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Sat Mar 8 22:18:44 GMT 2008

Ken, Rick, Jeff and others..

I have always wanted to say this but never had the guts, since it is
probably politically incorrect.

There is no doubt that there is some added value to be treated for a complex
hand injury by a qualified hand surgeon.  However, most hand injuries can be
dealt with adequately by a "General" Trauma Surgeon, or a "General"
Orthopedic Surgeon.  Since the FIRST world society developed the
medico-legal environment that promotes some of the behavior mentioned in the
previous posts on this issue, those "altruist" "General" docs will not take
the risk anymore.

Since that same FIRST world society became clients instead of patients, they
demand the best of care and nothing less (even theoretically).  The courts
followed the trend and supported this society.  Thus, our bunch of dedicated
docs, full of altruism faded out sometime in the last century (the 20th).

But now, this FIRST world society of clients (not patients) wants to bargain
about the amount of money they are prepared to pay these "super" hand
surgeons.

Well, if they are not prepared to pay they do not deserve the service.  As
we say here, "This society made this cake - now the same society should eat
it" - or something like that.

Sorry about this emotional post.

Mickey Stein

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of KMATTOX at aol.com
Sent: Saturday, March 08, 2008 2:23 AM
To: trauma-list at trauma.org
Subject: Re: Hand Call Coverage at Busy Urban Trauma Centers

I can imagine many, if not the MAJORITY of emergencies that are manifest on

the HAND, I would RATHER have a NON-DECLARED HAND SPECIALIST  to care for  
myself or my family , than someone with the narrow declared focus of the  
DECLARED HAND SPECIALIST.     I would hope that every  emergency room
physician would 
comprehend and appreciate that.

k 

In a message dated 3/7/2008 6:18:09 P.M. Central Standard Time,  
Rick.Moore at TriadHospitals.com writes:

ED  physician thinks the patient needs a
specialist, specialist says "I don't  repair that type of injury" and
then the higher level of care center  refuses to take the patient. At
this point the patient is at the mercy of  an ED physician or general
orthopedist who may or may not handle the care  appropriately. I am very
confident in our ED Physicians and our General  Orthopedists, but if the
hand belongs to my wife, my children or myself, I  want the Hand Surgeon!
And our patients deserve no less.
Rick  Moore

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Hand Call Coverage at Busy Urban Trauma Centers