Emergency department directors are reporting inadequate on-call trauma coverage, and many report a loss or downgrade of their hospitals' trauma center designations, according to a survey in the journal Academic Emergency Medicine.
"Without adequate on-call surgical coverage, our healthcare system cannot provide for emergency and trauma patients," said Mitesh Rao, MD, lead author of the survey and study: The Shortage of On-Call Surgical Specialist Coverage: A National Survey of Emergency Department Directors.
Rao, with the department of emergency medicine at Yale University, and clinical scholar with the Robert Wood Johnson Foundation, said 21% of ED deaths and permanent injury can be linked to shortages of specialty physician care. "Transferring patients significant distances to an available specialist is sometimes the only option, but it can create a dangerous delay in care," he said.
The survey found that 60% of respondents could no longer provide 24-hour coverage for at least one medical specialty in the last four years. More than three-quarters of respondents reported that their EDs have inadequate coverage for plastic surgery, hand surgery and neurosurgery. Almost one-quarter of survey respondents reported an increase in patients leaving before being seen by a specialist.