RE: Physician-Staffed Helicopters

["Paul M. Wright, Jr." <pmwright@home.com>]

>>That would be myself, 
>>as an RN making a diagnoses based on "my field experience". I would love to 
>>be that patients lawyer.

 

I have to kind of chuckle whenever I read that kind of statement because it usually means all the really good arguments have been used up.  The legal reality is that lawsuits are based on bad outcomes and the liability generally falls to those shown to have acted unreasonably with regards to the standard of care.  In my experience, credibility weighs much more heavily than credentials in those cases but regardless, patient care should be rendered for best possible outcome and not because of a hypothetical future lawsuit. 

 

In the real world, flight nurses can and do make changes in the care plan that are often somewhat at odds with the direction established by the referring physician.   When those changes are made within an accepted system of medical control, the liability is not significantly different than when a physician is present as a member of the flight team.  Your statement implies otherwise, but I doubt you can back it up with either case law or anecdote that demonstrates the difference.

 

>>As far as the Australian study, you are right, there has been no study in
>>North America or Canada (and I am not sure why?...anybody know?)

 

I can venture a guess that it's because there is severe competition for resources to study things that matter and this particular issue doesn't.  If a program can support the cost of physician staffing and if there is determined to be a marketable competitive edge to it, the clinical efficacy doesn't matter - you either accept it or you don't and a study is not going to sway anyone's opinion.  Looking at it from the perspective of a program that offers physician staffing and uses it as a differentiator in the market, do you really want to commit resources to a study that will, in all likelihood, fail to convince anyone of the value of what you're doing unless they are already a true believer?

 

On the other hand, for the vast majority of air medical programs for which the cost or logistics would be prohibitive, it really doesn't make sense to commit to study something you can't afford anyway.

 

regards!

 

paul

 

 

Paul M. Wright, Jr.

Mesa, AZ