Trauma Care in Europe

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In an earlier post, I indicated that I attended and was invited to be a  
speaker at the European Association for Trauma and Emergency Surgery (EATES)in 
 Antalya, Turkey.   This was a spectacular meeting with 1200 attendees,  of 
trauma surgeons, critical care surgeons, orthopedic surgeons, thoracic  
surgeons, abdominal surgeons, vascular surgeons, foregut surgeons, minimally  
invasive surgeons, surgical intensivists, trauma resuscitatiologists,  
anesthesiologists, emergency physicians, acute care surgeons, emergency  surgeons, 
and trauma/emergency medicine public health  physicians.    The meeting was 
in two different large rooms with  those interested in head, neck, 
thoracic, abdominal, and vascular surgery in one  room, and those with primarily 
osseous and soft tissue extremity injury meeting  in the other.  In addition, 
medical students, residents, fellows,  registrars, administrators, CEOs, 
CFOs, COOs, and public policy political  persons were present.     
 
The comments in this post are totally and solely my own.   NO ONE  has 
suggested I write this editorial, and no one has reviewed anything I have  
written here.    
 
Many of the above medical professional persons are listed due to the  NON  
STANDARDIZED nomenclature of physicians in Europe and the Middle  East.   
Around the world, but especially in EUROPE there is a great  need for a 
standardization of nomenclature as to what physicians are  called.   EATES is in 
an excellent position to accomplish this long  needed nomenclature 
standardization.    More importantly, there  is great debate as to just what each 
named "specialist" can do in the EMS,  resuscitation area of the hospital, 
dispatch, disaster, OR, ICU and clinic  locations.    Many qualified physicians 
are literally prohibited  from caring for patients because of this jealous 
protection of turf, both in  Europe and in the United States.    EATES is also 
in the most  ideal position to address these turf and credentialing 
challenge.    THIS MUST BE DONE if there is to be progress in the care of emergency 
surgery  patients, be it in disaster, burns, interpersonal trauma, war, 
industrial  accidents, road traffic accidents, or others.    Furthermore, the  
systematic public health approach to trauma care is going to be mandated by 
the  consumerism movements of governments and the public in  general.    
 
I was struck with the protectiveism of the word "trauma" and just who owned 
 it.    In each country, different specialist tended to want to  "own" the 
term "trauma" for their discipline.    No where did  this seem to be more 
volatile than in Germany where the orthopedist who does  almost exclusively 
bones, joints, and soft tissue wanted to continue to solely  own the term 
trauma.   This may be an over simplification on my  understanding, but it seemed 
to me that if the German orthopedic surgeons would  merely call themselves 
orthopedic surgeons with interenst in "______" (pick any  term), much 
progress would be made in Europe.    
 
It is time that all of us address a trauma and emergency surgery Integrated 
 Collaborative Network with a public health focus on our approach.    This 
means a system approach.   
 
I am looking forward to EATES leading the entire world on their approach to 
 these issues.   There was much discussion in formal meetings and from  
panels on these subjects, but no closure or total agreement.  I also found  a 
significant disparity between what was said by the "elder" trauma and  
emergency surgery statesmen (and officers of the organization) and the younger  
less vocal surgeons from each country.   I noted none of the YOUNG  persons at 
the table during formal panels.    I also did not note  ANY officers who 
were female.     
 
Much progress will be made by EATES in the future and I do hope to be an  
observer of these advances.   The whole world will benefit from such  an 
EATES leadership.  
 
k
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