title: Perception of differences between trauma care and other surgical emergencies: results from a national survey of surgeons.
abstract: A national sample of 2500 surgeons was surveyed. Thirteen variables were analyzed to ascertain perceived differences between trauma care and other surgical emergencies, as well as to identify factors contributing to a preferential reluctance to treat trauma. The response rate was 60%. Trauma was perceived as most likely to occur at inconvenient times by 67% of respondents, more often complex (44%), and more demanding of specialized knowledge (39%). Trauma was viewed as less likely to be reimbursed by 35% and most often litigious by 30%. Fewer respondents perceived differences for risk of exposure to lethal pathogens and violence (26% and 9%) and personal or professional rewards (25%). Surgeons who prefer to treat trauma view it as more often demanding of specialized knowledge and more complex than other surgical emergencies. Surgeons who prefer not to treat trauma or take trauma call perceive it as never personally or professionally rewarding, more often disruptive to personal life, emotionally taxing, litigious, and inconvenient compared with other emergencies. Perception of dissimilar reimbursement and personal health risk are less often associated factors. Perceived differences in the litigious nature of cases are not based on fact. We conclude that the individual degree of reluctance or enthusiasm for trauma care in comparison with other emergencies is influenced by perception, personality, and myth rather than by logic and facts.
authors.affiliation: Shock Trauma Institute, Loyola University Stritch School of Medicine, Maywood, IL 60153.
authors.forename: T J
authors.initials: TJ
authors.lastname: Esposito
authors.forename: A M
authors.initials: AM
authors.lastname: Kuby
authors.forename: C
authors.initials: C
authors.lastname: Unfred
authors.forename: H L
authors.initials: HL
authors.lastname: Young
authors.forename: R L
authors.initials: RL
authors.lastname: Gamelli
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D016009:Chi-Square Distribution; D004630:Emergencies; D013502:General Surgery; D006801:Humans; D007349:Insurance, Health, Reimbursement; D016013:Likelihood Functions; D008875:Middle Aged; D016079:Refusal to Treat / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States; D014947:Wounds and Injuries / Q000191:economics / Q000601:surgery*