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Tue Jul 3 23:32:01 BST 2007

OK - so now you have me laughin' my butt off and smilin' big time.....THANKS, I needed that!!!

>>> "Enrique Daza" <edazamd at verizon.net> 7/3/2007 5:20 PM >>>
My point was that we are all "just" general surgeons to the public and even 
to other Physicians and Surgeons. The definition of General Surgery today is 
"Clear as mud" to everyone except to the one actually doing "real" General 
Surgery for a living. I feel like I made my point. So I will also shut up.

E Daza MD FACS
Non Fellowship Certified High Volume Per Diem Emegency/General/Trauma 
Surgeon

----- Original Message ----- 
From: "Ronald Gross" <Rgross at harthosp.org>
To: "Trauma &amp; Critical Care mailing list" <trauma-list at trauma.org>
Sent: Tuesday, July 03, 2007 4:47 PM
Subject: Re: non-trauma surgeons doing trauma

Ah, I see - clear as mud!

OK, so use me as an example - I went into practice as "just" a general 
surgeon, having spent my time as a resident at Bellevue Hospital but not 
having completed a trauma/critical care fellowship, but loving both and 
focusing on trauma and critical care in my professional practice.  I ran the 
ICU at the Norwalk Hospital, got that hospital its ACS COT Level II 
verification and state designation (1st Level II in CT), and have moved on 
to be the associate director of trauma at a Level I trauma center in CT. 
80-90% of all the trauma we see here - depending on the time of year, and 
the phase of the moon - is blunt and about 80% of that is non-operative.  I 
am a full time trauma surgeon who fills in per diem to cover for the deficit 
in surgeons willing to go into non-laparoscopic both sides of the body, 
non-specialized-to-a-single-organ-system general surgery.........

Am I a real trauma surgeon, or "just" a general surgeon who is faking it as 
a High-volume trauma surgeon?

As I said earlier, you are gonna have to do a helluvalot better then that!

I think I better shut up now!

;-)

Happy 4th to all,
Ron

>>> "Enrique Daza" <edazamd at verizon.net> 7/3/2007 4:35 PM >>>
The assumption would be that the high volume surgeons are trauma/critical
care certified so that they do trauma full time and that low volume surgeons
are "just" General Surgeons who cover on a per diem basis to make up for the
deficit in surgeons willing to go into trauma. The whole acute care premise
would then hold that General Surgery is Trauma and Trauma/Acute Care Surgery
is General Surgery. No? The American Board of Surgery certainly thinks so.

Somewhere I read that 90% of trauma in the country is managed by non
Trauma/Critical Care certified General Surgeons. This would include inner
city and rural setting, penetrating and non penetrating trauma. And let's
face it, trauma has become a non operative venture most of the time, even
low velocity penetrating.

----- Original Message ----- 
From: "Ronald Gross" <Rgross at harthosp.org>
To: "Trauma &amp; Critical Care mailing list" <trauma-list at trauma.org>
Sent: Tuesday, July 03, 2007 4:17 PM
Subject: Re: non-trauma surgeons doing trauma

OK, so now define high volume and low volume!!  Given the act that in most
trauma centers outside of the inner city where penetrating trauma is usually
only 10-20% of the cases seen, most trauma care involves non-operative
management, are those surgeons high volume or low volume surgeons?

In order to be called a trauma surgeon (high volume be damned), does one
need to be critical care certified?  To be defined as a trauma surgeon, do
you have to be trauma/critical care fellowship trained?

Sorry Enrique, but you are gonna have to do a helluva lot better then
that!!!

Ron
>>> "Enrique Daza" <edazamd at verizon.net> 7/3/2007 3:41 PM >>>
High Volume surgeons would be considered the full time trauma surgeons and
low volume surgeons would likely be non-trauma on full time surgeons.

----- Original Message ----- 
From: "Valerie Malka" <osiris11_2000 at yahoo.com>
To: "Trauma &amp, Critical Care mailing list" <trauma-list at trauma.org>
Sent: Sunday, July 01, 2007 1:27 AM
Subject: non-trauma surgeons doing trauma

> Dear List
>
>  Does anyone have any references or know of any research/studies which
> have been done looking at outcomes of trauma patients treated by
> non-trauma surgeons vs trauma surgeons ?
>
>  Thankyou for your help
>
>  Regards
>
>  Valerie Malka
>
>
> Dr Valerie Malka MBBS,FRACS,MIPH
> Director of Trauma Services
> Department of Surgery
> Westmead Hospital
> Westmead, Sydney
> Australia, 2145
>
> Tel: 612 9845 7072
> Fax: 612 9845 8321
> Website: www.westmeadtrauma.org 
> Website: www.austraumaconference.org 
>
> ---------------------------------
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