Hand Call Coverage at Busy Urban Trauma Centers

[Mike Smertka]

Could I just inquire?
   
  when speaking of transfering to a higher level of care, or in this case a hand specialist, with the reduction of federal payments, is such a specialist economically sustainable for a major trauma center much less a smaller facility?The discussion started on what to pay these physicians. I just want to know if a facility even can pay them. It just seems like the patient population would have to be regional, and that being the case; if the hand specialist was not at the highest level of trauma facility, how is it possible to justify the cost or care of transferring to a different facility? It also seems that if the patient is able enough to take themselves after other forms of care, then paying extraordinary amounts for on call time doesn't seem reasonable. I don't claim to be a surgical expert, but the logistics of the matter seem a bit excessive. 
   
  From my cynical side: If the purpose is a return to productive society most of the patients I have seen would benefit more form a alcohol or drug rehab specialist than a hand specialist. Reality just crushes the life out of my idealism. But i guess it is heavily dependant on patient populations.
   
  Mike

KMATTOX at aol.com wrote:
  I can imagine many, if not the MAJORITY of emergencies that are manifest on 
the HAND, I would RATHER have a NON-DECLARED HAND SPECIALIST to care for 
myself or my family , than someone with the narrow declared focus of the 
DECLARED HAND SPECIALIST. I would hope that every emergency room physician would 
comprehend and appreciate that.

k 


In a message dated 3/7/2008 6:18:09 P.M. Central Standard Time, 
Rick.Moore at TriadHospitals.com writes:

ED physician thinks the patient needs a
specialist, specialist says "I don't repair that type of injury" and
then the higher level of care center refuses to take the patient. At
this point the patient is at the mercy of an ED physician or general
orthopedist who may or may not handle the care appropriately. I am very
confident in our ED Physicians and our General Orthopedists, but if the
hand belongs to my wife, my children or myself, I want the Hand Surgeon!
And our patients deserve no less.
Rick Moore





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