General Surgeons And Trauma Call

[Eyeh8bullies]

Hello,

MS4 curious here: Can general surgeons take trauma call without SCC/ACS or other trauma related fellowships? I thought it was yes (can take trauma call w/o fellowships), but seeing that things are becoming more and more specialized, I wanted to double check whether that answer is still correct.

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[TraumaLlamaMD]

At most places (excluding bigger trauma centers), taking general surgery call includes taking care of surgical trauma patients who present while you’re on call. You don’t need a trauma fellowship for this. If you’re trying to take a job taking exclusively trauma call, at a trauma center, most places would prefer to hire fellowship trained surgeons although I’d guess there are more rural hospitals which don’t require fellowship to take acute care/trauma call.

 

[balaguru]

At most places (excluding bigger trauma centers), taking general surgery call includes taking care of surgical trauma patients who present while you’re on call. You don’t need a trauma fellowship for this. If you’re trying to take a job taking exclusively trauma call, at a trauma center, most places would prefer to hire fellowship trained surgeons although I’d guess there are more rural hospitals which don’t require fellowship to take acute care/trauma call.

It depends on the facility. At a nondesignated facility where you take call you may get consulted on a trauma patient. You should accept the consult if you have the capability and capacity. If you don't have the capability or capacity then tell them to stabilize +/- your help and ship out. At a designated facility it depends on the level of designation. Non-fellowship trained surgeons can take call but these call pools are often staffed by a company with an exclusive contract with the hospital. There will be regional variations on how open these companies are to hiring or subcontracting with non-fellowship trained surgeons. My advice is that when signing a call agreement with a hospital with a trauma designation do not agree to provide trauma coverage without appropriate compensation. Overtriage is common, especially at new level 3 facilities. So when the nursing home patient falls and comes in with a head lac and GCS of 13 you might be required to cancel your clinic full of patients or elective cases to come in to see this patient. Designated trauma programs require that a trauma surgeon is at beside within a certain timeframe for level 1 trauma activation: 15 minutes for ACS accredited level 1 and level 2 facilities and 30 minutes for level 3 facilities accredited by the state of Texas. There is a very real opportunity cost to providing this level of availability. Getting paid $3K/d for trauma call at a level 3 facility is not unreasonable. Hospitals pursue trauma designation because they can bill separately for the activation and they are reimbursed higher for ancillaries associated with an activation.

 

[TypeADissection]

Yes. If you decide that you want to go into a community and be a kick-ass general surgeon, there's a good chance you'll be taking trauma call. Especially if you're at a Level 2 or 3 center. But no worries, you'll most likely be well prepared by your residency training to stabilize a patient and ship them or if needed take them to OR for ex lap. There's a good chance though that if you're headed into a community setting, then you're going to be more than OK not dealing with the really nasty stuff.