A new BCAS?

[DartmouthDave]

Hello,

Primary health care is a specialization. Primary Health Care isn't a side project.

Just like flight crews (good ones) are specialized in transport medicine. That is why I selected the ITT. They are at the top of their game because of a combination of specialization, education, training and clinical exposure. That is what I mean by 'top of their game'.

The same for ORNG, the Stollery, and many more.

Are they the best people for Primary Health Care. No. Because, they don't do primary health care on a regular basis.

This is not a nursing bias. It is the inherent complex nature of medical care. Heck, why dose an EP need to consult a Radiologist? They learned how to read a CT in medical school. Oncologist? Nope......The GP can manage this cancer patient all on their own.

Maybe tomorrow I would run the ventilators at work. Heck, who needs an RT. I understand pressure and volume cycled ventilation. Who needs them!! Even better, I can defend any protest as 'turf' war and a 'RT' bias. While I am at it, I think I will do a few CT-Angios as well. It only took the tech three years of school. Again, all protest is 'turf' war and 'bias'. How about Physical Therapy??? OT??? Speech Language??? They are all in the medical field?

No, of course not. That would be foolish.

We may be closer on this issue than you think. Paramedic can be a part of the primary health care team but not as independent practitioners. Yes, they can be helpful. Now, here is a fine point. Can Paramedic practice independently within their specialization (emergency care).....yes of course.

If you what to do a PA or a NP job? One needs the education (2-3 years) and residency. Then sure, go for it.

Cheers....

PS....yes 'muddle' was a bad selection of words...

[tniuqs]

Maybe tomorrow I would run the ventilators at work. Heck, who needs an RT. I understand pressure and volume cycled ventilation. Who needs them!!

Yea who needs those clowns ... Bwhaa haa ha that's a knee slapper.

cheers

[DartmouthDave]

Hello,

When I say Primary Health Care Provider I am talking about a person that can Dx, prescribe medications, refer, and follow up on their patient's primary health care needs (not emergencies) within their level of skill and knowledge. In addition, provide this level of care to all age groups.

Show me a Paramedic program that covers this material?

Maybe we are thinking about two different things here?

Cheers

[tniuqs]

Good point:

Then I am forced to ask in BC why is the title "Primary Care Paramedic" used ?

cheers

[DartmouthDave]

Good point:

Then I am forced to ask in BC why is the title "Primary Care Paramedic" used ?

cheers

Hello,

We are talking about two different things here. Primary Health Care, according to Health Canada is:

"Primary care is the element within primary health care that focusses on health care services, including health promotion, illness and injury prevention, and the diagnosis and treatment of illness and injury."

Sure, a PCP and an ACP can be a part of health promotion/injury prevention activities. Or, drop by check out how a patient is coping at home. Do a risk assessment. Fine.

But, they can not diagnosis and manage a patient over the long term the same way a NP or a PA can. I am not talking about an emergency here. I am talking about dealing with Mr. Smith HTN and DM. Or, Mr. Jones depression and ETOH issues. Things like that. Over an extend period of time.

You think that a PCP/ACP/CCP can do this, fine. I do not. Lets agree to disagree.

Besides, on your next pneumonia call at a nursing you can assess the patient, have the patient consent to you assuming care, review the patient's old charts, review the labs, talk with the family, talk with the Family Dr and then adjust the patient's medications. Prescribe some new medications; antibiotics for example. Then, add her to your practice so that you can come back later to reassess the patient because as a primary health care provider why bring her to the ED. This is not a short-term relationship. Book a CXR. Review a CXR. While you are at it leave a number to deal with family calls, patient's calls, and nursing home calls. Dr's calls. Plus, respond to 911 calls.

I will now make my egress from this issue.

[tniuqs]

We are talking about two different things here. Primary Health Care, according to Health Canada is:

Before you run away ... perhaps contact Heath Canada and Employment Canada as THEY are not calling a horse a horse, nor is the BC government define the same as Health Canada or WHO. (I personally like the WHO definition far better more inclusive really.

You think that a PCP/ACP/CCP can do this, fine. I do not. Lets agree to disagree.

But these are not protected titles under BC legislation anyone can call themselves a "PARAMEDIC" in fact your avatar suggests you are an RN/Paramedic ? Sure with additional education why not ? Bringing this full circle that of Practioners in Rural Communities Teaching and education on all that "down time" and "muddling about" oh your regreating that freudian slip I suspect ...

