working with your medical director
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Working with your Medical Director. Rick Barney MD FAAEM Director Pre-Hospital Care Beloit Memorial Hospital. EMS Quality. Directly correlates with: Having a medical director Medical Director is active Medical Director has EMS experience Is an Emergency Physician. - PowerPoint PPT PresentationTRANSCRIPT
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Working with your Medical DirectorWorking with your Medical Director
Rick Barney MD FAAEMDirector Pre-Hospital
Care Beloit Memorial Hospital
Rick Barney MD FAAEMDirector Pre-Hospital
Care Beloit Memorial Hospital
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EMS QualityEMS Quality
• Directly correlates with:• Having a medical director• Medical Director is active• Medical Director has EMS experience
• Is an Emergency Physician
• Directly correlates with:• Having a medical director• Medical Director is active• Medical Director has EMS experience
• Is an Emergency Physician
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Shortage of Good Medical DirectorsShortage of Good Medical Directors
• It is required by administrative rule.
• Many services expect this for free• Most doctors due not want responsibility• Time• Money• Legal risk
• can’t always find malpractice insurance to cover EMS duties.
• It is required by administrative rule.
• Many services expect this for free• Most doctors due not want responsibility• Time• Money• Legal risk
• can’t always find malpractice insurance to cover EMS duties.
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Sharing Resources is long overdue
Sharing Resources is long overdue
• Combining people and resources will become increasingly necessary
• This should include use of shared medical director• County Medical Director• Hospital EMS Medical Director• Ad hoc sharing
• Combining people and resources will become increasingly necessary
• This should include use of shared medical director• County Medical Director• Hospital EMS Medical Director• Ad hoc sharing
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Engage your Medical Director
Engage your Medical Director
• Pay them something• Let them know what your expectations are
• Advise them of your service goals
• Pay them something• Let them know what your expectations are
• Advise them of your service goals
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Find the person you want
Find the person you want
• Find a good medical director in your area.
• Might be regional person• Ask them to be your medical director
• We want to succeed• We gave these goals• We need your expertise to get there• This is what we can do for you.• Have a written contract
• Find a good medical director in your area.
• Might be regional person• Ask them to be your medical director
• We want to succeed• We gave these goals• We need your expertise to get there• This is what we can do for you.• Have a written contract
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Rookie Medical Director
Rookie Medical Director
• Part of the problem in finding someone is they do not know what to do
• Arrange for a mentor• Experienced medical director• Does not have to be close
• Part of the problem in finding someone is they do not know what to do
• Arrange for a mentor• Experienced medical director• Does not have to be close
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Ghost Medical Directors
Ghost Medical Directors
• Common problem- especially rural
• Get rid of yours if you have one
• Engage someone new you want and see what happens
• Common problem- especially rural
• Get rid of yours if you have one
• Engage someone new you want and see what happens
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Services that have no MD involvement
are often dangerous
Services that have no MD involvement
are often dangerous
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DUTIES of Medical Director
DUTIES of Medical Director
• First-a periodic medical needs assessment of the service area• # of calls• Types of calls• # of squad members- what are they willing to learn and be responsible for?
• Type of service- resources available
• First-a periodic medical needs assessment of the service area• # of calls• Types of calls• # of squad members- what are they willing to learn and be responsible for?
• Type of service- resources available
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ANSWERANSWER• Level of service• Scope of practice• Training- location and cost and time
• Development of Protocols• On-line medical control• Continuing assessment and education
• Level of service• Scope of practice• Training- location and cost and time
• Development of Protocols• On-line medical control• Continuing assessment and education
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Level of serviceLevel of service
• Emergency Medical Responder• EMT• Advanced EMT• Intermediate • Paramedic
• Emergency Medical Responder• EMT• Advanced EMT• Intermediate • Paramedic
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Scope of PracticeScope of Practice
• What all is necessary• What makes sense• Scope is fairly set by administrative rule
• What all is necessary• What makes sense• Scope is fairly set by administrative rule
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Training Training
• Often an obstacle• Too much• Too far• Too much time
• Often an obstacle• Too much• Too far• Too much time
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ProtocolsProtocols• Get samples from services around area
• Try to standardize by area• With training and oversight, get as much autonomy as possible
• On-line control is often poor and unreliable
• Get samples from services around area
• Try to standardize by area• With training and oversight, get as much autonomy as possible
• On-line control is often poor and unreliable
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OversightOversight
• Chart reviews• Squad meetings• Skills reviewed• Ride along by MD• Spending time in the ED
• Chart reviews• Squad meetings• Skills reviewed• Ride along by MD• Spending time in the ED
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There are more and more EMS PhysiciansThere are more and more EMS Physicians
• Go to urban areas with ALS• No end in sight to rural shortage of qualified medical directors
• Mandated regional approach would help• County• Hospital
• Go to urban areas with ALS• No end in sight to rural shortage of qualified medical directors
• Mandated regional approach would help• County• Hospital
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Understand the ResponsibilityUnderstand the Responsibility
• Enormous• Most skills done require medical oversight
• Service providers truly are extension of the Service Medical Director
• Thus, MD must have total authority over medical practice of the service
• Enormous• Most skills done require medical oversight
• Service providers truly are extension of the Service Medical Director
• Thus, MD must have total authority over medical practice of the service
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Medical Director Course
Medical Director Course
• Every Medical Director should take one
• Should attend State meetings• Medical Director Meetings should be more common• Funding• Time• reimbursement
• Every Medical Director should take one
• Should attend State meetings• Medical Director Meetings should be more common• Funding• Time• reimbursement
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ReviewReview• Quality mandates medical involvement
• Find the person you want• Share• Engage• Reward• Ask questions• Respect authority
• Quality mandates medical involvement
• Find the person you want• Share• Engage• Reward• Ask questions• Respect authority
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Questions??Questions??