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Beating up on Shock Trauma


From the pummeling he's been taking, you'd think Dr. Kimball I. Maull had just demolished the entire emergency medical services system for Maryland. He's being accused of usurping control of the statewide program, summarily cutting off medical training for firefighters, irrationally denying paramedics vital treatment techniques, trying to weaken other hospitals' emergency-room programs by diverting patients to his R Adams Cowley Shock Trauma Center, overloading his center with non-emergency cases and turning the whole shock-trauma system over to University Hospital.

These critics claim they are voicing their concerns because they want to save the shock trauma system. Yet they are the very ones who are now threatening to dismantle this much-acclaimed pioneering medical program, often for very personal and selfish reasons.

What precipitated this organized attack on Dr. Maull was his effort to fire three veteran shock-trauma physicians who had staunchly opposed the new director's attempts to make changes at the downtown Baltimore center. Since then, the rumors have been flying: he's going to make the center a mere appendage of University Hospital and the University of Maryland medical school; he's going to make the hospital prosperous and famous by diverting patients away from other area trauma centers; he's going to cripple efforts of paramedics to do their jobs effectively.

Little of what's been rumored is based on facts. Doctors opposing the director can't cite evidence to back up most of their allegations. Some of their charges are contradictory. For instance, how can Dr. Maull be plotting to overwhelm his trauma center with non-emergency cases from University Hospital while simultaneously grabbing more patients away from other trauma centers across the state? It's a physical impossibility.

Since coming to Maryland from Tennessee five months ago, Dr. Maull has taken a number of sensible steps to revamp the shock trauma center. He's agreed to accept University Hospital's trauma patients (as required by state legislators and state regulators). He's halted a controversial EMS medical technique pending further discussions. He's tried to make some personnel changes. That's been the extent of the upheaval. Critics are making much ado about very little.

It is understandable that Dr. Maull, who has extensive credentials in trauma medicine, would want to make changes in the shock trauma program. His predecessor, R Adams Cowley, was renowned for the changes he made in emergency medical treatment. Now it is the new director's turn -- if he's ever given a chance.

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