The "Panel"

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There have been many good points made here--many with passion. A varied
panel will help. To be honest, part of the problem many have with the United
States air medical industry is one of arrogance--either real or
perceived--on the part of the industry. The HEMS operators know that the
states cannot regulate them (for our international colleagues, Lyndon
Johnson deregulated the airline industry decades ago and air ambulances,
which are considered nonscheduled air taxis by the FAA, fall under airline
regulations). Tennessee lost a law suit when they tried to enhance HEMS
standards. There is also an arrogance from many in the medical community who
support widespread HEMS--not all, but some. There is a continuing mantra of
"You don't understand the literature" or "That is not what the literature is
saying" or "You have a selection bias" or something to that effect. Medical
literature is what it is. The beauty of science is that studies can be
evaluated and, if needed, repeated. You do not have to have a secret decoder
ring to evaluate the medical literature on HEMS. Granted, the overall
quality of HEMS is literature is fairly low. But, like many things in EMS,
there has been a reversal of the burden of proof. That is, the HEMS system
has become widespread and entrenched and instead of proponents publishing
literature supporting their point, they say "prove it doesn't work."  Where
else in health care does that occur? Drs. Mattox, McSwain and others have
made a life's work of writing and reading the medical literature. Surely
their read (and the read of all educated men and women) should carry the
same weight. When other first world countries (e.g., Canada, Australia,
Germany, United Kingdom, et al) are doing something different than those of
us in the United States, it is time for pause and introspection.  Perhaps
"the panel" will be that introspection.

Bryan

Bryan Bledsoe, DO, FACEP
Clinical Professor of Emergency Medicine
University of Nevada School of Medicine
Department of Emergency Medicine
University Medical Center of Southern Nevada
Las Vegas, NV

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