Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Why is trauma activation so expensive?

Skeptical Scalpel, MD
Policy
July 15, 2018
111 Shares
Share
Tweet
Share

An 8-month-old baby fell 3 feet and hit his head on a carpeted floor in a San Francisco hotel room. He was crying and the parents, who were from South Korea, called an ambulance. By the time the child arrived at the hospital he was obviously fine. After a bottle, a nap, and a few hours in the hospital, he was discharged.

The hospital sent a bill two years later, which included a charge of $15,666 for a trauma activation.

A trauma activation involves paging a number of hospital staff to go to the emergency department as quickly as possible. Those paged may include an attending surgeon, two or three surgical residents, an anesthesiologist or anesthesia resident, a respiratory therapist, a critical care nurse, and operating room nurse, and x-ray technician, a chaplain, and various others.

The trauma team assesses the patient and if serious injuries are present, expeditiously diagnoses and treats the problem. But in cases like the one described above, the team quickly disperses and returns to their usual duties.

The story above was one of several recounted in an article on Vox. The authors found a huge variation in the fees for trauma activation ranging from $1,112 in one hospital to a high of $50,659 at another.

This is not a new issue. In 2014, I blogged about a Tampa Bay Times story on trauma activation fees in Florida which at the time averaged over $10,000 with a maximum of $33,000. That article said hospital administrators admitted the charges were based on what other hospitals were charging and were unrelated to the resources used.

A different California hospital’s trauma activation fee was $22,550 for a young man injured in a minor motorcycle crash. He suffered a cut on his head that required two staples and received some IV fluid and ibuprofen. No X-rays, scans, or bloodwork were done.

I can understand hospitals charging a fee for trauma activations to help recover some of the costs of having a trauma service. The staff may require some special training. Managing the service, collecting data, and other incidentals may increase costs.

However, nearly all of the personnel involved in a trauma activation are already in the hospital and receive their salaries whether trauma activations occur or not. In the above examples, I would guess most members of the team spent 0 to 5 minutes at the patient’s bedside.

Despite attempts to do so, bills like those mentioned in the Tampa Bay Times and Vox stories are impossible to defend. The Vox piece quoted a hospital spokesperson: “Trauma team activation does not mean every patient will consult with and/or be cared for by a trauma surgeon. The activation engages a team of medical professionals. Which professional assesses and cares for a trauma patient depends on the needs and injury/illness of the patient.”

That statement hardly justifies the bill which admittedly is not resource-based.

The American College of Surgeons told Vox that to avoid missing a seriously injured patient a 25 to 35 percent over-triage rate is acceptable. I agree with that, but it doesn’t mean a five-figure trauma activation fee is warranted for a patient with a cut on his head requiring two staples.

Imagine going into a shoe store and trying on four pairs of shoes. The salesperson, paid by the store owner, has gone to the back and retrieved them one at a time. But you decide not to buy anything. Should you be billed for the salesperson’s services?

Or at a car dealership, you test drive a car with the salesperson as a passenger. You determine the car is not what you had in mind. Should you have to pay for that experience?

“Skeptical Scalpel” is a surgeon who blogs at his self-titled site, Skeptical Scalpel.  This article originally appeared in Physician’s Weekly.

Image credit: Shutterstock.com

Prev

The can and can't of cannabis

July 15, 2018 Kevin 0
…
Next

How to thrive during your residency

July 16, 2018 Kevin 0
…

Tagged as: Emergency Medicine

Post navigation

< Previous Post
The can and can't of cannabis
Next Post >
How to thrive during your residency

More by Skeptical Scalpel, MD

  • The hospital CEO who made a surgical incision. What happened?

    Skeptical Scalpel, MD
  • Medical error is not the third leading cause of death

    Skeptical Scalpel, MD
  • Should speed-eating contests be banned?

    Skeptical Scalpel, MD

Related Posts

  • Expensive Medicare patients aren’t who you think

    Peter Ubel, MD
  • Why is health care so expensive in the United States?

