Trauma centers may give us some pointers in policy-setting to address the alleged fiscal cliff: Stopping the bleeding first reduces the need for tax transfusions.
A recent article in The Wall Street Journal reported how the nation’s medical trauma centers’ efficiency at stabilization of violence-related trauma victims has driven homicide deaths down, despite rising incidences of gunshot and stab wound violence.
The victims, despite their standing as the constituency least liked by the mainstream and lawmakers, teach valuable first-responder lessons about allocation of resources and sustainability that go far beyond the medical profession.
In the past five years, most of the middle class – admittedly more liked by lawmakers – has gotten financially shot and stabbed. Individuals from post-college to retirement age who never expected they’d be placing themselves in harm’s way have fallen prey to financial disruption from which they will take years to recover, if at all. They are now bleeding from a thousand financial cuts.
So here are the trauma center lesson points:
Treatment in “The Golden Hour” right after injury ensures greatest survival. The longer a problem is allowed to go on, the worse it gets, so fix it fast to avoid structural complications downstream. But do it right.
An example: The stigma of long-term unemployment keeps many capable people out of the job market, during which they lose their skills. Many corporate-sponsored training programs to which our state unemployment office refers job-seekers – for example, retraining manufacturing personnel for biotech jobs – ask for exorbitant four-figure training fee costs. Trainees who pay the money and complete the programs are only offered a place in the resume pool. So much for private-sector engagement in solving this problem.
These job seekers first got shot, and now they’ve been stabbed. The state should address training programs that don’t bleed the already-empty wallets of those seeking help.
In an emergency, stabilize the patient first, then do one thing at a time to allow recovery. This gives a better idea if any individual procedure worked on its own. EMTs now administer fewer fluids and maintain lower blood pressure so patients don’t bleed out so fast. In other words, don’t throw good money after bad, wasting resources where your medical experience shows that it won’t do any good anyway. Recent research experience shows that the best way to prevent fatal bleed-outs is not to administer red blood cells (previously thought necessary to keep organs oxygenated) but to infuse more plasma and clotting agents.
In other words, if you’re hemorrhaging money, keep the blood from running out in the first place.
In seeking consultants, ask the people who see and treat the the largest number of dire cases. Practice makes perfect. So don’t just ask your friends in the legislature.
Statistical testimony from medical providers to the country’s least-liked constituency can provide valuable lessons to those held in better favor.
Immigrants in the 19th century were despised by the mainstream, but epidemiological research on them provided data that led to life-changing medical advances for all walks of life. In determining how to resolve the country’s budget woes, today’s lawmakers should be listening from the ground up to those making difficult financial passage through today’s troubling times.
