Show Notes: Medicine & Security: Standards, Curriculums, and Oversight with George DeBusk, MD | Episode #27

Travis

1 year ago

Overview

In this next episode, I was honored to be joined by M. George DeBusk, MD, MSc, FACS, FCCP. He’s a trauma surgeon and critical care physician specialized in trauma and emergency surgery. What makes him a fantastic resource for security practitioners like us is that he’s made a career out of educating, training, and providing medical oversight for security providers, first responders, law enforcement, and even special operations groups.

Dr. DeBusk holds dual certification from the American Board of Surgery in General Surgery and Surgical Critical Care and specializes in Trauma Surgery and Intensive Care Medicine. “Doc” completed a General Surgery residency at Harvard Medical School’s, Beth Israel Deaconess Medical Center and completed a Post-Doctoral Fellowship at MIT during his residency. He is a Fellow of the American College of Surgeons (ACS) and College of Chest Physicians. He is an elected member of the American Association for the Surgery of Trauma and has held the position of State Vice Chair of the ACS Committee on Trauma in the States of Massachusetts and New Hampshire. Dr. DeBusk also holds full medical licensure to practice in multiple U.S. states and abroad where he provides concierge medical care for private clients worldwide.

Topics that we focused on included: what type of medical training curriculum is most appropriate for security or executive protection professionals, how we can evaluate training providers, what the advantages are of having a physician like him supporting your team, and what deliverables you can expect to get from a medical director. And so much more!

*Nothing in this podcast recording or blog post qualifies as legal advice; please consult your legal counsel on all matters involving workplace medical practices.

Highlights from This Episode

The key medical skills that all EP professionals and security professionals should have: First aid and basic life support skills
If you’re going to provide an advanced level of care, you need medical oversight.
It’s fundamental for organizations to develop policies and procedures (plus related training) when it comes to rendering medical aid in the work environment.
The Good Samaritan Law does not protect you as much as you may think…for example, in the context of providing medical aid to an executive that you work with daily, this was not the intention of the law. (Consult your medical director!)
Anyone can teach medical skills, but you need to think about what certifying organizations have vetted their programs, such as the American Heart Association or NREMT.
There are so many considerations that people do not think about — such as conducting a medical intervention in a state where they are not licensed. And organizations employing security personnel also accept risk when they are not following best practices and industry standards.
Having a medical standard builds credibility and trust among ourselves and those outside of security. It is also an opportunity for us to police our own — because, on the flip side, those outside our industry could establish standards for us through the law. It also establishes what is appropriate in the security role, defining the scope advantageously for the security practitioner (e.g., standard VS non-standard practices).
A medical director can help organizations develop governance (policies, procedures, etc.) around medical topics, assess the program, quality control, create process improvement, take the right steps to reduce risk from liability, liaise with the principal’s medical physician, and help protect the protectors!

RESOURCES MENTIONED

Use CONTROL + F to search the transcript below if you want to learn more!

Transcript from this episode

*Note: this transcript was generated using automated software, and may not be a perfect transcription. But I hope you find it useful.

Travis 0:00
...Dr. debusk, it's a pleasure to have you on the podcast, I thought one really good way to kick things off, would be for you to share a little bit about your professional background and education. And then also dive in a little bit about some of the projects that you're involved in supporting security, law enforcement and military. I think that would be great just to give all the listeners like a bird's eye view of of Dr. debusk.

Dr. DeBusk 2:44
Well, wonderful, Travis, thank you so much for having me. It's a real pleasure and honor to be here today and speaking with you and your entire audience. I know the podcast quite well. It's a laudable project and quite well known. So thank you again for having me. Thank you. So who am I? People often asked me they're like, wait a second, how did you get into it? And I was like, Sure, no problem. I'm a double board certified trauma surgeon and critical care physician. So my backgrounds in general surgery and surgical critical care. I specialize in trauma and emergency surgery, although a lot of people say Oh, so you work in the ER. So well, I if I don't have to, I prefer it. Because that means that there's a lot of bad things going on. So I usually spend my time either in the ICU where I attend, or of course as a surgeon in the operating room. But I do a lot of stuff with pre hospital folks, first responders, teaching, educating, working, I do a lot with law enforcement. And that's really how I got started with itI. Working with them, and then special operations, law enforcement with the Massachusetts State Police for their stock team. I was their medical director for a period of time. So as far as my training, like I said, General Surgery was my background here in Boston at the BI Deaconess, which is part of Harvard Med School. And then because I went to grad school, I did a postdoc during my residency at MIT, in immunology, and I have medical licensure and in a number of US states, which is really, really beneficial because a lot of the work I do with law enforcement, especially here in New England, since the states are so close together and on the eastern eastern seaboard, but also with partners in the corporate bond sponsors that are all over the place in the United States and abroad. I have licensure so that I can provide that medical top cover. So it's been very, very helpful to do that. And having been at all levels of of academic trauma, I was there I At the beginning, when stop the bleed ticked off, because I was the state vice chair of the committee and trauma in Massachusetts and in New Hampshire, but when it came to Massachusetts, and because of that, I wrote the medical protocols, at least initially, for law enforcement agencies, you know, again, through work with them as state police and, and doing all of that, you kind of wonder over again, you know, you kind of got into this, actually through a good friend. And he asked me one day we were in the trauma bay, and he said, What do you want to you want to maybe do something with law enforcement? I was like, Yeah, but I had no clue about it, and getting together with them. And then working with at that time, we started working with military, so the ODA and some other groups and medics and what have you through the military, I started kind of making a left turn, if you will. And at that time, doing tactical medicine, or medical tactics, as I like to say, and special operations, I got involved with the journal Special Operations medicine, where I'm an associate editor, and, you know, Soma, which is Special Operations Medical Association. So, you know, at that point, it's like, well, wow, man, what do you, you know, how can you fit, you know, doing 100 220 hours a week of surgery and critical care and working with three hospital folks? Well, something's got to give, and eventually it did Travis, nobody can really do that, you know, it's tough on the family, tough on yourself. So, a couple of years ago, I left full time academic practice, and started a company, just really to help with getting insurance and malpractice and professional liability. So I started an LLC, called SP. And at that time, it was, as you can imagine, Travis, it was to do everything, provide oversight, training, you know, anything with medical devices, so on and so forth. And, you know, a lot of what I ended up, starting to do, I was helping law enforcement families, I get calls from the guys on the team. And more often than not, it was calls about their children or their spouses or something like that. So I was fortunate enough that when it came to, let's say, something, female or pediatric children, which I am not, you know, I can turn to my spouse and my wife, and who's a pediatric intensive care physician, and I oftentimes just hand the phone over to her, I think, can you figure out what's up. But eventually, that turned into a concierge medical practice for them. And now what we do is, you know, fortunately, or unfortunately, because it really just increased the level of complexity and effort and time that you have to spend, we've created an expanded view, actually, for different companies now as visa which has a lot of education, training, medical oversight for protective security, and law enforcement, and military partners. So and then we have a concierge professional practice, which does predominantly High Net Worth families. And in order to manage that, we've created an MSO, a management organization, where we have partners that help us with the day to day running of things, and now a medical device company that specifically does stuff, devices for law enforcement and military first responders and we just got a patent. So of all those things to bring it back around. It's like, well, what, wow. Even today, I see wow, that's a lot. But when you think about it, it's really just helping folks in the community really provide oversight, medical oversight to different folks, because it's becoming a really big medical legal issue nowadays, even in the military is recognize that even if you're six hours downrange by fixed wing aircraft, communications and connectivity, you can't You're really not alone anymore. You're in contact you're in communicate with with somebody in command. And at that point, when you got issues, especially medical issues, you're gonna have to run this up the chain to some degree. So that's, that's me in a nutshell.

