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Rename: Emergency Physicians are not Paramedics


Guest BoxWulf

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10 minutes ago, BoxWulf said:

I never have any malice behind anything I say. Also, I didn’t say physicians never worked outside of the hospital. My ‘statement’ was that an ATTENDING or on-call emergency physicians do not leave the ER to respond to emergency calls outside of the hospital. I didn’t speak anything regarding fellowships, training, or education.

You’re saying that EPs are qualified to be on-site and respond to emergencies. Yes! So is a regular MD, or a paramedic, or a nurse....

It doesn’t detract from my point where I said “...I would like one example...” because I, still, have never heard of an emergency physician LEAVING the EMERGENCY ROOM, to respond to an outside call. 
 

Edit: Thinking more about your post, this isn’t really a counter-argument, it’s more an informative add-on. I genuinely didn’t know that some fellowships (apparently one in NY) actually require on-site first response. That’s impressive.)

Your point in regards to an emergency physician leaving their post in an emergency room can't really be applied to real-life, it's a uniquely fictitious idea which makes it perfect for a space station like the NSS Aurora. In real life, in the US, an EP never needs to leave the hospital because they always have a staff, and there are institutions in place to bring patients to them, instead of having them go to the patients. We don't have that luxury in SS13 because a player may not want to be a paramedic. 

EPs are the next logical choice in response when we don't have a paramedic,  as they're emergency medicine, the fixers, they stabilize for treatment. That won't change even if the EP is changed to Trauma Physician. I as a CMO will still send the Trauma Physicians to respond and pick up patients if I don't have a paramedic. They are the people best suited for it. It would not make sense for me to send a nurse, or a resident, or an intern, to respond to an acutely injured patient as they don't have the training or the experience that an EP has. 

Changing the EPs title to Trauma Physician just renames the EP to something that may be easily confused with a surgical specialty, or to something which may force the player to change the background of their character to abide by the new title. It doesn't do anything else. 

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Guest BoxWulf
1 minute ago, LordRaven001 said:

Changing the EPs title to Trauma Physician just renames the EP to something that may be easily confused with a surgical specialty, or to something which may force the player to change the background of their character to abide by the new title. It doesn't do anything else. 

I disagree and refuted that earlier, we’ll leave it for the devs and community members to decide. 

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8 minutes ago, BoxWulf said:

I disagree and refuted that earlier, we’ll leave it for the devs and community members to decide. 

Alright. You do you. I'm giving you fair warning now that even if this title change goes through and compounds the already thick layer of confusion that surrounds medical in regards to who does what, when, where, and why. I will still be sending "Trauma Physicians" out to respond and retrieve if I don't have a paramedic, as will the other CMOs who have already been doing so. Changing the title and giving it a fancy new labcoat will do nothing. If the Trauma Physician then wants to argue with my call as the supervising physician they better have a good reason to justify why they're refusing to carry out the task assigned to them otherwise there will be punitive action that takes place. 

It's one thing to be properly trained and refuse to respond, it's another to not be properly trained and refuse to respond. There will need to be a lore clarification either by @Mofo1995 or the lore dev responsible for educational qualifications to determine if an Emergency Physician on a space station would have the proper training to respond to calls, as they should because it wouldn't make sense for them to stick around in the ICU waiting for critical patients to walk themselves to medical because there isn't a paramedic. 

Edited by LordRaven001
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Guest BoxWulf
On 07/01/2020 at 13:14, BoxWulf said:

I’m not saying that if there’s a lack of paramedics no one should step up, but it shouldn’t be expected. 

This was literally my first post. 

You’ve been consistently trying to derail this suggestion with your supposed IRL knowledge that hasn’t done anything to confirm ANY of my previous points. You seem to be personally upset about this and I’m sorry about that, but if the community wants this to happen, it will happen. 
 

Too many times I’ve seen EPs be scrutinized and yelled at and called paramedics because of their coats and lack of response to emergency situations outside the ER when there ARE paramedics in the Medical Bay. If you don’t have anything constructive to say about the points that I have actually made, you are breaking the rules. 

