California Burn Centers Spreading Care

The ABA/ACS has granted verification status to some 60 burn centers around the country, but Grossman isn't one of them.

"Burn units have a slim narrow margin to stay viable; you wouldn't want to see the little burns siphoned off—that would be an equation that would end up hurting some programs," says Robert Sheridan, chief of burn medicine at Shriners Hospital for Children in Boston and president of the American Burn Association.

Sheridan acknowledges that for many smaller, non-academic hospital centers, "It's not cost-effective to maintain beds waiting for burn patients to come in."

How does Grossman Burn Center care make money with burn patients when hospitals can't?

"For lack of better term, we market our services to the community, not just, say, at a community safety fair.  But we also market to self-insured companies, and to payer referral sources. And let them know we have a service for them," Forbes says.

Forbes says Grossman doctors specify that they be given dedicated units to care for their patients, so wounds can be closed quickly.  "We attack big burns with a whole team, to get them in and out quickly with minimal anesthesia," he says.

Why are there fewer burn beds?
David Greenhalgh, chief of burn surgery at UC Davis Medical Center and a member of the ABA/ACS verification team, listed several reasons why the number of burn beds has declined over the years.

For starters, there are fewer burns, because safety and prevention messages are getting through. Second, the trend throughout the country is for burn units to be larger, with more specific expertise available around the clock.

"It's not only having doctors and the beds, but you need the whole team, nutrition and respiratory therapists," Greenhalgh says.

"It's a concern. Burn centers need to take care of all levels of burns and handle all levels of trauma and critical care that goes along with them."

Forbes says that Grossman's policy is to take all types of burn patients, regardless of the extent of their burns.

"We're plastic surgery based. That's a distinction from other burn units in the country.  Theirs are general surgery based or resident run. We take a longer-term view of patients care. We're not just about the acute, initial phase, but everything we do is toward a mission of restoring patients to as much of their pre-injury status as possible. Emotionally, physically, functionally. And cosmetically."