ORANGE COUNTY VOICES : How Many Poison Control Centers Do We Really Need?

“Doctor,” the mother says, trying to keep her panic from coming across my phone line, “Susie just swallowed a whole mouthful of sunscreen. Is there anything to worry about? What should I do?” I would bet that the average Orange County pediatrician or family practitioner hasn’t the foggiest idea about the toxicity of sunscreen or any idea about how to look it up. I know I didn’t.

How comforting and efficient--and possibly life-saving--the ability at any hour to call the local poison center and talk to a professional who has the expertise and the resources to tell me how to advise Susie’s mother.

But as every politician and economist reminds us daily, these are not normal times. The cost of medical services of all types is the most frequently targeted villain in our current economic dilemma, and it is the unnecessary duplication of equipment and services that is most repeatedly blamed for the bloated cost of American medicine. The value of poison information centers to the victim and to the doctor can hardly be overestimated.

Yet at last count there were 107 poison information centers in the United States. Must there be a center in every community?

Unlike trauma centers, which must be hands-on close to the patient, poison centers are information resources. They are advisory--they don’t actually do anything to the patient. Does it make any difference, then, if the poison expert at the other end of the telephone line is in Orange County, Calif., or Orange County, Fla.? Why can’t one well-equipped information depot, with adequate, up-to-date research texts, sufficient staff and enough 800 phone numbers to ensure immediate service, do the job as well as 107? Indeed, if some of the hardware can be eliminated, and the staff thereby augmented, why can’t centralization make the operation even more efficient?

When I want to make a hotel reservation in Chicago or New York, it is just as easy to use an 800 number to reach the reservation desk (which may be in Kansas City or Tulsa) as it is to call the hotel. The same goes for airline tickets to Tokyo, or theater tickets in London. In an era of instant electronic data transfer, computers, and almost-always reliable and instantaneous long distance telephone service, why do we still need 107 local poison control centers?

Even if it is electronically possible for one center to replace the 107 now operational, that much limitation in one fell swoop might be a bit radical. After all, computers and telephone lines do go down, and there may be some hazards in Hawaii that are unfamiliar in Alaska. Accordingly, it might be prudent to begin by reducing the 107 local centers to four or five before considering just one.

As a consequence of a shrinking budget, our local poison information center was about to close up shop. Many well-intentioned Orange County residents are striving to keep it open. Aside from proprietary pride, I fail to see why.

At a time of economic recession when skilled workers are losing their jobs by the hundreds of thousands, I certainly do not mean to add to the list of unemployed health-care workers. But when government is drawing the medical-care purse strings tight enough to garrote all of us, is this not a safe and workable efficiency that would not endanger patient well being?