Attitudes toward trauma care of surgeons practising in Ontario

Abstract

Objective: To assess the attitudes of practising surgeons in the province of Ontario toward issues in trauma care management.

Design: A survey by questionnaire.

Setting: The study was carried out in a university-affiliated hospital. The survey respondents generally practised in a nonteaching setting; 48% were over the age of 50 years; 81% worked in an institution with 24-hour in-house physician coverage for the emergency department.

Subjects: All 2294 surgeons registered with the Ontario Medical Association were surveyed by completion and return of a questionnaire; 191 surgeons were registered in Ontario but were not practising in the province and were excluded from the survey. Questionnaires were completed by 575 surgeons, but 49 were no longer in active practice, so 526 responses form the basis of this analysis.

Results: The response rate to the questionnaire was 27%. One-third of the respondents wished to treat no trauma patients at all; 47% believed that trauma patients had a negative impact on their surgical practice; only 19% considered that trauma patients had a positive impact. Surgeons had negative attitudes toward trauma because of the night and weekend profile of trauma, its effect on elective surgical practice, the poor rate of reimbursement for time spent in trauma management, and the potential medicolegal liability of trauma cases.

Conclusions: These results suggest that there are few surgeons in Ontario who are truly committed to providing care to the injured patient. Strategies to overcome the perceived negative aspects of trauma care must be addressed because a crisis in the availability of surgeons to provide this care seems inevitable.