Community Paramedicine, or what some would rather call Integrated Healthcare, is a fantastic concept. Why not take basic medicine and evaluation skills to the patient recently recovering from a procedure instead of making them visit the MD's office?
Why not follow up with Mrs Jones on how her medications are doing?
Why not have a Paramedic check in on Mr Thompson and his blood sugar levels?
My first paying gig in EMS was for a system that did just this. We visited our list of clients based on the schedule and checked their blood sugar, blood pressure, medications and checked the fridge for food. I hated it. I hated it because it wasn't what 18 year old me wanted to be doing. I didn't see the value in the program until I was about to finish my employ there and noticed we never ran a 911 call on any of our home visit regulars. We weren't providing Emergency Medical Services (EMS), we were doing something completely different. Call it by any name you like, but don't call it EMS.
Today I'm a huge supporter of decreasing the demand on 911 by focusing on reducing the number of people who call. One of the proven tools used to combat 911 calls is making people healthier before they need 911.
Community Paramedicine is just the thing each and every community in America can use to reach out to a niche that needs to be addressed.
When I was in England all those years ago Paramedics with only 1 year experience were out on their own making recommendations, referrals and taking people directly to what they needed, not just a 2 person cot van to an ER (Or AE for those who favourite that term.)
The concepts have been proven over and over again and some systems are even carving out revenue streams to make it profitable or, at least, not at cost.
I applaud their efforts and if the opportunity ever comes along for me to get involved...
...I'll pass.
In my opinion Community Paramedicine is too important to be trusted to the 911 crowd. We need folks more interested in sitting and talking than squeezing a few home visits in between calls for service. Some systems have adapted schedules and providers to respond only on the Community cars and that's great, but a greater separation is needed.
Yes, I'm advocating splitting EMS even further than we are now. A split that will allow this new sub specialty to thrive.
Community Paramedicine needs to be a specialty, a half brother, not a spin off hoping to get picked up for a second season.
It will not succeed if it is tied to the chaos that is 911 for profit and must succeed if 911 for profit has any chance of surviving another 10 years. We're approaching a cross roads to possibly finally squeeze our little patient care machine into the main stream of medical professionals. Do we want to squander that opportunity by having Community Paramedicine as a side project of EMS or as a full fledged community service independent of the lights and sirens?
I know 18 year old me had a different reason for having this opinion, but the opinion remains: 911 and community care shouldn't mix. They should each focus on their strengths and excel at the service they provide the community instead of stretching us so thin only our merit badge classes hold us above water.
Why not follow up with Mrs Jones on how her medications are doing?
Why not have a Paramedic check in on Mr Thompson and his blood sugar levels?
My first paying gig in EMS was for a system that did just this. We visited our list of clients based on the schedule and checked their blood sugar, blood pressure, medications and checked the fridge for food. I hated it. I hated it because it wasn't what 18 year old me wanted to be doing. I didn't see the value in the program until I was about to finish my employ there and noticed we never ran a 911 call on any of our home visit regulars. We weren't providing Emergency Medical Services (EMS), we were doing something completely different. Call it by any name you like, but don't call it EMS.
Today I'm a huge supporter of decreasing the demand on 911 by focusing on reducing the number of people who call. One of the proven tools used to combat 911 calls is making people healthier before they need 911.
Community Paramedicine is just the thing each and every community in America can use to reach out to a niche that needs to be addressed.
When I was in England all those years ago Paramedics with only 1 year experience were out on their own making recommendations, referrals and taking people directly to what they needed, not just a 2 person cot van to an ER (Or AE for those who favourite that term.)
The concepts have been proven over and over again and some systems are even carving out revenue streams to make it profitable or, at least, not at cost.
I applaud their efforts and if the opportunity ever comes along for me to get involved...
...I'll pass.
In my opinion Community Paramedicine is too important to be trusted to the 911 crowd. We need folks more interested in sitting and talking than squeezing a few home visits in between calls for service. Some systems have adapted schedules and providers to respond only on the Community cars and that's great, but a greater separation is needed.
Yes, I'm advocating splitting EMS even further than we are now. A split that will allow this new sub specialty to thrive.
Community Paramedicine needs to be a specialty, a half brother, not a spin off hoping to get picked up for a second season.
It will not succeed if it is tied to the chaos that is 911 for profit and must succeed if 911 for profit has any chance of surviving another 10 years. We're approaching a cross roads to possibly finally squeeze our little patient care machine into the main stream of medical professionals. Do we want to squander that opportunity by having Community Paramedicine as a side project of EMS or as a full fledged community service independent of the lights and sirens?
I know 18 year old me had a different reason for having this opinion, but the opinion remains: 911 and community care shouldn't mix. They should each focus on their strengths and excel at the service they provide the community instead of stretching us so thin only our merit badge classes hold us above water.
Comments
The same can be said for EMS as a whole when it comes to the relationship between EMS and Fire Departments. I know this is a hot-button topic; but one of the biggest things holding EMS back is fire departments who use EMS as a "cash cow" rather than treating it as the specialty it deserves to be. How many departments consider going from the ambulance to the engine or truck to be a promotion? Hell, at some departments, it is an OFFICIAL promotion, not just viewed that way. Some fire departments even take paramedic interns despite not operating their own ambulances; they just force their way onto the private ambulance despite the fact that these fire medics never transport unless they've got an intern.
I like the idea of community paramedicine as a specialty in it's own right; but until EMS ITSELF is treated as a specialty and not FD's little b***h, it'll never happen.
EMS is still new by many standards. We are still trying to find (force) our way in to the healthcare system. How can we expect to be able to start doing CP?
There are some very good CP programs. Most of which who are rich in resources and have a type of staff that "wants" to do CP.
In my mind, CP today is what EMS was back in the 1970's. New and no standards. Until there is a big buy in by the healthcare system in general AND there are standards developed, we will be spinning out wheels. The problem is that when it is no longer in vogue, what happens then?
I push for it for a different reason. LEOs and firefighters have career options, EMS not so much. A CP program provides a great career alternative for a medic who has already done 10-20 on an ambulance and might want to try something different.....much like a cop who does 10 years on patrol then becomes a detective or a school resource officer.
More, they become the four walls of the box we get stuck in!