What Happens When Neurosurgeons Don’t Answer Their Phone?

In the United States, approximately 1.7 million patients per year sustain a traumatic brain injury.1,2 Estimates from the CDC suggest that roughly 52,000 deaths are attributable to traumatic brain injury nationwide.3 Some of these patients require immediate neurosurgical intervention to survive, such as when a patient requires removal of an enlarging hematoma from around the brain.

In 2013, approximately 2.8 million visits to the emergency department were associated with brain injury.4 Today, experienced neurosurgeons who are willing to provide emergency care are in limited supply. It is particularly hard to find those who meet and fulfill the stringent requirements for the American College of Surgeons trauma verification. Many neurosurgeons find professional satisfaction by delivering care in an elective setting, further limiting the number of available neurosurgeons to care for emergencies. Subsequently, there is a growing need for surgeons who will readily take on emergency neurosurgical cases. A surgical hospitalist program may provide the optimal solution when neurosurgeons don’t heed the emergency call.

Why Neurosurgeons Don’t Answer an Emergency Call

The workload of most surgeons has become increasingly difficult to maintain. On-call burdens and the pressure to produce more elective volume have contributed to the declining availability of surgeons for emergency care, and this is especially true for neurosurgeons. Many of today’s neurosurgeons have chosen to focus on providing high-level elective care that focuses on specialty cases. Emergency care is disruptive to this sort of an elective practice and often times emergency patients don’t have the means to provide payment for such services. The disruption of the elective practice and the inability to be paid for services to reduce the likelihood that neurosurgeons will happily embrace the emergency call burden.

According to Lynette Scherer, MD, FACS, Chief Medical Officer of Surgical Affiliates, the need in helping emergency neurosurgery patients has quadrupled in recent years because there has been a significant shortage of neurosurgeons who are willing to take emergency cases. Additionally, since many neurosurgeons perform elective cases, hospitals aren’t pressuring these highly specialized physicians to take cases they don’t want. “Neurosurgeons can really command a presence at the hospital because their cases are so valuable to the hospital and the care they provide is so critical,” said Dr. Scherer, “and the hospital often won’t force them to take the emergency call as long as they are doing their elective cases.”

Impact on Patients Requiring Emergency Neurosurgery

The lack of hospital neurosurgeons to provide care for emergency cases can result in delayed patient care and the worsening of patient outcomes. Additionally, when a neurosurgeon doesn’t answer an emergency call, hospital efficiency will subsequently be impacted since staff will need to take the time to find someone that will help the patient.

Hospitals in rural communities are especially affected by neurosurgeons who refuse to take on emergency neurosurgical cases. “If a patient shows up in a small rural center looking for help,” commented Dr. Scherer, “that hospital may be calling for hours trying to locate a neurosurgeon.” Hospitals in major metropolitan areas, although better connected and more likely to find a surgeon to help in an emergency case, are also impacted by the shortage of willing emergency neurosurgeons. Many patients have to be transferred to a center that will take them, which delays treatment for potentially life-threatening issues.

The Surgicalist Approach for Emergency Neurosurgery Cases

The surgicalist program with Surgical Affiliates offers a one-of-a-kind initiative for the field of neurosurgery. This program provides neurosurgeons who are willing and ready to take on an emergency neurosurgical procedure. At Surgical Affiliates, there is a 24/7 neurosurgery team available for emergency cases, such as cases involving epidural hematomas, traumatic brain injury, acute or infectious spinal cord processes, or stroke-related care. Hospitals who can’t find a neurosurgeon to answer an emergency case can simply partner with Surgical Affiliates who will provide a team of neurosurgeons available for immediate care.

Learn How a Surgicalist Program Can Improve Neurosurgical Care

Currently, Surgical Affiliates is the first organization to offer a surgicalist program for neurosurgery and is seen as the leader in facilitating greater and more immediate care for patients presenting with life-threatening neurosurgical problems.  If you wish to learn more about the surgicalist approach and how you can use it to improve the level of care your emergency neurosurgery patients can receive, contact us today for a free program analysis consultation.

References
1. Faul M, Xu L, Wald MM, et al. Traumatic brain injury in the United States: national estimates of prevalence and incidence, 2002–2006. Injury Prevention. 2010;16: A268.
2. Annual Number of TBIs. Centers for Disease Control and Prevention. https://www.cdc.gov/traumaticbraininjury/pdf/tbi_blue_book_annualnumber.pdf. Accessed December 8, 2017.
3. Get the Stats on Traumatic Brain Injury in the United States. Centers for Disease Control and Prevention. https://www.cdc.gov/traumaticbraininjury/pdf/bluebook_factsheet-a.pdf. Accessed November 8, 2017.
4. Taylor CA, Bell JM, Breiding MJ, Xu L. Traumatic Brain Injury-Related Emergency Department Visits, Hospitalizations, and Deaths — the United States, 2007 and 2013. MMWR Surveill Summ. 2017;66(No. SS-9):1–16.
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