Erie doctor opens office to help with end-of-life decisions

ERIE, Pa. -- Mike Gallagher now carries two medical cards in his wallet in case he needs emergency treatment.

One is a Medicare insurance card, while the other looks like a driver's license but is actually a medical identification card. It provides emergency department physicians and nurses with vital information, including what lifesaving measures Gallagher is willing to have done.

It's a card the 53-year-old Millcreek Township man wishes he had in 2005.

"I had a bad car accident, and when the paramedics tried to check my airway, they couldn't open by mouth fully because of the prosthetic work I have had done to my jaw," said Gallagher, who suffered serious facial injuries in 1988 when a football player crashed into him while he was filming a Cleveland Browns football game for WJET-TV. "They think the injury is from the accident. Later, they do blood work on me and see that I'm almost in kidney failure. They also think that's due to the accident."

Gallagher was alert enough to inform them about his facial surgeries and chronic kidney disease, but he feared what would have happened had he been unconscious.

Now he worries less because he carries a card that includes that information, along with a QR code that links to a video Gallagher made that lists what lifesaving measures he is willing to have them perform.

He received the card from the Institute on Health Directives, a new downtown Erie medical office founded by Ferdinando Mirarchi, D.O., UPMC Hamot's medical director of emergency medicine. Mirarchi is a longtime advocate of educating people about end-of-life care.

"There is a problem in ERs nationwide with both 'over-resuscitation' and 'under-resuscitation,'" Mirarchi said. "Patients are receiving life-sustaining treatments when they shouldn't be, but other patients are not receiving them when they should be."

One problem is that too many patients with terminal illnesses haven't outlined exactly what they are willing to undergo in case of a medical emergency. Do they want CPR or to be hooked up to a ventilator?

Gallagher said he wants every lifesaving treatment available, if it can help him make a full recovery. He doesn't want them if, say, his kidney disease worsens and he has no hope to regain consciousness or leave the hospital.

"I had this card made so my children don't have to make these decisions," Gallagher said. "It's all on the card."

Gallagher is one of the institute's first patients. Its office is located in the Erie Technology Incubator at Gannon University, 900 State St.

The office is located there because it is not affiliated with Hamot, though Mirarchi remains a full-time Hamot employee. In an email, Hamot Chief Operating Officer David Gibbons said the hospital supports Mirarchi's passion for this initiative. And it is too early to determine how UMPC will incorporate this information.

"To create this vision of the practice, I had to do it outside of UPMC," Mirarchi said. "They have a system approach to ensure best practices, and I had to disclose that I'm doing something different."

Mirarchi's goal is to have patients referred to his office by primary care physicians, estate planners, funeral planners and family members. Mirarchi and his staff would educate patients about the best ways to legally document the emergency treatments they want and their end-of-life care.

Some, but not all, of the patient's visit could be covered by health insurance, Mirarchi said.

"This isn't about making a lot of money," Mirarchi said. "This is something that is needed, not just in Erie but everywhere."

David Bruce can be reached at 870-1736 or by email. Follow him on Twitter at twitter.com/ETNbruce.