You have two doctors. One sick or wounded, one on duty. If the on-duty doctor helps the other one, then you have two doctors and can save twice as many people. I don't see that as particularly cynical -- or surprising.
There are essentially two different situations for triage:
1 - there are enough resources (people, supplies, room, etc.) to handle all of the patients. Practical application of triage involves getting the right resources to the right patients at the right time.
2 - there are NOT enough resources to handle all of the patients. This situation sucks. You KNOW that some, probably many, of the patients will die. You fix the ones that you can treat, and you try to make the ones that you cannot save at least comfortable.
While I sincerely hope and pray that none of us face this second situation, as an attending surgeon practicing trauma and critical care medicine for over a decade in the "ivory towers", I can tell you that it is really the "ivory trenches". Our EDs nationwide are already overflowing, and not just from the worried well.
At my institution, our orthopedic surgery team operates around the clock. Several of my recent call nights have involved responding to over 20 major trauma cases a night. A quick glance at the trauma pager over the last 24 hours (a light Saturday night): 6 MVCs, 1 fall, 4 GSWs, 1 burn, 3 blunt assault. These are just the trauma patients that the ED doctors could NOT handle, and does not include the emergent general surgery patients that came in (acute appendicitis, cholecystitis, bowel obstruction, abscesses, etc.)
Despite the volume of trauma climbing (trauma visits alone up over 100% in the past 7 years, going from about 2200/year to over 4400/year), we have FEWER attending surgeons covering the trauma surgery service. The 80-hour work week rules for residents have further reduced the available resources; when gaps in resident doctor coverage occur, the attending has to deal with it. I have to make triage decisions about resources every day.
Just do a Google search on physician work force, much less surgeon work force. The storm is coming - fewer doctors, much fewer general surgeons, increasing population.
Some of my suggestions for what you can do if you are not a doctor/nurse:
1 - learn CPR (in a disaster, this experience will help you identify those who have problems that you can maybe fix with your own hands (e.g. airway), as well as those that you cannot
2 - volunteer at your local hospital, especially the ED.
3 - prepare your own medical supplies kits for home and car - don't need to buy the ready-made kits, but you do need to read what is in them and why in order to make your own decisions about what you need and are prepared to use. If you don't know how to intubate, carrying an endotracheal tube and laryngoscope is not likely to help anyone.
4 - take a disaster preparation course if you can. And be prepared to realize that disasters are NOT pretty. The triage choices that have to be made in the second situation are ones that can haunt you for the rest of your life.
I’m not surprised, nor do I disagree with the policy. However, I frequently work with health care workers and have reason for my cynicism. One of my acquaintances is an emergency room tech who refuses to get flu shots and would not get the small pox boosters being recommended in the days following 9-11. His concern: the miniscule risks. The reason why he wasn’t worried about his chances: he knew, as a hospital worker, he’d be the first to be vaccinated or treated in a pandemic or biological warfare terrorist attack. In other words, he is willing to increase the risk for the rest of society since he knows he’ll be taken care of first.