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18 minutes ago, LordRaven001 said:

Alright. You do you. I'm giving you fair warning now that even if this title change goes through and compounds the already thick layer of confusion that surrounds medical in regards to who does what, when, where, and why. I will still be sending "Trauma Physicians" out to respond and retrieve if I don't have a paramedic, as will the other CMOs who have already been doing so. Changing the title and giving it a fancy new labcoat will do nothing. If the Trauma Physician then wants to argue with my call as the supervising physician they better have a good reason to justify why they're refusing to carry out the task assigned to them otherwise there will be punitive action that takes place.

Frankly, you're doing an exceptionally good job at just saying "Yeah, I'm a jackass". The cool thing about this being a video game is that we don't need to entirely abide to real life. Emergency Physicians, as a role, aren't Paramedics, and should not be the default role expected to act as one or be punished in the event that there are any missing, especially not when EVA response comes up, because EVA training isn't actually a requirement of every single job, believe it or not, especially not for roles that aren't explicitly first responders.

If they want to volunteer to take the place of a first responder if one is lacking, absolutely fantastic. But they should not be the ones forced to do so. If I wanted to play a first responder, I would play a first responder. If you force somebody into a role they don't want to do and didn't sign up for, and then punish them if they don't want to do it, you're a cunt, no ifs or buts about it.

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29 minutes ago, furrycactus said:

Frankly, you're doing an exceptionally good job at just saying "Yeah, I'm a jackass". The cool thing about this being a video game is that we don't need to entirely abide to real life. Emergency Physicians, as a role, aren't Paramedics, and should not be the default role expected to act as one or be punished in the event that there are any missing, especially not when EVA response comes up, because EVA training isn't actually a requirement of every single job, believe it or not, especially not for roles that aren't explicitly first responders.

If they want to volunteer to take the place of a first responder if one is lacking, absolutely fantastic. But they should not be the ones forced to do so. If I wanted to play a first responder, I would play a first responder. If you force somebody into a role they don't want to do and didn't sign up for, and then punish them if they don't want to do it, you're a cunt, no ifs or buts about it.

Goret has reminded everyone to remain civil, as a developer you're held to a higher standard than the rest of the community, insulting me in a public forum doesn't make me change my point, it emboldens my previous statement. To respond, I've already touched on your point and informed the right people, more specifically the Lore Master. I specifically said "It's one thing to be properly trained and refuse to respond, it's another to not be properly trained and refuse to respond. " in response to the same exact point that you brought up. You seem to have ignored that in favor of insults. If you continue to insult me I will take appropriate measures and inform the appropriate people, keep it civil. 

43 minutes ago, BoxWulf said:

This was literally my first post. 

You’ve been consistently trying to derail this suggestion with your supposed IRL knowledge that hasn’t done anything to confirm ANY of my previous points. You seem to be personally upset about this and I’m sorry about that, but if the community wants this to happen, it will happen. 
 

Too many times I’ve seen EPs be scrutinized and yelled at and called paramedics because of their coats and lack of response to emergency situations outside the ER when there ARE paramedics in the Medical Bay. If you don’t have anything constructive to say about the points that I have actually made, you are breaking the rules. 

It doesn't matter what anyone else thinks besides your superior, people yell at Medical for the stupidest of reasons. I've been told as a CMO who was the only member of Medical and Command during an autotraitor round from hell which was responded to by merc ERT that I quote "fucking suck" at my job. Consistently.

You keep bringing up the point that there are a couple of CMOs who chastised the EPs for not responding to emergency calls. A couple of ways to deal with this are as follows. The first one can be you say you're not properly trained to respond to calls and therefore someone else will have to bring them in, any reasonable CMO will understand, if they continue to harass you afterwards that is an issue for an IR. Another response would be that someone is dead, you do not need to respond to collect dead people, they will find their way back to you, that is not an emergency. If the CMO still continues to harass you, file an IR, if they suspend you without justification, file a character complaint or ahelp. 

