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The Utah office that receives about 3,000 bodies a year to determine cause of death is still trying to escape a vicious cycle, the state's chief medical examiner told lawmakers Tuesday.
Like many other states, Utah struggles to attract forensic pathologists. But heavy work loads and the ensuing delays for death investigations has made it difficult to attract pathologists who would help the office finish autopsy reports on time.
With supply low and national demand high, pathologists in the U.S. can decide where they want to go, and they're not choosing to work for a medical examiner's office that hasn't been accredited for the last 20 years and offers the prospect of long hours and lower pay than they can make in private practice.
"If they know they're going to an accredited office they can be sure what their workload will be," Dr. Erik Christensen, Utah's chief medical examiner, told members of the Social Services Appropriations Subcommittee. "If they don't, there's no telling what their workload might be."
Lately, the workload has been far above national standards for forensic pathologists who investigate and determine cause and manner of death in homicides, suicides, drug overdoses and other suspicious cases.
Christensen testified at the Capitol on the second day of the legislative session to give an update on how his office was spending a $1 million budget bump approved last year to address the persistent issue of delayed autopsy reports.
To receive national accreditation, medical examiners need to complete 90 percent of their autopsy reports within three months. As of last year, the office took an average of five months to finish reports.
In recent months, reports have been completed in just under four months, Christensen said, but that number is artificially low because it includes work by retiring employees who only worked on finishing open reports before departing.
The former medical examiner, Dr. Todd Grey, retired in August and Dr. Julie Schrader, a former assistant medical examiner took a job in Nevada the same month.
But Christensen added that the office is moving in the right direction.
Christensen said three new employees will begin once they finish training this summer. And the office now offers incentives like signing bonuses and moving expenses for employees.
However, along with the ability to make more money in private practice, few pathologists are certified in the U.S. every year and there are around 500 total in the country, Christensen said.
Of the extra money lawmakers approved last year to help address the delays, the office has spent about $282,000 on part-time investigators who do the work of about 1.5 full-time employees, Christensen said.
Despite those recent improvements, lawmakers were critical of the office's inability to meet national accreditation standards.
"I'm not casting blame, but I'm disappointed that our wait time is still 110 days," said Sen. Todd Weiler, R-Woods Cross. "I'm just wondering if a year ago when you asked for this money if it was anticipated that it would take a year to get these new people in place."
The office conducted a search for a new chief medical examiner and landed on Christensen, who was a deputy in the office before Grey left, and an out-of-state candidate who declined the job, Christensen said. Of seven assistant medical examiner candidates interviewed over the past year, only one accepted a job in the office.
"Pretty much all of them declined, citing our workload as their primary reason for doing so," he said.
Another lawmaker, Rep. Paul Ray, R-Clearfield, had another idea for improving the office's turnaround of autopsy reports: create regional or county-by-county offices that examine deaths in their areas.
"I think in Utah we're always going to be behind the eight ball," Ray said. "If we spread them out by the counties you have less caseloads, quicker turnaround times, I think it'd be easier."
A majority of states use a regional district system, according to the Centers for Disease Control and Prevention.
Even if the additional hires help the office catch up, three trends may continue exacerbating the problem: increasing population and a rise in suicides and drug overdoses, which Christensen said account for a majority of investigations lately.
"Until we get more people on board our turnaround time really is not going to improve substantially simply because there's not enough people to go around and get it done," Christensen said.
Twitter: @TaylorWAnderson