Observations of the Physician's Role in EMS

In Croatia, the model of emergency care is different than what we see in the US and in other western countries. Here, there is a physician on nearly every ambulance. When they go to a scene with the nurse ( no paramedics here), they determine if the patient can stay home or needs to go to the hospital. It is very common for them to treat the patient, with a shot or wound care, and then direct the patient to a clinic the next day. If they decide to take them to the hospital, they go to a large compound where there is no "catch-all" emergency department. There are small areas in the internal medicine clinic, surgery clinic, gyn clinic, and peds clinic that are set up to see these patients.
The clinics are staffed by nurses and physicians of various specialties that commit to managing the clinic emergency patients in between their in-hospital duties.

The reform of EMergency Patient care has mandated the establishment of Emergency Departments like we are familiar with in the US. THe one in Zadar will open in September and this is where all ambulance patients will go.

This has caused some concern, because they will then allow patients to self report to the ED/Hospital. The process to date is that the patients can only cone to the hospital if they are directed here by their clinic, or by an EMS physician who has seen them via the ambulance.

They are moving towards a system more like ours, with patients reporting to a centralized ED, and yet, with our experience, we see the value of their current system where patients are triaged and treated outside the ED for minor concerns.

We can learn a lot from each other.