Dr. David Boyd: World Leader in Emergency Services
“Trauma care is an amazingly complex and demanding field,” says Dr. David Boyd, MDCM’63. “Every case is different. People get shot differently, they are critically injured, you have to think fast and have a rapid, accurate response to their situation.” Although attracted to a research career, instead he dived into the fast-paced field of trauma care, and then brought a wave of change to emergency medical services (EMS) across the state of Illinois, then the entire United States, and many other parts of the world.
The McGill years (1959-1963) provided his MD and Master of Surgery (MDCM) qualifications. “McGill was the best academic choice I ever made. We had a great class and world-class professors.” He met Joyce Moore, MDCM’63, in the anatomy lab and by second year they were married.
After a rotating internship at the Cook County Hospital (CCH) in Chicago and two years in the US Army, Dr. Boyd accepted a fellowship in shock trauma research at the University of Maryland. Looking for more clinical exposure in trauma care, he went back to CCH — which treated about 7,000 gunshot wounds per year. “I also saw this as a goldmine for academic research and teaching in trauma surgery and critical care medicine. I used the William Osler teaching approach from McGill as a guiding principle for setting up a program.”
CCH was exploring another dimension of trauma care at the time: organizing a single ward with the equipment and experienced people who can deal with the din, distress and demoralization. Dr. Boyd threw himself into this process. The trauma care doctor with new ideas was frequently asked to be a public speaker. He was declared one of the city’s Outstanding Men by the Chicago Junior Association of Commerce and Industry. Governor Richard B. Ogilvie of Illinois tapped him to set up a state-wide trauma and EMS system, emphasizing the critical aspect of getting the urgently wounded patient to competent definitive care as soon as possible. Despite warnings it would end his academic career, he took the challenge. “I went into it anyway, deluding myself that this would be over quickly and I could get back to teaching and research soon.”
The choice of Trauma Center hospitals, which was essential to establishing the Regional Trauma and Emergency Medical Services System, turned into a political hot potato, but he found the challenges invigorating. “We were making a difference on a big scale.” His work on EMS culminated in being appointed by President Gerald R. Ford as National Director of Emergency Medical Services Systems, to replicate the “Trauma/EMS Systems Model” in some 304 Regionalized Systems for a comprehensive national program. Later as a consultant he helped organize EMS systems in China, Japan, Finland, England, Portugal, Italy, Kuwait, Egypt, USSR, and several Canadian provinces. “I didn’t get a contract in Quebec,” he adds, “but I was delighted when an official told me they were already using ‘le modèle Boyd’ for their EMS system.”
Returning to medical practice, Dr. Boyd worked both in trauma and general surgery at the Blackfeet Indian reservation in Montana and other native communities. He became involved in issues such as teen alcohol use, EMS, and tele-medicine. Today he is National Trauma Systems Coordinator for the Indian Health Service.
Dr. Boyd helped his McGill Medical Class of 1963 to hold memorable and well attended reunions, with generous class participation that established a sizable endowment for scholarship support for young McGill medical Students with financial need.
His most cherished recognition is the Blackfeet Nation’s honorary name, Pita Ana (Eagle Man).
[Malcolm McLean]
Dr. Boyd has published over 140 scientific articles on Trauma, Shock and Trauma/EMS Systems including a textbook on EMS Systems. He has received many honors including the “Distinguished Career Award” from the American Public Health Association (APHA), Injury Control and Emergency Medical Services Section in 1998, the National Safety Council (NSC) Surgeons’ Award for Service to Safety, and the Journal of EMS Physio Control “Living Legends of EMS Award” in 2006. His recent Robert E. Marshall Award stated: “Dr. David Boyd is recognized as the person responsible for developing the trauma care and emergency medical systems in use throughout the United States. Through his vision and unrelenting pursuit of accomplishment, Dr. Boyd is responsible for saving countless thousands of lives every year.”
David R Boyd, MDCM, FACS Comment on; McGill Medicine Focus Article. (March 6, 2012)
McGill University and especially the Faculty of Medicine has traditionally been recognized as an international academic center. In the attached article, the author Malcolm McLean chose to focus on the multinational connections to the Illinois’ and US National Trauma and Emergency Medical Services Systems (EMSS). He also notes the deep roots with the Cook County Hospital (CCH) in Chicago. A most venerable of the great public hospitals had trained more “interns” (28,000, as of 1963) than any other. Visitors, former trainees, professionals and dignitaries from around the US and world came to see this great institution on a regular basis.
The development of the CCH Trauma Unit (TU) by Drs Baker and Freeark in 1966 focused increased attention. Also the establishment of the Illinois Department of Health Trauma/EMSS Office across the hall from the TU was particularly attractive to countless hundreds of curious professionals, policy makers and politicians looking for ideas and direction for replicating similar Trauma/EMSS programs at home. The combined ongoing TU activities and practices and professional leadership taught clinical care, applied research and organization concepts to students, residents and visitors. It was here that the “Systems Approach” principles and practice were created and disseminated. Complex component interactions of systems were readily taught in practical terms and readily transferred elsewhere.
The CCH TU and Illinois Department of Public Health (IDPH) became the “Trauma EMSS Menlo Park” generator of new ideas, provider roles and vernacular (i.e. Trauma Centers, Trauma Medical Directors, Trauma Nursing, and Systems Coordinator, Technical Personnel and Research and Evaluation with the new Trauma Registry). The many new systems concepts and technical elements were published in a spectrum of venues, but none more effective than the CCH-TU in-house printing press that produced 1,000 copies of each per month. These included concept, plans, policies, protocols and later legislation and regulations. More than half of these went out of state and around the world, some with a literal translation into a native tongue.
The impact of these CCH TU and Illinois Health Department activities became the basis of testimony to the US Congress and the passage of the “Emergency Medical Services Systems Act of 1973 and as Amended in 1976 and 1979. This provided funds (i.e. $300 million) for Regional Systems Development, Technical Assistance, Training and Research. National coverage with a contiguous 304 Trauma/EMSS Regions was soon established and exists today. The Illinois Trauma program establishing the “Lead Agency” concept to be replicated in every state, territory and other major health authority, This secured a governmental focus for medical leadership, public support and political sponsorship. From the basic trauma initiative other clinical programs were grafted on and advanced treatment technologies followed on.
With the establishment of the National Office of EMSS, with Boyd as Director, in the Departments of Health, Education and Welfare, Health and Human Services, the international connections continued and expanded. These included visiting dignitaries, Ministers of Health, Safety and Defense. There were many exchanges with NATO countries, several with “Cold War” ramifications, and other humanitarian exchanges. Of interest was how well the US Trauma/EMS Systems Approach could be replicated in these very different political and socioeconomic settings. Partial replication was most typical. Accounting for an awareness and consistency to existing cultural norms and local practices, these were truly bi-directional educational experiences,lessons learned and reapplied later in Indian Country here in the US.
An overall learning experience was that “Change” is not easy, and resistance to change is correlated with the extent and significance of these effects. Also new approaches require new concepts, leadership, participants, technologies and venues for success. And, finally, major medical interventions must be worthwhile and gain broad professional, public and political support.
In summary, the Trauma and Emergency Medical Service System was an idea that occurred spontaneously from distant military roots, and captured the attention and enthusiastic participation from a broad representation of society. Fortunately, the opportunistic possibilities were evident and effectively exploited by many, changing the entire delivery system for trauma and all other acute medical conditions in a very short time.
Thank you,
David R Boyd MDCM, FACS
New Market, MD