southeastern institute of research 1 oems virginia emergency physicians omd study (co-sponsored with...

Southeastern Institute of Research1

OEMSVirginia Emergency Physicians

OMD Study

(Co-Sponsored with the Virginia College of Emergency Physicians)

November 18, 2005

Prepared By

2 Southeastern Institute of Research

2005 OEMS

Virginia Emergency Physicians

Survey

Table of Contents• Objectives and Methodology

• Profile of Current and Former OMDs

• Initial Motivation with Volunteer OMD Service

• Challenges to Volunteer OMD Service

• Overall Satisfaction with OMD Service

• Awareness & Perceptions of an OMD Shortfall

• What it Will Take to Convince Physicians there is an OMD Shortfall

• Potential Solutions for OMD Shortfall

• 7 Key Take-A-Ways


2005 OEMS


Survey

Objectivesand

Methodology


2005 OEMS


Survey

Study Objectives

• Explore issues related to physician’s roles and responsibilities within the state’s Emergency Medical Services (EMS) system.

• Investigate the Operational Medical Director (OMD) short-fall and how to encourage more emergency physicians to become OMDs.

• Part of longer survey which also investigated VACEP membership issues.


2005 OEMS


Survey

Methodology

• Study was conducted Sept. 20 - Oct. 19, 2005

• 1,208 survey links were sent out to emergency physicians across Virginia– 888 were emailed– 320 were sent in the regular mail

• 261 physicians completed the survey• No incentives were offered• Response rate for the study is 22%• Study results contain a margin of

error of +/- 5.4% at the 95% confidence level


2005 OEMS


Survey

Profile of Current and Former OMDs


2005 OEMS


Survey

4 Out of 10 of All Respondents (43%)Have OMD Experience

Q13: Are you now or have you ever been an Operational Medical Director, generally referred to as an OMD?

Yes, current OMD27%

No, never been OMD

57%Yes, former

OMD16%

“An OMD is a physician currently licensed to practice

medicine in the Commonwealth, who

is formally recognized by OEMS and responsible for providing medical

direction, oversight, and quality

improvement to a licensed EMS agency,

such as volunteer, career, commercial,

or government rescue squad(s).”

261 total respondents

x 43% of all

respondents as

OMDs = 112.23

Respondents

This translates

into roughly a

+/- 9% margin of error


2005 OEMS


Survey

Most OMD Respondents Are Serving Rural Areas

Q17 (Current) & Q42 (Former): What kind of area do/did you primarily cover in your OMD role?

27%

32%

41%

24%

24%

51%

0% 20% 40% 60% 80% 100%

Metropolitan/Urban

Suburban

Rural

Current OMD

Former OMD


2005 OEMS


Survey

Most OMDs Are Part-Time Volunteers

Q22(Current) & Q47(Former): Which of the following best describes your [current] OMD position? Q23(Current) & Q48(Former): Is/was your [current] OMD position full or part-time?

2%

7%

90%

83%

17%

20%

13%

67%

77%

23%

0% 20% 40% 60% 80% 100%

Both

Paid

Volunteer

Part-time

Full-time

Current OMD

Former OMD


2005 OEMS


Survey

Over a Third of Current OMDs Have Been Serving as an OMD for Over 10

Years

Q14(Current) & Q39(Former): How long have you been serving/did you serve as an OMD?

7%

5%

12%

32%

39%

5%

21%

16%

23%

21%

14%

4%

0% 20% 40% 60% 80% 100%

Over 15 years

11-15 years

6-10 years

3-5 years

1-2 years

Less than 1 year

Current OMD

Former OMD

Former OMDs

Generally Stopped

their Service

After 5 or Less

Years…

76% served 5 years or

less


2005 OEMS


Survey

Three-Quarters of OMDs Spend at Least 15 Hours a Month on OMD

Duties

Q18(Current OMDs) & Q43(Former OMDs): How many hours per month do you currently spend on OMD duties (or when you stopped serving as an OMD)?

32%

29%

22%

5%

2%

10%

26%

26%

24%

7%

9%

9%

0% 20% 40% 60% 80% 100%

Over 24 hours

20-24 hours

15-19 hours

10-14 hours

5-9 hours

Less than 5 hours

Current OMD

Former OMD

Paid OMDs reported spending

much more time on their OMD duties

than did volunteers (however, due to the

small sample size, this was

not statistically significant and should

just be viewed as a

trend).


