• What is TS, LLP
   
• Purpose
   
• TS, LLP Board of Directors
   
• Officers of the Corporation
   
• Participants in Each Specialty Group of the Managing Partners
   
• Sub-Specialty Surgeons as Independent Contractors to TS, LLP
   
• Medical Guidelines for the Trauma Program
   
• Medical Directors of Key Trauma Programs
   
• Why TS, LLP
   

Why TS, LLP

By 1995, the trauma patient volume had grown to 2000 patients per year. Several specialty groups (general surgery, orthopedics, head and neck surgeons) had hired surgeons who wanted only to focus on patients with traumatic injuries. Anesthesia (OAG) and radiology also added additional members to help with the workload. Trauma physicians and surgeons took pride in what they helped to create, liked the recognition from the American College of Surgeons Committee on Trauma, and depended on the trauma program financially.

Each specialty recognized the need to dedicate financial and intellectual capital in support of the trauma program and believed that they should work collaboratively. Consequently, the group of specialists (anesthesia, head and neck, orthopedic surgeons, and radiologists) approached William Long, Trauma Medical Director, and ask him to form and lead a group of trauma specialists. Their goals were to achieve the following:

1. Exclusive contract with hospital to provide physicians/surgeons for the trauma program.
2. Control of credentialing process to attain highest quality and credentials of trauma participants/providers.
3. Control of trauma call schedule
4. Market rate call pay for each specialty’s trauma commitment
5. Fair reimbursement from medical insurance companies in exchange for verified quality of care by trauma experts.
6. Hospital Resources - (nurses, techs, therapists, physical plant and equipment) to keep pace with modern trauma care.
7. Shared information about trauma program finances to assure some money is returned to trauma program as long as the trauma program revenues exceed expenses.
8. Trauma physicians and surgeons participate in hospital strategic planning.
9. Representation on the medical staff and hospital’s medical executive committee, since trauma has the largest in-house patient volume of any service/program in Legacy.
10. Identity of trauma care at Emanuel hospital as a community, state, and regional resource for which government, civic and business leaders, the medical community and the people expect outstanding care.

Certain members of the TS, LLP, prior to its creation, had approached the Oregon Legislature to create an Oregon Trauma System, and increase funding for trauma care. They convinced the surgical community to approve "franchised trauma centers" based on merit and performance. TS, LLP physicians and surgeons provided key leadership that enabled Emanuel Hospital to secure one of two level 1 trauma center franchises in the State of Oregon.

The role of trauma specialists within the medical staff structure needs to evolve further. As of 2006, the hierarchy of medical staff representation lists trauma as a section of the Department of Surgery, even though non-surgical specialists (anesthesia and radiology) and almost all surgical specialists work in the trauma program. The physicians that specialize in trauma believe that trauma should be established as a department within the medical staff.

TS, LLP want to expand resources and manpower to meet the community needs for trauma and emergency surgery care. We have proven our model works, and the trauma specialists remain committed to provide the highest level of trauma care.

In summary, every one of these components has been carefully put in place, building on the previous commitments and building blocks for the trauma program. To take one component out has deleterious effects on the ability to do the remainder of the commitments.

What follows is a status report on these building blocks and the commitments made by the various nurses, specialists, PA’s, etc. Following the current status report will come recommendations for what needs to be done.