med copters collide

[Mike Smertka]

Having read the arguments about medical helicopters, I was wondering.
How many flights are actually scene runs? If they are inter-facility, doesn’t a physician have to sign off on medical necessity just like ground transport? (I don’t know, it may vary state to state)
I think that would be important to know before talking about regulating, just so we would know what needs regulating.
In the matter of scene runs, I would think a medical director’s authority over his EMS persons trumps the advertizing message of companies. So if a medical director decides on a protocol on when and who can be called, you take away the air providers “educational” advantage on EMS persons. 
Speaking of education, it may require some courses taught on when air med is medically necessary.  Several years ago I read an article on how many physicians said they were not given enough training on identifying drug abusers. (inner city folks try not to laugh) Could it be the people educating physicians on when to call a helicopter are people that have an interest in seeing that helicopter called?
In the Prehospital setting I am ashamed to say a good old fashioned butt chewing might be an easier way than legislated regulation. 
On the facility transfers, somebody higher up the chain at both facilities needs to put their foot down. I think peer pressure would be a better tactic in this group as opposed to using the same for Prehospital.  Maybe even possibly like an M&M meeting there could be a regular interdisciplinary review on Air med usage by an organization every month or so, discussing specific cases?
It just seems logical to me that if providers quit calling, a lot of these problems will take care of themselves. Just my mad thoughts.
Mike