By Suzanne Hoholik
The Columbus Dispatch
COLUMBUS, Ohio — In the regulation of medical professionals in Ohio, different boards have different rules.
The state medical and nursing boards say they have authority over everyone they license. But the Ohio Emergency Medical Services board says its jurisdiction is a bit fuzzier.
The EMS board, which certifies 40,593 emergency medical workers, can discipline licensees for improper actions on the job, and for felonies or crimes involving moral turpitude in their private lives.
But there are exceptions. This oversight doesn’t apply to emergency medical technicians who are part of the state’s execution team or those working in hospitals.
EMTs in the prison system and hospitals perform procedures outside their scope of practice, which is usually a reason for discipline.
This issue recently came up when the board was asked how intermediate-level EMTs could participate in lethal injections when they are not certified to use the necessary drugs.
But the board’s lawyer said last month that the board doesn’t have jurisdiction. Her reasons: The personnel don’t wear clothes that identify them as emergency-medical workers and don’t “represent themselves as acting EMTs.”
The board agreed.
“If they did that in the back of a squad, that would be different,” said Mark Burgess, chairman of the EMS board. “They aren’t functioning as an EMT in that particular case.”
Burgess also said the board has no authority over emergency medical technicians hired by hospitals to perform medical procedures beyond their state certification.
“Their scope of practice is determined by the hospital,” said Tiffany Himmelreich, spokeswoman for the Ohio Hospital Association. “It would vary from hospital to hospital based on the scopes they have written.”
Situational exceptions like these don’t apply to other medical professionals.
“If a doctor is practicing medicine in the state of Ohio and they hold an Ohio license, they are under the jurisdiction of the medical board and must comply with the statutes and rule outline in this state,” said Joan K. Wehrle, executive staff coordinator for the medical board.
The same goes for nurses, said Betsy Houchen, executive director of the Ohio Board of Nursing.
Other states have grappled with EMS oversight as well.
In Michigan, officials changed state policy several years ago to address emergency medical technicians who work in hospitals.
“Their license does not transfer outside the prehospital environment,” said John Hubinger, director of emergency medical services in Michigan. “It’s on the hospital to make sure they’re adequately trained and they work directly under the supervision of a physician.”
In Indiana, the EMS Commission has authority over all EMTs all the time, said John Erickson, spokesman for the Indiana Department of Homeland Security.
Dr. Jonathan Groner, a former Ohio EMS board member, brought up the issue of lethal injections.
His concern was prompted by the testimony of two intermediate EMTs in a federal lawsuit filed by an Ohio Death Row inmate challenging lethal injection.
Groner, a pediatric surgeon at Nationwide Children’s Hospital, opposes capital punishment. He said the board lawyer’s argument has holes. “If you took out ‘EMT’ and put in ‘physician,’ and took out ‘EMS board’ and put in ‘medical board,’ no one would buy it,” Groner said.
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