IDMTs

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I co---uld.........slow.........it down..................?
 
idq1i said:
It's my problem that the DoD continues to employ functionally illiterate people. It's embarrassing
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Well I'm special. Momma always said...........oh wait...........we-------ll I am.........sp..........ecial. That help?
 
Now address the problem. Oh wait look a shiny penny. Where was I?
 
idq1i said:
It's my problem that the DoD continues to employ functionally illiterate people. It's embarrassing
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You forgot the period.
 
Lmao, isn't that what we are discussing now?
 
To include you.
 
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Idmt said:
Lmfao. BEST YET!!!!!!!!! Your comparing the IDMT program to the Nazis defense? Yea reminds me of a great quote. "it's funny how sometimes the people you'd take a bullet for are the ones behind the trigger."
Ritu Ghatourey
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Nope. Nuremberg was just one situation in which soldiers claimed that what they were doing wasn't their fault because they were just following orders, yours is another. You keep eluding to the fact that what occurs in an IDMT's practice isn't the IDMT's fault, but rather his superior officer's. I'm just pointing out that the defense has been used before. The link uses Nuremberg as one example, but lists many. If your conscience leads you to believe that there's a link between what you did and the Nazis, that's your on you.
 
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“Never argue with a fool, onlookers may not be able to tell the difference.”
 
Perrotfish said:
How much experience is usually required to apply to IDMT school? E6 with 10 in? E4 with 5 in? Can you go straight from your A school? I'm curious how they match up to IDCs.
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Well I got out about a year ago. As of that time you needed to be a 4N051 and an E5. That is to say you would have had to have completed basic training, technical training (EMT-B and Intermediate nursing), OJT and correspondence courses. All 4Nox1 Airmen hold a National EMT-B Certification and are eligible to challenge LPN exams immediately after training. An E5 in the Air Force would have to be in for about 4 years. Imagining that the first year your in training you would have about 3 years of clinical experience screening in patients and discussing their conditions with the MD. Thats typically 18 patients a day 5 days a week 52 weeks a year, so after 3 years that is about 14000 patients give or take for leave and holidays. After that you must have commander approval and a letter of recommendation from a 4N E7 or higher to ensure you are not a ***** and then may apply to IDMT school. IDMT school is a 7day a week course though I don't remember how long it is. After you complete your IDMT training you will return to your base and begin seeing patients under the very direct (literally looking over your shoulder) supervision of a board certified physician, usually the medical directer. After a few months of that they ill sign off and you will be able to see patients similar in scope to a PA. Fun fact the IDMT is what gave birth to the PA field. IDMTs were trained in response to not having enough Doctors in the war setting. Afterwards PAs were developed in response to not having enough Doctors in the private sector. For a bit more info on IDMTs go to this link http://www.metc.mil/academics/IDMT/
 
Navy1234 said:
The PA pathway was started as an extension of Navy IDCs... Not AF IDMTs (https://www.aapa.org/threeColumnLanding.aspx?id=429) . I have personally worked with both as a supervising physician and they are not equivalent training curriculums.
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Though the article that you reference does state that former corpsmen were some of the first to go to the first formal PA school that does not necessarily mean that it was based off of the IDC training. In fact the same article states "Stead based the curriculum of the PA program on his knowledge of the fast-track training of doctors during World War II". During WWII the majority of the medical needs were taken care of by the Army. During the same time period the Air Force was not its own entity yet and was still known as the Army Air Corps. Therefore one could easily draw the conclusion that PA training is closer to the Air Force than the Navy. I am not saying that one or the other is better than the other or that they are the same training. They are however very similar to each other and anyone who says that one is better than the other are simply stating an opinion and not a fact. In fact both AF medics and Navy corpsmen who are the basis for each field now go to the same school and are in integrated classes. Though the Navy does not have additional clinical rotations that the Air Force does. http://www.metc.mil/academics/BMTCP/
 
Good afternoon folks, I realize that this is a slightly dated post but I'm going to throw in my two cents anyway.

Before all the holier than thou types in the room have to guess this, yes I was an IDMT, yes I volunteered for that duty, and yes I am proud of my service and my contribution to medicine. My last assignment in the AF also required that I attend paramedic school or an abbreviated version thereof. So I believe I have a unique perspective on this discussion

In answer to some of the questions above, yes there is board certified MD involvement in every phase of IDMT training. An MD helped write the courseware, an MD is in charge of the course, and the same MD (along with 2 PAs and 3 IDMTs) is one of the instructors. From there crispycritter was correct: As soon as the newly minted IDMT returns to their home base they enter a certification program covering medical, dental, immunization tech, Public Health, and Bio-environmental duties.

Since there are a few references to paramedic Vs IDMT, let me illuminate that subject just a bit. One of the enlightened posters stated that IDMT (IDC, etc..) school should be longer to better match that of paramedics. That is an interesting thought except that's not the way the military works. They take a subject, compact it into the shortest timeframe possible, open the student's head, jam the information in, an hope it doesn't leak before it's needed.

For example: IDMTs are taught the same physical exam that a PA is (in 1999 when I went through). 182 tests on the patient. In IDMT school you have 1 week to memorize and be able to perform that exam with a max of 2 errors and only one in the same body system.

