The premise that the American College of Surgeons' advocacy for the development of trauma systems may not be feasible is both provocative and, I would argue, possibly self-defeating. However, feasibility is realized only when issues such as those raised here are addressed and there is the surgical leadership and political will to create such a system.
Such trauma systems must be inclusive, meaning that the resources of all committed facilities are used. Only the most seriously injured patients require the resources of level I and II TCs.