This is the most overlooked change in the business of Trauma Surgery staffing; so why don't more people know about it?

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*With the development of the Acute Care Surgery model, the door opened wide for surgeons to no longer live where they practice.*

So why wouldn’t someone want to live where they practice?

If the conditions were right, I am sure most providers would prefer to practice in the community where they provide clinical services. When the question is posed to surgeons that work essentially as hospitalists and do not go “home” for at least a week a month, a few themes began to appear.

· Most training programs are in the urban environment. Therefore providers and their families begin putting roots down. Factors such as school continuity for their children and social support for spouses are important.

The market is saturated in areas such as New York City, driving compensation down.

· Practicing in a rural or suburban environment allows a wider breadth of cases, and to be more “hands on” when not in teaching facilities.

So, how can a facility that is having trouble recruiting Trauma Surgeons use this information to get a good candidate?

Accept that this is the reality, and that you are competing with centers that have accepted this reality.

Accommodate physicians who are reluctant to relocate.

· Make room for commuters. Trauma physicians do not have to live full-time in your community. Facilitate commuting by grouping a physician’s call days together in a block. For example, a trauma surgeon could be on call every other day for two weeks and then have the next two weeks off. He or she can staff your program for half the month, and then spend the other half at home.

· Enable remote PI participation. Another strong incentive is to allow physicians to participate remotely in monthly M&M conferences and PI activities via HIPAA-compliant videoconferencing. Remote participation further supports commuter surgeons. It is also a benefit to everyone on your medical staff because it lets physicians participate in PI from home, while traveling for conferences, on vacation, etc.