The emergency room (ER) of a hospital can often appear to be a whirlwind of activity. Within this fast-paced environment, numerous healthcare professionals are working diligently, each playing a crucial role. Their shared objective is clear: to save lives and minimize the long-term consequences of illnesses and injuries.
Among the key figures in the ER are trauma surgeons and emergency room doctors, also known as emergency physicians. Both types of doctors are essential in responding to critical situations, but their roles and responsibilities differ. To clarify the distinctions between trauma surgeons and ER doctors and how they collaborate, we spoke with Brant Putnam, MD, a seasoned trauma surgeon with 15 years of experience. Dr. Putnam is also a Professor of Surgery at the David Geffen School of Medicine at UCLA and the Chief of the Division of Trauma and Acute Care Surgery at Harbor-UCLA Medical Center.
Distinct Skill Sets of Trauma Doctors and ER Doctors
While both emergency room doctors and Trauma Doctors share the common goal of saving lives, their specific skill sets come into play at different points in a patient’s emergency care journey, explains Dr. Putnam. Emergency room doctors are the first point of contact for all patients arriving at the ER, addressing a wide spectrum of medical issues, from minor to life-threatening. “They are equipped to handle patients presenting with early symptoms of heart attacks or strokes, as well as individuals who have sustained injuries from trauma,” Dr. Putnam elaborates.
For instance, ER doctors are adept at performing crucial initial procedures such as intubating patients to secure their airway, initiating blood transfusions, and ordering necessary diagnostic tests. Simultaneously, they are continuously assessing the patient’s condition and making critical decisions regarding their immediate care. “Emergency room physicians are highly skilled in initial stabilization, and they effectively manage the majority of patients with less severe trauma,” notes Dr. Putnam.
Trauma doctors, often referred to as trauma surgeons, are specialists who are not typically stationed in the ER on a routine basis. Instead, they are called in when patients meet specific criteria, such as exhibiting dangerously low blood pressure following a major accident, or when ER patients require urgent surgical intervention to save their lives or prevent permanent disabilities. Ideally, a trauma doctor will be present in the ER alongside the emergency room doctor when patients with severe injuries are brought in. If surgery is necessary, the trauma surgeon takes the lead in the operating room. Furthermore, if the patient requires hospitalization, the trauma surgeon assumes primary responsibility for their ongoing care throughout their hospital stay and manages their follow-up treatment.
Educational Paths: Becoming a Trauma Doctor vs. an ER Doctor
The foundation of medical education is the same for all doctors, including both emergency room doctors and trauma doctors. All physicians begin with the same rigorous training in medical school. Specialization occurs after graduation, during the residency phase of their training. However, the path to becoming a trauma surgeon involves a more extended and intensive period of training compared to emergency medicine. “Committing to becoming a trauma surgeon is a significant undertaking,” Dr. Putnam emphasizes. “It typically involves completing a five- or six-year residency in general surgery, followed by an additional one to two years of fellowship specializing in surgical critical care and trauma.” In contrast, an emergency medicine residency usually lasts for three or four years, depending on the specific program. While there is some overlap in their training, trauma surgeons must maintain expertise in the definitive surgical management of a wide range of injuries, whereas emergency room physicians primarily concentrate on the immediate stabilization of patients in critical conditions.
Duration of Patient Care: ER Doctors vs. Trauma Doctors
Another key difference between trauma doctors and ER doctors lies in the duration of their involvement with patients. The primary role of an emergency room doctor is to stabilize and treat patients within the ER setting. After initial treatment, they arrange for patient admission to the hospital or referrals to other specialists for further care, as needed. Trauma doctors, on the other hand, provide continuous care for their patients over a longer period, from the initial emergency phase through surgery, hospitalization, rehabilitation, and ultimately to discharge, Dr. Putnam clarifies. “I believe the defining characteristic of a trauma doctor, distinguishing them from an emergency room physician, is their comprehensive commitment to caring for severely injured patients from the moment they arrive at the hospital, throughout their surgical needs and acute hospitalization, all the way to recovery.”
(Related Article: Myths About ER Doctors)
