Aug 31, 2012
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I am an EMT in Paramedic school, and hope to eventually attend medical school. I love the fire department and would like to volunteer for as long as I'm physically able to. If I keep my paramedic certification current could I function as such as a physician? I know PAs who were also paramedics who still functioned as such but someone told me that doctors cannot because of their unrestricted medical license. Paramedics function under their medical license similarly to a PA, and this person said one MD cannot function under another MDs license.

But I was wondering if you could if you only operated under your paramedic certification, and did not issue any type of medical control with a physician's authority. Thoughts?
 

alpinism

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Sure.

You'd just have to work under your paramedic license and not your medical license. Basically you'd be following SOPs like everyone else and not diagnosing/treating outside of that scope of practice.

You could also just work as medical control for a local FD/EMS service. Some places have physician response vehicles for major emergencies as well.

Pitt, Einstein (PA), and Mercy St Vincent (OH) to name a few.

If you're willing to move overseas, England and Australia both have HEMS units staffed with physicians.

London's Air Ambulance:

 

link2swim06

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Dec 14, 2007
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I am an EMT in Paramedic school, and hope to eventually attend medical school. I love the fire department and would like to volunteer for as long as I'm physically able to. If I keep my paramedic certification current could I function as such as a physician? I know PAs who were also paramedics who still functioned as such but someone told me that doctors cannot because of their unrestricted medical license. Paramedics function under their medical license similarly to a PA, and this person said one MD cannot function under another MDs license.

But I was wondering if you could if you only operated under your paramedic certification, and did not issue any type of medical control with a physician's authority. Thoughts?
EMS systems are all a little different. The old saying is "if you have seen one EMS system, you have seen one EMS system." So what anyone tells you may not be applicable in your specific system.

In my state if the paramedics are following the standing orders then they are working under the state medical director's license. However, if they radio into the base (in the ED) and I can give additional commands, making them act under my license (well my attending's license technically). So even though I am not out in the field I am still constantly involved during all my shifts.

Occasionally departments will have a chase car (like a suburban) a doc can drive out to a complicated scene. There are fellowships off EM where you would get to do this all the time. However, the bottom line is there is minimal equipment and resources on an ambulance compared to that of a tertiary care center...so you aren't going be able function like you would in the ED. I don't really know what the poster above me is talking about working under a "paramedic license only"...quite frankly if your EMS system director is fine with you giving medical command then you are working under your own license even if you are on scene. This again is system dependent.

Bottom line...there are plenty of opportunities to get involved in EMS from EM.
 

southerndoc

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Once a physician, always a physician (at least as long as you're licensed). Even working as a "paramedic," an attorney would be able to go after you based on your highest skill level (physician).

I ride on the fire engines, ambulances, response vehicles, etc. all the time. I have my national registry, but not my state license. I function on my physician license and carry a few extra drugs (etomidate, rocuronium).

There are helicopter EMS agencies in the US that use physicians (Cleveland MetroHealth LifeFlight, Spectrum Health AeroMed, etc.).
 

Tenk

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Assuming you make it all the way to being an ER attending in 7+ years from now and the current system is still in place, the best thing to do in a situation like this is to become a local EMS director. By doing so you can basically outfit your own little EMS mobile and run around doing pretty much whatever the hell you want under your own license while still interacting with local EMS. You'll have your own autonomy with a structured system in place for med legal purposes.

This is a gross oversimplification but some of the EMS junkie docs I know really enjoy this avenue.
 

InFactotum

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Assuming you make it all the way to being an ER attending in 7+ years from now and the current system is still in place, the best thing to do in a situation like this is to become a local EMS director. By doing so you can basically outfit your own little EMS mobile and run around doing pretty much whatever the hell you want under your own license while still interacting with local EMS. You'll have your own autonomy with a structured system in place for med legal purposes.

This is a gross oversimplification but some of the EMS junkie docs I know really enjoy this avenue.
Can you give any further insight on how they got into this? I'm a former medic, current EM intern, and would love to be able to do this in the future.
 

deuist

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While I was in residency one of my attendings worked as an EMS medical director and had his car outfitted with lights, sirens, and tons of medical equipment. I tried to get him to tell me how he went about getting it all set up, but he refused to say. I think he was under the impression that I only wanted the lights and sirens – which might be true.
 
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