Houston FD Hiring EM Physicians for Remote Triage

Discussion in 'Emergency Medicine' started by OCDEMS, 05.17.14.

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  1. OCDEMS

    OCDEMS 2+ Year Member

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    http://www.click2houston.com/news/n...-to-curb-unnecessary-ambulance-rides/25964116

    "The city plans to hire 30 ER physicians who will work in shifts every day of the year. "

    Basically, the City of Houston is planning to hire EM physicians to work at a dispatch center and do remote consults with non-emergent patients in the field and divert them to more appropriate resources. Thoughts? Anyone in the Houston area think this would be a neat part-time gig?
     
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  3. GeneralVeers

    GeneralVeers Globus Hystericus 10+ Year Member

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    Depends on the liability protection. At the end of the day there is quite a bit of risk to this as you are telling a certain subset of people not to go to the ER. This is why nurse help lines generally just tell everyone to get seen.
     
  4. EctopicFetus

    EctopicFetus Keeping it funky enough 10+ Year Member

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    I agree. Garbage and a waste of time. I am ok with out of the box thinking but I doubt it matters much and I would really worry about the liability.

    Its like those websites where you can see a doc online. I think if its an appointment with your pcp thats one think but a virtual UC or ED visit has low quality, and while the costs might be low the quality is such crap i believe it is expensive.
     
  5. daveyjwin

    daveyjwin Senior Member 10+ Year Member

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    Of note with this, Texas has excellent Med Mal reform, and while this would be a bad thing in most other states, it might actually be okay in one like Texas.
     
  6. Arcan57

    Arcan57 Junior Member 10+ Year Member

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    I think this makes some fundamental assumptions about why people use 911 that aren't necessarily valid. There probably are a subset of patients that genuinely don't realize that they don't need urgent medical care. However there are a lot of patients for whom taking a free taxi to the ED where they'll be seen that day is so powerful a lure that it's going to trump any attempt at diverting to outpt clinics, etc. If the doc deems the transport unnecessary, I can easily see a number of the high frequency utilizers start playing "symptom chicken" where they keep tossing out potentially serious complaints until the doc either gives in or has a recorded conversation that documents telling EMS not to transport someone with chest pain, shortness of breath, syncope, and recently resolved focal neuro deficits.

    IMHO, they'd be far better off taking the money they're going to pay the EPs staffing this and utilize it to keep community clinics open an extra couple of hours in the evening.
     
  7. Dr.McNinja

    Dr.McNinja Nobel War Prize Winner SDN Moderator 10+ Year Member

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    Per their director, you have sovereign immunity. And you're basically skyping. Imagine a triage shift from hell.
     
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  8. @JackShephard

    @JackShephard

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    It should save money - and if the malpractice is right, everything should be fine.

    This is a part of a bigger problem.

    You can't have a system that HAS to deliver emergency care to everyone yet has the same standards for malpractice as a physician in a clinical office setting seeing patients they've known for 10 years.

    The EPs need to be given more freedom to practice medicine less defensively if we want to control costs.
     
    Last edited: 05.18.14
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  9. Vandalia

    Vandalia 2+ Year Member

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    The only way this would work is "sovereign immunity", which apparently this has. Basically you can't sue the government unless they let you - which as a taxpayer, I can never see why they would ever let anyone, but that is another story.

    Would the money saved equal the difference in salary between physicians and nurses/EMTs doing the same thing? I doubt it. However, we spend so much money on other questionable research I figure this is worth a shot.
     

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