Can you diagnose in the field?

[Ridryder 911]

One needs to remember that not all diagnoses has to be used in the same terms as "medical diagnosis". For example in nursing, they have their own diagnoses and not use the same terminology as the medical diagnoses such as "impaired oxygenation', potential for injury, etc..

We in EMS would have to develop approved ones for EMS as well. I am sure we would never be able to utilize the same terminology as physicians do. Legality, of having the same would be tremendous.

R/r 911

[iMac]

............................NO.........................

[JPINFV]

............................NO.........................

Care to elaborate?

[ERDoc]

Though the legal semantics is the only thing that really seperates what we do from MD's in the hospital most of the time.

:shock: :shock: :shock: :shock: :shock: :shock: :shock: :shock: :shock: :shock: :shock: :shock:

I wouldn't even know where to begin with this one.

[ERDoc]

Let's face it, anyone that can read a book can make a diagnosis. It doesn't take an MD to be able to look at a constellation of symptoms and say that a person has X. Google the symptoms and you will likely get your answer. Simply making a dx just takes some basic reading. However, you can't bill for making the diagnosis and you will legally have no ground to stand on should you tell someone how to treat their problem. Someone who has read a book also can't treat the diagnosis, only someone with a license (usually requiring some additional knowledge) can treat diseases. Anyone in the field can make a differential diagnosis, you just don't have the tools (and in some cases the knowledge) to confirm the diagnosis and treat all of the time. Hell, there are plenty of diagnoses I cannot make in the ER. I'm sorry if this is a little confusing, it's 3am and I am quite tired.

[zippyRN]

Let's face it, anyone that can read a book can make a diagnosis. It doesn't take an MD to be able to look at a constellation of symptoms and say that a person has X. Google the symptoms and you will likely get your answer. Simply making a dx just takes some basic reading. However, you can't bill for making the diagnosis

Once again the inherently messed up nature of USAmerican healthcare comes to the fore - the best patient care we can bill for - tail wagging the dog ...

and you will legally have no ground to stand on should you tell someone how to treat their problem.

is there statute which says " only these people can make a diagnosis" ?

to the none USAmerican " nursign diagnosis " and the like seems extremely convuluted and a " we've got to have it but it;s got to be different' system , certainly in UK Nursing practice careplanning is driven somewhat differently becasue there isn't a made up tset of terminology to creat the

Someone who has read a book also can't treat the diagnosis, only someone with a license (usually requiring some additional knowledge) can treat diseases. Anyone in the field can make a differential diagnosis, you just don't have the tools (and in some cases the knowledge) to confirm the diagnosis and treat all of the time. Hell, there are plenty of diagnoses I cannot make in the ER. I'm sorry if this is a little confusing, it's 3am and I am quite tired.

valid points

it's also the progress from possible bony injury / clinical signs of bony injury - 'oooh that's broken' (when reviewing the triage requested X ray ) - that a doohicky type A fracture and it's going to need plating let me ring the orthopods

[scott33]

Once again the inherently messed up nature of USAmerican healthcare comes to the fore - the best patient care we can bill for - tail wagging the dog ...

The alternative being to "bill" the entire country for healthcare, whether they need it or not, as with the UK national insurance system.

As I have said, the US system isn't perfect, but neither is the UK's. Money (or lack thereof) is the big problem with the NHS. Companies such as BUPA and BMI would not have survived in the UK, had there not been a demand for private healthcare.

[zippyRN]

The alternative being to "bill" the entire country for healthcare, whether they need it or not, as with the UK national insurance system.

personally i think NI is a pretty good deal

http://www.hmrc.gov.uk/faqs/nicqc1.htm

http://www.hmrc.gov.uk/employers/e12-non-contr-out.pdf or http://www.hmrc.gov.uk/employers/e12-contacted-out.pdf

'contracted out' refers to whether you have an employer run pension scheme and are therefore 'contracted out' of the state second pension

at 9.4 % of gross wages between the LEL and UEL and 1 % on earnings above the UEL (contracted out) slighly more if you are i nthe state second pension

given that provides

free primary care , free EMS and Emergency department care , free emergency inpatient care, free elective inpatient care if you are prepared to wait a few months , free inviestigations related to any of the above

subsidised prescriptions ( flat fee of 6.65 gbp per item for primary care and hospital outpatient prescriptions in patient and discharge prescriptions are free) , dental and optical services

plus providing free versions of the subsidied services to chidlren, the elderly and those on low incomes

no one falls out of the net

NI also contributes to a proprotion towards social security type benefits

As I have said, the US system isn't perfect, but neither is the UK's. Money (or lack thereof) is the big problem with the NHS. Companies such as BUPA and BMI would not have survived in the UK, had there not been a demand for private healthcare.

private healthcare is based in three areas in the Uk

- vanity / impatience of the individual - vanity in doing procedures that are not funded by the NHS unless there are wider implications ( a lot of cosmentic stuff) - impatient peopel who want things NOW! NHS waits are much reduced from the figures in the past certainly no more waits f years unless there are clinicla reasons why (e.g. need to deal with other problems first like the overweight smokers with vascular problems - stop smoking and loose some weight before assessing their need for surgical intervention)

- a perk used by employers to recruit / retain and reduce theamount of time key staff may be off work

- providing protected capacity for NHS funded elective work

[Dustdevil]

personally i think NI is a pretty good deal

I suppose that is a fundamental difference between us and the rest of the world. Americans don't believe that ANYthing they are *forced* to do is a "good deal." Restricting my personal freedoms and choices is hardly a good deal. Making me pay for something I'm not even using is not a good deal. Kinda why the whole communism thing is dying a painful death. It's only a "good deal" to those who produce little to nothing for society. The rest of us get farked.

Not to mention that if it weren't for free enterprise in the American healthcare system, the rest of the world wouldn't have most of the innovations they are currently using. Without financial rewards, there is no incentive for progress.

You cannot possibly be so naive as to actually believe that any of that is "free," so why would you be so dishonest as to say it is?

[BushyFromOz]

Americans don't believe that ANYthing they are *forced* to do is a "good deal." Restricting my personal freedoms and choices is hardly a good deal.

Would countries who have mandatory voting be seen to be forcing democracy on its citizens? :shock:

Not to mention that if it weren't for free enterprise in the American healthcare system, the rest of the world wouldn't have most of the innovations they are currently using. Without financial rewards, there is no incentive for progress.

That is an outstanding point, and i will forever remember this one! 8)