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Howard R. Champion, FRCS (Edin)
Annapolis, Md

Arch Surg. 2000;135:719.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Hurrah for Dr Esposito for providing a much-needed articulation of the fact that for the greater part of the 1990s the trauma community has exhibited symptoms of progressive loosening of tenuous bonds to reality. Massive achievements were realized in the 1970s and 1980s as bona fide attempts were made to provide timely matching of patient need with available expertise and resources. The difficulties that have occurred since then in delineating and documenting these as statistically significant outcome improvements may be a testament to the fact that but a small fraction of those patients corralled into trauma centers truly benefit in terms of lifesaving. Another fraction may benefit from reduced morbidity and reduced cost, but at what expense for all those who do not need to be there? Many of those who die, will die anyway. Most of those who do not, will not anyway. The . . . [Full Text of this Article]

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Trauma and Trauma Care Systems: In the Throes of an Identity Crisis: A Plea for Changing the Vernacular and the Mind-set
Thomas J. Esposito
Arch Surg. 2000;135(6):716-718.
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