Travis 9:39
Yeah. You've got a fantastic background. It's It's amazing. So many projects that you're involved in from Special Operations medicine to supporting law enforcement, MIT, you're a Bruin but we also won't hold that against you.

Dr. DeBusk 9:53
That's right. Yeah, went to USC.

Travis 9:55
You'll notice the logo for the podcast is all Trojan colors.

Dr. DeBusk 10:01
I did notice that, you know, that's one of those things where I was gonna keep an eye on the DL and say much, but no, thanks for pointing that out. But it's a pleasure. Yeah, absolutely.

Travis 10:11
Yeah. And so I have so many questions now that I'm listening to you talk about some of these different topics. One thing I wanted to ask about was just getting your general thoughts on an ideal curriculum for some an ideal medical curriculum for someone working in executive protection. And I'll give you just like a quick background from me, someone who is, you know, maybe has like the most basic medical training on the planet. So, back, when I was doing executive protection, I went through an EMT licensure course, here in California, and that course, in particular, maybe not the best way to learn. So it was, it was essentially like an expedited course, where was Monday through Friday, about eight hours a day for something around a month. And then once you did that, you took the written exam, you did the practical exam, you did all your ride alongs along the way, and then boom, suddenly, you're an EMT, although, really, you only have about 30 days of training. So, so that's like, a brief look at, you know, the perspective of getting medical training from someone who's, at the time, I was only in my early, early 20s, I knew a little about security, and even less about medical. So coming from so just hearing what it looks like, from a non from like a, you know, really like an immature professionals perspective, when they're first getting started in the industry. From your perspective, what is the ideal curriculum? For someone getting involved in executive protection?

Dr. DeBusk 11:54
Where No, that's an excellent, excellent question. Because when you think about executive protection, we're really talking about a spectrum of qualifications of responsibilities. And that's anything from the halls and walls, you know, as we talk about parking lots all the way up to and including, maybe even paramilitary operations, and we always see those photos and pictures of, oh, you know, people doing, you know, advanced training with, with rifles and what have you. And really, when, you know, creating, and setting down any sort of reflection, when you reflect on what do people really need? This is something that many institutions have worked out over 100 years or so. And really to provide for the common good, if you will, it sounds so you know, lofty here, it's really as fundamental as first aid and basic life support. And that's for a lot of reasons, one, because there's a great deal of experience behind that. And that more or less institutionalized, such that it is well regarded, and the majority of things that people are going to see are your very common everyday problems, medical issues. We talked about signs and symptoms, you know, well, somebody's having, you know, diabetic issue, or somebody's having a seizure, or what have you 90% of the things that EMS does, it's not so much and of course, it depends on where you are, are really common everyday issues, chest pain, abdominal pain, stuff like that. So if we were going to provide and if anybody was going to sit back and say, Okay, well, what have, you know, what do we need and what have other people done, other countries have done being involved with board of executive protection? You know, I looked around when I was asked to put together the medical standards, initially of well, what does let's say the UK do, and they do what's known as first responder courses, emergency courses, FRAC, and they have various levels, and that's also proprietary system. But the bottom line is they ask and require for their credentialing and the licensure, preK three, which is really, you know, first aid, basic life support and stop the bleed. So, these are the things that I would say, and I have espoused that when we're asking anybody and that's to provide along the continuum of executive protection. You're really looking at asking folks to know first aid and basic life support.

Travis 14:59
Yeah, that makes sense. hence just focusing on the most common and most critical issues that we could expect to run into. And just day to day, it's not necessarily going to be, you know, using them using the sexiest tools that we bought on Amazon from a special provider to use, like a chest seal or something crazy. It's more, it's more attending to like the routine things that happen, someone's trips and falls, they need a sling, they need to cover an open wound and clean it.

Dr. DeBusk 15:29
Correct. And I will say that, since you brought it up, when we're talking about more advanced medical techniques, I know lots of folks, you know, in the United States in CONUS, and abroad that do have a medical kit, it's important to understand that if you're talking about executive protection, those those teams, those details that do go abroad, there's differences in potentially licensure and what people can and can't do, what medications that can and cannot give, if at all. If somebody needs advanced medical education, then fine that that's wonderful. But I'll tell you, I'll give you an anecdote. While I was working with the State Police, I had started a medical Consortium for what was or is known as netpac, New England state police administration compact. And basically, because the states are so close together here in New England, it's very common that, you know, special operations team SWAT are your stocking will go across for mutual assistance and mutual aid agreements over state lines. Well, that's great. And, you know, we have everything from, you know, one state team, having zero medical assets to another team having an extensive amount of assets, including a physician that goes with them, that does their medical threat assessments, their medical advanced. And, you know, can you call in additional assets, you know, so we saw the gamut. But what we noticed is that, when you're when you're doing anything medical, and we'll touch base about that later, but anything medical, you have to have the credentials and the licensure to practice if you're going to be doing anything more extensive, the minute at least a Massachusetts you think about placing an IV? Well, now you're talking about an advanced life support rig and ALS rig, and you're talking about a paramedic. So doing anything advanced is going to require absolutely require a physician medical oversight, you know, medical direction. So when we talk about, well, what to what do folks in EP need? Well, I guess it really depends on what your job role is, if you're in a private, you know, family, doing, you know, EP for private family, well, how often are you really going to need to do something extensive, God forbid, you do anything at all? You know. So, I think it really depends on what folks are doing with their job roles are, it's better before people start thinking yeah, I'm gonna get this really great, you know, check dealer, you know, needle decompression, or this basically a stomp bag for those folks that know. You know, like I said, going back to that anecdote, our team went over state lines, and I had a wonderful conversation, I'm being sarcastic, with the State Ag who said, Look, if your guys come over into my state, and they provide this advanced medical care, and you at least providing top covered do not have medical licensure, or them for that matter, the credentials and something goes sideways in, in their job, he's like, I'm gonna hold you for practicing without a license. So people need to be very, very careful that that experience for me alone, Travis was eye opening, somewhat nerve wracking, because then it was okay, well, creating this consortium, we've got to be supportive of the different teams. And that's really why I went and started gathering different licenses in the different states in New England. So yeah, I have licensure to practice medicine in a number of different states here and abroad, just to provide that top cover to the teams and the details.

Travis 19:40
Right, yeah. And even thinking a little outside of licensure and just like, day to day how organizations operate. I've definitely talked to a number of people working in private security roles, whether it's executive protection, whether it's private security at like a retail or entertainment venue. And I'm talking about not third party providers, people that are full time employees of the organization. And there have been a number of times where I've chatted with them. And when it comes down to, I guess, their understanding of policy and protocol for providing medical aid, usually, the it's like a very gray area where they, they feel like it's their duty to intervene and help someone, but not necessarily that there's specific direction from the top that says, you could do X, Y, and Z, and you can't do A, B, C, and D, you have to leave that for someone else. So that's something that I that I've seen a little bit of, too.

