Docs with Glocks: The reserve officer physician

What's the role of the reserve officer physician as TEMS personnel on SWAT callouts?

A number of years ago, someone coined the phrase “Docs with Glocks.” I am not sure how this started or the meaning behind the phrase but the physicians I have been associated with wear a lab coat, carry a stethoscope, and have a credit card with a limit higher than my annual salary.

Don’t take this the wrong way. After 30 years in law enforcement and the medical field, everything I have learned (medically) was provided to me by some very intelligent, well educated, and highly skilled physicians, all of which have my greatest respect and admiration. These docs have, without a doubt, given me the education needed to save more lives than I have digits to count them.

On the other side, not one physician has provided me with the knowledge or technical skills needed to package these patients and extricate them safely from point A to point B, in some of the worst case scenarios that are tough and extremely dangerous. 

In all SWAT callouts that utilize healthcare professionals to provide medical support, a physician will have to be available, either for direct medical control or on-line medical control. The physician should be well-educated in out-of-hospital emergency care or military medicine. All healthcare professionals — including physician assistants, nurses, paramedics, EMT-Basics, and first responders — work under the guidance of a physician medical director. TEMS for physicians in the civilian setting is not common place, and having a physician present in the actual hot zone during operations, is even less common.

So what would be the role of a reserve officer/physician as a TEMS individual on SWAT callouts? The physician should be responsible for team health management. That responsibility would include preventative medicine with an emphasis on the concept of a healthy before, during, and after operations approach. There should be programs in place for proper nutrition and exercise. The physician could act as the medical advisor for the tactical unit, highlighting smoking guidelines, drug and alcohol counseling, and stress management. The physician could also provide training, education, and credentialing to officers and other healthcare providers attached to the unit. During educational and training exercises, the physician could assess clinical skills proficiency during high-risk and tactical evolutions.

Advanced medical care, as would be provided by a physician, is extremely limited in the hot zone due to the unpredictable and ever changing nature of that area. This is a statistic that has been widely proven in military operations since physician presence in the front row of an active conflict, throwing lead back at the bad guys, is unheard of.

If the reserve officer physician were available on-site during tactical missions, he/she would be a valuable asset in providing advanced medical care in the field hospital once casualties were evacuated there from the hot zone. 

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