However, the Navy's top doctor, Vice Adm. Harold M. Koenig, said the residency cuts were only on hold pending more study.

The plan to eliminate 87 of Portsmouth's 200 residency positions - held by doctors who have completed medical school but who are still in training - troubles several top-ranking military and congressional officials. They worry it would significantly affect patient care at the hospital, which serves 425,000 active duty military, their families and retirees in the area.

The Navy announced the cuts in February, saying it planned to consolidate most residency training programs at Bethesda National Medical Center in Bethesda, Md.

The move prompted letters to Koenig from Hampton Roads congressmen and Marine Corps Gen. John J. ``Jack'' Sheehan, the commander-in-chief of the U.S. Atlantic Command. They questioned why Portsmouth should lose its programs when it is home to the largest concentration of sailors, and when it is opening a new, state-of-the-art hospital next summer. They were concerned that dismantling the programs would hurt patient care.

Congressmen Owen B. Pickett, D-2nd District, and Norman Sisisky, D-4th District, have submitted an amendment to the Department of Defense appropriations bill prohibiting the residency changes, Sisisky said Tuesday.

They also are preparing another amendment requesting a major study of military medical facilities in Washington. ``Do we need both Walter Reed (Army Medical Center) and Bethesda? The downsizing seems to be taking place in the field rather than in Washington,'' he said.

Two weeks ago, Chief of Naval Operations Adm. Jay L. Johnson, suspended any actions regarding the cuts until he met with Koenig for an in-depth briefing.

Koenig briefed Johnson last week. On Friday, Rowley said Koenig called and told him the residency programs would remain for now. ``(Johnson) and Koenig concluded that now is not the right time to think about closing training programs,'' Rowley said.

``The whole reason to think about closing the programs was the assumption that Navy medicine was going to downsize,'' he said. But although the Navy itself is shrinking, the number of people who qualify for military medical care is nearly the same, given rising numbers of dependents and retirees.

The military's medical staff already has been reduced as part of overall downsizing, with the number of military nurses, doctors and other health providers cut by as much as 50 percent in some locations. Overall, the military has lost more than a third of its health-care facilities, while the number of people using military health care has declined by 9 percent, according to the Department of Defense.

Koenig's office said the residency changes were on hold until an in-depth analysis of its impact on Portsmouth was completed, and until the upcoming Quadrennial Defense Review, the Pentagon's self-assessment of the nation's military strategy, operations and structure, is released.

That report, due to Congress May 15, may recommend changes in the size of the naval force, to which Navy medicine would need to respond.

When the cuts at Portsmouth were announced, Navy officials promised that patient care would not suffer, saying civilian doctors would be hired to compensate for the loss of residents, who spend most of their time on patient care.

But, Rowley said Tuesday, ``it costs a lot of money to buy that care on the outside if we can't provide it in house. So we think there's a good possibility we are not going to be doing any significant downsizing'' in military medicine, he said.

Tuesday, Sheehan said through a spokesman that he was ``very happy for the enlisted members and their families that use Portsmouth Naval Hospital.'' Those were the people he feared would be most affected if the residency programs were cut.

The uncertainty of the past two months has taught the staff at the 360-bed hospital that they need to forge stronger relationships with other medical institutions in the area, such as Eastern Virginia Medical School and Children's Hospital of The King's Daughters, which have their own residency programs, Rowley said.

``In this world, it's an evolutionary process and those who are the strongest are the ones who are going to survive,'' he said.

EVMS sometimes sends residents to the Navy hospital for special training, but there is no formal program, school officials have said.

Rowley suggested that could change, noting that the chairs of the Navy's and EVMS's residency programs have been meeting over the past several months to find ``more areas of cooperation in training residents.''

``In the past, the attitude of medical institutions has been to compete against each other in a medical arms race; now we realize that doesn't make any sense. If we cooperate in some areas, patients get better medical care.''

Rowley warned that the issue of residency cuts could be revived, but said he hopes Portsmouth will be in a stronger position by then.

``If the military truly does decide they're going to downsize military medicine, then we're going to have to go through this again; but we hope that we've got the visibility now so they will seriously look at which hospitals are more appropriate to close in the future.'' ILLUSTRATION: [Color Photo]

TAMARA VONINSKI/The Virginian-Pilot

Cmdr. Glenn Zausmer, right, and Lt. Cmdr. Bob Chamberlain, residents

at Portsmouth Naval Hospital, discuss a patient's medical scan. The

hospital will keep its 200 residents for now.

What happened

Navy officials reportedly have decided not to eliminate 87 of

Portsmouth Naval Medical Center's 200 residency positions - held by

doctors who have completed medical school but who are still in

training.

What it means

Some military and congressional officials worried that the cuts

would harm patient care at the hospital, the Navy's busiest, which