MERGINET.News, June 3rd -- See what's new!

["Richard Bilger" <rbilger@merginet.com>]

We're pleased to bring you the latest additions to
MERGINET.News (June 2001 Vol. 6, No. 6).
You can view this issue online at:

http://www.merginet.com/index-news.htm
Select "MERGINET.News" or "Current Issue" from
the navigation menu's.

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FROM THE EDITOR:
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Click onto MERGINET.News for the June 3, 2001, issue. We offer
work by three familiar EMS names: Keith Wesley, MD, Tom Scott,
and Liz Criss. Keith Wesley has written a motivating feature
titled “Be Excellent.” Tom Scott is moderating MERGINET’s newest
discussion list, the Ambulance Billing and Reimbursement
Discussion. This is a superb resource for managers who are
battling the Health Care Finance Administration (HCFA) Medicare
reimbursement woes. This month marks the launch of Tom’s monthly
articles about his particular niche of expertise. Also returning
to our site is popular clinical writer Liz Criss, with an article
about ectopic pregnancy.

As always, your MERGINET “regulars” are here. Vic & Vern are
convening a Board of Directors for Vic and Vern’s EMS STAT Rescue
Car Wash & Video Rental. Valerie DeFrance reviews on-line
education web sites, and Mike Taigman’s regular book review
offers more traditional reading. Harold Cohen reviews a study
about sub-q epinephrine. In “Management Matters,” new material by
the folks at “EMS Best Practices” is online about cost cutting
for administrators and barrier protection for operations folks.

Please come see what’s on our table this time around! As always,
feel welcome to send your comments, concerns, and compliments. We
reply to everyone who writes. Send email to publisher Richard
Bilger at rbilger@merginet.com or me at kate@merginet.com -- be
in touch!

Welcome to June 2001!
Your editor, Kate Dernocoeur

######## ONLINE SURVEY DEADLINE APPROCHING #########
        Frontier EMS Needs Your Help: EMS Provider Survey!
-----------------------------------------------------------------
--------------
Frontier EMS is in critical condition. All EMS providers can
help.
Support U.S. Senate Bill #587 (see "Good Job!" in this weeks
edition  of Sharps), and if you live in a rural/frontier area,
fill out
the survey in this release of MERGINET. Information gathered will
be used to augment an EMS need statement to state and federal
legislatures. The deadline for data collection has been moved up
to
June 15, 2001. Please take time if you haven't already to
complete
the survey. Your input counts.

                Click here to help us with this survey.
            http://www.merginet.com/index-survey.htm

#####################################################

New in this issue!

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Features
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>> Case Study: Ectopic Pregnancy
by Liz Criss
Probably one of the most difficult cases to encounter is the
female patient with abdominal pain. What could it be? Sometimes
the pain is the result of a minor, transient problem, but other
times the pain could be a symptom of a potentially life
threatening condition. While the list of possible causes for
abdominal pain in females ranges from an uncomplicated urinary
tract infection to pregnancy, there is one that is very dangerous
for women of childbearing age — ectopic pregnancy.

>> HCFA Brings on Coding Woes
by Tom Scott
The Health Care Financing Administration postponed implementation
of the new Medicare Fee Schedule, but only the fees themselves.
Effective January 1, 2001, a new set of HCPCS codes, the codes
used to identify the level of service being billed, were required
for all Medicare ambulance claims. Furthermore, the zip code of
the pick-up location is now required on all Medicare claims.

>> Be Excellent!
by Keith Wesley, MD, FACEP
At a conference recently, I overheard some fire chiefs describing
their services to one another. They spoke proudly of the size of
their service area, response times, cardiac arrest saves, and the
number and models of their new engines. As I listened, I wondered
how each measured their service's quality. I approached and asked
each to describe the measures or benchmarks they used to come to
their opinions. With a confused look they repeated the same
figures I had already heard. Size, speed, and saves.

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Medic Life
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>> STRAIGHT TALK: Cynics and Idealists
by Kate Dernocoeur
It's no secret that idealistic people are powerfully drawn to
EMS. In every town in America and beyond, people get involved in
emergency care in order to make a difference. They want to change
the world, or at least help their neighbors. They want their
actions to matter. No news there. But the next piece is a
constant ache: why do so many people in emergency care end up so
darned cynical, burned out, negative, and downright nasty?

>> In His Own Words: EMS Development Project in India
by Keith Holtermann
We are looking for instructors to teach the EMT course who are
experienced in running and/or teaching EMT classes. We are also
seeking students and alumnae interested in assisting with the
course.

>> Board of Directors Named for Vic and Vern's EMS STAT Rescue
Car Wash and Video Rental
by Vic & Vern
Vic and Vern, being the wise entrepreneurs that we are, have
decided to go the same way as our large corporate peers such as
Pepsico, Frito-Lay, Chateau Whistler Resorts, and Studio 5 Web
Designers! We are setting up a Board of Directors. Of course, we
expect this board will have as much control over us as our
current medical directors....


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Educators Corner
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>> Continuing Education Online: A Comparison of Three Services
by Valerie DeFrance
Service members, students, visitors to my EMS web sites, and
others frequently ask me about obtaining online Continuing
Education Units (CEU) or Continuing Medical Education (CME) as it
is known is some states. While I have offered them links, I have
not been able to convey any personal experience with these online
educational sites. I thought it was high time I looked into these
services and did a comparison.

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Columns
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>> Meta Analysis: A Research Technique That's Growing in
Acceptance
by Harold Cohen
This month we will look at research from a slightly different
angle. As the practice of medicine has changed, so too have the
ways of conducting research. The traditional approach in clinical
decision making is gradually being replaced by the principles of
evidence-based medicine or evidence-based practice. Reliance on
anecdotal experience, physiologic plausibility, and content
expertise is also being replaced by the acceptance of randomized
clinical trial as the objective standard used for making clinical
decisions.

>> Book Review: Getting Your Organization to Change
by Mike Taigman
"Please show me your hands if your EMS organization does annual
performance evaluations. How many of you with the word 'quality'
in your job title spend all your time doing chart reviews? How
many of you have tried to improve morale among your employees by
having an employee of the month award?"

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Management Matters
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>> For Operations: Is Your Staff Cavalier?
by John Becknell
The days of medics not protecting themselves from blood-borne
pathogens is over, right? Maybe not. If you were to observe your
EMTs and paramedics managing bloody trauma patients in the field,
would they be using full barrier protection and observing
universal precautions according to your protocols? You might be
surprised, as were the researchers in a recent observational
study who found that health care workers were "cavalier" in
protecting themselves and others from blood-borne diseases while
managing emergency trauma cases.

>> For Administrators: When Cutting Costs: Go For Small-ticket
Capital Expenses
by Lauren Simon Ostrow and John Becknell
Competition for EMS dollars has never been more intense. Add to
that an anticipated drop in Medicare reimbursement for ambulance
transport and you have a stressed-out EMS administrator looking
every which way to slash costs. With salaries being most EMS
organizations' single largest expense, it's logical to consider
cutting personnel. But business consultant Tom Copeland insists
that compelling evidence exists to prove that you can achieve far
more sustainable value by sensibly reducing small-ticket capital
expenditures.

More online!

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MERGINET.News Online!
Click here: http://www.MERGINET.com/index-news.htm

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education and fun to the all in EMS, Fire, Rescue and Emergency
Medicine. Updated daily.
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