Texas paramedic practitioner reflects on 1 year of serving vulnerable populations
Austin-Travis County EMS Paramedic Practitioner Travis Baker has spent the last year treating hundreds of homeless and low-income patients in place
AUSTIN, Texas — Travis Baker is providing a new method of emergency medicine and medical services to some of the Austin area's most vulnerable populations, but with a more personalized and streamlined approach.
Baker, a paramedic practitioner, was hired by Austin's medical director's office and Austin-Travis County EMS a year ago this month as a resource for the community to respond to emergencies that might not be life-threatening but need special attention.
His emergency response capabilities, though, allow him to provide a level of service beyond a traditional ambulance medic. As a certified paramedic and physician's assistant, he can diagnose, treat and refer patients as well as prescribe and fill medications.
"Filling this gap goes well beyond emergency calls," Baker said. "It's a new delivery of medicine and emergency call response that hopefully can provide access to care for folks that might not have that pipeline relationship with health care facilities."
Most of the time his service calls are for low acuity needs, such as wounds, abscesses, skin infections, and exacerbation of existing conditions such as asthma and chronic obstructive pulmonary disease, he said. Baker also handles medication refills, and treats minor injuries such as cuts or sprains, on the streets or in someone's home.
Baker said he treats between 80 and 120 patients a month, mainly on the streets, traveling in an emergency response vehicle equipped with high-tech medical equipment. Although many of Baker's patients are experiencing homelessness, he also treats people whose lower income status might deny them access to quality health care.
"Emergency medicine is a safety net in America, and EMS only gets paid if they take someone to the hospital — but that is not always the best solution," he said. "This program is about providing the right care at the right time."
He said by intervening on site, it prevents the need for unnecessary and costly trips to the emergency room. It also helps free up ambulances to focus on emergency calls that do require a ride to the hospital.
In some cases, the patient might need to see a doctor immediately. But if it's not life-threatening, such as a broken bone, this program would allow ambulances to take patients to an urgent care center, where they can get a better value and be seen quicker. The team of Community Health Paramedics that responds with Baker also helps connect clients to services they need.
"It's a way not to overburden the emergency department," he said. "Because not only can we treat them on site, but we try to help them better navigate their issues and connect them to resources, such as Medicare or Medicaid, that can help them continue their treatment moving forward."
So far Baker is the only person in the county that provides this type of service and he is the first in Texas to function in this capacity, although he said similar programs are ongoing across the nation. Follow-up checkups are often necessary and he is responsible for responding and following up with every patient.
As he continues to provide services to some of the most vulnerable populations in the county, he said he is also working to establish more funding and grow the program. His goal now is to one day be able to expand the program's coverage to 24 hours a day.
"I believe we are providing a valuable service for vulnerable populations in the city of Austin," Baker said, "and while in emergency medicine you are always seeing people on one of their worst days, I try to treat everyone I encounter with dignity and respect."
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