Physician field response: a national survey

Area of Science:

• Emergency Medicine
• Public Health
• Medical Systems Analysis

Background:

• Physician field response (PFR) units represent a critical component of advanced emergency medical services (EMS).
• Assessing the current landscape of PFR units is essential for understanding their integration and effectiveness within U.S. EMS systems.

Purpose of the Study:

• To evaluate the availability, scope of practice, and training requirements of physician field response (PFR) units across emergency medical services (EMS) in the United States.
• To identify any existing trends or standardization in PFR unit operations.

Main Methods:

• A mail survey was distributed to physician medical directors of EMS systems in the 125 most populous U.S. cities.
• Follow-up mailings and phone calls were used to increase response rates, with surveys sent to multiple services within cities if applicable.

Main Results:

• 71% of surveyed cities reported no PFR capability; of the 29% with PFR, most utilized an on-call system rather than a dedicated unit.
• Reported scopes of practice included physician triage (94%) and blood administration (97%), with less common procedures like tube thoracostomy (40%).
• Training requirements were highly variable, with significant percentages of PFR teams lacking formal training in areas such as incident command systems (47%) and hazardous materials (41%).

Conclusions:

• There is substantial variability in the availability, training, and scope of practice for physician field response units nationwide.
• The study found no discernible standardization or clear trends in the implementation or operation of PFR units across U.S. EMS systems.