2005 OEMS


Survey

Time is Divided Between Meetings, Teaching, Paperwork, and Personnel

IssuesTime On Paperwork May Be Increasing

Q19(Current OMDs) & Q44(Former OMDs): What percentage of this time do (did) you spend on each of the following in your role as OMD?

16%

21%

32%

32%

17%

30%

26%

27%

0% 20% 40% 60% 80% 100%

Personnel issues

Paperwork

Teaching/training

Meetings

Current OMD

Former OMD


2005 OEMS


Survey

Almost Two-thirds (60%) of Current OMDs Serve 2 Agencies, While Two-Thirds (66%) of

Former OMDs Served One Agency

Q15: How many agencies do you serve as an OMD today? [CURRENT OMDs]Q40: How many agencies were you serving as an OMD when you stopped? [ASKED OF FORMER OMDs]

0%

0%

0%

0%

5%

0%

2%

10%

17%

66%

7%

0%

1%

6%

4%

7%

3%

11%

16%

44%

0% 20% 40% 60% 80% 100%

10 or more

9

8

7

6

5

4

3

2

1

Current OMD

Former OMD

71% current OMDs serve 1-3 agencies

Research Note:

Directional finding

suggesting this conclusion


2005 OEMS


Survey

Number of Agencies Served Increased Over the Course of Respondents’

OMD ServiceCurrent OMDs

6%

1%

1%

3%

0%

7%

0%

4%

11%

66%

7%

0%

1%

6%

4%

7%

3%

11%

16%

44%

0% 20% 40% 60% 80% 100%

10 or more

9

8

7

6

5

4

3

2

1

Now

Started

Q16(Current OMDs) & Q41(Former OMDs): Thinking back to when you first started your OMD service, how many agencies did you serve when you first became an OMD?

Former OMDs

0%

0%

2%

0%

5%

0%

0%

12%

5%

76%

0%

0%

0%

0%

5%

0%

2%

10%

17%

66%

0% 20% 40% 60% 80% 100%

10 or more

9

8

7

6

5

4

3

2

1

Stopped

Started

The average current OMD

had 2.4 agencies

when he/she started

service and now has 3.1

agencies.


2005 OEMS


Survey

Time Spent Per Month Also Increased Over the Course of Respondents’

OMD ServiceCurrent OMDs

4%

7%

11%

21%

23%

33%

26%

26%

24%

7%

9%

9%

0% 20% 40% 60% 80% 100%

Over 24hours

20-24hours

15-19hours

10-14hours

5-9 hours

Less than5 hours

Now

Started

Former OMDs

5%

0%

13%

28%

28%

28%

32%

29%

22%

5%

2%

10%

0% 20% 40% 60% 80% 100%

Over 24hours

20-24hours

15-19hours

10-14hours

5-9 hours

Less than5 hours

Stopped

Started

Q18(Current OMDs) & Q43(Former OMDs): How many hours per month do you currently spend on OMD duties (or when you stopped serving as an OMD)?

The break-down of how these hours are spent does not

differ between when OMDs started and

the present/when they stopped.


2005 OEMS


Survey

Initial Motivation

With Volunteer

OMD Service


2005 OEMS


Survey

Most OMDs Were First Introduced to “OMD

Service” When they Were Approached by an Agency that Needed Help

Q24(Current OMDs) & Q49(Fomer OMDs): What event first introduced you to OMD service?

12%

7%

37%

44%

4%

16%

26%

54%

0% 20% 40% 60%

Other

Volunteered on own

Requested by people inpractice

Approached by agency

Current OMD

Former OMD

NOTE: The differences between

current and former OMDs do not reach

statistical significance.


