Rattletrap
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street credibility for EMS Physicians
- Thread starter Rattletrap
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VinBin
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Not sure about you guys, but just having a Medical Director who seems to care, and is involved in some level with Management/Operations is enough, I'm not sure how much "streed cred" matters...
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Rattletrap
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Ahhhhh. but when you are dealing with small hospitals street credibility is very important when he has no clue what is going on by radio traffic.
Try having a family practitioner who one day decides he is going to be an er doc.
Try having a family practitioner who one day decides he is going to be an er doc.
VinBin
Forum Captain
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Oh, I thought this was regarding Medical Directors...
Having a physican with no background in EMS will probably be a problem.
Having a physican with no background in EMS will probably be a problem.
We haven’t had a good discussion on medical directors in a while (if ever) so I’m glad you posted this.
I think a medical director can make or break an ems system. It’s one of the most important factors when making a decision to join a system for me (even ahead of money, location, etc.) Every ems provider should be have a close relationship with his/her medical director (ESPECIALLY als providers).
With this in mind, lets comment on the author Dr. Sabina Braithwaite. I know a little about her because I have a friend who works in her system. She’s one of the worst medical directors out there. She runs a mother may I system; they have to call for everything. She’s one of these “I’m afraid of being sued and have no backbone so everything is going to be by the book” medical directors. In other words, she is a narrow minded, ruthless dictator who has no trust in her ems providers and thus takes all of their freedom away. She makes the KEDs absolutely mandatory no matter how ridiculously minor a glf or mvc may be. So for her to be writing an article on street cred is laughable at best.
I’m not writing this to slander her. I’m writing this to critique her methods and point out the vast differences that exist between medical directors. She’s a former paramedic. This means nothing to me. In fact, the best medical directors are not former ems providers but instead, serious researchers who are willing to take chances and trust their ems providers.
Remember, ems providers can/should/do have a say in who they choose to be their medical director and should choose wisely.
As for “street cred” (aka having experience on the street), it means very little if anything to me. It’s nice that medical directors know about the unique challenges that face us in the field…but, I wouldn’t respect a doctor any less if he/she didn’t have street experience. It’s just not that different than working in a hospital and if anything, working in a hospital is harder.
I think a medical director can make or break an ems system. It’s one of the most important factors when making a decision to join a system for me (even ahead of money, location, etc.) Every ems provider should be have a close relationship with his/her medical director (ESPECIALLY als providers).
With this in mind, lets comment on the author Dr. Sabina Braithwaite. I know a little about her because I have a friend who works in her system. She’s one of the worst medical directors out there. She runs a mother may I system; they have to call for everything. She’s one of these “I’m afraid of being sued and have no backbone so everything is going to be by the book” medical directors. In other words, she is a narrow minded, ruthless dictator who has no trust in her ems providers and thus takes all of their freedom away. She makes the KEDs absolutely mandatory no matter how ridiculously minor a glf or mvc may be. So for her to be writing an article on street cred is laughable at best.
I’m not writing this to slander her. I’m writing this to critique her methods and point out the vast differences that exist between medical directors. She’s a former paramedic. This means nothing to me. In fact, the best medical directors are not former ems providers but instead, serious researchers who are willing to take chances and trust their ems providers.
Remember, ems providers can/should/do have a say in who they choose to be their medical director and should choose wisely.
As for “street cred” (aka having experience on the street), it means very little if anything to me. It’s nice that medical directors know about the unique challenges that face us in the field…but, I wouldn’t respect a doctor any less if he/she didn’t have street experience. It’s just not that different than working in a hospital and if anything, working in a hospital is harder.
bstone
Forum Deputy Chief
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There is a little bit of self-back patting with some medical directors. As you all might be able to tell from my signature, I am a future EMS physician. I think discussions like this are very, very important for people in my position. I intend on being involved in pre-hospital EMS as a physician, helping to guide and take EMS into the next phase. I am hoping that having been an EMT-Based and now an EMT-Intermediate I will have some unique insights in this arena.
And for the love of G-d....please kick me in my butt as hard as you can if I develop a complex. Thank you.
