Wondering what the scope of the job is. At what point does a MD need to intervene?
Sub IDCs can and have done surgery in extremis. I had an IDC who was FMF in the middle east and performed field surgery on severely wounded people in combat settings. I've seen a guy with testicular torsion in crippling pain have his balls untwisted while underway so he could avoid losing them. That's probably the most intense thing I've seen, but I also don't have much sea time under my belt.
My IDC has.
It depends on the surgery, and like devildocjames said, the location.
Emergency appendix removal and you’re underway on a submarine? Yeah, doc is gonna do that.
Same procedure at a hospital? Doc is not gonna do that.
Now you got me wondering if any IDC on here has performed an appendectomy and how it turned out
This is a common urban legend and couldn’t be further from the truth.
I... I don't think you know what an "urban legend" really is. It's okay to not always be the cool kid on the block.
I don’t understand why you have to resort to personal insults.
I'm sorry you feel insulted? I didn't think it was insulting, but okay.
Are you an IDC or another medical provider? Cause the IDCs in this thread are backing my statement up. When I go to the hospital or a clinic, the IDC can’t even prescribe me medication without having a doctor double check it, but when I’m underway on the big blue wet thing, the IDC has a lot more autonomy. It’s not an urban legend, an IDC, if necessary, is going to complete life-saving procedures to include surgery. Same for while in combat. If surgery is necessary, in a deployed situation, they will do surgery.
Prescribing medicine is not a technical skill. I think that is what everybody is failing to realize. There is a difference between diagnosing and having technical skills. If there is an IDC here that has done an appendectomy or similar caliber surgery let’s hear from them.
Prescribing medication is actually a technical skill and it is controlled too depending on substance. So … my point still stands.
Prescribing medication is certainly a technical skill, buddy.
By technical I mean physical skill which must be learned through repetition. Are you really equating prescribing 800mg ibuprofen to doing a cholecystectomy?
You learn what types of medication and dosages to administer from repetition, too. If you really think that an IDC forward deployed on a ship or with NSW is only trained to administer Motrin, you're mistaken. If you think that an IDC isn't trained to perform emergency medical procedures, you're also mistaken. I have done many trainings with IDC's and performed chest tubes, escharotomy, cricothyrotomy, and numerous other procedures to move you on to the next echelon of care. IDC's are trained to do these things, which are certainly technical. Sure, an IDC isn't going to be doing neurosurgery on a small boy. But that's not what they're there to do. But I'm sure you already knew that.
You no doubt are well trained, I never denied that, but you are not a surgeon. Your civilian counterpart is a paramedic. Last I checked they don’t do surgery either. Paramedics- like IDCs- are experts emergency in medicine. I would take a paramedic over a family doc any day for an emergency.
All I’m arguing is that in response to OPs question, no IDCs don’t do surgeries, despite the common myth that they do.
Urban legend? Lmao it literally happened in WW2.
In today’s Navy if a submarine IDC has a Sailor they have strong suspicion for appendicitis and are alone and unafraid, the boat will likely attempt to steam to friendly waters within MEDEVAC radius…if they can’t for some reason, the CO, weighing the good faith and accurate advice of the IDC will ultimately own any decision to perform surgery.
Coming in hot with the sauce.
It’s also worth noting that the reason we have Physician Assistants as a degree and licensure program is because of IDCs.
Physician assistants don’t perform surgery either. They can be first assists. But they aren’t doing it on on their own.
Also not entirely accurate. An IDC that gets out of the navy still has to go to school for quite sometime. It’s not a 1-1 swap.
No shit Sherlock. The first PAs were IDCs, as I said: the reason we have a licensing program that makes PAs is because of IDCs.
Let me try to say it another way:
The PA licensing / degree program was created using the training given to corpsman with combat medic experience as a model. They built the PA program around combat medic training.
I can explain it to you but I can’t understand it for you.
You know I was being polite with you, but you’re so arrogant you can’t do a simple Google to back up your “tribal knowledge”. Some of the first students were former corpsmen, but the program was based on training doctors to address a shortage of primary care physicians. It wasn’t created because of IDCs as you are saying. If you read beyond the first paragraph you would understand that. I hope you don’t practice medicine in a similar manner.
So here read up PA History
You’re the only one in this thread using tribal knowledge until this last comment. You have a whole host of people telling you that not only can IDCs do lifesaving surgery in extremis, but they actually have.
And this was my source: https://navypa.com/navy-pa-info/blog/corpsman-up-our-pa-beginnings-and-our-future
Our profession began with a vision of Dr. Eugene Stead, who had the revolutionary idea to start a new profession and a new program. The concept and establishment of the educational program grew out of a committee chaired by Dr. Andrew Wallace. Dr. Wallace had worked with Navy Corpsmen at Bethesda Naval Hospital and knew the value that Navy Hospital Corpsmen had in regards to "intelligence and motivation." (Condit, D. Our Military Heritage, Physician Assistant, November 1993)
I don’t practice medicine. If you weren’t barging around picking fights with everyone while being so new to r/Navy maybe you’d know that.