2005 OEMS


Survey

Wanting to Support the Community Was the

#1 Motivation for Serving as an OMD; Former OMDs Were More Likely to Say that It Was Part of

Their Job Responsibility Than Current OMDs

Q25(Current OMDs) & Q50(Former OMDs): What motivated you to serve as an OMD? [QUESTION NOT ASKED OF THOSE WHO SAID THEY WERE REQUESTED BY PEOPLE IN THEIR PRACTICE]

8%

4%

28%

28%

48%

60%

72%

52%

76%

3%

8%

10%

21%

56%

58%

60%

67%

75%

0% 20% 40% 60% 80%

Other

Being around latest equipment

Part of job responsibility

No one else to do job

Liked knowing fire/police/rescue squads

Wanted to have impact on policies

Like to teach & train others

Like EMS environment

Wanted to support community

Current OMD

Former OMD

NOTE: Percentages total more than 100 because

respondents were

permitted to select more

than one option.


2005 OEMS


Survey

Challenges to VolunteerOMD Service


2005 OEMS


Survey

When Asked About the Challenges Facing Physicians in the Practice of Emergency

Medicine, Malpractice Issues Top the List

38%

30%

36%

35%

29%

25%

23%

25%

38%

41%

42%

55%

64%

68%

0% 20% 40% 60% 80% 100%

Increased regulation of medical community

Inappropriate use of ER services by public

Reimbursement issues

Availability of nursing staff

Inability of patients to afford insurance

Cost of malpractice insurance

Malpractice liability

"4" "5"--Critical Challenge

Q1: To what extent do you believe that each of the following issues is a challenge facing physicians in the practice of emergency medicine today?

NOTE: Percentages shown are

based on the responses of

all respondents.


2005 OEMS


Survey

Availability of Qualified Emergency Physicians

& OMDs, and Quality of Pre-Hospital Care Are Not Seen As Major Challenges

25%

24%

26%

28%

35%

36%

6%

8%

11%

26%

20%

23%

0% 20% 40% 60% 80% 100%

Availability of qualified emergency physicians

Quality of pre-hospital emergency medical

care

Availability of volunteer OMDs

Lack of organization to advocate with one

voice

Support from hospital administrators

Support from other physician specialists





all respondents.


2005 OEMS


Survey

Malpractice Liability And Reimbursement Issues - Are The Single Biggest Concerns in

the Practice of Emergency Medicine

3%

2%

3%

5%

6%

8%

8%

12%

14%

16%

21%

0% 20% 40% 60% 80% 100%

Other




Lack of organization to advocate with one voice







Q2: What is the single biggest challenge facing physicians in the practice of emergency medicine today?

Current OMDs were less

likely to say that

malpractice insurance is the biggest concern and

more likely to say that

inability of patients to

afford health insurance is the biggest

concern.



all respondents.


2005 OEMS


Survey

When Asked About the Challenges Facing OMDs, No Pay, Time Commitment, and Lack of

Support & Training Lead the List Liability Issues Are Not Top Of the List

15%

28%

21%

30%

22%

26%

30%

28%

38%

40%

30%

2%

10%

10%

15%

23%

23%

27%

27%

29%

29%

30%

0% 20% 40% 60% 80% 100%

Little or no support from EMS Regional

Council

Conflict with agencies' internal staff

Little or no community recognition

Administrative paperwork

Exposure to medical liability

Exposure to civil liability

Little or no OMD training

Little or no support from partners

Little or no support from hospital

Time commitment

No pay

Current OMD

Former OMD

Q28: Please rate the degree to which each of these is a challenge to you in your current OMD position?

NOTE: Percentages

indicate those who selected “4” or “5—

Critical Challenge” on

a 1-5 scale.

Not the major challenge


2005 OEMS


Survey

Likewise, when Current OMDs Were Asked What they Like Least About Being an OMD, Liability

Issues Were Not at the Top of the List

0%

6%

36%

6%

14%

8%

11%

11%

8%

19%

2%

6%

26%

7%

9%

9%

9%

11%

15%

17%

0% 20% 40% 60% 80% 100%

Don't know/Refused

None in particular

Other

Paperwork

No pay

Agency politics

Liability issues

Not having enough time

Personnel issues/conflicts

Time commitment

Current OMD

Former OMD

Q29(Current) & Q54(Former): What do/did you like least about being an OMD? [OPEN-END]

NOTE: Percentages total more than 100

because some respondents gave more than one answer.


2005 OEMS


Survey

No Pay and Time Commitment Were Also Significant Reasons Why Former

OMDs Say They Ended Their OMD Service

Q55: What were the reasons you ended your OMD service?

