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Could University Medical Center lose its Level 1 status as a top-performing trauma center?

That is the very real fear simmering among UMC trauma officials, as they continue to battle a devastating shortage of trauma surgeons.

The trauma center has been operating with a patchwork trauma team for much of the past year, after three trauma surgeons, including the trauma director, resigned last spring.

That reduced the team to only two full-time trauma surgeons, aided by two part-time trauma surgeons who fly in for two-week stints from Phoenix and New York. General surgeons are pulled in from the main hospital to fill in gaps for this bare-bones team.

If UMC is unable to recruit and hire as many as four new full-time, fully committed trauma surgeons by the end of the year, the trauma center's Level 1 status could be in jeopardy.

That is the deadline for verification of Level 1 status by the American College of Surgeons.

That verification is required by the Arizona Department of Health Services for all seven of the state's designated Level 1 trauma centers.

Right now, only one trauma center — St. Joseph's Hospital and Medical Center in Phoenix — has ACS Level 1 verification. The other six are now in the process of trying to get it.

Failure to maintain Level 1 status could mean the loss of the vital $4-plus million UMC gets every year as a Level 1 center from the Prop. 202 casino gambling funds. That money is now paying for the trauma and specialty surgeons UMC does have.

In a case of extraordinarily bad timing, UMC had its first consult visit from the verification team in May — just when the center started losing trauma surgeons.

"So their main concern — our major weakness — was, we've got to have committed trauma surgeons," said Eileen Whalen, vice president of UMC's trauma and emergency services.

"If our trauma team remains the way it is now, that could endanger our Level 1 status. That's a concern for us. It is why we are recruiting so heavily.

"Is this ideal? No. Are we worried? Yes. We want six full-time trauma surgeons here by July 1. My biggest worry is the decline of our reputation if we don't succeed."

UMC has been interviewing 11 trauma surgeon candidates who have flown in from around the country, but it does not yet have a firm commitment from any of them.

Among the factors that appear to be discouraging some candidates is Arizona's malpractice situation — the fact that there is no liability protection for trauma physicians, as many other states provide.

They also are worried about the overall stability of UMC's trauma team, and whether they would get "protected time" for research and teaching — or whether the workload will be too heavy for that, Whalen said.

Given this daunting challenge, UMC's trauma director, Dr. Peter Rhee — who took that post in September — said he would like the verification process delayed.

"I can fix this place, but it's going to take time," said Rhee, who works extremely long hours and appears exhausted and a little discouraged. "I've been here four months, and we have no trauma surgeons coming in.

"They see me working the hours I do, and that hurts the recruiting. That will change, but right now it's tough."

Also hurting his efforts is the national trauma situation. Trauma surgeons are in huge demand across the country, but the supply is low. As a result, trauma-surgeon salaries are doubling, and UMC is having trouble competing with that.

Despite all this, Rhee gives UMC "a 90 percent chance" of getting its Level 1 verification by the end of the year. He points out UMC does in fact have full trauma coverage now, though in a temporary arrangement.

"It's always a risk to go through this process, but we expect to pass."

If UMC doesn't?

"I don't want to think about it," he said.