The Greater Laurel-Beltsville Hospital has modified a policy that led earlier this month to the mass resignation of its gynecology staff. But the staff chairman who quit said yesterday that he would not return to the hospital.
The unprecedented mass resignation was announced Sept. 4 by the gynecologists, who charged that some surgeons at the hospital were performing operations for which they were insufficiently trained.
The dispute centered on whether general surgeons should be permitted to perform gynecological operations.
One of the hospital's general surgeons branded the resignations an "ethical outrage" and said the charge of insufficient training was "totally untrue."
"I would send my wife to one (a general surgeon) if need be," said Dr. Stuart Battle, the hospital's assistant chief of surgery and a general surgeon himself. "That's how much I believe in that."
The hospital's board of directors voted Wednesday night to allow general surgeons who had completed their training before 1968 and who met certain other criteria, including "current competence," to apply for privileges to do gynecological surgery.
Before Wednesday's rule change, any physician who had "at least 18 months approved gynecological training" could apply for such privileges, according to Dr. Robert McCeney, the chief of the hospital's medical staff.
McCeney said the board has tightened the rule, providing a "sort of grandfather clause" for surgeons who trained at a time when surgery programs included more gynecological training.
He added, however, that modification of its policy following the resignation did not mean the hospital was trying to woo the departed gynecologists back. If any of the 21 physicians who quit want to return to the staff, McCeney said, they will have to apply as new applicants fos hospital privileges and will not be taken back automatically.
But Dr. Nasser Rezai, who quit as head of Laurel's department of obstetrics and gynecology, said the rule change was an "unfortunate" decision because Laurel, which opened only 18 months ago, has no need to "grandfather in" anybody.
"The hospital lost a unique opportunity to present itself as a progressive institution and rise above the mediocre," Rezai said yesterday.
Rezai said when he resigned that he did not question the general surgeons' technical competence to perform the disputed operations but said they may lack the training and experience to properly diagnose and treat a woman's problems.
A gynecological surgeon has special training in surgery on the female reproductive system and usually operates only on the uterus, ovaries, vagina and related organs.
A general surgeon is trained to operate on a variety of areas of the body.
The Laurel board of directors charged in a statement issued yesterday that many of the gynecologists who resigned continue to practice in other area hospitals where gynecological surgery is performed by general surgeons.
A survey of several area hospitals showed that several do permit general surgeons with appropriate training to perform such operations. But at Johns Hopkins University Hospital, a renowned teaching institution in Baltimore, the assistant chief of surgery said he couldn't "conceive of a general surgeon" doing a purely gynecological operation, such as a hysterectomy for cancer of the womb.
Dr. Robert Smith, the chief of surgery at Washington Adventist Hospital in Takoma Park, said that this longstanding and normally quiet feud between surgeons and gynecologists is coming up less and less because general surgeons rarely want to do gynecological surgery.
"It's a big stink over nothing," he said of the unusually vocal battle at Laurel. The problem, he said, is being solved "though attrition."