If local physicians have any say in the matter, they’d like to see Grand County hire a Moab-area resident to serve as the medical director of the county’s emergency response team.
For much of the past decade, Grand County Emergency Medical Services (EMS) has relied on the services of Dr. Doug Murdock, who lives along the Wasatch Front and is affiliated with Orem Community Hospital and Utah Valley Hospital in Provo.
However, Moab Regional Hospital Chief Medical Officer Dr. Steven Rouzer – who said he is not representing the hospital in a “real sense” – wants the department to look closer to home for those services.
“I think it’s time to bring the medical director back to Grand County,” he told the Grand County Council during its regular meeting on Tuesday, Feb. 6. “I think (Murdock has) done a wonderful job, but I think it’s in the interests of the county – it’s in the interests of everyone else – to have the medical director be one of us.”
Grand County Council member Patrick Trim, who also works for Moab Regional Hospital, said that a physician’s proximity to the community is one factor that’s worth consideration.
“This is more of a continuity-of-care issue … and I think that’s important,” Trim said. “If you’re hurt in the field, do you want a Grand County physician (as EMS medical director), or do you want somebody up in Salt Lake, and I think that’s the issue.”
Grand County EMS Assistant Director Will Barnhardt said his department is in the process of transitioning to the medical command of Dr. Angela Alexander, who specializes in emergency medicine at Moab Regional Hospital. Along the way, though, Barnhardt said there have been some logistical delays – including a proposed move to establish an EMS special service district.
Traditionally, Rouzer said, a physician who is based in the community would serve as the department’s medical director. But about eight years ago, the last Moab physician who occupied the position was no longer able to serve due to a medical disability, he said, so she relinquished the job.
Rouzer said that other local physicians – including himself – volunteered to take over. But Barnhardt said that no one locally came forward, so the EMS department ultimately recommended the selection of Murdock.
“It was always intended as a temporary measure, but we got such great care out of him,” Barnhardt said.
Murdock is an “exceptionally qualified” emergency medical physician who has served as the medical director of multiple EMS agencies in Utah.
“Dr. Murdock has done an excellent job providing medical direction for us,” Barnhardt said.
Rouzer told the council that he doesn’t want anyone to assume that he’s criticizing Murdock in terms of his dedication to the job.
“He’s certainly credible, qualified, very energetic and a man who for the last essentially 10 years has been traveling down on a monthly basis to meet with the EMTs and to serve his function as a medical director, and he’s never let anyone down,” Rouzer said.
Murdock could not be reached for comment. But Barnhardt said that Murdock is supportive of the transition to a local physician.
“We’re not directly involved”
The department’s medical director establishes guidelines that EMTs and paramedics use in the field to treat patients who are in pain. It’s not an immediately hands-on role, Rouzer said, but that person formulates rules and guidelines that are used in the day-to-day practice of medicine.
“For essentially the last eight years or so, the rules that govern the behavior and the medical care provided by (local) EMTs originates with (Murdock) from Salt Lake City, and those of us who work at Moab Regional Hospital and take care of the patients when they arrive don’t have a direct say in that decision,” Rouzer said.
Officials from the state’s emergency medical division periodically review the hospital and its trauma program, and according to Rouzer, they identified concerns about local physicians’ involvement in EMS operations.
“When they have come down, one of the things that they have commented on is, there does seem to be a shortcoming that the existing physicians are not involved in formulating and in direct supervision of the activities of the EMTs as they are bringing patients to the emergency department,” he said.
Once those patients arrive at Moab Regional Hospital, Rouzer said, they are under the control of that facility.
“But for however long it may take until they arrive, actually, the functioning guidelines originate elsewhere,” he said.
EMT team members are also in regular communication with hospital officials.
“They’re not going to call the doctor in Salt Lake City to ask them,” he said. “They will call us, so in a sense, our interaction does exist, but when it comes to organizational meetings, discussing things with EMTs, we’re not directly involved.”
According to Grand County Council Administrator Ruth Dillon, the county’s EMS department has the authority to recommend a selection for a new EMS medical director. But the final approval of any hiring decision rests with the county council itself, and council chair Mary McGann indicated that she’s receptive to Rouzer’s suggestion.
“It sounds like something we might want to do,” she said. “Sooner than later.”
Grand County Council member Jaylyn Hawks questioned whether others in the local medical community support Rouzer’s views on the matter.
“May we assume by your presence and comments here that the ER (doctors) and Moab Regional Hospital are willing to take this on again?” she asked.
Rouzer said they are.
“They’ve been willing actually to do that for about three years, and it seemed like it was about to be achieved, but it never really got finished,” he said.
According to Rouzer, there may have been issues about who would pay for Alexander’s medical malpractice insurance. By his estimates, it would cost $10,000 to buy insurance for the new medical director.
“I think that that’s a problem that seems like it’s probably close to a solution,” he said.
Department transitioning to new person, but needs final county council approval
