Patching to a BHP While Working for a Private Company
Question# 830
I'm employed as a PCP within the RPPEO. I work a second job with a private event EMS company with the full scope of practice of a PCP. We have a medical director, but he is not readily available by phone.
If I was working a shift at this private company, would I be allowed to call a base hospital physician for a consult?
If I was working a shift at this private company, would I be allowed to call a base hospital physician for a consult?
Answer:
Thank you for your MedicASK regarding patching to a BHP while working for a private company. You bring up a very interesting question, and one that is complex and can be open to interpretation when looking at all of the different regulations, legislations, and standards for paramedics in Ontario.
In short, the answer to your question is unfortunately no, you cannot currently patch to a BHP while working for a private company. A paramedic by definition set out in the Ambulance Act is, "A person employed by or a volunteer in an ambulance service who meets the qualifications for an emergency medical attendant as set out in the regulations, and who is authorized to perform one or more controlled medical acts under the authority of a base hospital medical director, but does not include a physician, nurse or other health care provider who attends on a call for an ambulance." Meaning, when you are working for your paramedic service within Eastern Ontario under the purview of the RPPEO, the service is under our performance agreement for municipalities with the Ministry of Health. Therefore, our funding is for the exclusive use of the base hospital's activities (including Online Medical Consult), ultimately excluding private corporations.
The interpretation is that if a paramedic is working as a “paramedic” (defined term above from the Ambulance Act), which is loosely understood to be as a first responder in a call for service – generally understood to be a 911 call or interfacility transfer, the “Base Hospital”, a defined term in the Ambulance Act, has the sole authority and oversight of that paramedic, while operating in the capacity under the Act. This is why for example, you can be delegated by your other medical director when working for your private company, as you are not operating under the provisions of the Ambulance Act.
To put it into simple terms, you must patch to your private company's Medical Director while working for them as you are not a deemed a paramedic if you are not working for your paramedic service and being paid by them.
In summary, if a paramedic is employed by a land ambulance service and is responding to a call for service under the regulations of the Ambulance Act, the regional base hospital has complete oversight of the care provided and delegation of controlled acts in Ontario.
As you can see, it is a convoluted web of medicolegal language! We hope this helps. Please reach out should you have any further questions.
In short, the answer to your question is unfortunately no, you cannot currently patch to a BHP while working for a private company. A paramedic by definition set out in the Ambulance Act is, "A person employed by or a volunteer in an ambulance service who meets the qualifications for an emergency medical attendant as set out in the regulations, and who is authorized to perform one or more controlled medical acts under the authority of a base hospital medical director, but does not include a physician, nurse or other health care provider who attends on a call for an ambulance." Meaning, when you are working for your paramedic service within Eastern Ontario under the purview of the RPPEO, the service is under our performance agreement for municipalities with the Ministry of Health. Therefore, our funding is for the exclusive use of the base hospital's activities (including Online Medical Consult), ultimately excluding private corporations.
The interpretation is that if a paramedic is working as a “paramedic” (defined term above from the Ambulance Act), which is loosely understood to be as a first responder in a call for service – generally understood to be a 911 call or interfacility transfer, the “Base Hospital”, a defined term in the Ambulance Act, has the sole authority and oversight of that paramedic, while operating in the capacity under the Act. This is why for example, you can be delegated by your other medical director when working for your private company, as you are not operating under the provisions of the Ambulance Act.
To put it into simple terms, you must patch to your private company's Medical Director while working for them as you are not a deemed a paramedic if you are not working for your paramedic service and being paid by them.
In summary, if a paramedic is employed by a land ambulance service and is responding to a call for service under the regulations of the Ambulance Act, the regional base hospital has complete oversight of the care provided and delegation of controlled acts in Ontario.
As you can see, it is a convoluted web of medicolegal language! We hope this helps. Please reach out should you have any further questions.
References
Ambulance Act
Patching - ALS PCS