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Calif. Hospital Agrees to Pick up the Tab for Paramedics' Medical Director

MARIN, Calif. -- Marin General Hospital has agreed to cover the cost of having one of its emergency department physicians provide training and support to more than 70 paramedics in Marin.

Dr. Mark Bason-Mitchell will serve as the Marin County Fire Department's medical director, replacing Dr. Jim Pointer, who has held that position as a contract employee for the past decade. Under the new arrangement, Bason-Mitchell will provide medical direction for paramedics working for the Marin County Fire Department, the Ross Valley Paramedic Authority and the Southern Marin Emergency Medical Paramedic System.

The hospital, which is overseen by the publicly controlled Marin County Healthcare District, agreed to cover the cost of Bason-Mitchell's services to paramedics after being approached by Battalion Chief Mike Giannini, who heads Marin County Fire Department's emergency medical services division.

"We contacted Marin General to see if they'd be interested in forming a partnership in much the same way that the other fire agencies have with Kaiser," Giannini said. Kaiser Permanente plays a similar role for emergency medical technicians in San Rafael, Novato and Corte Madera.

"We wanted expertise from a physician with direct emergency medical experience to help broaden the education of our paramedics," Giannini said.

Lee Domanico, Marin General's chief executive officer, said, "As a district hospital, we view this collaboration as part of our mission. We see it as having great value for the community, and leading to a more coordinated experience and enhanced patient care."

Giannini said the hospital will be spending a bit more than the $60,000 that the fire department was paying Pointer annually. Bason-Mitchell will be providing about 24 hours of training a month to paramedics, compared with the eight hours a month that Pointer was providing.

"So we've literally tripled the contact time with the paramedics as a result of the restructuring." Giannini said.

In addition to providing training, the medical director is necessary to allow the fire department to buy medications and medical supplies, Giannini said.

If paramedics need to transport a patient to the hospital, they are required by Marin County policy to ask the patient which hospital he or she wants to be taken to, Giannini said. An unconscious patient is taken to the nearest hospital, unless trauma center facilities are required. In such cases, patients are taken to Marin General, the county's only hospital designated as a trauma center.

Giannini said 70 percent or more of the fire department's patients are taken to Marin General, about 20 to 25 percent go to Kaiser San Rafael, and 5 percent go to Petaluma Valley Hospital.


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