Academic Consequences of a Trauma System Failure

Houston is served by only two trauma centersHermann Hospital (University of Texas Medical School at Houston [UTMSH]), and Ben Taub General Hospital (Baylor College of Medicine). In mid-1988, Hermann Hospital, prompted by a shortage of ICU nurses and $8.0 million/yr of uncollectible trauma charges, began to divert critically ill and injured patients to the already overburdened Ben Taub General Hospital.The academic consequences to UTMSH included a severe loss of clinical experience by the surgical residents and medical students and a severe reduction in faculty-generated billing. The lost billing from the trauma service and the other clinical services approximated $8.0 million/yr. This equated to an $13.5 million decrease in the anticipated billings for the year. Alternative revenue sources were not apparent.Other centers with a heavy trauma system commitment are at risk to suffer similar unsettling academic sequelae as our trauma systems fail.