County paying more for autopsies amid staffing shortages

Sarah Volpenhein | Marion Star

MARION — The county has to pay more for autopsies now that the Franklin County Coroner's Office has put a hold on taking external cases.

Marion County is now sending its autopsies to Toledo, after receiving a letter from Franklin County Coroner Anahi Ortiz saying that her office was experiencing a "critical shortage" of forensic pathologists and would be suspending its services until further notice, according to a copy of the letter obtained from the Marion County Coroner's Office.

The Marion County Coroner's Office was "surprised" by the letter, said April Short, an investigator with the office, who received the letter on May 11, giving them a three-day notice before Franklin County's decision went into effect on May 14.

"We are in the process of recruiting two more pathologists and hope to offer our services again in the next few months," Ortiz's letter reads.

The Marion County Coroner's Office relies on out-of-county coroner's offices to perform autopsies on certain people who die here. Marion County does not have the facilities to perform autopsies nor does it employ a forensic pathologist trained to investigate deaths.

"We've got pathologists here that look at slides, that run the lab, but to do an autopsy, you have to be trained in forensic pathology," said newly appointed Marion County Coroner Dr. Mark Davis.

In Franklin County, the coroner's office has the budget to hire six forensic pathologists, but beginning this week, when a 75-year-old pathologist retires, the office will only have two on staff, Ortiz told the Star on Friday.

It doesn't help that there is a nationwide shortage of forensic pathologists, a fact only exacerbated by the ongoing opioid epidemic, which has placed strain on county coroner's offices and led to increased caseloads and stretched budgets.

There are an estimated 500 full-time forensic pathologists across the entire country, which is about half the number of pathologists needed to meet demand, according to a 2012 report by a scientific working group supported by a division of the U.S. Department of Justice.

The National Association of Medical Examiners, which certifies coroner's and other forensic offices, recommends that forensic pathologists perform no more than 250 autopsies per year, a limit that is often exceeded in understaffed or overloaded coroner's offices.

Until Franklin County is fully staffed, the Lucas County Coroner's Office in Toledo will perform examinations of people who die suddenly, unexpectedly, suspiciously or violently in Marion County. With Lucas County, the cost will be higher, about $350 higher for the examination and transportation.

"That's unfortunate because we're trying to watch county dollars. We're trying to be conscious of the budget," Davis, the county coroner, said.

Last year, the county paid for 86 autopsies, with deaths from drug overdoses and car accidents the most common causes of death among autopsy cases.

Lucas County charges $1,450 per autopsy, or $150 apiece more than Franklin County charged. Plus, transportation costs about $200 more, according to costs provided by Short, given that the distance to the Lucas County Coroner's Office is about double that of the distance to the Franklin County Coroner's Office.

Short said there haven't been any delays as a result of switching to Lucas County and that the turn-around time for autopsies remains between 12 and 14 weeks.

"They've been wonderful to work with at this point," she said.

Katie Keesee, a secretary with the Lucas County Coroner's Office, told the Star that besides Marion County, only one other county — Morrow County — has begun sending cases to Lucas County as a result of Franklin County's freeze.

It is unclear how long it will take before Franklin County starts taking out-of-county cases again.

The pool of forensic pathologists to choose from is limited, and the six-figure-paying positions can sit vacant for years.

"This year, I think they're only graduating 40, 45 forensic pathologists out of fellowship programs in the whole United States," said Ortiz, the Franklin County coroner.

Those numbers have been stagnant for years. Out of more than 17,000 medical school graduates per year, only 30 to 40 ultimately become forensic pathologists, according to the 2012 report by the Scientific Working Group for Medicolegal Death Investigation.

Part of the problem is that forensic pathologists make less money than private-practice doctors in similar medical specialties.

Ortiz said she has had to petition the Franklin County Commissioners to raise the doctors' starting salary and to hire a recruiter to find forensic pathologist candidates.

"One of the things we're seeing recently is they won't even look at us ... because of the salary. We were really, really low," she said. "I was able to get an increase in salary for the forensic pathologists, which helped us to get at least two interviews."

Public-sector forensic pathology jobs often pay less than private-sector jobs in similar medical specialties. As a result, the six-figure jobs sit vacant.

The forensic pathologists that Franklin County has recently hired have been difficult to retain as well, Ortiz suggested, saying that two of the pathologists who left this year were recent hires.

The pay and the workload were part of the reasons they left, she said.

"A lot of (the workload) is driven by the overdose situation," Ortiz said. "Here in Franklin County, we've also had an increase in homicides and suicides, so it's really put a real undue burden on the remaining doctors."

svolpenhei@gannett.com

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