Dr. DeBusk 20:42
Yeah. And that's an incredibly important topic. Because when I work with fire departments, law enforcement, more often than not, what happens is there's a physician. And that's usually an emergency physician, but it can be a trauma surgeon, or really any number of physicians, but I find that it's more like an absentee landlord relationship. Crews, EMS crews will come in to the trauma bay or something. And I'll see they've done something, again, another anecdote, they'll they'll have done some sort of therapeutic, let's say, for those people that know TX, a tranexamic acid for bleeding, and the patient's completely fine, you know, they're sitting up talking or whatever. And I asked him, I'm like, Well, why did you start this therapeutic? This medication? It's like, well, it's in our protocols. And I'm like, Well, have you discussed this with your medical director? And they're like, No, we don't even know who they are. So. So I, I find that happens more often than not is one, if an institution or an agency as a standard operating procedure protocols, I've I've known institutions, one in particular that had a shooting, unfortunately, there was a negligent discharge on the line. And while you know, the person was holstering, and they had no protocol in place for dealing, and this is actually a statement, state institution, they had no protocol in place for managing or dealing with that, with that problem. That's somebody getting shot on the line. So when you ask, Well, okay, at a fundamental point, what what do we need? And that's, again, going back to why I started the company initially, when working with first responders, is that okay, at least, at a minimum, have somebody put in place a policy protocol of how to deal with things and, and those are actually very straightforward to come by, I get a lot of requests for that. And to be honest, that's the most fundamental thing that SP that does, is create policies for agencies, companies, you know, protection, executive protection, overseeing what types of education as we talked about, you know, they're going to need their licensure eventually. But it's really those policies. Others actually have a policy or something in place, but it may be, let's say, old antiquated or simply not applicable. So that's kind of the next level, it's like, okay, well, let's see what you folks have in place. And is it now at this point, you know, applicable? Is it pertinent, because one thing that we probably all know about working in EP is is insurance. And what's interesting about that, and not to go off on too much of a tangent here, when talking with one insurance company for EP, I asked them at one time. So how often do you offer, you know, an additional writer, or any sort of medical contingency medical problem, let's say, for example, your your client, your principal, is an older gentleman, let's say 56 years old, and a corporate executive, and this person and he was don't know this, but let's say that person has heart disease, they have diabetes, they have all these problems. And like I heard before, it was Fred Burton, who mentioned that at one of the conferences a couple of years ago, he said, You folks in EPA are going to encounter more likely going to encounter a medical issue more than they are somebody pulling out a gun or somebody you know, trying to shoot your client or whatever. So it behooves people to really get a you know, getting back to the education training, but really having that medical oversight, because like you say, they're almost flying blind, they don't know what they don't know. And that that could be a big problem. People will say, Well, I'm protected by the Good Samaritan Law. I don't know if you've heard about that, Travis, but I get those questions, you know, periodically, and I have to let folks know, it's like, well, that's not necessarily true when you're being paid by the client, you know, the client, Good Samaritan laws were put in place. And, again, I'm not an attorney, I have to always let people know is the disclaimer, not an attorney and work with one, I certainly don't play one on TV. Nor do I, you know, it's 1000s, you know, my legal consultation. But the fact of the matter is that the Good Samaritan Law really is variable, in its interpretation from state to state, some states have a very, you know, conservative approach to it, where others are less so. And that is, again, those were put in place to protect first responders, actually immediate responders, those people that were nearby, from the fear of any sort of legal peril, by just trying to help their common, you know, their, their neighbors, so to speak. And unfortunately, the the aspect of that, that criteria were that, you know, for those people that, you know, may know that the Good Samaritan parable, it was somebody who, you know, didn't know, the person who got beat up. They didn't do it for any reward. And a couple of other things, they didn't plan for it. And the aspects of, you know, a theory of for the Good Samaritan Law don't necessarily hold true for EP. I mean, we hopefully know our clients or our principals, we get paid, you know, by them. And if we do have any additional medical training, well, the next question becomes, well, you know, what can you do? What can you render us as aid? You know, because, again, there's a lot of I mean, it the medicine is such a litigious yield. And like I've mentioned before, even the military was, is getting that. I mean, you saw recently in the New York Times, or at least you've heard about the SEAL team. You know, SEAL training, one of the things they said, when that fella I think he passed away from training recently was that they did not have appropriate medical direction medical oversight. That was a big thing. You know, so here you have one of the world's foremost Special Operations and, and training that I mean, it's, you know, almost mythical, you know, medical training yourself being out in Southern California, you know, having been in the Marine Corps, you know about it, and yet, here we are to this day, and, you know, even even, they do not have appropriate top cover medical top cover and medical direction. So how can we put that through, you know, and translate over to EP, I find a lot of paucity there's a real lack of appropriate medical oversight.

Travis 28:20
Yeah, those are all very interesting points. And I think you're, you're kind of diving into the next topic that I wanted to mention, which is really the benefits of medical direction when you talk about understanding Good Samaritan about potential legal issues involved when people lack the protocols when maybe when they lack training when they lack specific direction from the top. So can you can you tell me a little bit more about what medical oversight looks like in a typical organization, whether it's EP or otherwise, just so people out there who are less familiar can understand how that works?

Dr. DeBusk 28:58
Yeah, no, my pleasure, really, when we're talking about medical oversight, I like to explain to folks that it really comes down on the shoulders of the physicians, that they're really there to provide direction, Insight assistance. And in order to do that, first and foremost, there should be a collaborative relationship with the EP team, where we're there, like I said, to support where, at times, I find, you know, and I've heard this before, that physicians are in this ivory tower. And it's unfortunate, because that's really not my perspective there. You know, in order to ensure that any sort of operational and clinical components, you know, and administrative for that matter, they have to be cohesive and and complement the role of the PT and And we're but just one component of that. And when you talk about teams that, you know, what their responsibilities are, what are the things that they have to manage? You know, notwithstanding the personalities, let's say you have a principal, but also, you know, their roles. You know, the last thing they need is, is a physician who, you know, whose ego can barely fit through the door. You know, and I found that out in dramatic fashion, when working with law enforcement, and, you know, the stock team. You know, it took a couple years, I will be quite honest, it took a couple years before I felt that I was accepted by the team. And that's just that, and that was, you know, nothing, you know, particular to me are specific to me. The other physicians that I've talked to today, they said the same thing people need to feel comfortable with you. And they need to understand that the medical practice standards, because again, like you mentioned, you, you have a background in medicine, you know, to whatever degree, you were an EMT, or let's say you're in the military, and you got some, let's say, stop the bleed training, or T, Triple C, or what have you, they need to feel that you're going to force multiply, if you will, or at least augment and support what they already know. So that whatever medical training is, is sought, you know, that they're looking at, and I've heard Travis so many different things, of really high speed operators as Ge, what are the you know, the war on terrorism is winding down, you have these incredibly well trained high speed folks coming back from overseas, and now they're selling what they have a skills, their skill set for an inordinate amount of money. And at the end of the day, you say, Well, what are those standards? You know, how, where, who's certifying, who's licensing? Do we get continuing education? As you mentioned, for EMTs, which I think is a great education and training, it's like, okay, well, where are they? Are they providing the hours, the continuing education hours? Is there an institution that is, you know, providing that, you know, so again, with medical oversight of that adherence to medical practice standards, ensuring certification and licensure personnel is not only, you know, there, but it's up to date. And, you know, making sure that if there's anything as far as quality assurance and performance improvement to be done, and there always is, that's the whole point of it is that, even if it's a simple medical issue that a team got involved in, and again, like I said, I go back to it, the majority of things that are detailed is going to see as a medical issue, is there any AR or after action report? It was there a debrief? Again, you know, Principal, I had a bellyache. Okay, no problem. But But it had been something more serious, you know, because your principal have an inflammatory bowel disorder. And, you know, I've come across on multiple occasions where a principal actually, you know, you know, will have such bad issues with their condition with their their medical problem, that it now diverts, it becomes the biggest thing that the EP team has to deal with this person has to be in, you know, close distance to a bathroom, let's say. So, I've seen that, you know, it, most folks in EP don't understand that, you know, at least when I'm doing an advance of even a fundamental portion. The client, the principle is not necessarily going to let you know, their medical issues, and yet, it becomes probably the biggest threat that a team could potentially face, you know, so while their minds are on, you know, this, this this bad player, if you will, or making sure, you know, they can, you know, there's a good egress or what have you. That's my perspective. So providing that oversight, you know, also entails knowing the client and then I compile that and I turn around to the agency owner, the EPA agency owner or, you know, the AIC or what have you, and I say, okay, these are things that I can tell you, because of HIPAA and privacy standards. But these are the things that you should be cognizant of, so that whoever's running the detail, or the agency owner can then you know, either make that adjustment, that allotment or And or the agency owner can then go back to the client and say, Okay, well, there's going to be these additional considerations for the team. And therefore, we're going to have to, let's say, add, let's say, either an insurance writer, which will increase the cost and, and that's another thing that we do and as people does is like, okay, when I go to, you know, when I'm consultant, and when the company's consulted, they then agency, that up agency will then upsell those additional services, those medical services, because, again, it's not just, you know, the belly aches or whatever it's, well, we are ensuring for the client's total safety, and security. Because, again, if you have to hit a bathroom, you know, every 40 minutes, and I'm, I'm exaggerating here, but when that is such a consideration in the mind of the principal, believe it, it's going to be an important issue for the IC and for the detail. So that's part of what you know, we do as, as a company is help provide that additional asset to EP t. So you know, and again, like I said, it has to be collaborative, and it's not there to break the bank, because I get that a lot. Oh, you're a surgeon, you're this and, you know, well, yeah, I am. I enjoy it. But that's not what I'm here to do. Like, you know, when working with first responders and law enforcement, I'm here because I really do enjoy the community. And I really do want to provide that additional component and asset and that's something I find really engaging, and other people do, as well. I mean, that's our, that's our livelihood. Right. That's our these are our careers, you know, Travis. So, you know, we're really there just to support and it's not, you know, anything exorbitant in any way, shape or form, you're not, I'm not surgery rising, the people that I employ, yeah, they're orthopedic surgeons or their, their, you know, ophthalmologist or pediatric intensive care folks, or whatever they happen to be. They're there as consultants, and you know, a lot less expensive, than a lot of the attorneys that I'm finding are out there. And I don't mean to be pejorative with, you know, legal counsel, there are wonderful help. But the fact of the matter is, is that, just like you would go to an attorney to ensure you know, that you have appropriate counsel, it's the same idea, and you're coming to a physician who has experience with law enforcement and has experience with, you know, EP, secure transportation, for instance, we're working with now that, you know, our corporate clients may be different, they may need something different, versus our solo practitioner. So look, practitioners would do very, very well, just to have an SOP and place a policy in place that, again, if something does go sideways, and somebody starts asking questions, we all hope that it doesn't, that's great. But if it does, when those questions do start to come up from risk management, God forbid, third party counsel, legal counsel, or what have you risk adjusters, then even the solo practitioner, because they Yes, I have this in place. I, you know, it's it's usually boilerplate Travis, a lot of the stuff that we provide, and it's really not expensive at all, that here you go, here it is, if we need to adjust it for you, that's great. We do. But again, EP folks need to know that something has to be in place, whether it's, you know, simplistic,

