Advertisement

 

 

Trauma Surgeons: Lifeguards at the Shallow End?

Trauma Surgeons: Lifeguards at the Shallow End?
Author Information (click to view)

Bruce Davis, MD

Bruce Davis, MD, is a Mesa AZ based general and trauma surgeon. He finished medical school at the University of Illinois College of Medicine in Chicago way back in the 1970’s and did his surgical residency at Bethesda Naval Hospital. After 14 years on active duty that included overseas duty with the Seabees, time on large grey boats and a tour with the Marines during the First Gulf War, he went into private practice near Phoenix. He is part of that dying breed of dinosaurs, the solo general surgeon. He also is a writer of science fiction novels. His works include the YA novel Queen Mab Courtesy, published by CWG press (and recently reissued by AKW Books as the e-book Blanktown). Also published through AKW Books are his military science fiction novel That Which Is Human and the Profit Logbook series, including Glowgems For Profit and Thieves Profit.

The Website: www.thatwhichishuman.com
The Blog: www.dancingintheor.wordpress.com

+


Bruce Davis, MD (click to view)

Bruce Davis, MD

Bruce Davis, MD, is a Mesa AZ based general and trauma surgeon. He finished medical school at the University of Illinois College of Medicine in Chicago way back in the 1970’s and did his surgical residency at Bethesda Naval Hospital. After 14 years on active duty that included overseas duty with the Seabees, time on large grey boats and a tour with the Marines during the First Gulf War, he went into private practice near Phoenix. He is part of that dying breed of dinosaurs, the solo general surgeon. He also is a writer of science fiction novels. His works include the YA novel Queen Mab Courtesy, published by CWG press (and recently reissued by AKW Books as the e-book Blanktown). Also published through AKW Books are his military science fiction novel That Which Is Human and the Profit Logbook series, including Glowgems For Profit and Thieves Profit.

The Website: www.thatwhichishuman.com
The Blog: www.dancingintheor.wordpress.com

Advertisement
"The trauma service these days consists mainly of babysitting recovering orthopedic and neurosurgical patients."
Share on FacebookTweet about this on TwitterShare on LinkedIn

There was a time, during my training and early in my career when the trauma surgeon was the fighter pilot of the surgical world. We were the Top Knives, the Master Surgeons, of our respective hospitals. Certainly the surgeons who trained me in the craft embodied that, and it was something I aspired to.

The nature of trauma has changed over the thirty years since I finished my residency. Penetrating trauma has fallen off to less that 15% of our total evaluations at the same time that non-operative management of liver and splenic injuries has become the norm. Cars are safer than they were 2 decades ago and the injury patterns have changed as a result.

I recently reviewed my trauma experience for the past year in preparation for applying for the ABS recertification exam.

I attended 518 Level 1 trauma activations in the past year. Of those, 294 were admitted as Trauma Service patients. Out of that total I did 21 major surgical procedures (not counting sewing up lacerations or chest tube placements in the trauma bay).

“I fear that trauma surgeons have gone from being the Master Surgeons, to the lifeguards at the shallow end of the gene pool.”

 

Those numbers seem to be in line with reported national averages. Operative intervention is now only a small part of what the trauma surgeon does, although I would argue that the acuity of those operative cases is higher than it was 20 years ago.

I reviewed the charts of the trauma admissions with which I was involved. 86% presented with a blood alcohol level in excess of 0.08 g/dl, or legally intoxicated. 47% returned a positive urine drug screen for other drugs such as opioids, benzodiazepines, methamphetamine, or marijuana. 76% were uninsured or underinsured (meaning that without the stop-loss portion of my trauma contract, I would not have been paid for my work).

The trauma service these days consists mainly of babysitting recovering orthopedic and neurosurgical patients. That’s not to say that these patients don’t have ongoing problems that are best managed by a team of surgeons, but they are not patients that we as trauma surgeons have operated on. All too often, the operating service signs off on day 3 or 4, and we are left doing the bulk of the postoperative care, rehab care, and discharge planning.

Not terribly exciting to a fighter pilot personality. I fear we have gone from being the Master Surgeons, to the lifeguards at the shallow end of the gene pool.

 

51d2xqFmkTL
Like What You’re Reading?!

Get Dr. Davis’s new book, Dancing in the Operating Room, a collection of these and other short essays about life and love in the world of surgery and medicine, now available from Amazon in print or as an e-book. Check it out!

 

Submit a Comment

Your email address will not be published. Required fields are marked *

eighteen + nineteen =

[ HIDE/SHOW ]