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A workgroup convened by the Oregon State Medical Examiner’s Office last year has issued recommendations to address the staffing crisis at state and county medical examiner’s offices. Mainly, it suggests more state investment: on loan forgiveness, new facilities, and additional staff.
The report, recently obtained by WW, was quietly completed last month by the Medical Examiner Improvement In Oregon Workgroup, which is made up of staff from law enforcement agencies, counties and medical examiner’s offices across the state. It describes an overburdened and understaffed system that is doing far less work than it should be. The medical examiner system, which conducts death investigations, is a crucial public health tool for the state as it attempts to address epidemics of drug use and violence.
“Oregon’s medical examiner system has reached a tipping point,” it says. “Significant caseload increases driven by sudden and sharp rises in drug-related and violent deaths have placed unsustainable pressure on the underdeveloped infrastructure of the medicolegal death investigation system.”
A 2022 “after-action review” report commissioned by the state in the wake of the pandemic found that Oregon’s medical examiner system is “historically underfunded and understaffed” and “does not have capacity to provide robust operational support to disaster response.”
It’s a national problem, which federal lawmakers are currently trying to address by creating new fellowships and other pathways into the field.
This new report goes into far more detail about Oregon’s system’s limitations. The state has nine forensic pathologists, most in Portland. It should have 17, the workgroup’s report says. That forces the state medical examiner’s office to “aggressively triage cases,” the report says.
In 2022, the state conducted 1,000 autopsies. According to one national recommendation, a state the size of Oregon should have performed over 4,200.
To address the staffing shortage, which is driven by intense competition for the highly trained pathologists, the workgroup recommends the state create a new student loan forgiveness program and eliminate some residency requirements to “recruit foreign forensic pathology residents.”
The workgroup also recommends increasing the size of the state’s autopsy facility in Clackamas County and build at least one more, maybe two, in Central or Eastern Oregon.
“Failure to address the worsening deficits throughout Oregon’s medical examiner and death investigation system will have far-reaching detrimental effects and risks a system-wide collapse,” the report says.
The state medical examiner is a division of Oregon State Police, which is now tasked with delivering a similar report to state lawmakers by October.