Crippled Trauma System

The withdrawal of Huntington Hospital in Pasadena from the trauma system should not have surprised anyone (Part A, Feb. 24). Private hospitals are not in the patient-care business for altruistic reasons; they are in it for financial returns. When their bottom line turns negative, they will not, and should not be expected to, go into debt. Either they will be reimbursed or they will not give the care. Simple as that. The fundamental mistake that was made in 1983 was to assume that all hospital members would act the same, that county hospitals and private hospitals would bear the same load and unfailingly accept and care for all patients. This assumption was naive and doomed the system to failure.

What will happen now? The worst thing the bureaucrats could do is to try to keep the system alive. This will only delay the inevitable and throw more money into a doomed enterprise. The next worst thing would be to try to force-feed these patients into the county hospitals. This will compromise patient care and create more Martin Luther Kings at the other county hospitals.

The best solution is to abandon the trauma system (which has never been shown to work well) in favor of the old proven system where patients were taken to the closest hospital emergency department. Require those hospitals who are to accept these patients to have a panel of specialists on call who will respond in a timely manner to the emergency physician’s call. This is an easy system to monitor; it spreads out the loss from these trauma patients into more manageable chunks, and it will not diminish the level of patient care.

JOSEPH MORALES, M.D.

Pasadena