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DID SURGEON'S PUNISHMENT EXCEED 'CRIME'?

If a state Health Department review panel is right, surgeon John Bell-Thomson is arrogant, abusive and occasionally "negligent," "grossly negligent" and "morally unfit." Those are the bureaucratic terms a hearing committee used in suspending the Erie County Medical Center heart specialist for a year and ordering psychiatric counseling.

But those who work with him express bafflement at the finding. They credit Bell-Thomson with resuscitating ECMC's troubled heart program and turning it into one of the best.

That makes this case about far more than the travails of one gifted but demanding surgeon. It's about the future of one of this region's key public facilities.

The penalty is a blow to an ECMC that has turned itself around and is competing in a new health-care marketplace. It's a blow to a region that needs all of the talent it can get and that can't afford to have a public-relations roadblock needlessly thrown in ECMC's path.

The key word there is "needlessly." The first priority must be patient protection. The hospital also has a responsibility to stand up for its nurses, who deserve not only their supervisors' respect, but protection from rude and boorish behavior.

Yet many ECMC nurses uses words like "excellent" and "very professional" to describe Bell-Thomson. The say he demands professionalism from himself and his staff, but they view that as a positive. And except for voicing suspicions about competitors that want to bring ECMC down, they don't know where the confidential charges came from.

The most serious charge -- which resulted in the "gross negligence" finding -- concerned a high-risk multiple procedure Bell-Thomson performed on a patient who subsequently died. The committee called it inappropriate and attributed it to Bell-Thomson's "I can do anything attitude."

But defenders note the patient only had months to live anyway, that Bell-Thomson fully explained the situation to the family and that he proceeded only on the wishes of family members, who made an excruciating "quality of life" decision. In fact, his lawyer notes, the patient's daughter came from Ohio to testify on Bell-Thomson's behalf.

Another ECMC nurse says her father is alive today only because Bell-Thomson performed a high-risk surgical procedure that no one else in the area could do.

No doubt that's why ECMC officials have supported Bell-Thomson so strongly, even while insisting that the heart unit he whipped into shape will survive his suspension.

Yet, a seemingly-impartial state panel heard both sides and concluded the doctor in some cases didn't do what a "reasonably prudent physician" would have done. The panel never questioned Bell-Thomson's competence. But it concluded he deserved a year off to think about his attitude.

The Health Department is appealing the one-year suspension as too mild. That leaves the public wondering what to think. And it leaves ECMC in a bind. Some patients might now avoid the hospital if Bell-Thomson returns. Conversely, some might go elsewhere in search of expertise if he doesn't. That kind of uncertainty is unfair to ECMC.

The Health Department's appeal now goes to a five-member administrative review board. Normally, that might be sufficient. But this is not a normal case.

Two other options come to mind. One is for Bell-Thomson to seek an independent hearing in State Supreme Court, as many doctors do. While the one-year suspension might be up before such an Article 78 proceeding ended, it still would clear the air. It would either determine that the Health Department was right, or it would lift the cloud.

If possible, a quicker solution would be if the parties would agree to an independent arbitration process like that used elsewhere. Bell-Thomson could pick a doctor, the Health Department could pick one, and a neutral party like the American Medical Association could appoint one.

However it's done, the public needs to know if the Health Department was right, or if it went overboard, as the outcry from ECMC workers and some patients suggests.

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