10%3%

8%8%8%8%10%13%

20%28%28%

40%43%

0% 20% 40% 60% 80% 100%

Other

Little or no support from EMS Regional Council







Exposure to medical/civil liability

Time commitment

No pay

J ust served my time

Moved/changed jobs


respondents were


than one option.

After moving/changing jobs,

these were the top reasons that former OMDs gave when asked in an open-

ended question what the single biggest reason for ending their OMD service

was.


2005 OEMS


Survey

Most Current OMDs Are Aware of OEMS Indemnification Requirements; Many

Former OMDs Are/Were Not

Q32(Current OMD) & Q59(Former OMD): Are/were you aware that the OEMS regulations call for a written agreement between an agency and OMD that ensures adequate indemnification exists for the OMD—for both medical malpractice and civil liability?

5%

12%

49%

34%

3%

26%

71%

0% 20% 40% 60% 80%

Don't Know

Aware now, but not at time ofservice

No

Yes

Current OMD

Former OMD

This response was only an option for

former OMDs.


2005 OEMS


Survey

About a Third Of Current OMDs Have Additional Liability Insurance

to Cover Their OMD Duties

Q30(Current) & Q57(Former): Do/did you have additional liability insurance to cover your OMD duties?

12%

68%

20%

10%

57%

33%

0% 20% 40% 60% 80%

Don't Know

No

Yes

Current OMD

Former OMD

This difference is not statistically significant.


2005 OEMS


Survey

Of Those with Additional Liability Insurance, Very Few

Pay for It Themselves

Q31(Current) & Q58(Former): What additional insurance coverage do/did you have for your OMD duties?

6%

16%

19%

26%

52%

52%

0% 20% 40% 60% 80% 100%

Civil--MD pays premium

Medical--MD pays premium

Civil--no additional premium

Medical--no additional premium

Civil--agency/municipality pays

Medical--agency/municipality pays


respondents were


than one option. Also,

these percentages combine the responses of both current and former

OMDs.


2005 OEMS


Survey

OMDs Think that the EMS Regional Council

Could be Doing More Across The Board

8%

23%

34%

25%

35%

33%

42%

37%

5%

27%

30%

33%

37%

41%

47%

49%

0% 20% 40% 60% 80% 100%

Financial assistance support

Clear sense of my accountability

Clear sense of what is expected of me

OMD training support

Personal issues support

Clear understanding of my responsibilities

Clear sense of standards my agency must

meet

Clear understanding of authority over agency

Current OMD

Former OMD

Q33(Current OMD) & Q60(Former OMD): Please rate your EMS Regional Council in terms of their ongoing support of you in your OMD positions (when you were serving in an OMD position).

NOTE: Percentages

indicate those who selected Very Good or

Excellent.


2005 OEMS


Survey

Overall Satisfaction With OMD

Service


2005 OEMS


Survey

Most OMDs (92%) Say The Work Is Satisfying

Former OMDs Were Slightly More Likely to Say that Being an OMD Was Not Satisfying

Q27(Current) & Q52(Former): How personally satisfying has it been/was it to serve as an OMD?

5%

17%

29%

27%

22%

0%

7%

30%

39%

23%

0% 20% 40% 60%

Not at all satisfying

Not very satisfying

Somewhat satisfying

Very satisfying

Extremely satisfying

Current OMD

Former OMD


2005 OEMS


Survey

Most (82%) Current OMDs Are Likely to Continue to Serve as an OMD

Q38: How likely are you to be an OMD three years from now?

16%

11%

3%

19%

63%

0% 20% 40% 60% 80%

Very unlikely

Somewhatunlikely

Neither likelynor unlikely

Somewhatlikely

Very likely

Current OMD


2005 OEMS


Survey

OMDs Like Interacting with Medics Best, But Also Appreciate the Altruistic Parts of the JobLike Improving Quality of Care and Making A Difference in the

Community

Q26(Current) & Q51(Former): What do/did you like best about being an OMD? [OPEN-END]

3%

6%

9%

9%

17%

31%

34%

0%

20%

5%

18%

22%

22%

38%

0% 20% 40% 60% 80% 100%

Don't know

Other

Helping thepeople

Making differencein community

Improving qualityof pre-hospital

Teaching EMT's

Interaction withmedics/providers

Current OMD

Former OMD

NOTE: Percentages total more than 100

because some respondents gave more than one answer.


