Elliott R. Haut, MD, is a trauma surgeon and critical care physician at Johns Hopkins Hospital. He has recently published
Avoiding Common ICU Errors.
Can you describe your current research projects?
My current research interests fall into two main categories. The first is outcomes related to the system of trauma care.
My research group uses information from large databases to determine the best system to treat trauma patients.
We are currently working on a project that hopes to answer the question of, â€œWhat saves lives after major trauma?
The system or the surgeon.â€
My other main interest revolves around deep vein thrombosis (DVT). DVT has been suggested by multiple national
agencies as an important quality of care marker as a preventable complication.
However, my research has shown that there may be inherent flaws in using simple hospital DVT rates, and that these rates
alone are not valid markers of the quality of care.
As we look more closely for DVTâ€™s, we find more, and we might therefore be labeled as providing poor quality of care,
as measured by DVTâ€™s found, when we are actually looking harder for these complications to treat proactively.
I recently wrote an invited commentary on this touchy, yet nationally important, subject entitled â€œVenous Thromboembolism:
Are Regulatory Requirements Reasonable?â€ for the Society of Critical Care Medicineâ€™s newspaper.
What publication are you most proud of?
From a trauma system standpoint, my article titled â€œInjured Patients Have Lower Mortality When Treated By â€˜Full-Timeâ€™
Trauma Surgeons Vs. Surgeons Who Cover Trauma â€˜Part-Timeâ€™â€ will have the most impact.
This project is helping to establish trauma surgery as its own separate field by showing scientifically that those physicians
having an expertise and a specific body of knowledge of trauma surgery improves outcomes for injured patients.
In terms of â€œcoolâ€, the article in Rolling Stone Magazine (March 6, 2003) is at the top of the list.
I was in the right place at the right time during my trauma fellowship, when Rolling Stone came to Penn to do an article on
violent trauma in Philadelphia.
My boss at the time, Bill Schwab, asked me to show the writer around and make us look good. Next thing I know, there I am
written about and quoted in Rolling Stone.
Why is there so much penetrating trauma in the neighborhood around Hopkins?
If I could answer that, I would do it and fix the problem. Unfortunately, it is multifactorial, with so many interrelated reasons.
Partially, it is related to a culture of violence- the media, music, movies, and television portraying violence as culturally acceptable and even admirable behavior.
One of my mentors, Eddie Cornwell, has been working tirelessly to fight urban violence and he is currently promoting
public service announcements and a video called Hype Versus Reality, showing people what it is really like to be shot, not the
glamorized way it is portrayed in movies, TV, or music videos.
If you could be known for solving one clinical problem, what would it be?
I think this would have to be the problem of DVT. Deep vein thrombosis and
pulmonary embolism are the number one preventable cause of death in hospitalized patients.
Up to two million patients per year may be affected by DVT and PE, and more people die of this than breast cancer and
AIDS combined each year.
It is a huge public health problem that really has not received the media attention that it deserves.
The American Public Heath Association has called it a â€œsilent epidemicâ€ and the following link can explain how big a problem
this is in American healthcare. http://sites/insidesurgery.com/files.apha.org/NR/rdonlyres/A209F84A-7C0E-4761-9ECF-61D22E1E11F7/0/DVT_White_Paper.pdf
What would you say to a bright young medical student who is thinking about going into general surgery?
GREAT! As a general surgeon, especially an acute care / trauma / critical care surgeon, you will be well trained to deal with
any clinical problem that comes your way.
I can diagnose and treat nearly any acute surgical or medical emergency. We are perfectly qualified to take care of all types of sick patients whether it is in the emergency department, operating room, or Intensive Care Unit.
The pendulum has swung towards super-specialization within medicine, but we as acute care surgeons are giving some pushback.
We can deal with many complex difficult issues in a wide variety of fields.
Do you support the move by The Centers for Medicare and Medicaid (CMS) to not pay hospitals and providers for “preventable mistakes.”
Clearly, physicians should be held accountable for providing appropriate treatment and employing the best practices to
avoid preventable medical errors.
However, CMS has to identify â€œpreventableâ€ complications very carefully. Some complications can happen even if we do our
best to avoid them.
What gets you out of bed in the morning?
As a trauma surgeon, I start each day not knowing if that will be the day I save a life.
I have many patients out there who have been through multiple huge operations, weeks in the ICU, dozens of units of blood transfusions,
and long rehabilitation stays who now are back as functioning members of society.
There is nothing more amazing than shaking someoneâ€™s hand a year after his or her injury and saying, â€œYou are all better. Congratulations. You donâ€™t need me anymore. I hope to never see you again.â€ Thatâ€™s what gets me out of bed in the morning.
Disclosure: the interviewer is a former staff member at Johns Hopkins Hospital and has co-edited a medical manuscript with Dr. Haut.