And for the love of G-d....please kick me in my butt as hard as you can if I develop a complex. Thank you.
Ridryder911
EMS Guru
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Over the years, I have seen many good and bad EMS medical directors. Some of them had been medics in previous life and some had never set foot into an ambulance.
I wish I could say that most of the time, the post medics were the best EMS Medical Directors, but alas that is not always true. Many tend to forget, what it is like to be in the trenches or during the pathway of becoming a physician lost their feelings of EMS. .
So I agree, it is a personal issue. How well they want to be involved within their system. How much care do they want their EMS to provide, and the standards they want to provide. This may be by increasing educational requirements, aggressive protocols and cutting edge research.
So does it help to have experience? Sometimes. Yes, it is easier to discuss the situation(s), understanding of predicaments that one might encounter. That is, if they were good medics themselves (which is not always case) I have seen some become better physicians than they were medics.
I can understand the hesitancy of many physicians not allowing procedures and advances. Shameful yes, but would you trust your license and livelihood after reading some of the posts on EMS forums? I know by far, not all EMT's are created equal.
So they have the choice of requiring education, clinical competence, and maintenance of both. If you don't approve, find another medical director by quiting and go somewhere else.
R/r 911
I wish I could say that most of the time, the post medics were the best EMS Medical Directors, but alas that is not always true. Many tend to forget, what it is like to be in the trenches or during the pathway of becoming a physician lost their feelings of EMS. .
So I agree, it is a personal issue. How well they want to be involved within their system. How much care do they want their EMS to provide, and the standards they want to provide. This may be by increasing educational requirements, aggressive protocols and cutting edge research.
So does it help to have experience? Sometimes. Yes, it is easier to discuss the situation(s), understanding of predicaments that one might encounter. That is, if they were good medics themselves (which is not always case) I have seen some become better physicians than they were medics.
I can understand the hesitancy of many physicians not allowing procedures and advances. Shameful yes, but would you trust your license and livelihood after reading some of the posts on EMS forums? I know by far, not all EMT's are created equal.
So they have the choice of requiring education, clinical competence, and maintenance of both. If you don't approve, find another medical director by quiting and go somewhere else.
R/r 911
Last edited by a moderator:
And now we have the technology to "video conference" from the scene. The doctors can be there with you.
http://www.emsresponder.com/article/article.jsp?siteSection=1&id=5561
Tucson to Launch Ambulance to Hospital Video Conferencing
Rob O'Dell
The Arizona Daily Star (Tucson)
Jun. 19--A new live two-way video link between University Medical Center and the city's 17 paramedic units is expected to put Tucson at the cutting edge of medical technology when it goes online in August.
The system allows real-time videoconferencing over the city's public safety and public works wireless Internet system -- a wireless mesh that links the city's traffic signals and other public safety wireless functions.
Dr. Rifat Latifi, interim medical director of UMC's Level 1 trauma center, said the video link will be the first of its kind in the country and the world.
"We think it's an incredible thing," Latifi said. "Wherever a patient is, we're there."
It is an extension of the Southern Arizona Teletrauma and Telepresence Program, which provides a live link -- including videoconferencing, telemetry, digital X-rays and ultrasound -- between the trauma doctors at UMC and rural emergency rooms and doctors and nurses in Southern Arizona, to assist in the care of traumatically injured and critically ill patients.
Although the system does not yet have the ability to transfer X-rays and ultrasounds, the two-way video quality is top-notch, and UMC and the paramedics can see and hear each other in real time.
CONTINUED
http://www.emsresponder.com/article/article.jsp?siteSection=1&id=5561
http://www.emsresponder.com/article/article.jsp?siteSection=1&id=5561
Tucson to Launch Ambulance to Hospital Video Conferencing
Rob O'Dell
The Arizona Daily Star (Tucson)
Jun. 19--A new live two-way video link between University Medical Center and the city's 17 paramedic units is expected to put Tucson at the cutting edge of medical technology when it goes online in August.
The system allows real-time videoconferencing over the city's public safety and public works wireless Internet system -- a wireless mesh that links the city's traffic signals and other public safety wireless functions.