2005 OEMS


Survey

Awareness & Perceptions of

An OMD Short-fall


2005 OEMS


Survey

Availability of OMDs & Quality of Pre-Hospital

Care Is Way Down On The List of Challenges Facing Physicians in Emergency Medicine

38%

30%

36%

35%

29%

25%

23%

25%

38%

41%

42%

55%

64%

68%

0% 20% 40% 60% 80% 100%











2005 OEMS


Survey

Availability of Qualified Emergency Physicians

& OMDs, and Quality of Pre-Hospital Care Are Not Seen As Major Challenges

25%

24%

26%

28%

35%

36%

6%

8%

11%

26%

20%

23%

0% 20% 40% 60% 80% 100%

Availability of qualified emergency physicians

Quality of pre-hospital emergency medical

care

Availability of volunteer OMDs

Lack of organization to advocate with one

voice






2005 OEMS


Survey

Awareness of OMD Coverage Issue Is Mostly Among OMDs

57% of Current OMDs & 31% of Non-OMDs Have Heard There’s An OMD Short-fall

Q78: Which of the following best describes what you have heard regarding the extent of OMD coverage in your region—that is, the number of OMDs relative to the number of agencies they oversee.

20%

11%

32%

0%

24%

24%

20%

13%

3%

27%

30%

27%

53%

16%

0%

0% 20% 40% 60%

Have not heardanything

Surplus ofOMDs

No shortage ofOMDs

Small shortageof OMDs

Big shortage ofOMDs

Current OMD

Former OMD

Never OMD

Non-VACEP members

were particularly

likely to have not heard anything about this

issue.


2005 OEMS


Survey

Just A Quarter of Those Who Have Heard There’s a Short-fall Think it Has Already Negatively Affected Quality of Care; But

Another 60% Believe it Could in the Future

Q79: How do you feel the OMD shortfall in Virginia is affecting the quality of patient care? [ASKED ONLY OF THOSE WHO SAID THERE IS A SHORTAGE]

Don't know13%

Has already negatively affected

24%

Will not affect

quality of care5%

Could affect in future

59%


2005 OEMS


Survey

Is There A Short-fall Crisis?

% Aware % Say Short-fall Percent

of short-fall Has Already of Group Had Impact who say

already Had impact

All emergency physicians: 40% 24% 9.6%

Current OMDs: 57% 30% 17.1%


2005 OEMS


Survey

Yet, Only 5% Feel as though the Quality of Emergency Care Delivered in the

Pre-Hospital Setting Has Decreased.Almost Half Think It Has Increased

Q9: Compared to five years ago, how would you rate the quality of emergency medical care delivered in the pre-hospital setting (medical care leading up to the hospital setting) in your community?

Don't know14%

Decreased somewhat

5%

Improved somewhat

34%Stayed about the same

33%

Improved significantly

13%

Again, those who said their training was in something

other than emergency medicine

were more likely to say

the quality of pre-hospital emergency care had

improved.

Current OMDs were also

more likely to say that it had

improved.

NOTE: Less than 1% said that it had decreased significantly.


2005 OEMS


Survey

More Than This (14%) - Think the Quality of Emergency Care in the Hospital Setting Has

Decreased in the Past Five Years

Q7: Compared to five years ago, how would you rate the quality of emergency medical care delivered in the hospital setting in your community?

Decreased somewhat

10%

Decreased significantly

4%

Don't know13%

Improved somewhat

36%

Stayed about the same

16%

Improved significantly

22%

Those who said their

training was in something

other than emergency medicine

were more likely to say

the quality of emergency

care in hospitals had

improved.


2005 OEMS


Survey

What It Will Take To

Convince Physicians There

Is An OMD Short Fall


2005 OEMS


Survey

Question: what would it take to convince you there was a need for

more volunteers?

SHOW ME!• Statistics• Statewide listing of OMD positions

not filled• Delay in response to EMS calls• Numbers and facts• Hearing it from a local squad or

local OMD• Receiving regular notices of open

positions in the area and across the state

• Data

This question was only asked of

those who said that lack of awareness of need was a barrier in not volunteering as an OMD.

