ED people doing house visits?
Medical retrieval teams having a cup of tea and taking a detailed social history?
Emergency doctors going to someone’s home before they come to the ED and recommending treatment at home?
Including End of Life treatment?
Ever been to Maribor? Slovenia?
I spoke with Slovenian Emergency Physician and Pre-Hospital Gregor Prosen at dasSMACC. He talks like an emergency physician. He curses like an emergency physician. Gregor just exudes a type of ultra-competent critical care cool. He can do some fantastic shit and he does do it. He also goes on home visits. He gets in a car or 4wd and heads out into the country to see little old ladies, big old men, kids and strudel-makers. That part represents fantastic shit too. Listen to Gregor talk you through pre-hospital medicine in Maribor.
So here I am in Australia, in the western emergency medicine workforce. We are struggling with this and that. We are struggling with end of life care. We are struggling with the filter, or lack of a filter, between primary care and the so-called critical care service that emergency personality types all signed up for. We wanted to be intubating vomiting people, with no blood pressure, while upside down in a straitjacket and wrapped in chains and underwater. In a crater lake. Over an active volcano. Using an expensive machine. Any expensive machine really. That’s what we call rewarding. It’s just not fair. Whinge. Whinge.
So you go and try a bit of retrieval medicine. It looks very cool. Especially in the promo videos. (To quote Alex Psirides; “Helicopters!!!”) However, when you are getting around in one of those helicopters, or some other platform, there is a certain pressure on your use of that platform. How many times have aeromedical retrieval teams gotten out to the “scene” and decided to NOT bring that patient back to the hospital? Maybe that’s the best thing to do? And if it is the best thing to do then will your service get paid as much? Will your service get paid at all? How much does it cost to run an aeromedical retrieval helicopter anyway? (Clue; shit-loads.)
So at the end of the day it’s hard to use your judgement for some of the most important decisions. It’s hard not to get into the “You Call we Haul” trap. We even use “Time on Scene” as a KPI.
The pilot, the crew, the co-ordinator and even the helicopter itself seems to want you to get back to base ASAP. It might be whirring overhead or if it has landed just sits there and bristles. I do love these impressive women and men. I love working with them. I love flying around over Australia.
Slovenia clearly has a different history, different culture, different healthcare system, but maybe it has some seriously useful different perspectives.
Gregor Prosen is pretty bloody cool. He does cool stuff. He has a cool job and some of that cool stuff is done really very differently. Let’s learn.
I like FOAMed. I like it a lot. I would really like it to continue to facilitate knowledge transfer. We can learn something from the Slovenians. We can learn from the South Africans and Ugandans. We can learn something from the New Yorkers. It is not a one-way street.
Long live FOAMed. Long live non-english speaking FOAMed. Long live FOAMed from everywhere for everyone.
Long live the legendary Slovenian accordion player Bratko Bibič and thanks to him for the wonderful tune “Na Domačem Vrtu” or ”In the family garden” from the eponymous album by Bratko Bibič & the Madleys. I liked that title given Gregors story. You can find Bratko Bibič on iTunes but if you find it in on vinyl it would be more impressive.
If Slovenian or Serbian music is your thing check out Gregors friend and colleague; Sara Nikolić