med copters collide

[D.E. (Donn) Barnes]

Mike,

Please entertain a few comments on your message:

I have no knowledge concerning the number of scene runs as opposed to IFTs.
My expectation is there are more scene runs, but I could be incorrect.

The definition and requirements for medical necessity varies between states.
State or federal regulation might possibly create a standard where none
exists today.

A medical director's authority does trump, at least in my state, but medical
directors who don't play ball can be replaced... and often are.

A majority of medical directors of whom I have knowledge have little
training in anything to do with EMS. HEMS is a real foreign creature. I know
quality docs are out there, but the McSwains, Krins, Mattoxs, Wesleys,
Ferneaus, Rachts, Romigs, Beldsoes and Griswells appear more rare than one
might imagine.

Most education regarding when to call a chopper is provided by the marketing
people from the chopper companies. These same people provide nice
ballpoints, coffee cups and occasional ballgame tickets or scenic helicopter
rides.

Please explain where the incentive might be found that could cause providers
to curtail calls for helicopter transport. It doesn't cost them a dime to
make the call, they have all those nice ballpoints and coffee cups, and most
of them wish they could be a flight medic too.

An old man rambles...
Donn


“Liberty is telling people what they do not want to hear.”
—Eric Arthur Blair, from the preface to Animal Farm
 

> -----Original Message-----
> From: trauma-list-bounces at trauma.org 
> [mailto:trauma-list-bounces at trauma.org] On Behalf Of Mike Smertka
> Sent: Tuesday, July 01, 2008 10:49 PM
> To: Trauma & Critical Care mailing list
> Subject: RE: med copters collide
> 
> 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
> 
> 
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