or extensive and complex, knowing that that's in place makes it a lot easier when anybody even a client clients will ask, you know, well, my, my, my principal, the, you know, our, our charge, as you know, a lot of issues, are you guys covered for that? You know, then you can say yes, we do here it is in place, and we have, you know, periodic reviews, Qi quality improvement metrics in place where we have, let's say, outside, you know, third party, let's say ourselves, or, or whomever that has experience with these things in medicine, that, you know, again, we update as necessary, and we ensure that the client again, is it's not just their personal bodily safety, but it's, you know, their medical safety and security as well.

Travis 39:29
Yeah. It's fascinating to hear your perspective from being in that position where you're giving medical oversight for organizations like that. And when you talk about, like, how inexpensive it is, I mean, definitely people have to also think through okay, what's the cost of like, you mentioned, outside legal counsel coming after the organization or just thinking from the most pragmatic perspective, having medical oversight might be, I mean, it very well might lead to you saving your clients life, if you could To, you know, dispel some myths that some of the some of the agents might have picked up in a week long course that they did, or maybe just shedding light on how some of the tools are supposed to be used versus how they're actively using them right now, or just deploying additional medical equipment and gear that they hadn't considered, given, like you mentioned, being cognizant of the person that you're protecting their age group, their health consideration. So yeah, there's definitely like a cost factor there too. But then also, just on the most pragmatic level, when it comes to increasing the opportunity and likelihood for potentially saving someone's life or giving them aid in a situation that's significant. Definitely a lot of important points there. And another thing that I was thinking about as you're talking about that, too, was just, I wanted to get your thoughts on how people should think through selecting the right provider for training because I could, I could give you just my my rudimentary perspective, when I was in my early 20s, looking for an EMT course, I was looking at whether I could get the license, whether it would give me the license, the price and whether I could do it while I was going to school, essentially. So unfortunately, those are my criteria. And it probably should have been a little different. And then I think, to some degree, also, I think a lot of us will see really awesome marketing and branding from providers on all the social media platforms and on their websites. And if you'd like some, like for me, I can speak to myself in particular, when I see really cool branding and marketing, it does draw me in, when in fact, I probably know very little about the specific curriculum and the people that are operating the business and teaching the courses. So I wanted to get your thoughts on that area.

Dr. DeBusk 41:56
Yeah, absolutely. And again, excellent, excellent question. Because when we look at who is providing the education, I've said it before I've written about it, and there's lots of people out there who have great experience, and not to, as for myself, as a medical educator, teaching medical students teaching surgical residents, or whomever, even Junior attendings. I still teach at the Massachusetts General Hospital, you know, both, you know, in trauma. And one of the things that's important for anybody looking around is what are you know, you can find any number of courses, but the biggest question is, are the courses that are being taught are those from, you know, well respected institutions, let's say the American Heart Association, or the, you know, any EMT, National Association, you know, for EMTs, and, you know, EMS, anybody can teach? And I said this before anybody can teach. The question is, you know, when you're looking at that person and their institution, again, you know, do they have the NREMT supporting backing them? Are the certificates that they're getting, are those signed off on by a physician, a medical director, do those come from like, is that the American Heart Association? You know, because, for instance, when it comes to doing something like T ECC, I'm the I'm the medical director for, you know, an EMS Training Agency. And I'll tell you, just to do that alone, just for them, number one, to become an accredited training center. The the process, the application process, was was quite extensive. I had to provide a criminal background check of myself just to become the medical director. For us, you know, at least initially, or I should say, the first one I did for a small EMS Training Agency, it's since grown. But if somebody's going to be taking that training, are the cards that they're getting back. Is this a you know, an advanced cardiac life support card? Is this through the American Heart Association? These are the things that are important to any MP, I've spoken to them recently. And again, you know, there's a lot to go through for a training center to become credentialed. So again, anybody can teach. But I think some of the things to ask as well, okay, who is supporting this? Who's the institution behind it is this let's say an anti standard? The board of executive protection is going for antsy certification. Is this cap seeing basically for any sort of educational program, as an outside party come in to evaluate and you know, credential, the training program, the education program, something that we do is we create medical training programs that really kind of, you know, simplify and distill down the most important things that EPA needs. But we're doing that for corporate clients. But again, what, what is the background there? And how much time have they invested in that, because the other thing to note is that when, when a credentialing body comes in, as I mentioned, you know, they're looking at my criminal background, which, you know, thank god knock on wood, there is none. But you know, it, it asked that question of okay, well, who are your instructors? You know, when was the last time they got credentialed? What was the last time for yourself? As a matter of fact, you talked about ride time on on an ambulance, you know? Well, when was the last time you did that? When was the last time they practice? I mean, I think it's great that people are out there teaching what they learned, you know, from their time in the military or whatever. But if somebody's had this, you know, ages ago, you know, over two decades, well, I'll tell you this right now, just for myself, and my credentialing when it comes to medicine. I have to do that every couple of years. You know, so, medicine is, you know, yeah, I agree, you know, anatomy and physiology doesn't change, but the way we approach it, and that's another reason why when I hear tactical medicine, I'm like, Oh, well, that's great. But what we're really doing is we're taking medical concepts, medical techniques, medical management, and we're adjusting those to fit, tactical situation. But again, we're trying to apply things in a way that makes it feasible for the mission, you know. So that's why I say it's more like medical tactic than anything, but people need to be cognizant that whoever's teaching them, anybody can do so. But Caveat emptor, you know, be aware of what you're buying. And what you know, comes for that, because again, and I hate to say this, but I see so many people doing this. And that is, you know, I even seen, you know, some first responder agencies get and pay 10s of 1000s of dollars for training. And at the end of the day, it's basically like, you know, somebody a person's training program that they picked up over the years. And this is what they're teaching. And it's like, that's great, but if it's a medical legal issue, and somebody says, Well, okay, let's say, chest compressions or whatever, you know, heart attack. Okay, great. You took CPR from, you know, the American Red Cross? No. Okay. American Heart Association. No. Now, again, I'm being you know, I'm exaggerating, you're being dramatic, or dramatic at the bag. But the fact of the matter is, people, you don't want those questions and not that appropriate, up cover. Because, again, if you're going across state lines or into state, you know, and somebody has a medical problem, probably the only thing that you're going to be able to do, number one, it's not going to be pulling out anything from your stump bag. It's going to be you know, get them to the nearest hospital, you know, stat, you know, as quickly as possible. Because if you do do something, and I've heard this from other ERP providers have focused on details. They've, they've gotten themselves into into legal trouble. They've been sued, you know, again, it's not the criminal issue. That's the problem. It's the civil and that's an for this community, you know, and your listeners, Travis, the biggest issue is the civil and anybody can bring up anybody has civil liability, especially for EP employers, you know, that gets to vicarious liability when you're talking about teaching and training. Because any supervisory party and that's the issue, you know, I can't I'm not an attorney, but I've dealt with it as a subject matter expert. When I get called to testify. It becomes, you know, well, did the employer provide, you know, you know, the appropriate training, you know, this this person is conducting an activity. Well, that's great, but did they have improper ambiguous orders or the day ale in providing that employee proper, you know, protocols, procedures, as you asked about, initially, early on, you know, you know, did what they do in the employment, you know, did that involve risk or harm, you know that that's where I see a lot of things. And I hate to say it, but when I've gotten all my counsel, you know, whether it be an insurance issue or what have you. And they asked me, you know, is this, let's say, standard of care, or this is something that wasn't placed as protocols in place? Is this appropriate? Is this standard for somebody else in a similar situation to perform? And I'll tell you, if that that agency does not have anything in place, then it's very, very hard to support them. And I really, really do. I certainly don't want anybody to have these these issues. Like I said, I'm in this community for a reason, in up for reason. But I'll tell you, once people start talking about negligence, man, it it's hard for me to say anything other than No, I don't see any policies in place or protocols. You know, the training that they receive didn't come from, let's say, you know, any of those institutions, the NMT, did not credential this Training Center, or what have you. It becomes a perilous pursuit. And I really would hate to see and I do. But, again, if I get called, and I have, then I have to be honest. And and that's the end. That's the worst part, you know, having those types of issues come up. Yeah, hearing

