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Thomas J. Esposito, MD; Ronald V. Maier, MD; Frederick P. Rivara, MD, MPH; C. James Carrico, MD

Arch Surg. 1991;126(3):292-297.

Abstract
• A survey of the Washington State Chapter of the American College of Surgeons was undertaken to document the opinions of surgeons on trauma care issues. Thirty-nine percent of the total sample of surgeons who responded would prefer not to treat any trauma patients. These surgeons were more likely to be older, to practice in an urban setting, to feel that trauma call has a negative impact on elective practice, and to believe more strongly that reimbursement from trauma patients is not equal to that of nontrauma patients. They also agreed more strongly with the statements that these patients require a greater time commitment and pose an increased medicolegal risk. The most significant influence on preference not to treat trauma patients was exerted by the perception of a negative impact on practice, older age, and perception of increased medicolegal risk. Reimbursement issues and location of practice were less influential factors. This information can be used to target concerns and barriers to active, willing participation in a trauma care system and to tailor strategies to deal with them effectively.

(Arch Surg. 1991;1 126:292-297)

Author Affiliations
From the Departments of Surgery (Drs Esposito, Maier, and Carrico), Pediatrics (Dr Rivara), and Epidemiology (Dr Rivara), University of Washington, and the Harborview Injury Prevention and Research Center, Harborview Medical Center (Drs Esposito, Maier, and Rivara), Seattle, Wash. Dr Esposito is now with the Shock Trauma Institute, Loyola University Medical Center, Maywood, Ill.

Footnotes
Accepted for publication November 3, 1990.

Presented at the 17th Annual Meeting of the American Trauma Society, Washington, DC, May 3, 1990.

Reprint requests to Department of Surgery, Loyola University Medical Center, 2160 S First Ave, Maywood, IL 60153 (Dr Esposito).

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