For those who advocate Community EMS

[Just Plain Ruff]

I must've missed the part where Community Based Medicine involves first responders but I do believe in strict hospital based EMS which I've enjoyed in Noo Yawk. I have always pitched in to assist the ER staff in any endeavor required just as long as it didn't interfere with my bus being delayed for calls in my PAR, help work up patients, hold down EDP's, juggle stretchers, beds & equipment, run errands, mop blood off the Trauma room floor, whatever it took to keep the hive functioning, they took care of us & we took care of them. I'd never entertain the CVS concept even by direct order, I didn't attend EMS school for that.

So what's wrong with a medic or an EMT working at a CVS or a stand alone clinic?  60% of your work in a community hospital ER is exactly what they do at the CVS and it sounds like from your post that you do about 60% of that where you work as well.  

So explain what a PAR is? I'm not following, again with the abbreviations like the 10 codes, one area uses them, another doesn't.  gmd

And you'd never entertain the CVS concept even by direct order, be out of a job long enough and you just might if the money paid the bills, but thankfully you probably don't have to right now.  

And Community based medicine is a HUGE part of what we do in EMS already, you get that right?  We are already doing much of that when we respond to the 2pm chronic diabetic patient who is low on their sugar who you bring the levels up and they refuse to go to the hospital and you spend an hour on scene with them making them a sandwich and helping them with their meds.  And then you help them to call their doctor's office or you do that yourself for them and get them an appointment for the following day.  That's community medicine, or do you just get them to sign a refusal and go on your merry way?  

We already do community based medicine but many new medics don't realize that, they are so freaking focused on that next "cool call" that they forget that there's a human element in these patients and that spending the extra time with the patient can mean a big difference in the health and longevity of the patient.  If you are hospital based you have an even bigger impetus to look to yourself as a community based practitioner because you see these patients regularly and more long term than just the run of the mill street provider.  

So Medcom Radio, You did Miss the part that community based medicine involves first responders - it involves all of us working together to promote the better health of our patients.  The title "Community Based Medicine" practitioner is just that - at title.  

 

 

 

 

 

 

 

[Just Plain Ruff]

Rock_shoes here. For some reason the system tagged me as Ruff when I signed in. 

 

Admin?

Edited January 20, 2016 by Ruffmeister Paramedic

[rock_shoes]

One of the best calls I ever did was for a newly diagnosed diabetic. He called because he was concerned his BGL was elevated and his family doctor had put the fear of god in him regarding the dangers of chronically elevated BGLs. Naturally we checked it for him and it was perfectly fine. Then we investigated a little further. The real reason he had called was because he didn't know how to use his home glucometer to check his BGL. He didn't know how to use his home device because he was functionally illiterate and unable to make any sense of the instructions.

In a matter of 20 minutes we taught this gentleman how to use his home device and as a result he never accessed EMS services again for anything of a minor nature. That's community care and that's why EMS providers must accept that they have a valuable role to play within community care.

[Just Plain Ruff]

One of the best calls I ever did was for a newly diagnosed diabetic. He called because he was concerned his BGL was elevated and his family doctor had put the fear of god in him regarding the dangers of chronically elevated BGLs. Naturally we checked it for him and it was perfectly fine. Then we investigated a little further. The real reason he had called was because he didn't know how to use his home glucometer to check his BGL. He didn't know how to use his home device because he was functionally illiterate and unable to make any sense of the instructions.

In a matter of 20 minutes we taught this gentleman how to use his home device and as a result he never accessed EMS services again for anything of a minor nature. That's community care and that's why EMS providers must accept that they have a valuable role to play within community care.

Exactly, this is the reason why first responders are part of community EMS.  

[Just Plain Ruff]

Exactly, this is the reason why first responders are part of community EMS.  

No one is debating this.  We have all had experiences like this.  Sadly, people who are competent enough to follow directions and understand it are far and few between.  Although I am glad to truly help someone, a majority of our patients have no interest in helping themselves, and I will not waste my breath on them.  Get you shoes, coat, purse and lets go ma'aam.

 

What I refer to is this new approach being floating around where EMS makes appoints to go to someones house and follow up with them after a hospital discharge.  Being in a municipal service, and have no employment with a hospital or private company I frown upon being their lackey to help them retain more money for themselves in preventing readmissions.  

I am lucky though, we have 75 ambulances on the Chicago Fire Department and that isn't even enough.  So some idea like this would never work, looks like I will be spared.

[Just Plain Ruff]

No one is debating this.  We have all had experiences like this.  Sadly, people who are competent enough to follow directions and understand it are far and few between.  Although I am glad to truly help someone, a majority of our patients have no interest in helping themselves, and I will not waste my breath on them.  Get you shoes, coat, purse and lets go ma'aam.

 

What I refer to is this new approach being floating around where EMS makes appoints to go to someones house and follow up with them after a hospital discharge.  Being in a municipal service, and have no employment with a hospital or private company I frown upon being their lackey to help them retain more money for themselves in preventing readmissions.  

I am lucky though, we have 75 ambulances on the Chicago Fire Department and that isn't even enough.  So some idea like this would never work, looks like I will be spared.

It appears that someone is linked to my user name again.  I've been seeing some real issues with this site.  Database errors, critical failures, unable to connect with the database, incorrect user name issues.  and now someone is linked ot my user name.  

some times I have one unread posts and then the next time I will have 9 and then it goes back to just one even though I didn't read all the 9.  

ADMIN what's going on with this site.  

And by the way, I did not say what's in the above quote.  

 

Edited January 21, 2016 by Ruffmeister Paramedic

[EMT City Administrator]

First I have heard of issues.  No one else has reported any issues with the site.

 

[Just Plain Ruff]

First I have heard of issues.  No one else has reported any issues with the site.

 

offlabel here.... my posts (none on this thread) are being linked to this user name.

[EMT City Administrator]

PM Me with all the details as I am a bit confused.

[paramedicmike]

PM sent.