For decades, when Dane County coroners have needed an autopsy performed, they have turned to experts at the University of Wisconsin-Madison. Despite the perception among many that coroners perform autopsies, they typically are not qualified to do so.

Often coming from law enforcement backgrounds, coroners are typically the liaison between authorities, the public and families when someone dies unexpectedly. The wrenching task of informing next-of-kin about the deaths of loved ones is one of their chief duties. Under state law, coroners are also elected, just like county clerks and sheriffs.

But that is starting to change. Twenty-seven of Wisconsin's 72 counties have abandoned coroners in favor of hired medical examiners, and a state law will force Dane County to be one of them soon.

The trend is partly about giving greater oversight of the office to county executives and containing costs. But it is also about increasing the level of professionalism associated with the work of coroners. To that end, Dane County is considering severing its relationship with the UW medical school and hiring its own forensic pathologists even though UW officials are skeptical that the county would save money.

"We believe if we were able to secure the service of one or two pathologists it would be a cost-effective way to deliver that necessary service," says Topf Wells, chief of staff to County Executive Kathleen Falk. "And it would make very good use of some physical facilities that the county has," referring to the autopsy facility in the coroner's office in the City-County Building.

Wells says the idea has support on the County Board, but given the cost and a nationwide shortage of forensic pathologists, a UW official questions whether the county can pull it off.

"We've been doing (autopsies) for 50 years and we hope to continue doing them," says Gordon Ridley, senior associate dean for the UW School of Medicine and Public Health, which oversees the UW's two forensic pathologists. "I'd be surprised if they went in that direction."

The county pays the UW about $1,050 for each autopsy the medical school performs. The university's pathologists performed 207 autopsies for the county in 2007 and 153 in 2008, totaling $216,778 and $162,766, respectively. The average of those two years, $189,772, is likely in the neighborhood of what the county would have to pay for one pathologist of its own.

County Coroner Ray Wosepka says he's putting together a plan for county officials with an eye toward showing that they can break even by hiring their own pathologists.

But Ridley doesn't think the county can pull it off. For one thing, he says, the county will need at least two and maybe three pathologists to cover all shifts. And at about $200,000 apiece, the expense adds up to a tidy sum.

Underlying the issue is a state law forcing counties to change from a coroner to a medical examiner system upon reaching the 500,000 population mark, which will likely happen soon in Dane County. The county plans to make the change by Jan. 2, 2011, when the coroner who will be elected in 2010 would take office.

State Sen. Fred Risser, D-Madison, who has been in the Legislature for more than a half-century, says the population benchmark was commonly used when lawmakers wanted to target legislation for Milwaukee County alone since, for decades, no other county was even close to reaching a population of 500,000.

But because Dane County is fast approaching the benchmark, "they're going to have to re-examine that figure in the statutes," he says.

According to the U.S. Census Bureau, the county had 482,705 people last year. That's an 18 percent increase since 2000, and a mere 3.6 percent away from a half-million.

Aside from Milwaukee, other counties are under no statutory obligation. Yet more than a third of the state's counties have dispensed with their coroners and moved to medical examiners.

There are other signs that the coroner's office could be an endangered species. In 2005, a Legislative Council committee offered up a constitutional amendment to eliminate coroners' offices altogether, though the effort never got off the ground.

There may also be a national movement afoot to eliminate the coroner system, replacing it with a system of medical examiners.

The National Academy of Sciences is urging Congress to authorize funds for states and local jurisdictions to establish regional medical examiner offices, to provide incentives to get more students interested in forensic pathology, to establish national standards for the field and other reforms.

But the vast majority of medical examiner offices in Wisconsin are not run by forensic pathologists. They are administered by people with diverse qualifications, just like coroners, who are not required to hold medical degrees.

"The only difference is they are appointed, not elected," says Wosepka.

It's an important distinction. It means a medical examiner can be fired by county officials, while coroners, because they are elected to a constitutional office, can only be removed by the governor with cause.

Dodge County moved to a medical examiner system in 2002 after a new coroner overran his budget as he tried to modernize the office, which previously had been held by the same coroner for 26 years.

Rock County considered the change in 2005. That year, Coroner Karen Gilbertson resigned and pleaded no-contest to misconduct in office after being accused of stealing prescription drugs from death scenes. But after several citizens and some County Board members voiced concern about taking away the public's right to elect their coroner, the board decided to retain the coroner system.

Dane County officials want the medical examiner's office to be run by a bona fide forensic pathologist, which is a medical doctor with specialized training. That way the county can put the $77,688 a year it pays the coroner toward hiring a second pathologist to keep up with the caseload.

But so far, applicants haven't been knocking down the doors.

"We've had an advertisement out now for approximately two years and to date we haven't received any qualified applicants," says Travis Myren, director of the Dane County Department of Administration.

In fact, this year's budget included money for a pathologist, but those funds had to be stripped out to pay for UW's contracted services.

Myren chalks it up to a shortage of experts in the field.

"I think what our experiences have taught us is to do a very targeted, intensive recruitment for people with these specific skills and expertise," he says.

Ridley says the shortage is partly due to the fact that the prospect of practicing medicine on the dead holds little allure for medical students.

"There aren't too many medical school graduates that want to go into this," he says. "It's different work, I mean, you're dealing with complicated, often tragic cases. Most people go into medicine because they want to make people live better, or survive, or cure them, or whatever. And that's not what this is about."

He adds that the specialty doesn't pay as well as most medical specialties, but that could potentially change.

"Usually a shortage drives higher pay," he says.

That was the case last year in Milwaukee County, where County Executive Scott Walker, after cutting the top pay for newly hired forensic pathologists by $60,000 in 2004, was forced to jack up their salaries after four of the six pathologists quit. The top salary for new hires had exceeded $200,000 annually before Walker made the cuts in 2004.

Plans to change to a medical examiner system have been in the works for some time in Dane County. Former Coroner John Stanley, who died on Sept. 13 of an apparent heart attack, had planned to hire a pathologist in an effort to make the transition to a medical examiner system coincide with his retirement in 2011, Wosepka says.

Wosepka, who was Dane County Coroner for 13 years before retiring in 2001 after being diagnosed with throat cancer, says he intends to move ahead with Stanley's plans.

"When I came back, I said I'd do the best I could to see that John's wishes were taken care of," he says.

But Ridley doesn't think the effort makes any sense. The medical school provides a first-rate autopsy service at minimal cost, he says. After paying the salaries and benefits of the pathologists, the school doesn't even break even, he says, adding that the autopsies are a public service. The school performs them for about 35 Wisconsin counties, averaging about 250 a year, more than half of them for Dane County.

"If we didn't have the service at all we'd probably have more money," Ridley says. "But we're not really worried about that. It's not a major goal to try to soak the county for a lot more money."

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