Travis 51:30
about all the different legal aspects that are, you know, there's so many, there's so many things that we just don't know, when we're not doing this day to day, I think it just makes such a greater case for bringing someone like you bring someone like you on board just to get general advice from the top and at least identifying the low hanging fruit for, hey, here's what your organization's doing. Great. Here's some big areas of improvement. And then also, also, you mentioned some good points too, around how everyday practitioners who are not practicing physicians can, can I use, like some simple cheat codes for evaluating providers, like you mentioned, whether they're accredited by an AMT or American Heart Association, and then also thinking about whether there's any type of third party credentialing, like we do third party credentialing in security for so many different aspects, and then thinking about that on the medical side, too, just so you could have an outside perspective for how the work is being done, and the organization providing the providing the training the instructors themselves? I think that's, that's huge and very important. And that, that also connects back to, you mentioned the anzi standard. So you and I are both members on the board of executive protection professionals. And for those that are less familiar, we're working, we have a technical committee and a working group of 180 plus people working on developing an Anzi, American National Institute standard for providing executive protection, and duck. Dr. debusk, you're one of the subject matter experts working on the medical portion I wanted to get get your thoughts. What do you hope? Or what do you envision coming out of this standard? How do you envision that impacting the executive protection and really the security industry because others will also be paying attention to the standard and taking away some of the big important pieces?

Dr. DeBusk 53:32
Right now? Absolutely. And it's been a pleasure to come into this community to try and create something that provides a foundation that we can point to as as an industry and say, Okay, we have something in place where there was nothing beforehand. And you mentioned, you know, and see the American National Standards Institute. And really, I've written about this, I even brought this up at the recent conference that I've been talking about this for the past few years. And when we talk about standards, medical standards, and in particular, any standard manages expectations. I've put that in writing, I've had that in, you know, my my talks, my PowerPoints, and really what that does is and this is my hope, to your question, and that it creates a baseline for practice performance, it should establish consistency and uniformity. And when you do that, then it allows evaluations and comparisons, you know, especially for safety measures. Because once you do something like that, and this is where it's it's really interesting, when you talk about okay, well, how do you folks do it in medicine, because again, it's so litigious. We've talked about quality assurance and performance improvements. Well, it gives us the ability to create metrics for acquiring data and analyzing and looking at that and again, Why is that important? Well, I have had, you know, wonderful conversations, again, being a little tongue in cheek here. When speaking with other physicians, when we have what we call our morbidity and mortality conferences, and for your listeners, and for folks that may not know, that is, more often than not, at least in surgery, a weekly conference where you have all of the surgeons in an institution in a hospital get together, which is always tough to get everybody together, but it's so traditional, that we get in together in a room and we air our dirty laundry. And that's where we basically say, hey, look, you know, I did this, I perform this procedure, this is what happened, it didn't go, you know, the way I was expecting it to, and more often, not what it should be, instead of the Inquisition, you know, it and a lot of people, unfortunately, have weaponized, that that's not the intention. What it is, is where there is visibility, and transparency, again, as the BPP in NC requires that mitigates it lessen your legal risk, besides also, providing education and instruction that nobody's perfect. And neither the lawn or insurance that nobody assumes, or presumes that we are, right, that's, again, you know, tongue in cheek, it's like, well, that's why we call it practicing. You know, I practice medicine Well, okay. But really, by so doing, you actually have a community that stands together and says, Okay, this is what is appropriate. And there's the responsibility, and also that reciprocity, such that I, and I've had this before where I've been deposed. And, you know, you'll have counsel come by, and they'll start jumping on, you know, this particular medical book, you know, are you familiar with this? Doctor? Yes, I'm familiar with okay. Are you familiar with this, Doc? Yes, I'm familiar with it? Well, again, if you don't have something like that, no matter no matter what it looks like I, you know, I've heard recently, I was reading something from from one EP group, and well, the standards, you know, it's gonna, it's going to be watered down, it's going to supposed to be for everybody. And therefore, it's not really going to be for everybody, because we're talking about the lowest common denominator, and therefore, it's not going to be applicable to everybody. And, you know, are the people that are specialists, I have to disagree with that. Because fundamentally, regardless, if there is no standard, then you get the wild, wild west, and whose expectations right, the last person you want. And this is what we have seen in medicine, especially surgery, those expectations then become the prosecutors expectation. And God forbid, it goes to it goes to trial or something like that, because I'll tell you, the last thing you want is somebody outside your community coming in and policing you and asking questions, nobody wants that. So, you know, when we talk about these standards, and creating them, it's what is applicable. And again, the way I approached, you know, writing the initial medical standard, or the BPP, I looked, I literally went both within medicine, but also within engineering. And then eventually looked around the world at what other countries do for their standards when it comes to security and protection. I bring up the SIA the UK is sia security. You know, like I said, they require first responder medical training to get licensure, you know, as you know, different states here in CONUS, in the United States will require licensure, but at the end of the day, what providing those standards as I as I'll say, again, again, it manages the expectations of our community of our industry, and amongst our peers, then it builds that credibility and that trust, such that any outside organization can then look to those standards and say, Okay, we have something they have something. It's been discussed, it's been scrutinized. And therefore, it's something that can be trusted because many, many people and as you know, the types of advisors, the people involved their credentials, their backgrounds, yourself, myself, the other members of the board, our legal counsel that's on the board, we can point to that and say, No, we really have a wide swath, we covered the breadth of the perspectives within EP, that we can actually now feel comfortable in saying we're putting this forward for the scrutiny of our community of our industry. And eventually, the other point that I like to bring up, and that's something that a lot of folks don't necessarily recognize is that this actually defines deliverable, or consumer consumers. How many times travels? Have you and I heard, right, you know, a client or principal, asking a specialist, an EP provider, to do something that really is outside their idea of what their duties and responsibilities are? You know, yeah, you're trying to provide the summer. You know, I know, you're, it's a consumer based market, I totally agree. But then again, there should be an align that there's a minimum expectation between you, of the provider, the provider and the client, you know, I like to say no more, no less, you know, this is a place that I'm not going to go and I know what more or less the going rates are for this, that, you know, there. And if you want to upsell something, there's transparency, the deliverables are, you know, defined, and that, again, like anything protects, you know, the provider and, and the client. So, again, putting those all together, those medical standards that you were working on. It does, it creates that baseline for practice performance, enables the comparisons, the Quality Assurance and Performance Improvement, whereby it ultimately is going to limit, you know, and decrease mitigate the legal risk. I think that credibility and trust that comes along with creating standards, you know, is really, you know, immeasurable. It really is. It's hard to really say anything other than that.

