RE: Physician-Staffed Helicopters

["Andrew Berry" <Aberry@nets.org.au>]

Strange logic that you wouldn't do a study because you believe you know the outcome to be one you don't like and/or don't believe you can afford.

Without expressing a view about the efficacy of different team configurations, effectiveness (particularly cost-effectiveness) are surely the measures which need evaluation? 

We all know it's hard to mount an effective study in a climate when opinions are held so strongly. However, until that is done in the domestic USA (or a non-home ground study is accepted, we're going to see the bandwith sag from time to time with this hoary old subject.

In terms of affordability, most of the developed world outside of North America uses physician-based teams. ... and that in health systems which cost significantly less than the US model. My own country spends about half as much (% GDP) on health care as the USA and in most areas (incl. perinatal and paediatric critical care) achieves better outcomes.

>>>>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


Dr Andrew Berry ABerry@nets.org.au
State Director
NSW Emergency Transport Service 
www.nets.org.au

Hotline     +615 0055 NETS
Office       +615 005 CHILD
Facsimile  +615 008 CHILD
Direct       +615 005 BERRY


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