Dr. Tim Pieh wears a lot of hats in central Maine. He's an emergency medicine doctor at Maine General Medical Center, a volunteer for Belgrade and Rome fire and rescue, and a regional medical director for Maine EMS.
On this day, he's speaking to high school EMT students at Mid Maine Technical Center.
"Ready? Step one, you have to make a decision. What is the problem that the patient came in for?" Pieh says.
And while Pieh teaches the class, he's also on standby. Not for the hospital, but as a first responder to an emergency 911 calls that may come in.
Pieh is one of three physicians who have signed up to take part in the pilot program, called MD-3, although three more have been recruited.
He says the goal isn't to replace paramedics or EMTs but to assist them. The physicians, he says, can respond to complex or critical patients, or to low urgency cases, and treat patients at the scene instead of taking them to the hospital.
"So I've done that with a fishhook stuck in someone's thumb during blizzard right, and I do that as a first responder," Pieh says. "And there's no reason to put a paramedic level ambulance or other first responders on a dangerous transport to the scene when I can just go in and treat and release that case."
In the first few weeks of operations, MD-3 has already responded to 19 active physician cases, including pregnancy emergencies, sepsis and cardiac arrest.
On this day, things are slow. So as he waits for his radio to go off, he continues the EMT training session.
"So for us today the problem is trouble breathing," Pieh says to the class. "Simple, right? You get a 911 call having you respond to Fairfield, on Main Street for a 72-year-old female with difficulty breathing."
Mid Maine Technical instructor Abigail McMahon says she already plans to have Pieh return to her class. She says scheduling paramedics who are already overworked to stop by class can be a challenge. And she says Pieh brings special strengths as a teacher to the classroom.
"Sometimes he can pull stuff out of the students that was, you know, questionable if they even had there - so it's good and like really empowers them and gives them motivation to do better," McMahon says. "But also I think it puts into context like really where they can go from here."
Grant funding for the MD-3 program will run out in September, so to keep it going, Pieh has requested $350,000 from the county, enough to fund an additional year.
"If we could have funding for a year, then we could look at the data of our impact and then assess is it worth ongoing funding, and involve others in that assessment so that we can do a critical but a fair assessment of the idea," Pieh says. "It's a hypothesis, right? It's a proof of concept."
The model isn’t entirely new. Versions of it are used successfully in Europe and in other parts of the U.S.
Kennebec County commissioners are starting the budgeting process now, and will decide in the coming weeks whether to keep the program alive in central Maine another year.
