Medic working BLS only.

[Veneficus]

I see what your saying, I just don't believe a medic should be held responsible if the powers that be only allow him to operate at the emt level.

Handcuff ing the medic and then punishing him for something I do seems ridiculous to me. Even if we were operating in a pb system and I do something in my scope that I shouldn't and it determined to be detrimental to the patient I should bear the brunt not the medic.

I'm a certified provider and have the ability to operate on my own by the state, the medic shouldn't be held responsible for my actions, just as a doctor shouldn't if a nurse makes a wrong treatment decision. We are all providers and allowed to make decisions, if I make the wrong one I should be the one punished regardless of who else is there.

Very good topic and discussion.

I agree with your points.

But life isn't fair.

Something I think everyone keeps forgetting is the financial and emotional strain of having to defend yourself in the legal process even if you are not at fault.

In my home state any request for compensation over $20k has to be heard by a jury.

I would feel quite comfortable in front of a jury of my peers or even a judge, but look at the type of people who are commonly jurors.

 

[Trauma Chaser]

WOW even though he is a medic he is working under BLS protocals. And if it is a BLS rig you do not carry advance medications and supplies. I cant beleive someone hasnt at your company hasnt said something,

 

[Mzcr]

I disagree. Working BLS, the medic only has the equipment and authorization to treat at a BLS level. But you cannot remove their ability to make better field diagnoses.

 

[DrParasite]

However, when my patient cuts himself reaching across a motor fan or gets punched in a fight, I don't see the need for Mr. Medic to jump in.

I disgree. he should do it all. he should assess him. he should write the chart. he should provide all documentation. If he wants to be in charge, let him. he can perform his ALS assessment, and do whatever makes him happy, and he can fill out all the legal documentation, and let him hang for it if there is a problem

I am not going to lose sleep over it and neither should you.

question: if a doctor decides to volunteer as an EMT or work at a standby event as an EMT (he has the cert and everything, or was an EMT before med school) just for fun, should he be in charge of all patient care, or should the paramedic? after all, the EMT is working for a BLS service, but has additional training far surpassing the paramedic, but he isn't operating as a MD in this situation. Just something to ponder, and yes, I do know one doctor who works per diem as a medic (just for fun) and another doctor who volunteers as an EMT

 

[Lola99]

I disgree. he should do it all. he should assess him. he should write the chart. he should provide all documentation. If he wants to be in charge, let him. he can perform his ALS assessment, and do whatever makes him happy, and he can fill out all the legal documentation, and let him hang for it if there is a problem

I am not going to lose sleep over it and neither should you.

question: if a doctor decides to volunteer as an EMT or work at a standby event as an EMT (he has the cert and everything, or was an EMT before med school) just for fun, should he be in charge of all patient care, or should the paramedic? after all, the EMT is working for a BLS service, but has additional training far surpassing the paramedic, but he isn't operating as a MD in this situation. Just something to ponder, and yes, I do know one doctor who works per diem as a medic (just for fun) and another doctor who volunteers as an EMT

I have long since posting this realized there are far more inside pieces to that story than I care to explain, than anyone could understand, or than anyone would care to listen to.
...but I do find the advice you gave me humorous with the signature that followed.
Probably just me, but I was amused nonetheless.

 

[DrParasite]

I have long since posting this realized there are far more inside pieces to that story than I care to explain, than anyone could understand, or than anyone would care to listen to.
...but I do find the advice you gave me humorous with the signature that followed.
Probably just me, but I was amused nonetheless.

I'm not sure if that was a dig at me or a cheap shot at my signature.

Either way, if you want to fight it, go for it, and don't let the fact that everyone on here disagrees with you change your mind.

Personally, I don't think that just because he is a medic he should be in charge of anything, especially if you are all working for a BLS agency. But that is just my opinion, and I also don't think every call requires a paramedic (I know that's an argument for another thread), and I also think that there are bigger issues in EMS to worry about, and as long as he is going to write the chart, and hang in case there is a problem, let him be in charge. but again, that's just my opinion

I won't lose sleep over it, and I don't think you should either.

 

[Lola99]

I'm not sure if that was a dig at me or a cheap shot at my signature.

Either way, if you want to fight it, go for it, and don't let the fact that everyone on here disagrees with you change your mind.

