Tuesday, November 8, 2005

Health News (not so Surprising): Trauma centers ill-prepared for disaster

Emergency care is expensive, un-profitable, unpredictable, and absolutely essential. I particularly enjoyed the last part about stocking Tamiflu but not funding programs to change how ED's operate. American's trust expensive drugs over systems based clinical solutions any day. Granted I know it's no suprise that ED physicans argue they are underpaid and underresourced but they are also the first responders for any sort of mass casualty situation. When was the last time you saw Dermatologists begging for more government funding?

Trauma centers and emergency departments similarly are strained in many U.S. cities, experts say. . . "Trauma systems are never more than a couple of minor incidents from being overwhelmed," said Larry Gage, president of the National Association of Public Hospitals and Health Systems.

Trauma and emergency care is a money loser, serving many patients without health insurance. It's also expensive to maintain a round-the-clock staff of specialized surgeons and trauma-care medical workers.

In Atlanta, hospitals often pay subspecialists around $1,000 per day to take calls for trauma care. For those reasons, many hospitals have gotten out of trauma care, increasing the load on those that have stayed in that business, industry experts say.
In September, emergency physicians from across the country gathered in Washington to rally for additional government support. More than 3,000 physicians attended and spoke in favor of a measure that would increase Medicare payments to emergency doctors and hospitals by 10 percent. But the bill so far has only two sponsors. Emergency physicians say they are amazed that the Bush administration is willing to spend billions to stockpile Tamiflu for a possible super-flu outbreak -- even though it's not clear the medicine would be effective -- while showing disinterest in aiding emergency hospitals that would have to handle flu cases.

Emergency departments are the perfect cauldrons for a dangerous strain of flu to spread through large numbers of immune-compromised people, said Kellermann, the Grady physician. Emergency centers should be expanded to have respiratory isolation areas and other services, he argued.

"We're worried about a flu pandemic and we're parking patients cheek to cheek," he said. "That's just mind-bogglingly stupid."

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