County looking to change EMS leadership

Published 8:15 pm Tuesday, January 15, 2013

Polk County Commissioners said little at their Jan. 7 meeting as to why they felt it necessary to make a change in the leadership of the county’s emergency medical services other than “the county’s been suffering for eight to 10 years.”

Commissioner chair Michael Gage clarified that statement this week.

“What I said the other night – I shouldn’t have said it the way I said it,” Gage said. “The medical director doesn’t get paid a lot of money for the responsibility they take on. Dr. [Allison] Owens has done the best she can – I’m sure she has.”

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However, Gage said commissioners voted 4-1 to seek a new medical director because of an “evolving situation in which no one trusts each other,” within the Emergency Medical System (EMS).

Dr. Owens came on board at St. Luke’s Hospital as an emergency room physician in 1990. She took on the role of county medical director in 2000. She also currently serves as the hospital’s Emergency Room (ER) medical director.

“I am responsible for medical direction every minute of every hour of every day for this county,” said Dr. Owens, “which means I accept liability and responsibility of every medical action in this county every day. I put my family and my career on the line.”

All EMTs responding to medical calls within the county work under the medical director’s medical license.

For serving in this position, Owens receives a $4,000 a year stipend from the county. St. Luke’s Hospital’s property lease with the county also requires the hospital to pay an additional $4,000 a year for the position. St. Luke’s Hospital’s CEO Ken Shull said the hospital chose to increase their contribution to $8,000 several years ago in an attempt to better compensate for the responsibility the position carries. They raised the salary to a total of $12,000 a year.

“Prior to that the hospital felt it was not a reasonable compensation for what the expectations were,” Shull said. “It is not a lot of money for the duties that person performs.”

Dr. Owens said in 2002 she and EMS director Sandra Halford restructured the county’s manual related to the county medical director’s job description; a plan which was approved by the state in 2002. Owens said the description has been revised as needed based on state requirements and the county’s developing needs.

Owens said there are four main parts to the job:

1. Affirm the scope of practice at all levels of emergency services.

This means setting standards for the scope of care a volunteer first responder or Emergency Medical Technician (EMT) is able to provide based on that individual’s training. Owens said within the direction of the state office of EMS the medical director of a county cannot extend that level of practice, but can limit it.

Owens said Polk County was one of the first counties in western North Carolina to give EMTs the ability to carry EPI pens for allergic reactions, administer Albuteral and secure airways for patients in need.

2. Oversee educational content and scope, as well as quality, for all providers within the system.

3. To assure competence of all emergency response practitioners through ongoing evaluations.

4. To provide direction for online medical assistance for those in the field.

In other words, the medical director must be available at all times so an EMS provider out in the field could call in and talk to a doctor for advice on how to handle certain medical situations or what protocol to perform.

Dr. Owens said she acknowledges that she has not always been favored within the system, especially not when putting into place new training requirements.

“I think there have been times when relationships with the volunteer agencies have been strained,” Owens said, “but from my perspective we have made a lot of gains in EMS services provided in the county over the last few years and I’m very proud of those accomplishments.”

She said the system has in the last decade developed transport protocols, distributed new defibrillators throughout the county; added ambulance transport capabilities to Saluda and Green Creek so patients there don’t have to wait for an ambulance to come from another part of the county; created a medical response system in Tryon where before there was fire and police, but no medical responders; added paid staff to respond to medical calls in Columbus, Saluda and Tryon; created quarterly quality management meetings in which the various volunteer agencies can discuss issues within the system; expanded the response abilities of EMTs; changed the scope of practice exams within the county to be more clinically-based, which meant asking responders to show what protocol they would administer in a variety of medical scenarios; and have required that a written record be submitted of every patient encounter by a first responder to protect the system in the event of a lawsuit.

Another big change for the county’s EMS system also came in 2002.