Issue link: https://emsworld.epubxp.com/i/336320
M ost providers think they know about the roles of other healthcare practices. They often don't. While nurse prac- titioners are requesting independent practice without a supervising physi- cian in some states, at the same time nurses are opposing the concept of paramedics doing something other than responding to emergency calls and taking patients to EDs. Physicians oppose advanced scopes for interdisciplinary providers when we can barely keep our own heads above water. I initially trained as an emergency medical technician (EMT) in high school. I worked on an ambulance and as a medical technician in a hospital. I performed many low-skill technical procedures that helped free the nurses and physicians so they could provide more advanced clinical care. By utilizing me in this role, they could be more effective in their roles. I also observed paramedics and was amazed to see what they were doing in the field. However, when they crossed the threshold of the hospital doors, those same skills became "out of their scope" once they entered a medical facility. There are states today that require a paramedic to limit responses to emergencies and patient transports to the emergency department. Can you imagine what a nurse, paramedic, pharmacist or social worker could do to help navigate patients to the healthcare they need, instead of just transporting them to a hospital? The reality is that up to 30% of emergency 9-1-1 responses in this country aren't true emergen- cies. In fact, a large percentage of those patients receive treatment at home and are never transported, even though the EMS providers are not reimbursed for their time or supplies. Against the rules? Maybe, but it's definitely reality. I work as an attending physi- cian in a large county emergency department that has an emergency medicine residency program. That same department utilizes physi- cian assistants, nurse practitioners and paramedics in addition to the usual staff. There are examples of multidisciplinary teams across healthcare systems in this country. If we truly want to improve population health and patient experiences for less money, we must look at who does what. If we are going to be successful, we have to start working with each other, not against. We must work collaboratively to improve our delivery system. We have to start integrating our healthcare delivery, not only at our table, but at every table. —Jeff Beeson, DO 6 Integrated Healthcare Delivery July 2014 www.ihdelivery.com Eric Beck, DO, NREMT-P, Associate Chief Medical Officer, American Medical Response and Evolution Health Brent Myers, MD, MPH, FACEP, Medical Director, Wake County EMS System, NC Jeff Beeson, DO, Medical Director, Emergency Physicians Advisory Board, Ft. Worth, TX Collaboration vs. Competition Healthcare changes require focus on patients, not providers PUBLISHER Scott Cravens, EMT-B • 800/547-7377 x1759 Scott@IHDelivery.com BUSINESS DEVELOPMENT MANAGER Lorena Leggett • 949/330-9238 lorena@IHDelivery.com EDITORIAL DIRECTOR Nancy Perry • 800/547-7377 x1110 Nancy@IHDelivery.com MANAGING EDITOR John Erich • 800/547-7377 x1106 John@IHDelivery.com ASSOCIATE EDITORS Jason Busch • 800/547-7377 x1397 Jason.Busch@cygnus.com Teresa McCallion • 206/335-1118 Teresa@IHDelivery.com PRODUCTION SERVICES REPRESENTATIVE LuAnn Hausz • 800/547-7377 x1616 Luann.Hausz@cygnus.com SENIOR ART DIRECTOR - PUBLIC SAFETY & SECURITY Bobbi Burow • 800/547-7377 x1559 Bobbi.Burow@cygnus.com AUDIENCE DEVELOPMENT MANAGER Sharon Haberkorn • 800/547-7377 x1648 Sharon.Haberkorn@cygnus.com ADMINISTRATIVE ASSISTANT Michelle Endres • 800/547-7377 x1612 Michelle.Endres@cygnus.com CYGNUS REPRINT SERVICES To purchase article reprints, please contact Foster Printing Services at 800/875-3251, or e-mail sales@fosterprinting.com. LIST RENTALS Elizabeth Jackson • 847/492-1350, x18 ejackson@meritdirect.com Delivery Integrated Healthcare SUPPORTING ORGANIZATION FROM THE EDITORS IHD_06_Editorial0714.indd 6 6/17/14 10:20 AM