OPINION: Trauma center readiness: Ensuring access to life-saving care from all corners of New Mexico

In New Mexico, we are proud of our vast horizons and our rugged landscapes. But for a family on a remote stretch of Interstate 40, a worker in the Permian Basin or a patient on sovereign tribal land, that beauty comes with an unmentioned health risk: distance.

When a life-altering injury occurs, the difference between fatality and recovery is more than access to an ambulance or a helicopter. It is whether a fully staffed, world-class trauma team is standing ready before the patient ever leaves the site of the accident.

That readiness is the invisible backbone of New Mexico’s safety net. But today, that backbone is under strain.

As the Albuquerque Journal has reported, New Mexico’s health care workforce shortage has already led to the loss of nearly one-third of the state’s primary care physicians and left hospitals short thousands of nurses and emergency medical technicians. For trauma patients, that growing fragility in the system can mean the difference between life and death.

A readiness model for the worst-case scenario

At University of New Mexico Hospital, the state’s only Level I trauma center, our mission is to be ready for anything, for anyone, at any time. This requires a 24/7/365 "standing army" of surgeons, emergency physicians, nurses, blood bank specialists and operating room teams.

Trauma care cannot operate like a typical health care business. It is not volume driven; it operates under a readiness model. Much like a fire department, the capability must exist before the alarm sounds. We do not staff based on how many people we expect to be injured; we staff for the worst-case scenario.

Maintaining this state of constant preparedness costs millions of dollars every year before a single patient is even wheeled through our doors.

The challenge of the high desert

New Mexico faces hurdles that many other states do not. We have some of the longest transport times in the nation. In the "Golden Hour," (that critical window where medical intervention is most likely to save a life) our patients are often still hundreds of miles away from definitive care.

Because we are a border state with a massive rural and frontier footprint, UNMH serves as a regional lifeline. We aren't just a hospital for Albuquerque; we are the safety net for the entire state. When a mass-casualty event occurs or a natural disaster strikes, there is no "Plan B."

The mission of readiness falls squarely on a handful of dedicated institutions.

The tragedy is that the financial model supporting this readiness has not kept pace with the 21st century. Across the country, and acutely here in New Mexico, trauma centers are absorbing the skyrocketing costs of preparedness while serving a high proportion of uninsured and underinsured neighbors.

We are essentially providing a national security service on a local hospital budget. This is not sustainable.

The path forward: Federal investment

Congress has the opportunity and responsibility to treat trauma care as the essential national emergency preparedness infrastructure it is. By robustly funding grant programs as authorized by the Improving Trauma Systems and Emergency Care Act, the federal government can help states like New Mexico maintain the high-tech equipment and specialized personnel required to save lives.

Furthermore, Congress should expand funding for the MISSION Zero program, which allows trauma centers nationwide to continue the vital partnership of integrating military trauma providers into civilian hospitals, keeping their life-saving skills sharp while they care for our local communities.

Trauma readiness is more than a health care issue; it is a matter of public safety and national security. Whether it’s a car crash on a secluded dirt road or a large-scale emergency, New Mexicans deserve to know that the system designed to save them will be there when they need it most.

We cannot afford to take our trauma system for granted. In a state as big as ours, readiness isn’t a luxury. It’s the only thing that closes the distance between life and death.

Michael Chicarelli is the chief operating officer at University of New Mexico Hospital and a member of the Board of the Trauma Center Association of America.