A typical day at the Maricopa County Medical Examiner’s office begins with an all-staff meeting to review the morning’s caseload. For Dr. Bridget Eutenier, it’s going to be a busy day.
"I have a gentleman who was shot multiple times by another outside of his residence, so it’s likely a homicide," explained Eutenier, donning her protective clothing and a facemask.
She's got multiple homicides on her plate, so she’s swapped one of her cases with another doctor. He’ll be doing some simpler examinations. "Any time we have a number of homicides in a day that can increase the complexity," she said.
Eutenier is one of 10 forensic pathologists working full time here. But 10 doctors for the nearly 5,000 death investigations that pass through the office each year means long days and creative scheduling.
"With the economy downturn we lost three of those positions and we’ve been straddling eight to 10 physicians for the last five years," said Dr. Jeff Johnston, Maricopa County’s chief medical examiner. He explained keeping up with the work and staying fully staffed is important. The reports his office generates impact a lot of people, from homicide investigators and public health officials to the deceased’s loved ones. But for the last several years, "there’s too many of them," he said. "We still try to prioritize them based on the best interest of the public."
According to Johnston, the staffing challenges have not impacted the quality of the autopsy reports his office releases. What suffers is turnaround time on the reports. And Maricopa County is not alone
"The estimate is that we’re at about 50 percent of the forensic pathologists needed to adequately supply the demand in this country," said David Fowler, president of the National Association of Medical Examiners. Despite what you may see on TV glamorizing the profession, he explains that there are typically just 40 physicians a year that graduate with the right credentials nationwide. His agency also estimates that each year about 20 physicians will either retire or leave the field.
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There are several reasons behind this imbalance, but a lot of it boils down to money. On average, forensic pathologists are paid at about two-thirds of what a general pathologist makes. So if you’re going to do this job, you’ve got to be passionate about it. And if that's you, you’re likely in high demand.
"Everyone is going to have to try to protect their staff from being poached from another office," said Fowler. "And if you don’t, you’re going to lose staff and the workload goes up…you end up with a very rapid downward spiral."
So what’s an ME’s office to do to stay on top of things? That’s a question officials in Maricopa County are taking very seriously.
In a recent budget meeting, county supervisors approved $1.5 million in additional funding for the ME office for the coming year, so they can better compete for employees as they work to hire three additional forensic pathologists. Included is an adjustment to maintain industry-competitive salaries. And while that’s still less than the average hospital pathologist, officials hope a $10,000 moving package, six weeks of paid vacation and a lower caseload threshold might convince someone to come here rather than another major city.
As for Dr. Jeff Johnston at the Maricopa County Medical Examiner’s office, he’s confident this will help his office in the short term but added, "It’s a stress on the office and it continues to be a stress on the office."
In the end he says the medical profession as a whole needs to rethink training practices and expose students to forensic pathology earlier in their medical school experience. Hopefully then more people will consider a career in forensics.
EDITOR'S NOTE: The Maricopa County chief medical examiner's name has been corrected. It is Jeff Johnston.
Read More From The Business Of Dying Series:
Part 1: How Maricopa County Is Planning To Attract More Medical Examiners In Face Of Shortage Part 2: Arizonans Overwhelmingly Choose Cremation Over Traditional Burial Part 3: Death Becomes Her: More Women Enter Once Male-Dominated Funeral Service Industry Part 4: Laid To Rest: A Dignified Farewell For The Poor And Unclaimed In Maricopa County Part 5: Organ Transplant Surgery: How Death Can Sometimes Mean New Life