Travis 1:02:23
Yeah, it's really cool for me to hear about your perspective, where you're not just thinking in terms of what's going on in the US, but you're looking globally, at other countries at other organizations, like you mentioned, Sia. So for me, it's just really cool just to hear about your approach for helping develop some of those standards that we'll be going into the anzi EP standard, and then also your, your approach for developing a baseline so that we could compare different programs so that we could gather metrics around I think he mentioned safety, uniformity and the way that they approach medicine. So for me, it's just really cool, just to hear about your approach. And I think, for today, when so much of it is, like you mentioned the Wild West, really, the best way to go about it is developing that initial baseline. And then as the standard grows in the future, you know, maybe we can make that more specific and define more niche areas. But yeah, a baseline sounds like absolutely what's needed,

Dr. DeBusk 1:03:27
ya know, and, like, you know, it's a pleasure to be part of that. Because, ultimately, for me, I still have my day job. You know, and, you know, as, as I, as I get older, yes, you know, I'm getting older, and I come into contact, and I work with, you know, folks around the world, at some point, we have to stand up and say, Listen, you know, this is what the Japanese do or don't do. And that's, and that's an interesting thing, you know, because of the recent assassination of the former Prime Minister, when I went back to providers that I know, in, in Japan, I said, Well, what what does your credentialing body? You know, what do they do? What do they require for, you know, medical, for instance? Because that's, of course, my mind. They said, Honestly, we don't have anything and you're like, You're choking. You're the Japanese for Christ's sake. I mean, you guys come up with, you know, Toyota, you guys came up with, you know, all these, you know, metrics and ways to improve, you know, how you manufacture cars. Exactly. And you're telling me that, that you guys have nothing when it comes to security? And they're like, Nope, we don't. And you're like, Oh, my God, and then I pivot. And I looked at the Israelis, let's say and you know, because of the continual conflicts that they have there, or in Europe or what have your South Africa for that matter. So when I put together the standards, the You're looking at, as I mentioned before, you know, a wide breadth, a whole spectrum, from somebody watching a parking lot, God bless them to somebody who's, you know, armed. And in a paramilitary role, we have to provide for those folks that are, whether they're in the United States or they're in another country, whoever is putting together their SOPs or policies or procedures, needs to know that, where are they, what their capabilities are, you know, what they should be aware of, and where they're going to go so that if we're going to create this standard, that has to reflect the entire industry, or the industry as a whole, as I like to say, and that's anything again, it has to be applicable from the solo practitioner, all the way up to corporate and corporate teams. You know, I've heard recently that there's a large, multinational global provider. And I won't get into specifics, but I just found out they have no medical director, they have no medical oversight. And I'm like, I was, I was floored by that. I floored by hearing about that. And I said, Oh, my God, if again, you know, for all the things that we talked about, how, how can you say that what you're providing, is appropriate. And that's the thing, you know, again, bringing it back to what does that EP The fundamental EP provider need to have, since we're talking about medical, and I'll say it again, it's first aid, basic life support, you know, even pediatrics, we've created a critical pediatric management care course, there is no pediatric trauma, life support what you know, which is, again, phenomenal to me whether, you know, we're talking about the American College of Surgeons or American heart or whatever, you know, what is there, you know, out there that can deal with that, when you're talking about EP as an immediate responder, you know, again, even a fundamental thing that will protect, again, like I said, from the solo practitioner all the way up, just having a policy in place, you know, it's there at now, you know, law firms that you could go online, and they'll give you something, you know, I know, there's a lot, there's a lot of online, legal, you know, firms that will, you know, you'll pay X amount of dollars, and they'll give you a trust or whatever. And that's kind of what we're talking about here. If somebody, again, from the solo practitioner all the way to corporate, as that policy or that SOP, it can be very boilerplate. But if you don't have that, and you have a third party coming in and asking questions, and again, it doesn't necessarily mean that anything's gone sideways, they may just be evaluating your agency, your company for appropriateness Do do you have these things in place? Are you going to obtain medical writer or something? Oftentimes, again, unless an EP agency asks the insurance provider, my understanding is they don't even offer a medical writer. And yet, if it's the most important thing, it's the number one thing that somebody is going to encounter? I find that that right, there is there's some parallels there. There's some, you know, liability issues, but at a minimum, having just a piece of paper, a and just a policy in place. And again, it's not expensive saves really, really provide protection for the protectors, you know, what I like to say it's, it's, it's getting back to that movie, you know, who, you know, protects the protector, right? Because people don't know what they don't know. And unfortunately, there's a lot of people out there that are that say they provide medical care. I've every conference that I go to. I talked to folks and they say oh, you're a doctor, and you're an EP hmm, yeah, okay. I've heard, it's like, great, you know, you're gonna charge me an arm and a leg, you're gonna, you know, ask for my firstborn child. No, no, no. I, this is a great one. There's a very large company that provides medical services globally. They're met medical oversight their medical director as a phlebotomist. So, suppose I will rate It's wonderful if they're, they need to draw blood, but do they have any trauma experience? Do they have any EPA experience? Do they have any you know, etc, etc. Do they have any military experience? Do they? Have they done anything with EMTs? Nope, nope, nope, nope. Great. Another company I just spoke with the owner there. He's said, oh, you know, and talk. And, you know, I used to have a position. I'm like, great, you know, what were they like, you know, you're one of the few God bless you for actually, you know, thinking about it. And he goes, Yeah, they were an obstetrician, and gynecologist, and I said, Well, okay. And boy, did they charge an exorbitant amount of money. And I was like, I was I, and what did they buy? For you? Did they give you this? That and yeah, that, you know, the things that we talked about today, you know, these are basic things, you know, as we talked about standards and meeting these expectations of the community and an industry? And they said, no, no, they just wear a name on a page. And k gets back to, you know, these EMS teams, and, you know, these physicians that, you know, oftentimes, you know, EMTs, you know, fire departments and what have you, there's a physician, and it's a name on a paper, and, like I said, they're, they're nowhere to be found. And yet, you know, folks go out there, and it's like, it's almost like charlatans, you know, I really, and I don't mean to say that about my own, or be pejorative in any way, shape, or form. But you ask about, well, what should the EP provider be asking? Well, I, again, I think there's things that, you know, as I mentioned, again, they should be able to, you know, have a collaborative relationship, provide the, you know, development implementation for any policy and procedure. And again, that, you know, for medical director, the standard, I've written about this, too, you know, and put it in EP wired. And that is, you know, whatever that medical director does, when they have to be engaged, they have to be there, because, you know, if they aren't, then that becomes an issue for negligent supervision, even though, like I said, I brought up, you know, the recent issue with the SEAL team and SEAL training for buds. You know, if that's not in place, you know, that, that would open up the liability, you know, for negligent supervision, vicarious liability, you know, so, when it comes to finding that doctor, that position, and it should, but, you know, whoever they are, their services should be distinct and non competitive, you know, there should be no inherent conflict of interest. And they need to be upfront with that, you know, I mean, because if they have their own XYZ or whatever, then that could bring them into conflict. So, there has to be that disclosure, they have to be able to develop a medical policy protocols and guidelines, and yes, policy at the different from a protocol and from a guideline,

