Why surgeons prefer not to care for trauma patients
T. J. Esposito, R. V. Maier, F. P. Rivara and C. J. Carrico
Department of Surgery, University of Washington, Seattle.
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.