Personally, I don't think that just because he is a medic he should be in charge of anything, especially if you are all working for a BLS agency. But that is just my opinion, and I also don't think every call requires a paramedic (I know that's an argument for another thread), and I also think that there are bigger issues in EMS to worry about, and as long as he is going to write the chart, and hang in case there is a problem, let him be in charge. but again, that's just my opinion

I won't lose sleep over it, and I don't think you should either.

Sorry. Wasn't really meant to be either. Should've clarified 'cause I knew it sounded like it. My bad. Just that post and that signature together. One said yield, the other said, "you move". Lol. I got a chuckle, tiny as it may be.
I'm not worried about it. Never really was, but asking it here, to both everyone else and to me made it seem like a forefront. Because it's all everyone here knows about it all, it seems like more of an issue, and without all the pieces of the puzzle. And I put too much focus here, never outside of here, for a million and two reasons I don't care to explain.
Never a big deal at all.
I'll do my thing and he can do him. It's winter anyway. No racetrack for us

 

[JPINFV]

question: if a doctor decides to volunteer as an EMT or work at a standby event as an EMT (he has the cert and everything, or was an EMT before med school) just for fun, should he be in charge of all patient care, or should the paramedic? after all, the EMT is working for a BLS service, but has additional training far surpassing the paramedic, but he isn't operating as a MD in this situation. Just something to ponder, and yes, I do know one doctor who works per diem as a medic (just for fun) and another doctor who volunteers as an EMT

Using physicians are a terrible foil since, unlike RNs, EMTs, and paramedics, a physician doesn't lose the privileges granted by his medical license like the others do when they clock out. If the physician wants to write a perscription during a standby, it is perfectly legal to do so. In contrast, a paramedic working an event as an EMT can only operate as an EMT because of how the system is set up.

Additionally, there's a question of how supervision is performed. The higher provider doesn't have to be the primary provider to ensure that a proper assessment and treatment is performed, and provided everything that is supposed to be done, is done, I would question the need for the higher level provider to step in in the first place.

 

[jjesusfreak01]

Question: if a doctor decides to volunteer as an EMT or work at a standby event as an EMT (he has the cert and everything, or was an EMT before med school) just for fun, should he be in charge of all patient care, or should the paramedic? after all, the EMT is working for a BLS service, but has additional training far surpassing the paramedic, but he isn't operating as a MD in this situation. Just something to ponder, and yes, I do know one doctor who works per diem as a medic (just for fun) and another doctor who volunteers as an EMT

This is somewhat silly. So long as they are licensed as an MD (or DO) in the state, they can't lower their level of licensure. They have an unrestricted license to practice medicine that encompasses the scopes of every nurse, paramedic, and emt on scene. Technically though, the paramedic would be in charge of patient care unless the local statutes allow a doctor on scene to take over patient care, in which case they could do so. This would probably never happen though, since you really shouldn't have doctors with EMT certs (or paramedic certs, though there are a few exceptions). There are few reasons to keep up a lower certification when you have the unrestricted license.

That said, i'm trying to get into med school for next fall, and am going to attempt to get enough CE to renew my EMT cert before I head off to medical school (for no particularly good reason). Since I just got the cert, and it has a 4 year period before expiration, its entirely possible I could be near the end of my residency before it actually runs out.

 

[JPINFV]

That said, i'm trying to get into med school for next fall, and am going to attempt to get enough CE to renew my EMT cert before I head off to medical school (for no particularly good reason). Since I just got the cert, and it has a 4 year period before expiration, its entirely possible I could be near the end of my residency before it actually runs out.

Er, what now? In 4 years, you'd just be about starting residency, not finishing it.

 

[Trauma Chaser]

ok on our vol fd we back up the county ems on every bls and als call. they have three stations throughout the county with 2-3 rigs at each station. so we usualy get there within 5 minutes of each other. we have paramedics like myself on the vol FD along with emt's, and first responders. do i act as a paramedic???? yes, because i have the knowledge, training, and certifications...duh - but do we have advanced equipment out on the rig?????? nope alllllll bls equipment so other then telling the als unit whats happening and packiging the patient for when they arrive. then when the rquipment gets there and its ok with the paramedic in charge of the rig, ill jump in and help. so if you have the equipment use it if not open a first aid bag, open the o2, and drive that cart lol.

 

[Veneficus]

This would probably never happen though, since you really shouldn't have doctors with EMT certs (or paramedic certs, though there are a few exceptions). There are few reasons to keep up a lower certification when you have the unrestricted license..

