State Budgets

County Morgues Go Under the Knife


The bodies line up in the morning at Wayne County’s Detroit morgue, each bagged on a steel gurney awaiting an autopsy by one of five pathologists. That’s three fewer doctors than the county could afford a year ago. It’s a hectic place: Besides run-of-the mill cases such as drug overdoses and auto accidents, Wayne County’s morgue handles plenty of homicide victims. The Detroit-Livonia-Dearborn metropolitan area ranks No. 2 in the nation for murder and negligent manslaughter, at 18.2 deaths per 100,000 residents, according to the FBI. For Chief Medical Examiner Dr. Carl Schmidt and his 30-person crew, it’s not just working on 2,400 corpses a year that’s a strain. “The paperwork is astounding,” says Schmidt, who’s lost some 40 percent of his staff to spending cutbacks since 2007.

The red tape contributed to a gruesome backlog in 2009 and 2010, when the morgue was forced to stack up unclaimed bodies—at one point more than 100—in a refrigerator and trailer. Some families could not afford to bury or cremate their loved ones, Schmidt says. The situation drew national attention.

The county is now looking to academia for help. Effective Oct. 1, Wayne County will begin paying the University of Michigan to perform autopsies. Schmidt and his team of pathologists will continue to work out of the same 50,000-square-foot morgue on Detroit’s east side, but they’ll be on the school’s payroll. And they’ll be joined by three pathologists from the university. Salaries, which now top out at $120,000, will rise to $160,000 a year, although the benefits won’t be as generous.

Under the new arrangement the morgue will double as a teaching facility for the university’s medical students. The county will also be able to forgo the $800,000 it would have had to spend upgrading the lab, Schmidt says. That won’t be necessary now, as the university will take over blood, tissue, and toxicology tests—a move that will result in the elimination of five positions at the morgue. “The old ways aren’t going to work anymore,” says Wayne A. County Executive Robert Ficano. “The bottom line is, over three years we save $1.5 million, and at the same time we have a prestigious medical institution that’s become a partner and allows us to be more efficient and effective.”

Other regions have also outsourced their morgues. The University of New Mexico has run its state’s medical examiner’s office since 1978, according to Operations Director Amy Boule. The University of North Carolina is home to the state chief medical examiner’s office, where state-paid pathologists teach and perform about 1,500 autopsies a year, about one-third of the state’s total, says office administrator Patricia Barnes.

County morgues have another good reason to team up with universities: a shortage of talent. The U.S. has about 500 certified forensic pathologists and needs at least 1,000 more, according to a 2009 report by the National Academy of Sciences. “There are few resources for training in pathology, and the medical examiner’s office provides that training,” says Barnes.

That affiliation with the University of Michigan may aid Dr. Schmidt, 54, in what he considers the most important part of his job: solving medical mysteries that help the living. He recounts that in more than one instance, his autopsies revealed advanced coronary disease in gunshot victims in their 30s. Dr. Schmidt urged relatives to get their cholesterol checked. With the university, “we will have access to resources,” he says. “If we find something strange we can ask [the scientists at the university], ‘Can you find what this is?’ It might be important to that family.”

The bottom line: Wayne County has contracted with the University of Michigan to perform autopsies, a move that will save $1.5 million over three years.

Christoff is a reporter for Bloomberg News.

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