Natural and manmade disasters such as hurricanes or terrorist attacks typically set off an urgent need for medical care in the affected areas. Physician assistants are among the health care professionals that can help fill this need by joining a Disaster Medical Assistance Team (DMAT). There are over 50 DMATs nationwide, and each operates under the National Disaster Medical System (NDMS), a part of the U.S. Department of Health and Human Services.

What is a DMAT?

A DMAT is a self-sufficient medical unit comprised of various medical professionals and support staff, including physicians, PAs, nurses, paramedics, logistics, communications and administrative personnel. When a federally-declared disaster occurs, a DMAT can rapidly deploy to the disaster area to assist an overwhelmed local hospital or set up a free-standing medical facility. The basic cache of supplies sent with each deployment includes tents, stretchers, water purifiers, generators, communications equipment, medical supplies and stock pharmaceuticals. Within 24 hours, a team can establish a fully operational, free-standing medical facility that will remain self-sufficient for up to 72 hours, treating roughly 300 patients before needing further supplies.

In addition to responding to natural and manmade disasters within the U.S. and its territories, DMATs provide medical care and support to many large-scale events. Past events have included presidential inaugurations and the 1996 Olympic Games. Whether dealing with a natural disaster or high-risk event, DMATs are capable of providing quality medical care in austere and less-than-ideal conditions.

PAs in Demand

PAs play an important role on every DMAT and are currently in high demand across the country. A full team deployment typically consists of 35 members, including one or two physicians and one or two midlevel practitioners. While deployed, the physicians, PAs and NPs see patients, stabilize injuries, treat illnesses and order medications and basic diagnostic testing. And while the practice of medicine remains the same, the work environment and local infrastructure changes. A PA on a DMAT deployment must be accommodating and flexible, as he or she could be placed in one of several different practice environments. The DMAT PA might help supplement the medical staff of a local hospital, treat acute medical issues at a disaster shelter or as part of a roving medical strike team, or might be asked to provide care in one of the self-sufficient DMAT field hospitals.

Volunteer Time

Although DMAT members, including PAs, are paid as intermittent federal employees during a deployment, much of the time commitment is on a volunteer basis. Volunteer requirements include training, meetings and on-call time. Most teams have quarterly meetings, one or two annual training sessions and three months of on-call time per year. DMAT members are expected to submit availability of at least two weeks for each month-long on-call period. Members can continue to work their regular jobs while on-call but must be available to leave if the team is activated and deployed to a disaster area. DMAT volunteers are covered under the Uniformed Services Employment and Reemployment Rights Act (USERRA), the same law that provides job protection rights for members of the armed services.

Professional Requirements

In addition to the time requirements, a PA must meet several professional requirements to become part of a DMAT. The PA must be certified in CPR and ACLS and have at least one year of clinical experience after PA school. Although a PA working in any medical specialty can become a DMAT member, those PAs with experience in emergency medicine, family medicine or urgent care are an especially good fit.

Disaster Medical Assistance Teams, including the New Jersey team (DMAT NJ-1), are always looking for qualified and dedicated PAs, physicians and NPs. For PAs with an interest in disaster medicine, joining a DMAT team can provide an unparalleled experience in the field of disaster medicine.

For additional information, visit the following Web sites:
www.ndms.dhhs.gov
www.dmat.org
www.nj1dmat.org

Gregory K. Wanner, MS, PA-C, works in emergency medicine and urgent care at Underwood-Memorial Hospital, Woodbury, N.J. Brian T. Kloss, DO, JD, PA-C, works in emergency medicine at SUNY Upstate Medical University, Syracuse, N.Y.

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