FINALLY A GOOD QUESTION!

From Michael Hay, Reno, NV:

Dan

I appreciate your long service and accomplishments during your career. Your strong advocacy efforts in the field are well known in the Bay Area and are appreciated by many people. There are a couple of questions that I am curious to hear your take on. These are areas that I feel will have an impact on each of us as we continue to evolve as a profession in the next few decades.

1. Do you see ems as public safety or public health? why

2. What is your opinion of the new educational standards requiring all paramedic applicants to come thru an accrediated program (2012 I think), and what do you think the impact will be on rural/ frontier areas? Do you have an idea on how we can assist the rural or frontier areas in this endeavour?

3. What is your opinion on advanced scope medics and do you support allowing paramedics providing limited primary care in the rural and underserved areas?

4.Would you advocate moving the association in conjunction with an organization such as the American College of Surgeons in the direction of assisting with the development of regional and local trauma infrastructure/plans in both the U.S. and abroad helping those who really need our assistance and expertise?

Would you support a bylaw change advocating term limits for board members? why or why not

Thank you for your attention and good luck in the election

My response to Micheal:

Michael:
As previous comments have been removed because the monitors of the forum have felt that they did not conform to the guidelines here, let me advise you that my comments and yours may be edited or removed.

As per NAEMT: “The views expressed here are strictly personal and are not necessarily subscribed to by the association. Messages that harass, abuse or threaten other members; have obscene, unlawful, defamatory, libelous, hateful, or otherwise objectionable content; or have spam, commercial or advertising content or links are liable to be removed by the website administrator. We also reserve the right to edit the comments that do get published”

If you want additional information, or documentation, email me at daniel.gerard@comcast.net

Thank you Michael for your excellent comments.

To answer your question:
1. Do you see EMS as public safety or public health? Why?
I view EMS as having feet in both camps, but most importantly I think we have not paid as much attention to public health as we should have. There are 2 distinct traits of public health that interface perfectly with the mission of EMS, the first is dealing with prevention and the second is identifying at risk populations and dealing with health care issues for a given population.
The fire service has been providing fire prevention services in the community for decades. It is through these efforts that they have made fantastic strides in reducing damage to property, death, and disability over time.
If EMS applied that same model, in the context of public health, and put forth the same effort and achieved the same level of success, what would EMS be able to do in our own communities to reduce death and disability? It boggles the imagination.
If we used the public health template to develop service delivery models to target our at risk populations, we would achieve greater efficiency in service delivery, by concentrating on efforts and resources on large portions of the population.
It is also critically important to maintain a foot inside the public health arena as well, in order to provide them the resources they require for emergency response. As we deal with issues such as large scale disasters, H1 N1, bio-terrorism, health consequences related to hazardous materials exposure, public health needs to be able to have access to an emergency response capability and infrastructure. EMS allows public health to have the capability, command, communications, and control capacities that they require to respond to an event. It allows them to do this without having to re-invent the wheel.


2. What is your opinion of the new educational standards requiring all paramedic applicants to come thru an accredited program (2012 I think), and what do you think the impact will be on rural/ frontier areas? Do you have an idea on how we can assist the rural or frontier areas in this endeavor?

I realize this is a tremendous burden for many organizations. Unfortunately, there are some less than stellar paramedic programs in the United States. When there are poor paramedic programs, they are performing a disservice to people who want to enter the profession, and it lowers the standard of paramedics that ultimately enters our field. This in turn decreases our standing amongst other health care professionals.

Let us examine what has gone on with physicians. In medicine, until the release of the Flexner report, education of physicians in the United States run the gamut from extremely poor to excellent.

After the Flexner report, with the setting of standards and accreditation of medical schools, training and education improved, and so did the standard of care. If we want to do the same thing and have the same respect as all other health care providers, we need to move in this direction.

The best way to assist rural and frontier organizations is to improve delivery methods of lecture material via distributive learning (distance education). This way we could provide world class lecturers to everyone. If you have taken PHTLS and have had the opportunity and pleasure to hear Dr. McSwain, it is not only a privilege, but it is an outstanding learning experience. Using distributive learning, we can not only provide that experience to rural and frontier EMT’s and paramedics, now we can provide that knowledge to every EMT and paramedic in the United States.

Now lets expand that further: what if we took the best lecturers/educators, in every subject topic? Cardiology, Respiratory, Anatomy and Physiology? Imagine the world class education we could deliver to everyone.

There are incredible resources for education and health care in every state. If we partner with the leading academic and health care centers in each state, while I feel that there are numerous challenges, it is nothing we cannot overcome. We could then develop programs that would meet the requirements for CAAHEP accreditation.

3. What is your opinion on advanced scope medics and do you support allowing paramedics providing limited primary care in the rural and underserved areas?


I not only support this concept, I think that this is a fantastic opportunity to provide competent, caring health care providers, to improve primary health care in the community. The key to success is having a medical director for EMS who is in sync and working in partnership with the medical director for primary care services.

The positive effect of such a relationship is two fold. First patients benefit from receiving excellent primary care services from competent, skilled, and caring providers.

Second, those providers are given the opportunity to use a greater variety of skills, in a relaxed less pressured setting. They will have a greater opportunity to further refine their skills and this will benefit emergency as well as primary care patients.

Third, the EMS providers are out in the community, and this will give them a greater interaction with the residents, in a setting that is more conducive to have an exchange of information. When we are on an emergency call, there are many things I wish I could sit down and talk to patients about, but for a variety of factors, I cannot.

In a primary care setting, they can share that knowledge that they have, without having to worry that there is another assignment waiting.

Once the EMS team becomes a familiar face, you have greater buy-in when there is an emergency, hopefully there are less interpersonal conflicts, and overall with greater access to care, you will improve the health status of the more vulnerable members of the community. People will identify with the primary care paramedic, just as they used to do back in the day when the cop walked the beat in their neighborhood.

4.Would you advocate moving the association in conjunction with an organization such as the American College of Surgeons in the direction of assisting with the development of regional and local trauma infrastructure/plans in both the U.S. and abroad helping those who really need our assistance and expertise?

I would. EMS has not leveraged our relationships with other medical groups to our advantage.

EMS has had particular success with developing systems, whether they are trauma, stroke, or STEMI systems. This expertise, especially on the community level, needs to be capitalized on. This knowledge and expertise should be shared in all communities in the United States and around the world.

Raising the health status for at risk populations is a noble mission, one that we are cut out for. NAEMT has had some success with education in regards to PHTLS, but we need to take that a step further. Let us do more work in regards to trauma system development. We have demonstrated successfully that NAEMT’s educational endeavors work, let EMS show you what we can do for the development of trauma systems.

Thank you again for excellent question, stay safe,

Daniel