Trauma market is shifting, says OTA president Dr. Robert Probe
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Trauma in Flux?
Dr. Robert Probe, president of the Orthopaedic Trauma Association (OTA) tells OTW, “It seems that the market is shifting such that whereas most of the volume in trauma traditionally went to level one inner city hospitals, more and more community hospitals are trying to step into that business. The concern is that we don’t have an integrated, thoughtful system to support this trend. Only a few places in the country—like Shock Trauma in Maryland—have a state level plan for the diversion of major trauma. Then there is Chicago, where every hospital is pining to be a level one trauma center…so there is a dilution effect…and that is not an efficient way to spend resources.”
“What does this mean for patient care? On the surface the fact that care would be closer to home is appealing; one of the maxims of trauma care is that patients have access to a major level one trauma center within an hour of the injury location. The downside is that if there are too many trauma centers that means that no one surgeon is doing enough trauma to maintain a high level of care. This is especially true given that trauma injuries are going down. The OTA can’t and doesn’t want to get into the business of restricting the number of trainees…our role is to help maintain the quality of fellowships. There are some responsible programs that are ahead of the game and are voluntarily reducing the number of trainees—but not many.”