Why can't the US paramedics treat patients with a 100% indepence as they do south africa.?

Question

Calling medical control is a waste of time and communication errors can occur to the detriment of the patient.

Answer 1

in the US there are different level of Medics or EMT (emergency medical technician), there is EMT-Basic, EMT-Intermediate and EMT-Paramedic. A basic is just that, Basic used to assist and usually drive the ambulance. An Intermediate is usefull for the less severe emergencies and to help with the overall work load but they still need medical direction depending on the scenario and local guidelines. A paramedic is a licensed individual who does not need medical control and does work more freely. They are the true backbone of emergency medicine. but there are not nearly enough of them so often an Intermediate will respond to most of your run of the mill emergencies

Answer 2

In the US (and elsewhere), the medical union is a strong lobby and is reluctant to let people who are not vested members have any authority. It is nearly a priesthood.

Let's face it, a LOT of the problems the average person runs into can be handled nicely by someone with a moderate amount of training and a decent first-aid room. Some 80% of a doctor's caseload is the same basic stuff over and over that a competant nurse or medic could easily deal with.

So why don't they? Part is liability. in the liability-happy US, we want to blame everyone for everything, so other people want to cover their butts perfectly. This means that doctors want tests and absolute control over cases. It also means that the average insurance company is unlikely to cover some guy trying to open a 'minor medical' operation on his own without a degree- even if it were legal to do so.

Another part of the problem is the AMA figuring that it knows what we want and need more than we do. If you do not subscribe to their vision of what medicine is you do not get to play.

I SHOULD be able to open a shop and treat things that I can treat, and send the other people to a better trained person if needed.

I SHOULD be able, as a consumer, to be able to choose if I want to go to my doctor, the ER, or Joe's First-Aid hut, and be willing to live with the consequences of my choice.

In the series '30 Days', the star was trying to live at the poverty level for 30 days and hurt his wrist. It cost him over $500 for a ER visit and a $6 Ace bandage. In a free market economy, he should have been able to see anyone he wanted and gotten the total service for a much more reasonable price. Heck, I'm getting my entire bathroom remodeled for $5,000- why should a simple wrist injury cost 1/10th of that?

Answer 3

For one, I don't want the responsibility. I like to have command to consult. Also a lot of paramedics can't be trusted to be independent. Another reason is liability. If you do what command tells you to do, and do it correctly, then its the doctor's *** on the line, and yours a little bit, but not as much.

Doctors are more qualified to make certian decisions...they did go to school for 8 or more years, while us medics took a year long course.

Answer 4

ok. i don't know what part of the US you are taking about but on long island ny most of the fire departments ( which is also for the medical parts) are volunteer. they have to become at least a basic EMT but some choose to be come a paramedic. if your taking about the responce time you need to remember a few things:
1. if you call 911 the 911 dispatcher takes your call then trafers you to fire resuce ( at least they do on long island) then they call your loctcal fire dept. then the dispatches the EMTs
2. on long island where there is mainly just volunteer depts. not all the mmbers only a few are at the fire house at one thime so they need to get to the fire house and leave to go on the call

Answer 5

NOT familiar with South African emergency medicine, so please take these as strictly seat-of-the-pants OPINIONS.
1. Between good telecommunication links, ready availability of medevac copters, and quite a lot of hospitals, it may not be necessary to give US paramedics that much infield autonomy. (Don't know how long it takes to get victims in isolated areas of SA to medical care.)
2. In the US, we appear to have a quite a large number of ambulance-chasing shysters, whoops, excuse me, attorneys who seek only justice for the wronged victims of nasty evil malpracticing health care providers. These modern Paladins who work on percentages (and only if you win!---but of course, read the fine print.....) are not averse to filing nuisance-type malpractice/negligence suits. Insurers may find it cheaper to settle for a small amount of money---say $10,000 US---than to fight in court, even though the lawsuit is outrageous and frivolous. (This is why I carry my own nursing malpractice insurance---so there's a chance to order my own attorney to fight an action, rather than submit.)
3. The US is not one "bundle"---it's 50 states, plus the District of Columbia. The authority of paramedics and EMTs varies all over the place, depending upon what's been delegated to them by practice acts.