The U.S. trauma surgeon's current scope of practice: can we deliver acute care surgery?

The Journal of Trauma
C Clay CothrenDavid B Hoyt

Abstract

The evolving discipline of acute care surgery as an expansion of trauma surgery is undergoing intense critique. As we envision this new paradigm of surgical practice, an evaluation of our current status across the nation's trauma centers is an essential step. The purpose of this study is to determine the practice patterns of trauma surgeons at major trauma centers throughout the United States. A survey was sent to the trauma directors of the 1,288 designated trauma centers in the United States, as listed by the American Trauma Society. As proposed, acute care surgery would encompass performing emergent abdominal, vascular, and thoracic trauma procedures as well as providing critical care. The addition of simple orthopedic and neurosurgical procedures has been considered. The survey response rate was 72% among the Level I/II/III centers (n = 515) with 92% of Level I, 72% of Level II, and 59% of Level III centers responding. Of the 169 Level I centers, 31 (18%) reported their trauma surgeons perform the full complement of thoracic, vascular, and abdominal cases. Trauma surgeons managed the full range of injuries at 11 (6%) of the 187 Level II centers and 7 (4%) of the 159 Level III centers. At these 49 centers, only 41% of surgeo...Continue Reading

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