This amounts to only 27 people and

was therefore not coded into

categories.


2005 OEMS


Survey

Potential Solutions For

OMD Short-fall (if there is one now)


2005 OEMS


Survey

OMD Short-fall Solutions

Immediate: recruitment

Mid-term: programming

Long-term: paid positions


2005 OEMS


Survey

Immediate Solution to AvoidOMD Short-fall:

Have OMDs RecruitOMDs


2005 OEMS


Survey

There Appears to Be Some Opportunity to Convince Non-OMDs to Volunteer &

Former OMDs To Sign Up Again

Q38: How likely are you to be an OMD three years from now? [CURRENT OMDs]Q65: How likely are you to become an OMD again? [FORMER OMDs]Q77: How likely are you to ever volunteer for an OMD position in your community? [NON OMDs]

7%

22%

12%

17%

31%

12%

5%

41%

20%

10%

17%

7%

0% 20% 40% 60%

Don't know

Very unlikely

Somewhat unlikely

Neither likely nor unlikely

Somewhat likely

Very likely

Former OMD

Non OMD

43% of Non-OMDs say they are

somewhat or very likely to volunteer in the future.

24% of Former OMDs say they are somewhat or very likely to volunteer in the future.


2005 OEMS


Survey

8 in 10 Non-OMDs Know Someone

Who Is Serving as an OMD

Q66: Do you personally know anyone who is serving as an OMD?

No13%

Don't know7%

Yes80%

Current members of VACEP were

more likely to know

someone who is serving as

an OMD.


2005 OEMS


Survey

Yet, Familiarity with the OMD Position Among Non-OMDs is Low

Q12: How familiar would you say you are with the Office of Emergency Medical Services’ (OEMS) Operational Medical Director position, generally referred to as an OMD?

37%

11%

5%

2%

0%

29%

63%

0%

1%

0%

10%

89%

18%

11%

21%

0% 20% 40% 60% 80% 100%

Not familiar at all

Not very familiar

Neither familiar nor unfamiliar

Somewhat familiar

Very familiar

Current OMD

Former OMD

Never OMD

93% of all respondents were aware that every

agency that delivers

emergency care is

required to have an OMD

actively overseeing all

activities.

VACEP members are much more familiar with

the OMD position than non-VACEP members.


2005 OEMS


Survey

Recall, Few Volunteer On Their OwnMost OMDs Were First Introduced to OMD Service When they

Were Approached by an Agency that Needed Help

Q24(Current OMDs) & Q49(Fomer OMDs): What event first introduced you to OMD service?

12%

7%

37%

44%

4%

16%

26%

54%

0% 20% 40% 60%

Other

Volunteered on own

Requested by people inpractice

Approached by agency

Current OMD

Former OMD

NOTE: The differences between

current and former OMDs do not reach

statistical significance.


2005 OEMS


Survey

OMDs, Especially Current Ones, Say They Have Tried to Recruit Other

OMDs

Q36(Current OMDs) & Q63(Former OMDs): Have you ever tried to recruit other OMDs or talked to a colleague about becoming an OMD?

10%

37%

54%

3%

29%

69%

0% 20% 40% 60% 80%

Don't recall

No

Yes

Current OMD

Former OMD

While this difference can be looked at as a “trend,” due to the

small sample size of former

OMDs, the difference between

current and former OMDs

is not statistically significant.


2005 OEMS


Survey

Yet, Only 17% Of Non-OMDs Say They Have

Ever Been Asked to Be An OMD

Q69: Have you ever been asked to be a volunteer OMD?

No80%

Can't recall3% Yes

17%

Current and former

members of VACEP were

more likely to have been asked to be

an OMD.

Men and those who are

ABEM certified were

also more likely.


2005 OEMS


Survey

If Provided with Training and a List of Candidates to Approach, Half of Current

OMDs and a Quarter of Former OMDs Would Help Recruit Others

Q37(Current OMDs) & Q64(Former OMDs): Would you recruit others to be an OMD if OEMS and VACEP provided you with training and a list of candidates to approach?

