New Orleans EMS Loses Director...Again?

EpiEMS

EpiEMS

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The director of New Orleans Emergency Medical Services is resigning after more than three years at its helm, a spokesperson said November 19, 2021.

Dr. Emily Nichols, 43, informed her corps of paramedics she is departing an agency that has been beset by staffing shortages exacerbated by the coronavirus pandemic.

Spokesperson Jonathan Fourcade said the agency intended to announce her resignation Monday. He said her departure is expected in the next few weeks.

Details about why Nichols is leaving, and her future plans, weren't immediately available. Fourcade said Nichols wasn't forced out.

Mayor LaToya Cantrell appointed Nichols as director in May 2018. She completed her undergraduate studies at Princeton University and graduated from New York City's Yeshiva University medical school in 2002, and she served a residency at hospitals in Brooklyn and Philadelphia. She later worked as an emergency room physician at Ochsner Health System in the New Orleans area, specializing in pediatric care.
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Looking at the story & the admin staff there, coupled with the comp issues they have, I have to wonder - is a physician really the right kind of person to helm your service?
 
EpiEMS said:
is a physician really the right kind of person to helm your service?
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Why not? can you think of a person more qualified to lead a medical agency? Someone who can be the final authority on both clinical and operational aspects of everything within the agency?

They aren't the only EMS agency where the Medical Director is the Director of the EMS agency...
 
DrParasite said:
Why not? can you think of a person more qualified to lead a medical agency? Someone who can be the final authority on both clinical and operational aspects of everything within the agency?

They aren't the only EMS agency where the Medical Director is the Director of the EMS agency...
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Look how well that worked in Sedgwick County Kansas.
 
I wouldn't assume a random physician has any more administrative skills than, say, a random paramedic. I think management is its own discipline.
 
DrParasite said:
Why not? can you think of a person more qualified to lead a medical agency? Someone who can be the final authority on both clinical and operational aspects of everything within the agency?

They aren't the only EMS agency where the Medical Director is the Director of the EMS agency...
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I should probably have made this story a lead-in for a separate thread. My contention is that there is a necessary & proper division between clinical and operational aspects of a service* - physicians are clearly the clinical* experts, but often lack the (prehospital-specific, particularly) operational knowledge and management training required to run an organization effectively. If there is a conflict between clinical and operational sides and it's not clearly one issue or the other, you have a board of directors.

(I do recognize that there is countervailing evidence, for e.g., Goodall 2011, but there is not necessarily consensus.)

*Target state, I think that a paramedic should probably be a clinical authority over paramedicine, not a physician. Physicians are clinical experts in emergency medicine (etc.), not necessarily in prehospital care, perhaps barring an an EMS fellowship-trained physician.
 
DrParasite said:
Why not? can you think of a person more qualified to lead a medical agency? Someone who can be the final authority on both clinical and operational aspects of everything within the agency?

They aren't the only EMS agency where the Medical Director is the Director of the EMS agency...
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I don’t think organizational leadership is a tenet of medical school.

Leadership and clinical ability are separate things. And why does the physician need have final authority on operational matters?
 
DrParasite said:
Why not? can you think of a person more qualified to lead a medical agency? Someone who can be the final authority on both clinical and operational aspects of everything within the agency?
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Yes. How about a person who actually has education and experience in business and organizational management?
 
EpiEMS said:
I should probably have made this story a lead-in for a separate thread. My contention is that there is a necessary & proper division between clinical and operational aspects of a service* - physicians are clearly the clinical* experts, but often lack the (prehospital-specific, particularly) operational knowledge and management training required to run an organization effectively. If there is a conflict between clinical and operational sides and it's not clearly one issue or the other, you have a board of directors.

(I do recognize that there is countervailing evidence, for e.g., Goodall 2011, but there is not necessarily consensus.)

*Target state, I think that a paramedic should probably be a clinical authority over paramedicine, not a physician. Physicians are clinical experts in emergency medicine (etc.), not necessarily in prehospital care, perhaps barring an an EMS fellowship-trained physician.
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Is there anything to say that her CV wasn't up to muster though?
 
EpiEMS said:
I should probably have made this story a lead-in for a separate thread. My contention is that there is a necessary & proper division between clinical and operational aspects of a service* - physicians are clearly the clinical* experts, but often lack the (prehospital-specific, particularly) operational knowledge and management training required to run an organization effectively. If there is a conflict between clinical and operational sides and it's not clearly one issue or the other, you have a board of directors.

(I do recognize that there is countervailing evidence, for e.g., Goodall 2011, but there is not necessarily consensus.)

*Target state, I think that a paramedic should probably be a clinical authority over paramedicine, not a physician. Physicians are clinical experts in emergency medicine (etc.), not necessarily in prehospital care, perhaps barring an an EMS fellowship-trained physician.
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I actually agree with you 100% on this one... It's an argument I've had with people in my current area, including one former EMS director.

While I do think that the medical director should be full time, and be integrated into the EMS system, I think there should be a division between clinical leadership and operational leadership. If nothing else, running a major urban department's operations and overseeing all clinical aspects are too much for a single person to manage
 
DrParasite said:
If nothing else, running a major urban department's operations and overseeing all clinical aspects are too much for a single person to manage
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Absolutely. Even the best qualified, most experienced people would struggle to manage both. You need a division of labor & a structure that allows for it
 
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