The Institute of Medicine (IOM) report, “The Future of Emergency Care,” is a much needed wake-up call for all Americans as each and every one of us could face an unexpected, life-threatening injury or disease.  Health system changes over the past two decades have stressed surgical practice to the point that we now face a looming surgeon shortage, jeopardizing patient care in the most dire and extreme of cases.  Our nation’s commitment to disaster preparedness and response in the post 9-11/Hurricane Katrina era must include patient access to prompt acute care services in our nation’s emergency departments (ED). The reasons for concern are clear and the contributing factors are numerous; we commend the IOM for providing this timely insight.   

Current access to high-quality trauma and emergency system care, the best hope for people who are seriously injured or facing a life-threatening illness, is geographically arbitrary and inequitable across the United States.  The current liability and reimbursement system discourages surgeon on-call participation in trauma centers and EDs.  These issues are coupled with an aging population, surgeon retirements and a generally overworked profession.  Meanwhile, a trend towards subspecialization is reducing the pool of generally qualified surgeons who feel competent to handle the variety of scenarios presented in the ED.  Advances in surgical processes also have allowed surgeons to omit hospital-based care from their practices altogether, increasing the burden on those who do provide care through ED panels.  Meanwhile, surgeons who support trauma centers and emergency rooms face significantly increased legal and financial liabilities.   

Since its inception almost a century ago, the American College of Surgeon (ACS) has been dedicated to improving the care of the surgical patient and to the ethical and competent practice of surgery.  As the IOM reports outline, the College recognizes the system’s strengths, acknowledges its limitations and weaknesses and looks forward to working on the federal, state and local level to ensure that high-quality, acute care patient services are not compromised. 

Dr. Thomas R. Russell, Executive Director, American College of Surgeons, is available to answer questions and provide background on what the surgical professional is doing to remedy this potential shortage.

Contact:

This page and all contents are Copyright © 2006
by the American College of Surgeons, Chicago, IL 60611-3211