The majority of emergency department directors responding to a survey have reported inadequate on-call trauma coverage, according to a study published in the online and print editions of Academic Emergency Medicine.
Nearly one quarter of the directors also reported a loss or downgrade of their hospitals’ trauma center designations, the study found.
“Without adequate on-call surgical coverage, our health care system cannot provide for emergency and trauma patients,” lead author Mitesh Rao, MD, MHS, stated in a press release. “Twenty-one percent of emergency department deaths and permanent injury can be linked to shortages in specialty physician care. Transferring patients significant distances to an available specialist is sometimes the only option, but it can create a dangerous delay in care.”
According to the study findings, 60% of respondents reported losing the ability to provide constant coverage for at least one medical specialty in the last 4 years. More than 75% of respondents reported their emergency departments have inadequate coverage for plastic surgery, hand surgery and neurosurgery.
Furthermore, nearly 25% of respondents reported an increase in patients leaving before being seen by a medically-needed specialist.
“Patients with traumatic brain or hand injuries have a substantial risk of lifetime disability if they cannot get appropriate care in a timely fashion,” Rao stated. “We need to change the system to better handle the incentives and disincentives for surgeons who are willing to take call in the emergency department.”
The study noted that teaching hospitals fare better than non-teaching hospitals, with inadequate coverage reported at 68% of the former and 78% of the latter, but added this may increase the burden on “core safety net providers” if non-teaching hospitals increasingly transfer patients who need surgical care to teaching hospitals.
