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2008 Annual Meeting Abstracts


A Satisfying Surgical Practice: The Academic Trauma Service Model
Suresh Agarwal, MD, Lejla Hadzikadic, MD, Peter A. Burke, MD, Andrew Glantz, MD, James Becker, MD, Erwin Hirsch, MD.
Boston Univ Medical Center, Boston, MA, USA.

OBJECTIVES
Many authors and professional organizations question Trauma Surgery’s future as a specialty due to decreased operative volume, inadequate (institutional and individual) compensation and lifestyle. Our aim was to evaluate the quantitative and fiscal contributions of our long-standing practice, the academic trauma service (ATS), of including emergent and elective surgery with our trauma practice.
Table of Contents

  • DESIGN
  • RESULTS
  • CONCLUSION

DESIGN
Prospective cohort
SETTING
Level I or II Academic Trauma Medical Center
PARTICIPANTS
Prospectively collected databases from the Emergency Department (ED), Outpatient Clinic (OC) and Operative and Trauma Registries during Fiscal Years ’05 and ’06 for 5.2 trauma surgeons were reviewed.
INTERVENTION
Operation and post-operative care as outlined by ATS.
MAIN OUTCOME MEASURES
ATS clinical outcomes, quality assessment and revenue were reviewed in aggregate with the remainder of the Dept of Surgery.
RESULTS
There were 113911 ED visits, 4192 admissions excluding observations and 16500 ATS OC visits. Trauma surgery billing, combined, was higher than that of other sections without an increase in morbidity or mortality. Compensation for ATS follows institutional guidelines (academic rank, clinical and academic productivity) exclusive of payer mix. Three thousand two hundred eighty nine operative cases were performed by the ATS.
CONCLUSION
An ATS model based on trauma surgery, emergent general surgery, and an outpatient experience allows for a meaningful and diverse operative experience. This model makes it unnecessary for Trauma Surgeons to acquire skills outside their specialty but, rather, focus on maintaining and advancing traditional general surgical skills.

 

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