Hospitals Lack Hand Surgeons for Emergencies

Only 7 percent of Tennessee hospitals have a hand specialist on call 24/7 to handle emergencies

MONDAY, May 7 (HealthDay News) -- There is a shortage of hand specialists to provide emergency coverage in the state of Tennessee, according to research published in the May issue of the Annals of Plastic Surgery.

Melissa A. Mueller, of the Vanderbilt University Medical Center in Nashville, Tenn., and colleagues conducted a telephone survey of 119 Tennessee hospitals with both an operating room and an emergency room to evaluate the availability of elective and emergency hand surgery services.

Overall, 111 of the hospitals (93 percent) contacted completed the survey. The researchers found that, although 77 percent of hospitals offered elective hand surgery and 58 percent offered at least basic emergency coverage for hand injuries, only 18 percent offered occasional hand specialist call coverage. Even fewer, only 7 percent, offered 24/7 hand specialist call coverage. Those hospitals that did offer the services of hand specialists billed significantly more through commercial insurance than those without hand specialist coverage.

"Given these reports showing a decline in interest in hand subspecialty training and our data demonstrating a current deficiency of emergency hand coverage, shortage of emergent hand surgery is likely to worsen," the authors write. "Potential solutions include altering the structure and length of hand training itself by developing an integrated residency, arguing for increased compensation, increasing direct pay from hospitals for call coverage, creating multihospital coordinated call schedules, and encouraging more surgeons to pursue hand surgery training."

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