they should know what those differences are, I mean, I've written, you know, from, whether it be in medical journals, or, you know, manuals, trauma manuals for the different hospitals that I've been to, you know, somebody has to have that experience, you know, whether it's in place, and all you have to do is just look it over, peruse it, or actually create it, but they should be able to understand and oversee, you know, the medical education of your, of your folks, if you own a company, or again, or the solo practitioner, more often than not the solo practitioner is, you know, as, as we were talking offline earlier with my company, so it's like, I'm everything, right? I'm the accountant, I'm the marketing person. You know, I am the provider, I am the finance person, the accountant, everything, you know, that that's great. But it also helps you know, somebody understand what the big can't be what they aren't, and that is, you know, a clinician, but to understand the legal ramifications, and that is, you know, again, if you're getting medical equipment, good on you, man, you know, that that's, that's wonderful, you have an AED in the car for rate has it been, you know, has been looked at has it been, you know, standardized, you know, in QI in the past two years, you know, is it up to date, any piece of medical equipment has to be, you know, looked at and, you know, made has to be you know, queue wide to make sure it's working and what have you appropriately and always and forever, if somebody is involved with up to whatever extent again, that medical advance and you know, conducting medical and health insurance, and I'm the first person as I understand it, you know, at least to use the term and it's not just the medical advanced, we're like, Okay, well what's, you know, the patient's specific issues, meaning the principal and stuff, but intelligence really does mean not just the things that affect the client, the principal, but it is what affects the team. And that gets into you know, communicating with team leaders a agency owners, making sure that whatever QA, you know, Quality Assurance and Performance improvement measures are there. Being able to interact with a client's you know, medical providers, care doctors, what have you. Because, again, the principal may not know their own medical issues. It may sound funny, Travis, but that's very true. There's oftentimes right guys, you know, my doctor gives me this, that and the other. And I hear that all the time. It takes me about two seconds to look at the medications that they're on, if they even have that kind of list. And I find that very common, that they don't know what their own problems are. So how do you then counsel and, you know, provide security for the protection team that one of the principles issues, medical issues isn't going to come about, and now become the biggest threat they have to face. So interfacing with their medical care providers is really important. And as a physician in that role, I can breach you know, that, you know, that area, you know, broach the topic with, you know, both the principal, and, and their providers to find information out that, you know, interesting enough can be can be really, really, you know, important. And at the end of the day, we all want to believe, and I hope that at least for myself, I do with with the people that I employ, is to provide for their general wellness, their general health, because, again, fundamentally, it's all about the person, it's all about people in this industry more so than any other, what are we doing, right? We're protecting, we're providing for the, you know, the security, and protection of an individual or their family or their entourage, or whatever it happens to be. But, you know, for our company, you know, it's the brand valuation, it's, you know, protecting, making sure that there's privacy so that, you know, something does happen or their lifestyle, you know, or whatever the case may be, doesn't, you know, the optics, should it ever get into the public domain and becomes very visible, that the optics don't cause major embarrassment, you know, or that person or, you know, loss of valuation for a company or corporation, you know, and, well, who's going to make sure that that's the case, and that's, you know, Safeguard Well, it's the protection, you know, specialists, it's you and I, and if we're not in good health, and we feel that, you know, we're not respected or whatever the case may be, you know, that somebody or whatever is not looking after our mental health or mental well being, then that really lessens the degree of ownership, we take in, in the roles that we've been assigned. The care I mean, right. I mean, if I, if I own a small EP company, and I employ, you know, I don't know a handful of people, I'd like to believe that we're a family. I like to, you know, run my things. As such, you know, I place a lot of trust in these folks who are really protecting my company, right? I mean, my product as an entrepreneur, as a business owner is exactly that will, you know, can I trust that when you go out? Again, that that negligent supervision and vicarious liability, it rears its head? Again, it's like, are you interacting with my client, you know, appropriately, and do they feel like you're you're professional that you're providing and that you are in the know that you understand that, even if I don't, that you know, what those threats are, you know, whether they're on the street or whatever, or coming from within, you know, the medical threats. So, that's why I say a medical director really has, you know, these these components that, you know, they communicate well, with the team leaders, you know, in the agency owners, you know, care doctors, a specialist, really, you know, has experienced with EP and really, really has a collaborative relationship with the team. I, if for nothing else, the three A's apply, as we say in surgery, you know, and it's like, affable, available, you know, an adequate, you know, you don't need to be a trauma surgeon like me, although it gives me better insight, you know, and into what goes on. The fact of the matter is, I'm here as I like to see my role as protecting the protector and just adding that additional component, which, at the end of the day, as a business owner, I can upsell as an additional component of that client's safety and protection.

Travis 1:19:57
Yeah, and for me, one thing that really stands out out talking with you. And I think probably so few listeners have had the opportunity to spend time with a medical director with a practicing physician, someone with expertise in this area. For me, it's just very cool to learn about, really, to figure out what we don't know, like so often in security, we go and we talked with talk with clients, and they don't know anything about security, technology, hardware, the layers of security we're hoping to implement. So this is almost like a similar conversation with you talking with non medical professionals, just being able to better understand, like you mentioned, some of the things that we should look for. If we are exploring hiring a medical director, you mentioned some of the human element and collaboration, and then also some of the deliverables that we would definitely expect to receive from you know, that type of engagement. Yeah, so for me, this is just incredible education and learning about some of these things that we just may otherwise not consider. And you even mentioned to some larger organizations where they're not even thinking about having, they're not even considering medical direction, when in reality, does the risk manager there does the COO? Have they ever even considered medical being a big risk? So it's just some of these areas that we don't know what we don't know. So for me, I'm just taking away a lot of really cool ideas from this conversation. Yeah, and