34%

41%

24%

34%

19%

47%

0% 20% 40% 60%

Don't know

No

Yes

Current OMD

Former OMD


2005 OEMS


Survey

The Right Recruitment Message

For Non-OMDs & Former OMDs…


2005 OEMS


Survey

Non-OMDs Correctly Perceive the Biggest Issues Facing OMDs: Time Commitment and

Lack of Pay

Q68: What do you think are the biggest issues facing OMDs?

9%

5%

11%

12%

23%

25%

30%

30%

34%

38%

49%

50%

0% 20% 40% 60% 80% 100%

Other

Little or no support from EMS Regional Council



Exposure to civil liability



Exposure to medical liability



No pay

Time commitment


respondents were


than one option.

Remember, these were also seen as

the top 2 challenges by current OMDs.


2005 OEMS


Survey

In fact, Non-OMDs Say that the Time Commitment is the Biggest Barrier

to Volunteering as an OMD

Q70: What are the biggest barriers to volunteering as an OMD?

8%

18%

22%

26%

31%

61%

0% 20% 40% 60% 80%

Other

Not aware of need

Liability is too great

Easier to volunteer in other ways

No pay

Too much time required


respondents were


than one option.


2005 OEMS


Survey

Between 6-10 Hours per Month Seems to Be the Right Amount of

Time

Three-Quarters of

Current OMDs Spend

at Least 15 Hours a

Month on OMD

Duties

13%

21%

8%

7%

10%

26%

17%

0% 20% 40% 60% 80% 100%

Don't know

Other

Depends

16-20 hours

11-15 hours

6-10 hours

1-5 hours

Non OMDs

Q72: How much time per month and total length of service would be a reasonable expectation of volunteer physicians?

Respondents also reported that 1-2 years would be the most appropriate total length of

service.


2005 OEMS


Survey

Make An Impact:Non-OMDs Look at the Potential Benefits of

Being an OMD Differently than the Motivations of Current & Former OMDs

Q67: What do you think would be the biggest benefits of serving as an OMD?

8%

4%

52%

48%

76%

72%

60%

3%

8%

67%

56%

75%

60%

58%

2%

8%

21%

40%

45%

62%

71%

0% 20% 40% 60% 80%

Other

Be around latest equipment

EMS/Rescue squad environment

Know fire/police/rescue squads

Sense of serving community

Teach and train others

Have impact on policies/protocols

Non-OMD

Current OMD

Former OMD


respondents were


than one option.

Messaging:

Non OMDs: Make an impact on policies

Former OMDs:

Make an additional impact in

your community


2005 OEMS


Survey

Mid-term SolutionTo Avoid

OMD Short-fall:Programming

Support


2005 OEMS


Survey

Potential OEMS Support Initiatives Hold Promise – OMD Training–Related Ideas Have

Most Appeal

14%

31%

30%

23%

23%

31%

31%

34%

27%

21%

20%

23%

30%

30%

30%

33%

33%

41%

0% 20% 40% 60% 80% 100%

24/7 OEMS Q&A Hotline

Post "standard OMD agreements" online

Discussion group for "hot OMD topics"

Reports regarding pre-hospital patient care

reports

Description of available insurance policies

OMD "survival kit"

Online clearinghouse of information

Availability of OEMS support for QA/QI

activities

Expand OMD CMEs online

"4" "5"--Very Interested

Q34: How interested would you be in the following OEMS support initiatives designed to make OMD service easier for OMDs like you?


2005 OEMS


Survey

Former OMDs Show Even Greater Interest in Many Potential Support

Initiatives

53%

35%

68%

53%

51%

64%

61%

50%

55%

62%

71%

73%

73%

77%

0% 20% 40% 60% 80% 100%

Discussion group for "hot OMD topics"

24/7 OEMS Q&A Hotline

Expand OMD CMEs online

Description of available insurance policies

Post "standard OMD agreements" online

Online clearinghouse of information

OMD "survival kit"

Former OMD

Current OMD

NOTE: Percentages


Very Interested.”

Q61: How interested would you have been in the following OEMS support initiatives designed to make OMD service easier for OMDs?