Changing the job title will not resolve those issues, all it does is change the fluff and the lore around that job. It's not a good idea to hastily and without due contemplation change job titles. They're the thing which gives your character meaning. A Captain wouldn't be a Captain if Captain didn't exist. The same thing can be said for EPs. An EP renamed to a Trauma Physician implies that they have a different set of skills, and if they're the same set of skills why is there a differentiation? 

An alternative title that can be used instead of "Trauma Physician" is Intensivist or Critical Care Physician. An Intensivist (or CCP) is a Physician who primarily handles patients in an ICU. Their entire job revolves around the ICU, that is what I am understanding you want to happen. To make it so ER docs are primarily ICU. I have no issue with that, in fact I encourage it. What I do have an issue with is the title "Trauma Physician." 

Intensivist description: https://en.wikipedia.org/wiki/Intensivist

CCP/Intensivist description: https://www.umassmemorialhealthcare.org/umass-memorial-medical-center/services-treatments/critical-care/what-intensivist 

Edited by LordRaven001
grammar and spelling fixes.
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Guest Marlon Phoenix

Raven why are you specifically threatening to send out TRauma physicians in a specific retaliation to the suggestion? Please remain civil and do not do that.

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Guest Marlon Phoenix

What is being said.

Is that EPs are considered to be high ranking paramedics.

This is irrational. Yes, you can send out an EP as a responder. No one denied this 

You can also send out any MD or surgeon or nurse.

The argument is EPs are the same as MD or nurse in terms of first response.

This should not be the case.

As the person who organized the medical roles as they are now EPs are meant to be med-lite.

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Well to put it bluntly, you got it wrong.  MDs in game are most probably Internal Medicine specialists meaning they are just generalists (Hospitalists in proper terms), jack of all trades. EPs are doctors specifically trained to handle Medical Emergencies, the exact same as a Paramedic is, the difference is the setting in which they operate, Prehospital/hospital. EPs run the emergency departmemt, not the ICU, the ICU is handled by intensivists.

Edited by JMJ_99
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17 minutes ago, Marlon Phoenix said:

What is being said.

Is that EPs are considered to be high ranking paramedics.

This is irrational. Yes, you can send out an EP as a responder. No one denied this 

You can also send out any MD or surgeon or nurse.

The argument is EPs are the same as MD or nurse in terms of first response.

This should not be the case.

As the person who organized the medical roles as they are now EPs are meant to be med-lite.

Then as the person who organized the medical roles you should see that is incorrect. Emergency Physicians are literally "high ranking paramedics." During my associates I learned about a quarter of what Emergency Medicine Physicians know. We both practice emergency medicine, there is no special branch of emergency medicine for Physicians. I am trained to intubate, I am trained to put in IVs, I'm trained to calculate pediatric and beriatric dosages, I'm trained to administer highly potent chemicals.  Hell, even though it's not legal in my state for me to preform without the go ahead from my Medical Director I'm trained in emergency cricothyrotomy. Every single Paramedic agency in the United States is run by an emergency medical physician, who are emergency medicine physicians. Every single one. They're called Medical Directors. However, that is not the topic of this project. The topic of this project is to determine a sufficient name to bestow upon Emergency Physicians to prevent confusion and outline responsibilities. 

Trauma Physician implies that they're just an ER Physician renamed, there is no backstory, there is no qualifications for Trauma Physicians, there is nothing for a player to base their character off of using the title of Trauma Physician. That is the only issue I have with this suggestion.

Changing "Trauma Physician" to Intensivist or Critical Care Physician means they're not expected to respond, they don't have any training in pre-hospital care. It aligns them with the other generalists and internists that we currently staff (Surgeon, Medical Doctor, Nurse). It allows the player to tell the CMO directly. "My job is a Critical Care Physician/Intensivist, I am not trained in pre-hospital care, I am not trained to respond to emergencies, what I am trained to do is take care of patients who are critically injured WITHIN the bounds of the bay." Trauma Physician does not convey that, it conveys the opposite. 