Dr. DeBusk 1:21:29
that that really works both ways. For us as well, because one of the biggest thing that I've come to realize, and my company has come to realize is that we need to have, as I mentioned, you know, this a component of a medical director, and the experience working with the P, I have sent my folks. One of ours is a psychologist and a child behavioral therapist. Because how many of our clients, right? They have children and these children, let's be honest, their parents, both parents work, or they're never around, or whatever. And you know, or they're going through adolescence or whatever, you know, yeah. So you know, that's why we employ those folks. And my operations chief actually is, is an educator, you know, child educator and therapist. I sent her for training, you know, EP training. Because, you know, like I said, it works both ways, right? It's like, well, you have to understand what the medical assets, what your medical assets will be, what your medical oversight should entail. But, you know, on the flip side, we need to understand what the provider needs to you know, what their responsibilities are, how we can, you know, force multiply how we can really interdigitate and complement that, that team, or even the solo practitioner, or even the corporation, as you say, who doesn't know, you know, what they don't know. So what I like to do is, I always like to start with whoever calls me or emails me or whatever, is just to have a consultation, like anybody, you know, it's like, let's have a conversation, you know, what do you guys think? And what do you do, and, you know, and that's gratis, that's free. Because at the end of the day, if you are going to hire us FIFA, to do this for you, you really need to know what you're what you're getting that, again, it gets back to those standards, right. It's the expectations, you know, and, you know, no more, no less, you know, we're happy to do this than the other. But if this isn't in place, for instance, you know, then I'm going to say, All right, you know, let's at least start with having some thing, you know, on paper, where, you know, you can point to it, whether it's digital or physical. But yes, that's there. But again, you know, I get calls, you know, and people will text me or whatever, I've, I've had people in Africa, in the middle of Sub Saharan Africa, and they're out there at teams out there. And I'm, I'm getting a text through secure chat, you know, through secure communications. And they're asking, so, yeah, just want to run this by or something, you know. And again, at that point, well, depends on what, you know, somebody requires, you know, an EP company requires or, or the team, and that could come later, but fundamentally, what what do we provide? What can we give to you? And what do you need, you know, because if we are going to work together, we need to understand and like I said, I've sent my people for training. So that when somebody calls out let's say, certain terms that it reminds me of that CNN Good Morning, America, we're Robin Williams character, start speaking an acronym. So for any of your listeners that have been in the military, you know, for those of us that that our work with I've been in Have you in the military? Yeah, I mean, I speak in acronyms all the time. Our culture, that's our culture, right. But the fact of the matter is, is, you know, I'm happy to talk about what we can do, because oftentimes I find that just like that one fella who owns a company, you know, he's got somebody who doesn't know EP doesn't know what's required doesn't know, the legal issues, insurance issues, and is charging an exorbitant amount, it drives me nuts. Actually, a good example of that was Jerry hein. I met him, you know, we had, we had a great conversation over drinks last year. And he explained, you know, something where there was, you know, a medical provider that brought on board, private chat bags, big red bags of medical equipment, and you know, it, let's just say it scared the client. You know, why do you have all this equipment? You know? So, again, you're getting physician, you're getting somebody who's supposed to know their craft their trade? Well, that's great. And that's questionable. You know, we talked about that earlier, what, you know, should, you know, you'd be looking for in somebody like that, and I'm happy to answer those questions. But those will be in the B EPP standards as well. So people can look at, but more importantly, do they know what you need? Can they not scare the hell out of the client or the principal? Can they not get in your way? Can they not be an issue now that you have to worry about? And so I think, again, when I say that there has to be a complementary relationship between the EP with between the detail the company or the agency we're having, and their medical oversight? Again, that's probably when, like I said it not probably it is one of the things to look at is do they have any experience with, you know, law enforcement? Do they have any experiences in EP? Military? What have you what have they been the medical director? Have they been an engaged medical director? And more often than not, I'm happy to answer those questions. Because I'll tell you, if it's not me answering those questions on, you know, a collegial phone conversation. The last thing you want is somebody like me, or anybody, like me, answering those questions to counsel, you know, third party counselor, or legal counsel, and a deposition or something like that, because it does come up, you know, people have their jewelry stolen, people get into car crashes, you know, went out there. And, you know, if there's a medical issue, it comes up, and it becomes a civil issue, where the liability really kicks in, that you don't have anything in place, or you haven't discussed this beforehand. Don't think the Good Samaritan laws are gonna protect you. You know, because number one, you just don't know. But if there's negligence, you know, then then really, there's, there's, there's a lot there to be discussed.

Travis 1:28:17
Yeah. And I feel like that's a pretty good capstone for our conversation. Although I could definitely, I definitely have about 90 more minutes of questions to ask you, I think we might have to save that for the next session. But it's been really cool to hear your thoughts on everything from learning about the role of a medical director, the advantages that you have, in getting direction from a trained, licensed professional. And then also some of those more micro points around what might, where should the average practitioner focus their training like we like you mentioned, first aid, basic life support, even stopped the bleed, just so we can attend to those most immediate everyday high likelihood events? shout, shout out to Fred Burton, who also mentioned that to you about how that's going to be far more common and encountering a medical event, then we're going to see an attack on our principal or someone throwing a pie in the principal's face. Right, right. No, you're absolutely right. Yeah. And then also you sharing some insight around the BPP and the standard that we're working on, and just hearing about how that'll help develop a baseline that can really kind of like lay the foundation for for future initiatives. Correct. And Dr. debusk, were there any other points or topics that you really wanted to share before we wrap things up today?

Dr. DeBusk 1:29:45
No, no, I think again, when coming in, as the medical consultant and having been a director for different communities, and industries, people really an EP should under stand that it's not an attainable it's not something that is out of out of reach of finding actually competent and good medical oversight and it does not. It, these aren't exhorting us, you're not hiring them to do something to you. It's an asset, like anything, they should be able to tell you who they are, what they do, and who you know what their experiences are, and that they remain current, certified, licensed, what have you. So that it's one less thing to worry about. And more importantly, it's something that the client doesn't need to worry about. But can really be you know, a benefit? For a lot of reasons, you know, financially security, what have you. But if people understand that, and they're more than welcome to reach out to me, you've for questions and consultation. I'm happy to do that. It's a real pleasure, Travis, thank you so much. I love working with you, you know, on the BPP. And if we can give something to the industry where they can at least look back at and say, Here it is, you know, we've got something it's you know, it's on a tablet, you know, in stone, you know, at least you know, we've on earth it here it is no matter what, it's an attempt, it's a number of people, a large number of people have really gotten together to say no, we really, you know, have something that we as an industry can come to expect as being appropriate for for all of us and then fine, then, then we can debate it ad nauseam ad infinitum in the future, but at least we'll have drinks and maybe you know, cigars when we're doing it.

Travis 1:31:49
I hope so. And Doctor, for those that want to reach out to you, what's the best way for them to find your website or contact you?

Dr. DeBusk 1:31:57
Yeah, no, absolutely. They can email me directly. They to my email address, which is George G, E, O RG EMD. At a spitha.com. They can go to the website, which is a SP ITH a.com. And go ahead and sign up there and it will it will get to me, or you know, and my contact information is there, the phone number or LinkedIn, LinkedIn and social media is wonderful. They can find me on LinkedIn, whether it be US visa, or under my name debusk DB, us, okay, I'm there and reach out anytime. And I look forward to talking with you again, Travis. And it was a pleasure, even before we got on to recording, just hearing a little bit about yourself and how you came to the EP, the it's a wonderful community. And it's a it's a tight knit community. And I've I've found nothing but a lot of support. And, you know, everybody, everybody's trying to do the right thing. And not, you know, and do it, you know, in the right way. And I hope that ultimately as the board, you know, as the BPP, and anybody in the community, and for myself, personally and for my company, just to provide, you know, that additional support. Because, you know, nobody likes to go it alone.

Travis 1:33:28
We are surrounded by an incredible community of practitioners, including everyone that we see at conferences, people that are participating in standards development, those that are just writing articles, like yourself, for the community out there around specialized topics. So yeah, we are surrounded by a fantastic group of people. And when it comes to links to your website, your LinkedIn, I'll be sure to include all of that in the resources and show notes. Plus, I think he mentioned also the article from EP wired. So I'll include some of those resources there as well for everyone to find.

Dr. DeBusk 1:34:03
Well, thank you. I really appreciate it. And it's been a wonderful pleasure speaking with you. And I know we'll see you soon. And we'll talk more as we work with the next few versions. So have a wonderful day. And again, thank you so much. And then I want to thank your listeners too, for sticking it out all the way to the end. And and spending time with us today on this podcast.

Travis 1:34:28
Yeah, thank you, Dr. debusk. And it's a total honor because it's a very, it's a very rare opportunity that we get to talk with a professional like you with such niche and such really timely and critical information. So thank you once again, it was an honor.

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