Medical Director Ride-Alongs

[Fish]

Do we really want future emergency physicians to have their first professional exposure to EMS be from the likes of systems like Los Angeles County?

I didn't want to be the one to say it, but I will be the one to agree with it!

 

[Chris07]

That brings up a sad truth...The system in Southern California is far beyond a joke. That is why I plan to leave the state when I pursue med school

 

[JPINFV]

That brings up a sad truth...The system in Southern California is far beyond a joke. That is why I plan to leave the state when I pursue med school

Don't base where to go to med school based on the EMS system. It's a non-factor.

 

[Chris07]

I have medic ambitions prior to taking the full-fledged plunge into medicine. Considering I have about 2 years of Sciences to complete to even apply to med school, I figure why not go medic while taking care of my Med School prereqs...The only place I would want to work as a medic would be out of state or in areas with non-fire based ALS services (Riverside County or the like)

 

[Fish]

I have medic ambitions prior to taking the full-fledged plunge into medicine. Considering I have about 2 years of Sciences to complete to even apply to med school, I figure why not go medic while taking care of my Med School prereqs...The only place I would want to work as a medic would be out of state or in areas with non-fire based ALS services (Riverside County or the like)

Texas

 

[mikie]

not to change the topic..

For those with experience with medical directors/doctors on scene, how does the dynamic of the 'crew' change? Is the doctor doing interventions, observing/assessing and using the medics for interventions? Can they authorize you to administer a drug/dose outside the EMS system's protocols (yes I know some states, Texas for example, allow it)?

Just curious; thanks.

 

[johnrsemt]

In Indianapolis the Medical Directors (more than one) used to go out all the time; they had there own trucks and radios. I don't know if they still do; I haven't been there for almost 4 years.

The primary Medical Director was still an active Registered Paramedic. It was great at Audit and Reviews when a medic that didn't know better would make a comment like "well doc, if you knew what it is really like on the street in EMS you wouldn't be telling us to do that".

 

[cruiseforever]

Our Medical Director is very active with us. I have watched him grow up. He first started as a first responder with a local fire dept. Saw him in the ERs when he was in med. school. Now he is an ER Dr. and will shows up on calls when he thinks he might be of help. The scenes that I have had him on run very smooth.

 

[shfd739]

I know ours get out with the crews and run calls.

The first director I had with this service but in another state had his own SUV with lights/siren/radio and he would hang around the county and respond to calls. It was neat to have him on scene. He rode out the worst hurricane at the station with us and as soon as the weather cleared he was out on the streets alongside the responders.

The directors in my current area are pretty active and get out to see the crews every so often. This is how it should be.

 

[Shishkabob]

Both our main medical director and the associate directors are well known for randomly showing up on scenes, be it a cardiac arrest or something very minor. They will also ask the paramedic to come up with a differential of 5 things that could be causing the issue at hand.



Our medical director started as a medic with this agency so it's in his blood.


They usually let the medic retain control, but also authorize stuff outside of our protocols.

 

[feldy]

Our medical director comes out to calls fairly often. He has his own sprint car. We also have another EMS physician fellow that rides often. Then every shift, there is usually a resident that rides with the sprint.

 

[Chris07]

Has anyone ever heard of a PA or FNP riding out or responding to emergencies much like the med directors mentioned in this thread? If so how are they affiliated with your agency? Kind curious about it...a PA could be almost as effective as an MD in the field...minus the ability to bend protocol and such...but then again would they be anymore useful than another medic?

 

[Shishkabob]

Never heard of it, but I'm sure if a PA did it, the med director would give them a lot more leeway, even if not totally "unrestricted".

 

[jjesusfreak01]

Never heard of it, but I'm sure if a PA did it, the med director would give them a lot more leeway, even if not totally "unrestricted".

It is my opinion that paramedics that work in progressive systems are more limited by access to more advanced equipment than anything else. You could have an ER doc in the back of the truck and it would be a rare call that they could authorize an indicated procedure that the paramedic couldn't do on their own. The loadout of an ambulance is designed to maximize the use of space and treatments available for the providers to use, so it would be difficult to figure out what extra items (besides maybe a few drugs) could be carried that would allow a PA to practice at a higher scope. Just a thought.

 

[Shishkabob]

Unless the PA works under the same premise of medical directors, being placed in fly-cars, where they can have a completely different set of equipment and medications on board.



Our advanced Paramedics carry specific medications and tools in their SUVs that we don't carry on our normal ambulances.