Besides, on your next pneumonia call at a nursing you can assess the patient, have the patient consent to you assuming care, review the patient's old charts, review the labs, talk with the family, talk with the Family Dr and then adjust the patient's medications. Prescribe some new medications; antibiotics for example. Then, add her to your practice so that you can come back later to reassess the patient because as a primary health care provider why bring her to the ED. This is not a short-term relationship. Book a CXR. Review a CXR. While you are at it leave a number to deal with family calls, patient's calls, and nursing home calls. Dr's calls. Plus, respond to 911 calls.

Assuming that only a few entities like NP or PA are the only ones capable of multi tasking could make you look a bit foolish as there are more than just a few multi hat wearing persons out there.

Lets not forget that REMT-P do work in clinics, all by themselves in the industry world, GOM and middle east to just touch a few regions, they can and presently do this type of care ok not the nursing home scenario but very similar in practice. So is this not a better way of skinning a cat ? Heck GP MDs don't in many cases do this extensive a work up as you do are suggesting as but I just might.

btw the PA does not have a regulatory body in Canada quite yet, although I hear Tom A. is working on it.

Or, drop by check out how a patient is coping at home. But,they can not diagnosis and manage a patient over the long term the same way a NP or a PA can

I sure hope Happi does not see that comment because this is one of her strengths in an isolated community, I bet my bottom dollar certainly has great influence as to when that individual needs either home support or transport, my bet is that she doest just go back home after the report is given either.

cheers

[rock_shoes]

But these are not protected titles under BC legislation anyone can call themselves a "PARAMEDIC" in fact your avatar suggests you are an RN/Paramedic ? Sure with additional education why not ? Bringing this full circle that of Practioners in Rural Communities Teaching and education on all that "down time" and "muddling about" oh your regreating that freudian slip I suspect ...

Close but not quite Squint. The actual titles Primary Care Paramedic, Advanced Care Paramedic etc. are protected. The problem is that the word "Paramedic" is not protected. As a result any schmuck with a first aid ticket can call themself a "Paramedic". They just can't say they are a "Primary Care Paramedic" or an "Advanced Care Paramedic". The public doesn't understand the difference and as a result the government has allowed this disgusting little loop hole to continue.

Back more on topic I absolutely do believe that both PCP/EMT and ACP/EMT-P level providers do have a role to play in primary health care. Not as independant practitioners such as NPs or PAs, but an important role none the less. Where you can expect to see paramedics play a role in primary health care as independant practitioners in the future will be as "Paramedic Practitioners". Similair in concept to the UK's current usage of "Emergency Care Practitioners". They will be well educated and the majority of them will come from ACP and CCP backgrounds prior to being educated as "Paramedic Practitioners". Between their initial paramedic background and the practitioner education I fully expect these type of providers to be competent at both emergency and primary health care(think masters program). Whether they will actually be called "Paramedic Practitioners" or a PA specialty I don't know. It is something we can all expect to see very soon. There's a gap within healthcare that needs exactly this type of provider.

[tniuqs]

Close but not quite Squint. The actual titles Primary Care Paramedic, Advanced Care Paramedic etc. are protected. The problem is that the word "Paramedic" is not protected. As a result any schmuck with a first aid ticket can call themself a "Paramedic". They just can't say they are a "Primary Care Paramedic" or an "Advanced Care Paramedic". The public doesn't understand the difference and as a result the government has allowed this disgusting little loop hole to continue.

I stand corrected ... so seeing as there is no PA regulatory body I guess I could use that title eh what, I wonder how in northern clinics a non regulated professional can work and provide care ?????

The 'P' 'P' abbreviation thing just does't sound professional .

Edited March 22, 2010 by tniuqs

[rock_shoes]

I stand corrected ... so seeing as there is no PA regulatory body I guess I could use that title eh what, I wonder how in northern clinics a non regulated professional can work and provide care ?????

I know you know the territories are an entirely different world. Kind of like paramedics working up there. No one cares where you're registered as long as you're registered somewhere in Canada. You're SOP turns into whatever the over-seeing EP decides you're capable of. The "Wild West" still exists so to speak. In Canada it just happens to be north of 60.

The 'P' 'P' abbreviation thing just does't sound professional .

I think the title is going to need some work for sure. Paramedic Emergency Care Practitioner maybe? I know I don't want to walk up to the nurse's station and call myself a "P" "P". It would only be entertaining for about the first week. That would be a hellishly fun week .

Edited March 28, 2010 by rock_shoes