State officials called on two dozen West Virginia surgeons Thursday to end their walkout over malpractice costs as four hospitals cut staff hours and transferred more patients.

So far, five patients have had to be sent elsewhere because of the dispute. Two were sent by the Weirton Medical Center across the state line Thursday to a nearby Ohio hospital. Two from Wheeling Hospital were taken Wednesday to Pittsburgh hospitals, about an hour's drive away, and another was sent to a hospital in Morgantown Thursday.

Only one of the patients -- who was taken 90 miles from Wheeling to Morgantown -- needed emergency surgery.

Gov. Bob Wise will unveil malpractice legislation next week that has been months in the making, Health and Human Resources Secretary Paul Nusbaum said.

"Six days before our announcement is not the time to go and [walk out]," Nusbaum said. "I urge the physicians to give us time to fix this."

A group of Wheeling-area surgeons met with Wise and other state officials in Charleston for two hours Thursday afternoon.

Dr. David Ghaphery told Charleston's WOWK-TV that some doctors left the meeting ready to return to work, with the understanding that the Legislature would act once the next session begins Jan. 8. The doctors returned to Wheeling Thursday night to plan their next move, he said.

Health officials assured residents that state emergency medical personnel were on alert to help transfer patients and they unveiled a toll-free number for patients who need help with physician referrals.

The surgeons in Wheeling and Weirton began 30-day leaves of absence Wednesday or planned to begin leaves in the next few days. The surgeons say the state has ignored calls to help lower skyrocketing malpractice insurance premiums, a complaint aired by doctors in other states.

All four affected hospitals are keeping emergency rooms open. But except for plastic surgeons, they have almost no emergency surgeons available. Wheeling Hospital said it temporarily reinstated one of the surgeons on leave to work on a patient too ill to be transferred. It released no details.

The four hospitals also began reducing shifts of operating room nurses and other surgical support staff.

"It's definitely generating worries within our staff, both about their own financial needs and about the health of the community," said Howard Gamble, spokesman for Ohio Valley Medical Center in Wheeling.

Dr. William Ramsey, director of the Office of Emergency Medical Services, said no additional ambulances, helicopters or crews have been needed during the walkout's first two days.

The surgeons want the state to make it harder to file malpractice lawsuits, which they say would eventually lower their premiums. They also want the state to seek help from insurance companies and other third parties to pay a larger share of their costs.

Parkersburg-area doctors will consider a walkout during a meeting of the state medical association next week, said Dr. David Avery, a Parkersburg family practitioner and former association president.

"I'm afraid this is just the first bit," Avery said. "If the governor and the Legislature don't act, this will be spread quickly across the state -- and it will be all physicians, not just surgeons."

Michael Roberts, a surgeon at two Parkersburg hospitals, said Thursday there was "a good chance" the five surgeons at those facilities would stage a walkout in two weeks.

"We are basically in the same situation as the people in Wheeling," he said, adding that his malpractice insurance rates have jumped 140 percent. "We just can't keep up with the rising costs."