Your local emergency room (ER) may seem like an exercise in controlled chaos. There are several healthcare professionals who work in an ER, each with their prescribed role. But they all have the same ultimate goals in mind: saving lives and limiting the lasting effects of illness or trauma.
Two major players in the ER are the trauma surgeons and the emergency room doctors, also known as emergency medical specialists. They both respond to emergency situations, but what is the difference between trauma surgeons vs. ER doctors, and how do they work together? Brant Putnam, MD, a trauma surgeon for the past 15 years, Professor of Surgery at the David Geffen School of Medicine at UCLA and Chief of the Division of Trauma and Acute Care Surgery at Harbor-UCLA Medical Center, explains.
Different skill sets
While the goals of the ER doctor and the trauma surgeon are the same, their skill sets are different, starting from when a patient enters the ER, says Dr. Putnam. Emergency room doctors treat all the patients who come through the ER door, regardless of their illness or injury type. "They're going to be able to take care of patients who come in with the early stages of a heart attack or stroke, or a patient who has been injured after a trauma," he explains.
For example, ER doctors may intubate a patient, start blood transfusions and order testing — all while assessing the patient and making decisions about their care. "They're very well trained in that initial stabilization and the majority of patients with minor trauma are largely managed by emergency room physicians," says Dr. Putnam.
Trauma surgeons, on the other hand, are not routinely stationed in the ER, but will come if patients fall into certain categories, such as low blood pressure after a car accident, or if the ER patients need emergency surgery to save their life or prevent long-lasting or permanent damage. When possible, the trauma surgeon is in the ER with the ER doctor when severely injured patients arrive. If surgery is needed, the trauma surgeon operates. If the patient needs to be admitted, the trauma surgeon assumes primary responsibility for the patient's care, and provides follow-up care.
Differences in education for trauma surgeons and ER doctors
All medical doctors and surgeons start off with the same training in medical school. Specialization comes after graduation, during their residency. Training in trauma surgery is a longer process than ER medicine. "It's a significant commitment to become a trauma surgeon," Dr. Putnam says. "It's usually a five- or six-year residency for general surgery, followed by a year or two of surgical critical care/trauma fellowship. Emergency medicine residency lasts three or four years, depending on the program." Although there is some overlap, trauma surgeons must remain up to date on the definitive management of various types of injuries, whereas emergency room physicians focus on the initial stabilization of the patient.
Another difference between trauma surgeons vs. ER doctors involves their contact with patients. The role of an ER doctor is to stabilize and treat patients in the ER, and refer them for admission to the hospital or further care from other specialists, if needed. Trauma surgeons, however, follow the patients for a longer period, right through to rehabilitation and discharge, Dr. Putnam explains. "I guess it's really the commitment to taking care of a severely injured patient from the time of arrival through their need for surgery and acute hospitalization that is what makes a trauma surgeon different from an emergency room physician."
By Marijke Vroomen Durning