To AMA or Transport

[HERBIE1]

I disagree. While certainly not the end all, taken in consideration with consultation with YOUR medical director, then it is a good consideration. After all, from all the practictioners who are tending to this patient, they are the most knowlegable about the Pt.

Totally agree. Any MD worth his salt should also understand the predicament you were in and hopefully he can understand the potential for liability to you. A doctor has a higher medical authority than you, and a patient's PMD his certainly far more familiar with the patient than anyone else-including your medical control, so certainly his opinion is VERY RELEVANT.

[Lone Star]

Totally agree. Any MD worth his salt should also understand the predicament you were in and hopefully he can understand the potential for liability to you. A doctor has a higher medical authority than you, and a patient's PMD his certainly far more familiar with the patient than anyone else-including your medical control, so certainly his opinion is VERY RELEVANT.

The only 'problem' here is that the doctor in question is NOT the patients primary care physician, but a therapist.

The doctor that was called by the parent was the patients neurologist, not his primary care physician

Unless the patient is mentally incompetent, or the parent has legal documentation to prove DPOA, guardianship/conservatorship; they have no say in the treatment/transport of this patient. Even the therapist and neurologist will have to defer to your medical control physician, and your state/local protocols.

Remember, the license you're working under is your medical director's, not the therapist's, and not the neurologist's; and therefore ultimate say is that of the medical director.

[HERBIE1]

wrmedic82,

By no means am I trying to make this anything less than a civil discussion, nor am I 'beating a dead horse' here.

It's unfortunate that you're in this position, I'm just trying to see things from all angles.

The reason I asked for more information on this 'mysterious exception' was because I was under the impression that you had spoken to the supervisor that told you about it. I was just curious as to his 'explanation'.

ERDoc makes some valid points. I especially have to agree with the statement about it being the medical director's job to deal with these types of issues.

The etiology/pathology statement wasn't directed at you personally. I could see that you were merely responding to the questions being presented. I only mentioned that to keep the thread on topic.

Herbie,

Under the current structure of EMS systems, we are a designated agent of the medical director, and our authority to practice is an extension of their license. In this case, even though the 'neurologist is an MD with far more training than we have', I'm sure that the medical director would have the final say; since it is their license we're working under.

Not arguing that point, but I disagreed with the notion that just because a doctor isn't our medical control, his opinions are irrelevant. I said before, you don't want to get into these situations, but in our case, our "medical control" can be anyone from an RN to a 1st year resident. As such, we can get some outrageous "orders" from these residents- they may ask for treatment, drugs, or procedures that we do not have-often they are not familiar with our protocols, and I would be leery of having them handle an unusual case such as this. Point being, you still need to have your act together because for us, it is rare to ever have our actual medical directors on the radio. Just because someone is an MD, that does NOT mean their advice is always golden- you also need to have common sense and do what's proper and in the patient's best interests.