The editorial, “Primary care technician could fill coverage gap,” by Bloomberg View in the Nov. 14 newspaper, describes a concept to fill gaps in community primary care services. It suggests training primary care technicians like EMTs and paramedics, except with a focus on primary rather than emergency care.

The idea is not far-fetched, in fact it is already in place and growing across the country and around the world.

The term for this already accomplished concept is “community paramedicine,” and it targets the community health gaps identified by the editorial while assuring that communities have high levels of emergency care available. The main difference between this and the concept in the editorial is that the latter proposes a wholly new role in the health workplace, while community paramedicine takes existing EMTs and paramedics, already experienced in patient care, and prepares them to address primary care needs in the community. The highest level, community paramedic, requires a college-affiliated 300-hour course in addition to the provider’s paramedic training and experience. Many community paramedicine services can be provided by basic EMTs with some additional training by their medical director or others.

In Maine, 13 ambulance services are involved in community paramedicine pilot programs as authorized by the Legislature and overseen by Maine EMS. They are testing the feasibility of providing a number of different services by EMTs and paramedics in their communities.

Community paramedicine programs in other locales already are starting to prove their worth. In Texas, such a program reduced use of the 911 system and emergency departments by unnecessarily frequent users by 80 percent. In Nova Scotia, community paramedics were able to treat nursing home patients in their rooms and reduce their use of ambulance and emergency department by almost 70 percent.

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Kevin McGinnis, Hallowell

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