Dr. Rifat Latifi, interim medical director of UMC's Level 1 trauma center, said the video link will be the first of its kind in the country and the world.
"We think it's an incredible thing," Latifi said. "Wherever a patient is, we're there."
It is an extension of the Southern Arizona Teletrauma and Telepresence Program, which provides a live link -- including videoconferencing, telemetry, digital X-rays and ultrasound -- between the trauma doctors at UMC and rural emergency rooms and doctors and nurses in Southern Arizona, to assist in the care of traumatically injured and critically ill patients.
Although the system does not yet have the ability to transfer X-rays and ultrasounds, the two-way video quality is top-notch, and UMC and the paramedics can see and hear each other in real time.
CONTINUED
http://www.emsresponder.com/article/article.jsp?siteSection=1&id=5561
Hate to burst Dr. Latifi's bubble, but Acadian started video teleconferencing over 9 years ago for the offshore medics. I know several agencies that do this. Its a wonderful asset, but nothing new. I question the feasibility and logistical need on an ambulance though........................
Ridryder911
EMS Guru
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Whoopee ! Telemetry with pictures, now they really will not answer the radio! What difference is it going to matter if they see them or not? Okay, now they see the geriatric constipation, or even the AMI coming in... any new changes on orders or performance? Will the Doc's assess any better with a camera... what are they going to do differently or can do differently? What have the patient wave at the Doc?
Put that wasted money into education and training and improve your treatment regime.
Technological B.S. like the ECG that could transmit heart tones per- electrodes .... yes, one can hear a S3, S4...( CHF) but who cares ? It will not change the tx. modality..
R/r 911
Put that wasted money into education and training and improve your treatment regime.
Technological B.S. like the ECG that could transmit heart tones per- electrodes .... yes, one can hear a S3, S4...( CHF) but who cares ? It will not change the tx. modality..
R/r 911
firetender
Community Leader Emeritus
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My position is that there are facets of being an ambulance medic that "higher-ups" tend to be blind to, unless, of course, they've been there.
I do not automatically grant respect to someone with a title. I've spent too much time with too many incompetent physicians to do that. I do, however, respect those -- regardless of their qualifications -- who make an effort to work with, rather than against me.
I never much cared whether my EMS directors had back-of-the-rig experience as long as I found them to be curious and willing to see our experience from our points of view. The best of them would make an effort to ride along on a regular basis.
As far as this video-teleconferencing goes, no I really wouldn't want to be caught starting that IV while I'm asking the doctor if I should start the IV.
I do not automatically grant respect to someone with a title. I've spent too much time with too many incompetent physicians to do that. I do, however, respect those -- regardless of their qualifications -- who make an effort to work with, rather than against me.
I never much cared whether my EMS directors had back-of-the-rig experience as long as I found them to be curious and willing to see our experience from our points of view. The best of them would make an effort to ride along on a regular basis.
As far as this video-teleconferencing goes, no I really wouldn't want to be caught starting that IV while I'm asking the doctor if I should start the IV.
sandboxmedic
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in response to GUARDIAN, the OMD's are probably all into the idea,because it involves new technology. You know as well as I do every new PDA/IPOD gizmo ala Jack Bower is something they just "gotta have". Its a "tech-fetish", thats it.....LOL
BossyCow
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We are blessed with an absolutely spectacular MPD. He is always teaching, always listening and truly enjoys his work. We use video conferencing for our monthly trainings and run review and he is a bit of a techno-junkie.
I can't imagine him having time or inclination to watch us in the field on TV. I mean, have you looked at some of those images? Shaky, out of focus, jumpy... and being filmed in the back of a moving rig on our roads would read something like the film quality of the Blair Witch Project.
I think some MPD's are more into the control aspect of their jobs. Like bosses in all fields, some are more comfortable with the abilities of their employees than others.
I can't imagine him having time or inclination to watch us in the field on TV. I mean, have you looked at some of those images? Shaky, out of focus, jumpy... and being filmed in the back of a moving rig on our roads would read something like the film quality of the Blair Witch Project.
I think some MPD's are more into the control aspect of their jobs. Like bosses in all fields, some are more comfortable with the abilities of their employees than others.