SANDPOINT - Work on addressing the medical direction of Bonner County's Emergency Medical Services system is still moving at a glacial pace.

The county's EMS advisory board continues to groom the medical director's job description even though it finished tweaking the document and presented it to county commissioners more than six months ago for adoption.

At issue in the updated job description are requirements that Bonner County's medical director have the endorsement of Bonner General Hospital and a working relationship with the facility.

Commissioners have balked at implementing the job description due to concerns the new qualifications would effectively disqualify the current medical director, Dr. Scott French.

French does not have active medical staff privileges at BGH and some members of the advisory board do not expect the situation to change.

“We have not adopted it because there were several places in there that basically aimed toward Dr. French. To implement that job description … it would have had to make us terminate him,” Commission Chairman Lewis Rich said on Tuesday.

Rich reiterated the sentiment on Thursday, when a fatigued EMS advisory board revisited the job description and its sticking points.

But some board members emphasized the hospital-medical director link is standard practice around the nation and dispute that the job description is aimed at dislodging French.

“This job description was not to get rid of anybody,” advisory board Chairman Robert Tyler said on Thursday. He added that the qualifications aren't intended to engineer the hiring of anybody else either.

Proponents of closer ties between a system's medical director and a primary hospital contend it's an essential component of effective quality assurance and improvement. The link provides a 360-degree view a patient's treatment since the medical director would have easier access to hospital records.

“There has to be a good working relationship with the base hospital. That's the only way our system is going to improve,” Rob Goodyear, the board's vice chairman, said on Friday.

Others in the EMS community, however, can point to several examples where a system works smoothly without a direct connection to the hospital.

Bonner General has advocated for a medical director who is an emergency physician at the primary receiving hospital, but some are concerned that such an arrangement might unduly influence decisions on where patients are transported.

“If there's a practicing physician at BGH that has a financial interest in patients coming to BGH, then I see there's a potential for a conflict of interest,” said Bonner County EMS Chief John Givens.