In the ER, Baby-Faced Doc Is No Death Sentence
Organization, not experience, plays the chief role in trauma patients' survival.
Aug. 18, 2009— -- The next time you are in a fender bender and the doctor who meets you in the emergency room looks younger than you are, don't fret. New research suggests that the experience of your trauma physician matters less to your survival than does the overall organization of the trauma center you go to.
Researchers in the trauma surgery program at Johns Hopkins University in Baltimore, Md., reported Monday in the journal Archives of Surgery that having an experienced trauma surgeon is not necessarily better for you than having one who is just out of general surgery training -- at least in terms of your survival following a major trauma injury.
The study, led by Dr. Elliott Haut, assistant professor of Surgery and Anesthesiology and Critical Care Medicine at Johns Hopkins, looked back at death rates among 13,894 trauma patients at a single facility from 1994 to 2004. Before 1998, the center was staffed only with novice surgeons. But in 1998 a more senior surgeon, who spearheaded a new set of policies to organize the emergency department and improve patient care, was hired as director of the center.
After excluding patients with injuries too severe to have any reasonable chance of surviving, the death rate following the policy changes implemented in 1998 was reduced from 1.8 percent to 1.2 percent in the hands of only novice surgeons. But more importantly, the death rate after 1998 for patients of the more experienced doctors was 1.3 percent, a rate almost identical to the one achieved by less experienced trauma doctors.