EMS Fellows in the Field
This issue sees the debut of Doctor's Note. This bimonthly column will feature contributions from EMS medical directors from around the country who will discuss EMS operations and the role of medical direction. This issue, Jullette Saussy, MD, medical director for New Orleans EMS, discusses the EMS Fellowship program she is involved in.
As a paramedic for New Orleans EMS in the late 1980s, I hung on our medical director's every word. I would search out the emergency medicine doctors at the famous Charity Hospital to pick their brains, learn more about the patient I had just brought in, and stick my head in on any interesting case being seen at one of the largest teaching hospitals in the United States. New Orleans, known for its food, festivities and mass gatherings, was, and is, an unbeatable training ground for medical professionals. The paucity of primary care, general poor health of our population and preponderance of violence make this a utopia for learning to care for the critically ill and injured.
What better place for residency-trained emergency medicine graduates to sub-specialize in the area of running a high-volume urban EMS service? The City of New Orleans EMS Fellowship program offers extraordinary field training with a heavy dose of administration.
Drs. Chris Najberg and Matt LeBoeuf, recent graduates of LSU Emergency Medicine and our inaugural Fellows, are off to a running start. Funded by the city of New Orleans, they attend budget preparation meetings; homeland security planning meetings at the local, state and federal levels (including all-hazards disaster planning); city council presentations and mayoral meetings; contract negotiations; handle personnel issues and product evaluations; oversee continuous quality improvement projects; and attend disciplinary meetings as just a few of their daily duties. Both Fellows assist me in day-to-day activities and attend many of the meetings required of the EMS director, meanwhile ensuring that our medical protocols are adhered to closely.
Mass event medicine is a large part of the planning in New Orleans. New Year's Eve, Mardi Gras and the Sugar Bowl are just a few of the events for which we provide EMS coverage for thousands of citizens and visitors who grace our unique city. The Fellows respond to 9-1-1 calls for service in an ALS response vehicle, and are credited with performing the first prehospital RSI in New Orleans. They are trained in vehicle extrication and actively participate in our USAR team. Both the doctors and I proudly wear a New Orleans EMS uniform every day as we perform our duties as public servants. Our medics are not surprised to have a physician on scene providing guidance and a deeper understanding of the disease processes that afflict their patients.
The Fellows also provide on- and off-line medical control and give monthly lectures and pointers at staff meetings. Our EMS system provides emergency medicine resident education in the form of lectures, prehospital trauma meetings, journal clubs and a monthly rotation, which the Fellows actively oversee. For those residents who will be future Fellows, electives are available with our EMS system.
The success of this program has been overwhelming. Lauded by the medics, the public and city administration, New Orleans EMS looks forward to expanding this opportunity for postgraduate work. I have always felt strongly that the operational, administrative, political and medical sides of EMS should be brought together into one training opportunity. Becoming a medical director is but one facet of the various areas of expertise that comprise an EMS director. As EMS grows, so must the way we look at and advance it. For years, we have been embedded in fire services, health departments and private for-profit enterprise. It's time to recognize EMS as one of the three public safety agencies. Our mission, like our police and fire department brethren, has a theme of public safety, but the way we complete our charge is fundamentally very different. The public deserves professionals whose focus is to provide the best prehospital emergency care. New Orleans EMS is doing this, and the added expertise of our EMS Fellows has enhanced our service many times over.
I challenge my colleagues nationwide to continue to grow EMS into the specialty it truly has become. It is up to us to collectively steer our course as we grow and evolve as a profession. EMS Fellows are a superb way of doing this and creating the leaders of the future.
Jullette Saussy, MD, is a board-certified emergency medicine physician and an assistant clinical professor of medicine in the Section of Emergency Medicine at LSU Health Sciences Center School of Medicine. She is director and medical director for New Orleans EMS and medical director for the New Orleans Fire Department. For more information regarding the New Orleans EMS fellowship, e-mail jmsaussy@cityofno.com.