Again, to reiterate, I have no problem with ER physicians staying in the Medical Bay, renaming the title so they're more aligned to hospital care is actually something I support. What I do have a problem with is calling them Trauma Physicians, again for the reasons listed above. 

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It would have been very easy to suggest alternate titles with reasoning much earlier in this thread. Several back and forths could have been avoided. 

It was pretty clear that the intent of the suggestion was to keep the role from being the automatic next-choice as responders, not to shoehorn "Trauma Physician" in. While the job title IS mentioned as a suggestion in the OP, the title of the thread and crux of the OP is to rename EPs in a way that 1) stops them being confused with responders and 2) prevents making them the automatic next step for responder. If Intensivist or CCP is more fitting, it's easy enough to change the title to that. I've no personal opposition to either change, even though I'm fine with Trauma Physician as well. 

Quote

Hello!

We have a problem in Medical with the Emergency Physicians being identified as emergency responders. Too many times I’ve seen regular doctors and even CMOs expecting EPs to go out into space to fetch miners when it’s really not in their title. 
 

I’m not saying that if there’s a lack of paramedics no one should step up, but it shouldn’t be expected. 
 

My suggestion is simple: Rename the title to Trauma Physician, signifying their role to maintain the GTR to handle severe patients being admitted. Also, if possible, rename or change the color, or BOTH, of their jacket. People see paramedic jacket and automatically assume “paramedic” which really isn’t their fault.

While arguing back and forth that "yes EPs are responders" or "no they aren't" or whatever may be satisfying to parties with IRL experience present on both sides, let's not lose sight of the goal of the suggestion: In our RP server, we wish to keep the physician in the GTR instead of being the automatic choice as responder, or being confused for a responder. 

This thread absolutely does not to be as long as it is right now. 

Edited by Doxxmedearly
typo
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An alternative title that can be used instead of "Trauma Physician" is Intensivist or Critical Care Physician. An Intensivist (or CCP) is a Physician who primarily handles patients in an ICU. Their entire job revolves around the ICU, that is what I am understanding you want to happen. To make it so ER docs are primarily ICU. I have no issue with that, in fact I encourage it. What I do have an issue with is the title "Trauma Physician." 

This seems like a reasonable suggestion. Again, we can just.... make more titles. Have a CCP, have an EP, have a TP. Why not? there's really no reason for this whole strange back-and-forth we're having here.
Edit: To focus on the topic more. I can see Trauma Physician working, but I think CCP would be very fitting as well, and it also has a real life equivalent to which we can compare it to. As was pointed out much earlier in the thread, trauma physician isn't something that exists in real life. This fact is negligible, yes, but just something to consider. I'm fine either way, I just hope the change happens.

Edited by BoryaTheSlayer
Clarification
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Guest Marlon Phoenix
54 minutes ago, LordRaven001 said:

Then as the person who organized the medical roles you should see that is incorrect. Emergency Physicians are literally "high ranking paramedics."

No they're not. The only qualifications that matter are Biesel and Nanotrasen. Your region is a foreign country with different standards.

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It doesn't magically change, it's virtually the same everywhere. Medicine is a conformist field and it's that way for a reason

I'm done arguing about it, Borya is right it should be Alt titles and it should be changed to a lab coat.

Edited by JMJ_99
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Guest Marlon Phoenix

No it isnt. Asking whether or not EMTs are trained to use syringes started a flame war between four members of staff when i hammered out the medbay reform because they were in different western countries.

Its super complicated.

So irl policies are an informer, not gospel,  when it comes to informing gameplay decisions.

Edited by Marlon Phoenix
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Guest Marlon Phoenix
13 minutes ago, JMJ_99 said:

Parameds, EMT and EPs all train in emergency med, they all more or less know first response.

Never said they couldn't.  Please do not misrepresent my arguments. 

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