Medical control in EMS is often a feared aspect. Especially when you are first starting out and do not yet have the confidence to talk to the physician without being intimidated.

The intimidation is often just a perception and not actually what the doc is trying to do. Most of the time online medical control physicians are not dedicated to the phone line awaiting your call for orders or a patient report. They are usually emergency room doctors that are handling many responsibilities, medical control being one of them.

So, how do we get over the intimidation or apprehension of calling medical control? The easy answer is of course practice. An even better answer though is for you to know your regions protocols both standing and medical control options. Believe it or not, some medical control docs will not know all the medical control options or may even have a cheat sheet in front of them so they know what you are able to do in the field. By you having a firm grasp of the operating procedures and protocols, you can feel more comfortable and be able to converse with the doctor who has a lot more on his or her plate than your phone call.

Knowing what you want and why you want it will shorten your time on the phone with the physician. It will also give the physician a sense that you are a competent provider and not have him or her trying to read into your patient presentation each time you call. By knowing what you are responsible for and being able to present a good report will slowly build a report with the medical control physicians in your area, allowing them to trust your requests for advanced orders and allow you to provide better and faster patient care.

As a side note, having your own cheat sheet, pocket cards or field guide handy when calling will help you when first starting out and even later on down the line when faced with a note so common protocol option. It's not cheating or being lazy to have these tools. Because that is what they are "tools". You still need to be able to present a well designed patient report verbally and to do this you need to know your regions procedures. This will also help when writing your patient call report and when giving your verbal report to the nurses and doctors at the receiving facility. You sure don’t want to be reading out of a field guide or pocket card in front of everyone. That certainly will not build any trust and just imagine what the patient thinks.

Many EMS providers feel that medical is there for paramedics only, or for medical refusal situations. Most EMS medical control is also present as a resource for you in the field. Whether you are BLS or ALS, medical control can be used for many situations other than requesting advanced orders. Items such as transport decisions, care refusal and unusual treatment situations (i.e. DNR, Hospice, minors and even interagency discrepancies). Additional considerations of calling medical control can be for treating patients under standing orders. Perhaps a patient is not presenting in a way that falls in to any one treatment modality or you are hesitant to treat under standing orders due to patient history or current presentation.

By contacting medical control in the above instances you can have another resource to bounce your concerns off of. It does not necessarily make you incompetent or a poor provider. It does show that you are thinking about the bigger picture and not acting like a "cookbook medic" and just blindly following written procedures.

When operating in the field of EMS, you must remember that medical control is an important part of the process. It is not put in place to intimidate you or hinder you as an EMS provider. With practice, correct knowledge and even by using a few tips mentioned above you can quickly become very comfortable utilizing this resource. It is just another of the many tools in your arsenal as an EMS provider.


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Jim Hoffman is the owner of EMS Solutions.
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