Trauma centers: Too many cooks spoil the broth

I hope the accrediting body for trauma centers calculates the possible financial harm to both organizations

Editor’s Note:

Editor's note: Hospitals across the country are adding trauma centers at a record pace, spurred in part by the lure of greater profits, but critics say too many can hurt patient care.

I'm glad EMS folks are not the only ones who subscribe to the theory that more is better.

In emergency medical care, we have seen how increasing the number of ALS providers does not necessarily translate into better care. And the increase in the number of air ambulances has not yielded any perceived improvement in mortality rates in crashes.

Apparently trauma center designation has also jumped into this pool; as the article points out, there has been a growth of centers in the past few years. Old-timers might remember how trauma centers couldn't figure out how to stay open back in the '90s, especially in areas like Los Angeles.

What's changed?

Emergency care is a very costly endeavor. Unlike most business models, it's difficult to repurpose or utilize standing resources when they are not being used for their primary function. Staffing units around the clock, maintaining equipment readiness and keeping people trained to the most current techniques constitute a drain on any organization.

A trauma center can make up for that by having a high level of use; trauma teams maintain their proficiency by handling a steady flow of patients who need their services. But adding another center to the area can potentially cause immediate harm where neither facility stands to benefit. It's the same argument we have heard for paramedics and helicopters for some time.

The accrediting body for trauma centers need to take a very close look at the impact of adding centers. Financial reimbursement is but one issue, and a small one at that. If anything, I hope they calculate the possible financial harm to both organizations and what that means to the provision of trauma care overall in the region. 

After all, it's still about the patient, right?

About the author

Art Hsieh, MA, NRP teaches in Northern California at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. An EMS provider since 1982, Art has served as a line medic, supervisor and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook writer, author of "EMT Exam for Dummies," has presented at conferences nationwide and continues to provide direct patient care regularly. Art is a member of the EMS1 Editorial Advisory Board. Contact Art at and connect with him on Facebook or Twitter.

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