    Scott Treutlein, MD
  • Trauma from my first anesthesia job

    Patrick Flaherty, CAA
  • It’s time to invest in trauma-informed ACEs interventions

    Vida Sandoval
  • Trauma: Encountering the past in the present

    Siraj Zahr, PhD
  • Dirt masks and couples massages: My trauma bonds in medical school

    Micaela Stevenson

More in Policy

  • Healing the damaged nurse-physician dynamic

    Angel J. Mena, MD and Ali Morin, MSN, RN
  • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

    Mohammed Umer Waris, MD
  • Breaking down the barriers to effective bar-code medication administration

    Amy Dang Craft
  • The locums industry has a beef problem

    Aaron Morgenstein, MD
  • Canada’s health workers are sounding the alarm. We must act, now.

    Ivy Lynn Bourgeault, PhD
  • Race categorizations are worsening health inequities for the South West Asian North African (SWANA) communities

    Guleer Shahab, MPH
  • Most Popular

  • Past Week

    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • From physician to patient: one doctor’s journey to finding purpose after a devastating injury

      Stephanie Pearson, MD | Physician
    • Breaking the cycle of misery in medicine: a practical guide

      Paul R. Ehrmann, DO | Physician
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • Why are doctors sued and politicians aren’t?

      Kellie Lease Stecher, MD | Physician
  • Recent Posts

    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • The psychoanalytic hammer: lessons in listening and patient-centered care

      Greg Smith, MD | Conditions
    • From rural communities to underserved populations: How telemedicine is bridging health care gaps

      Harvey Castro, MD, MBA | Physician
    • 5 essential tips to help men prevent prostate cancer

      Kevin Jones, MD | Conditions
    • Unlock the power of physician compensation data in contract negotiations [PODCAST]

      The Podcast by KevinMD | Podcast
    • From pennies to attending salaries: Why physicians should teach their kids financial literacy

      Michele Cho-Dorado, MD | Finance

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 25 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Biomarkers of Response With Enfortumab Vedotin in Advanced Urothelial Cancer
  • At-Home Topical Therapy for Molluscum Contagiosum Gets High Marks
  • Senators Press Moderna's CEO to Drop COVID Vaccine Price
  • Senators Press HHS Chief on Alzheimer's Drugs, Opioids at Budget Hearing
  • Despite Abortion Restrictions, Ob/Gyn Remains Competitive Residency

Meeting Coverage

  • At-Home Topical Therapy for Molluscum Contagiosum Gets High Marks
  • Outlook for Itchy Prurigo Nodularis Continues to Improve With IL-31 Antagonist
  • AAAAI President Shares Highlights From the 2023 Meeting
  • Second-Line Sacituzumab Govitecan Promising in Platinum-Ineligible UC
  • Trial of Novel TYK2 Inhibitor Hits Its Endpoint in Plaque Psoriasis
  • Most Popular

  • Past Week

    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • From physician to patient: one doctor’s journey to finding purpose after a devastating injury

      Stephanie Pearson, MD | Physician
    • Breaking the cycle of misery in medicine: a practical guide

      Paul R. Ehrmann, DO | Physician
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • Why are doctors sued and politicians aren’t?

      Kellie Lease Stecher, MD | Physician
  • Recent Posts

    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • The psychoanalytic hammer: lessons in listening and patient-centered care

      Greg Smith, MD | Conditions
    • From rural communities to underserved populations: How telemedicine is bridging health care gaps

      Harvey Castro, MD, MBA | Physician
    • 5 essential tips to help men prevent prostate cancer

      Kevin Jones, MD | Conditions
    • Unlock the power of physician compensation data in contract negotiations [PODCAST]

      The Podcast by KevinMD | Podcast
    • From pennies to attending salaries: Why physicians should teach their kids financial literacy

      Michele Cho-Dorado, MD | Finance

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Why is trauma activation so expensive?
25 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...