Paramedic school on the other hand spoon feeds information at a glacial rate. General Pharmacology at my local community college is one quarter of education and covers ACLS drugs, narcotics, bronchodilators, and interactions. Pharmacology in IDMT school is one week of furious writing and study after class that covers all the same information plus antibiotics, antipsychotics, NSAIDS, muscle relaxers, otics, ophthalmics, Antidiarrheals, and more that I'm forgetting now. In other words, length of school does not equal quality of education.

One thing that I agree with idmt on is a feeling of awe that I was turned loose on the public with what I realized at the time was very little information in my head. I am truly thankful for the Docs that I had as preceptors at the time who filled in the gaps in my education from their years of experience. It wasn't until my second or third preceptor that someone explained to me what an IDMT was in their opinion. We were the eyes, ears and hands of a Doc who couldn't be on site to directly see them patient themselves.

Once I realized that it made my job a bit easier. I had a set of protocols (just like a paramedic) that I operated from on a daily basis to cover 90% of what we saw. When we came across a disorder outside of our protocols (or an atypical presentation of a common problem) we had a Doc on the other end of the phone or radio. As we learned more from each preceptor our protocol list grew accordingly. The most intelligent person I have ever met was my 3rd preceptor. Her saying went something like "in medicine you don't have to know everything, you just have to know when to punt". That statement works from MD to IDMT to EMT-B.

One of the good doctors above asked fairly derisively if idmt was still in medicine and working as an IDMT at Kaiser. Well, we haven't come to that point yet but I will tell you that advanced scope of practice paramedics are doing that very thing all over the world. The remote medical companies are realizing that, for the most part, MDs and PAs prefer their office or ER and paramedics love being out in the field. It's not a difficult decision to pick up an Ex-DOD medic and send us out to do the mission that Uncle Sam trained us for. I'm making a good living at it right now in fact.

If you are still in the military and get an opportunity to be around an IMDT, or IDC, please take the time to get into their heads and find out what is going on. You may be amazed at the force multiplier that emerges from what you now think is an untrained, "functionally illiterate" NCO. There was a quote above that compared IDMTs to not having enough pilots in the Air Force and substituting them with enlisted folks. As I remember that happened in WWII and one of the Sergeant Pilots (the always humble Chuck Yeager) went on to break the sound barrier.
 
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I would like to add to Remotemedic's comments. I recently retired from the Air Force. I currently work as a paramedic where our call volume is over 60,000 per year. My last 17 years of my military experience was as an IDMT. I think the key word everyone is missing is the first letter. I stands for Independent. This means we are a traveling hospital in one person. On certain occasions, we had two of us.

When I was trained in 1997, I learned X-ray, Lab (urinalysis to include bacterial testing, CBC with manual count, and culturing for Strep), Administration, Pharmacology, Advanced Surgical (life sustained procedures which we had to perform without any errors or we failed automatically), Patient Assessment and Diagnosis. We started with a class size of 40 and graduated with 12. We always discussed cases with out physician preceptors (which at times where thousands of miles away). We also did public health inspections, food inspection, water testing and industrial hygiene inspections. I was CAOHC certified. I performed immunizations and identified and treated reactions.

I have to say now being a paramedic, IDMTs are trained well above a paramedic level. My patient load was approximately 2000 per year over my last 12 years. This was not just acute patients, but included preventive health evaluations, occupational health and cardiovascular risk evaluations. Patients (active duty members) preferred seeing me over their actual physician. This was not because I gave them medication, but because I took the time to educate them on what was going on and why the they were getting the medication. Some of the time during my examination, the patient would tell me that the physician didn't even touch me (I know this is not true in all physicians). In some instances, I would contact my physician preceptor to get permission to treat them with more basic medications. More and more I was seeing physicians jump to high end medications when the patient could be treated with first level medications (I know this is old school but I didn't want to contribute to medication-resistant bacteria). I even had active duty members asking me if I could take care of their wives and kids, but of course, I told them I could not.

Both IDMTs and IDCs are valuable assets to both physicians and patients. I have worked along IDCs and we each have our own impact on patients.

Next, let me reinforce that we are not physicians nor do we ever claim to be, but let me ask you this. You as a physician, are you willing to step up and go (by yourself) to a remote combat location (regardless of what people say, we do go into combat environments) with no medical support other than what you carried in and combat soldiers (trained in first aid) and be comfortable? Ask and IDMT or IDC and we will all say, HELL YEAH! There was a saying when I was an IDMT. We were sent where they would not send physicians. My theory; because we were considered expendable.

Don't discount IDMTs or IDCs, instead get to know them and understand what we are and do. You will be amazed of the knowledge that some of us have. We have been and always will be a valuable asset to the military healthcare system.

Once and IDMT, Always and IDMT.

I am now looking towards becoming a PA. One of the reasons for this is that I had a regular Air Force medic watch me and wanted to do what I did so they went on and just recently graduated and is now working as a PA. I am glad that seeing me work as and IDMT influenced a younger inexperience medic to move forward to become a patient care giver.
 
Medic911c said:
You as a physician, are you willing to step up and go (by yourself) to a remote combat location (regardless of what people say, we do go into combat environments) with no medical support other than what you carried in and combat soldiers (trained in first aid) and be comfortable? ........................We were sent where they would not send physicians. My theory; because we were considered expendable.
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You have defined your role and provided the correct justification (to put it bluntly). It still doesn't mean you should operate independently outside of extreme environments.
 
The problem with IDCs an IDMTs is you don't know what you don't know.
 
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