Hartsock Langdon A, Selassie Anbesaw W, Hogan Kathleen A
Dept. of Orthopaedic Surgery, MUSC, 96 Jonathan Lucas St., Ste. 708, Charleston, SC 29425, USA.
J S C Med Assoc. 2003 Oct;99(10):310-4.
There are approximately 300 orthopaedic surgeons in South Carolina, a state with a population of approximately four million. There is one orthopaedic surgeon per approximately 13,000 people, which should be adequate to meet the demand for orthopaedic care. The problem is not the quantity of orthopaedic surgeons. The problem is staffing our trauma centers with orthopaedic surgeons who are enthusiastic, have an interest in trauma care, and maintain high levels of CME and technical expertise. They need to be supported with appropriate medical liability reform, such as has been adopted in other states, and methods should be put into place to compensate surgeons for expensive, time consuming, and potentially risky procedures performed on uninsured and under insured patients. The number of patients with extremity trauma in South Carolina increased 25.6 percent during a five-year time period and is expected to continue to increase. It is estimated that 40 percent of all surgical charges generated for orthopaedic surgeons staffing trauma centers are for self-pay patients. Given the higher liability cost and lower reimbursement from other payer sources for elective procedures, it will soon become impossible for orthopaedic surgeons to continue to provide services at trauma centers without support from hospitals or government agencies.
南卡罗来纳州有大约400万人口，该州约有300名骨科医生。大约每13000人中有一名骨科医生，这应该足以满足骨科护理的需求。问题不在于骨科医生的数量。问题在于为我们的创伤中心配备热情高涨、对创伤护理感兴趣并保持高水平继续医学教育（CME）和技术专长的骨科医生。需要通过适当的医疗责任改革（如其他州已采用的改革）来支持他们，并且应该制定方法，对为未参保和参保不足的患者进行的昂贵、耗时且有潜在风险的手术给予外科医生补偿。在五年时间里，南卡罗来纳州四肢创伤患者的数量增加了25.6%，预计还会继续增加。据估计，在创伤中心工作的骨科医生所产生的所有手术费用中，40%是自费患者产生的。鉴于择期手术的责任成本较高，且其他支付方的报销较低，如果没有医院或政府机构的支持，骨科医生很快将无法继续在创伤中心提供服务。