Yes I concede it happened once in WWII, but in response to OP’s question no that is not something that happens now with regularity.
3 times actually, but no shit it doesn’t happen anymore, though it could, and I guarantee if your options were certain death or just try anything you’d magically warm up to the idea of an IDC treating you.
Sea story time!
We were an independent deploying CG - ie no strike group. But although it was during OEF/OIF, we were not in theater.
We had an officer that needed an emergency appendectomy. Rather than have IDC (who was awesome, by the way) do surgery, Sixth Fleet and AFRICOM got us clearance to chopper her to a civilian hospital in our SH-60, along with another woman officer to chaperone her.
Part of it was that her symptoms were slow enough (24 hours notice?) that we could work through the chain of command all the political clearances to send her ashore. But this was also in Africa, on an independent deployer. I feel like it tells you that most COs (and IDCs) will move Heaven and Earth to avoid putting themselves in the situation of HMC/S performing surgery in anything short of a shooting war…and maybe not even then.
Ask yourself this - if the patient died, what would an investigation think?
TL;DR - No need for doc to get gifted a scalpel at graduation. They are trained for it a little, and I’m sure it’s happened, but even ‘emergency’ surgery there are a lot of levers to pull that avoid Doc having to cut.
I’m currently in IDC school, graduate soon. I can tell you we will NOT being doing appendectomies. We are trained to recognize, treat, and MEDEVAC. If you can’t MEDEVAC, that’s risk the CO assumes. You just recommend and advise. If Captain says we can’t, MFR and treat as best as you can. Idk who the hell thinks we’re trained to do appendectomies. That’s insane.
Thank you
Depends on the environment.
A surgeon goes to medical school for 4 years then does 5 years of residency. An IDC is not remotely qualified to do any type of actual surgery.
It still depends on the environment and situation. Where the surgeon is too precious to get their gear dirty or become too encumbered in a FOB or out on a convoy/etc, there would be an IDC. I think you may have forgotten that HMs do more than file records and take vitals. I'm not/was not an IDC, but, if I needed to cut into someone, I would have without hesitation, if I were comfortable with the skill needed to do "X".
It's safe to say, that surgeons have most people's respect for the schooling. I would definitely prefer to have one instead of myself or an IDC cutting into someone, but, when push comes to shove, if the environment and circumstance does not allow a provider to be present then the leak still needs to be plugged.
I didn't say the were "qualified". There's a vast difference between an ED and a tactical environment.
There is a difference between rending lifesaving first aid and perform surgery. An IDC’s job is to stabilize and get the patient to higher level care. They do have higher training than your fleet HM, but nowhere near a real doc.
As discussed in the thread below, no IDC would ever perform an appendectomy. I’ve met a fair number of IDCs that can’t even stitch correctly, the last thing I would want them doing is fishing around someone’s abdomen looking for the appendix like it’s an anatomy class.
I see you can read a book. I'm proud of you and I'm certain your parents are equally proud of you.
the branch of medical practice that treats injuries, diseases, and deformities by the physical removal, repair, or readjustment of organs and tissues, often involving cutting into the body.
Yes, cutting into someone to plug a hole, insert a chest tube (which I have personally done), is still surgery.
I too have met plenty of IDCs. I have also met plenty of providers and supposed surgeons. It's wild how many times instruments and gauze gets left behind by these noble people. It must be someone else's fault though.
Hey though, they went to a little more school.
This kid doesn’t have a great imagination. In extremis, in a no-shit we can’t wait, there’s no evac, we’ve exhausted all options, can’t keep stabilized and this person is likely to die if nothing is done, you would absolutely go for broke. Any CO in their right mind would ask Doc to do whatever they can.
These situations will be incredibly rare, I’m sure a Submarine could at least steam to an area where they could transmit a message for med-advice.
IDC from what Ik can perform life saving surgery but they will be to be seen by MD soon after
This thread is so twisted around the axles. Is, in extreme situations an IDC allowed to do what could be considered a surgery in a hospital probably. Do they have the technical and surgical competency to do it? Probably not. I bet they could do alot if a surgeon gets MSTeams-ed in.
But, there a reason for 4 years of medical school and 5 years of residency. It's to have the technical competency to preform procedures and know what to do when it's gone wrong.
So are they allowed? Maybe. Can they? Probably not.
Anyone can perform surgery - once.
And IDC might even be able to keep the patient alive;)
IDC's will have some trauma training, but they not doing open heart surgery. But in an emergency, they'll do what they can because no one else can.
And MDs don't intervene - the reason you're being treated by an IDC is because there is no MD there.
Their scope of practice is minor surgery. This means no penetration of the major body cavities. Think stitches or removing foreign objects from wounds and bodily orifices.
In extremis someone might need to do something more to save a life, however, they are going to put a college try into getting you to a real surgeon instead.