2005 OEMS


Survey

State Tax Credit & Sovereign Immunity Would Make the Position More Appealing

Across All OMD Audiences – Former, Current, and Potential

30%

35%

77%

48%

61%

80%

64%

57%

58%

90%

92%

37%

48%

72%

62%

73%

78%

70%

82%

63%

90%

85%

49%

66%

69%

70%

72%

75%

82%

83%

86%

62%

39%

0% 20% 40% 60% 80% 100%

Greater recognition at state-wide events

Greater recognition in local area

Free CME credits

Hospital support w/ EMS coordinator

Comprehensive initial orientation program

Free ongoing training

Ongoing support on issues management

Credit for some time by hospital/practice

Making it a paid position

Soverign immunity on OMD liability issues

State tax credit for volunteer time

Non OMD

Former OMD

Current OMD

Q35(Current OMDs), Q62(Former OMDs), & Q76(Non OMDs): What impact do you think each of the following potential OMD-support initiatives would have on making the OMD position more appealing?

NOTE: Percentages


Highly Positive.”


2005 OEMS


Survey

Long-termSolution To Avoid

OMD Short-fall:Shift To Paid OMD Position


2005 OEMS


Survey

Half Believe that OEMS is Responsible for Shoring Up the Shortage; 40%

Don’t Know

Q80: Who is responsible for shoring up the shortage? [ASKED ONLY OF THOSE WHO SAID THERE IS A SHORTAGE]

40%

11%

20%

22%

25%

51%

0% 20% 40% 60% 80% 100%

Don't know

Medical Society of Virginia

VACEP

Hospitals

Individual physicians

OEMS


respondents were


than one option.


2005 OEMS


Survey

If the Facts Show there is a Shortfall of OMDs that is Compromising Pre-Hospital Care,

Over Half of the Respondents Would Support Transitioning OMDs into a Paid Position

Q81: If the facts clearly support that there is a shortfall of OMDs, and that this shortfall will eventually compromise the quality of pre-hospital emergency care, which of the following solutions will you favor?

9%

3%

34%

54%

0% 20% 40% 60% 80% 100%

Other

Contribute $500 for stipend

Personally volunteer

Support transitioning into paidposition

This position was described

as an “all-paid,

statewide position

reporting to OEMS.”


2005 OEMS


Survey

Contribute $500 For Stipend Generated Comments

“Asking physicians to pay another annual fee to support this position is an insult.”

“Asking physicians to support an OMD program with a special assessment (like

the injured infant fund) is an ABSURD solution to the problem.”

“I have no intention of paying $500 to supplement any OMD.”


2005 OEMS


Survey

Moving To Paid System Received Many Positive Comments

“There is too much needed to be done (as an OMD) for it to be volunteer.”

“It would ensure that the person chosen would be 100% dedicated and committed to the task.”

“If the people I am working with are compensated, then I should be compensated.”

“A full time paid position would be more accountable and lead to less conflicts with time and partners.”

“There has to be a stop to the expectation that physicians will continue to provide time and services without some basic level of compensation. We are being squeezed by insurance agencies, EMS rules,

etc.”


2005 OEMS


Survey

7 Key Take-A-Ways


2005 OEMS


Survey

7 Key Take-A-Ways1. Most were asked to serve and most signed on for OMD

service to support the community.

2. No pay, time involvement, and support (from hospitals and partners), not insurance liability issues, are the greatest challenges facing OMDs today.

3. Current OMDs may be serving longer and serving more agencies than former OMDs. And, time involvement and number of agencies increases with tenure.

4. Most are satisfied, however, with OMD position and will stay on as OMD.

5. Fifty-seven percent of current OMDs and thirty-one percent of non-OMDs have heard there’s an OMD short-fall. Yet most are not aware of its impact. In fact, most believe pre-hospital setting care has actually improved.

6. Physicians need data/ facts to believe there’s a short fall.

7. Solution to OMD short-fall issue can work on a number of levels: aggressive recruitment of OMDs by OMDs; programming training support services; and moving the whole system to a paid model. All three options will work from a demand standpoint.


2005 OEMS


Survey

Thank You

southeastern institute of research 1 oems virginia emergency physicians omd study (co-sponsored with...

Documents

omds slide

omd respondents

omd role

current omd position

average current omd

physicians roles

q19current omds q44former

quarters of omds