The days of a physician arriving at a hospital or field response unit offering disaster assistance are over, largely because of medicolegal issues that have evolved surrounding proper disaster credentialing.
While volunteers play a key role in emergency and disaster response, their legal protection often lacks clarity. It is advisable now for physicians to acquire formal education and training in both disaster preparedness and response to be credentialed to assist during disasters.
Many physicians, however, lack necessary disaster training. Neither medical schools nor residency training programs place much emphasis on disaster response curricula.
That may seem odd, given that in the second half of the previous century there were 2,064 disaster declarations made in the U.S. — an average of more than 40 a year.
But, instead of offering disaster response as core curricula, many medical schools and residency program refer instruction in disaster response to outside agencies. One 2013 study (J Am Podiatr Med Assoc. 2013 Jan-Feb;103(1):87-93) implored the medical profession to conduct “deliberations regarding academic competencies at the...medical school and continuing education level...for a surge response role.”
Another 2013 paper (Southern Medical Journal: January 2013, Vol 106) attempts to raise awareness of the physician disaster response issue. The Kumar paper also provides pathways for physician education and involvement.
Ajoy Kumar, MD, of Bayfront Medical Center in St Petersburg, FL, and author of the paper, told Homeland1, “If you asked how many of the faculty, students, residents and fellows are involved in Medical Reserve Corps, Community Emergency Response Teams, Disaster Medical Assistance Teams or even emergency/trauma you would be surprised.”
Kumar, chair of the Disaster Preparedness Committee for the Florida Academy of Family Physicians, said the American Medical Association has developed both basic and advance disaster life support courses to educate physicians. Also, the Federal Emergency Management Agency offers several free online packages.
Another source of physician-disaster education, according to Kumar, are local Medical Reserve Corps, which are managed through county health departments. Many of these courses require tests and provide physicians with a certificate upon successful completion.
Kumar said, however, there remains no consistent formalized training within and among institutions that integrates the elements of the federal 2012 National Response Framework. This framework is direct descendant of the 2008 National Response Plan.
NRF provides policy guidance regarding how the federal government responds to all hazards that occur within the U.S. Subsequently, state, local, and tribal responses were developed and implemented to work in concert with the NRF.
“Should a physician want to join a formal medical response team, such as the Disaster Medical Assistance Team or Medical Reserve Corps, it is highly recommended that he or she complete the FEMA courses,” Kumar said. These include:
- “Introduction to Incident Command System” (IS-100.b)
- “Applying Incident Command System to Healthcare Organizations” (IS-200.HCa);
- “Introduction to National Incident Management System” (IS-700.a); and
- “Introduction to the National Response Framework” (IS-800.B).