Actually I know several physicians who keep their medic certs. One who keeps his EMT cert. (Sorry JP not referring to you yet )

Many do so as a form of street cred. For some strange reason doctors who interact with EMS are given considerably more weight to thier opinions when they are not thought of as "school boys who hide in the hospital and wouldn't know what to do without the safety of it." (I don't advocate that philosophy but I know it exists. Look at what some of the people on this forum say about physicians who are not EM specialists.)

Another reason is teaching. At least 2 states I know of will allow a physician to be an EMS instructor by virtue of an unrestricted medical license. However they must obtain the proper credentials on paper and that includes being an EMS provider.

Some maintain the certification as a demonstration to other physicians that EMS providers can be smart people. Most of the physiicans I have encountered everywhere think extremely poorly of EMS. Particularly in the US. Actually I would say the only physicians who have any appreciation for EMS are the ones that deal with it all the time. But not all of them.

I was once told that "once you become a doctor, you will never be anything less."

For the same reason a physician cannot pretend to have lesser knowledge when specialized equipment is not available, neither can a medic. Though the treatment options are limited.

I can see doctors who are also EMS providers calling themselves medics or whatever in order to disguise the fact they are also physicians. But I think it is absoltely impossible for a doctor to "act like" and EMT or medic, the knowledge and thought process has been absolutely made part of you. Only with mind altering substances could you seperate yourself from it.

 

[firecoins]

Only with mind altering substances could you seperate yourself from it.

which ones do you suggest?

 

[JPINFV]

Actually I know several physicians who keep their medic certs. One who keeps his EMT cert.

I can see anther reason, if they still spend time on an ambulance for what ever reason, is legal reasons. If it takes two EMTs or paramedics to staff an ambulance, then an MD won't cut it. An MD/EMT or MD/paramedic, however, will count for staffing. Of course this makes things interesting when a physician acts as a physician while also counting as a member of an ambulance crew.

 

[Veneficus]

which ones do you suggest?

alcohol seems the favorite.

 

[STXmedic]

I can see anther reason, if they still spend time on an ambulance for what ever reason, is legal reasons. If it takes two EMTs or paramedics to staff an ambulance, then an MD won't cut it. An MD/EMT or MD/paramedic, however, will count for staffing. Of course this makes things interesting when a physician acts as a physician while also counting as a member of an ambulance crew.

How would transfer of care work in that situation? Multiple casualty incidents? "Why did the doctor ride with that person and not MY family member?!" Could be an interesting set-up for a lawsuit.

 

[jjesusfreak01]

Er, what now? In 4 years, you'd just be about starting residency, not finishing it.

Right, but my current cert doesn't expire for 4 years, so if I get enough CE in the next year to re-cert, i'll have 3 years + 4 for the renewed cert.

Actually I know several physicians who keep their medic certs. One who keeps his EMT cert. (Sorry JP not referring to you yet )

Many do so as a form of street cred. For some strange reason doctors who interact with EMS are given considerably more weight to thier opinions when they are not thought of as "school boys who hide in the hospital and wouldn't know what to do without the safety of it." (I don't advocate that philosophy but I know it exists. Look at what some of the people on this forum say about physicians who are not EM specialists.)

You hit the nail on the head there. Those were the "few exceptions" I was referring to. Our medical director has a paramedic cert for some of those reasons. He also spends time in the field assisting on calls in a QRS vehicle.

 

[Trauma Chaser]

when physicians work ems they work as medical direction or as a paramedic. even when they need some one to do an amputation, a physician can't do it, they have to call a surgeon. great respect to doctors who wrok the street though.

 

[JPINFV]

when physicians work ems they work as medical direction or as a paramedic. even when they need some one to do an amputation, a physician can't do it, they have to call a surgeon. great respect to doctors who wrok the street though.

If a case is so severe that you need to do a field amputation, then the emergency physician is going to be able to amputate. The scope of practice for physicians does not work like the scope of practice for EMTs and paramedics.

 

[JPINFV]

How would transfer of care work in that situation? Multiple casualty incidents? "Why did the doctor ride with that person and not MY family member?!" Could be an interesting set-up for a lawsuit.

If a MCI was occurring, I'd be questioning why the physician was transporting instead of leading the medical branch on scene.