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Is a trauma surgeon always a trauma specialist?

      Many inpatient trauma services are now staffed at a senior level not only by surgeons, but also emergency physicians, anaesthetists and intensivists. Each of these specialties brings its own unique skill set, and this mix can be synergistic. Emergency physicians are highly trained in the resuscitation of the undifferentiated trauma patient, as well as in the initial assessment of complex medical and psychosocial issues. Trauma surgeons have operative expertise, and the attendant skills of acute decision-making, post-operative management, and outpatient follow-up. Anaesthetists are proficient at intraoperative resuscitation, analgesia, and perioperative medicine; and intensivists specialise in the ongoing management of the critically ill patient, including complex multiple team interactions and family discussions. Recently, the merits of adding a trauma-focussed geriatrician to the team have been outlined [
      • Read D.J.
      Reply to editorial: the death of the trauma centre.
      ]. A team-based approach involving robust, open and respectful discussion of clinical cases on a regular basis may yield important insights from these different specialists.
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