EMS providers love to claim that “EMS isn’t taken seriously” by you-name-the-other-healthcare-profession. And we’re right. We rarely are taken seriously. I’ve complained before about some of the reasons why. (See also: T-shirts with flaming skulls and sayings about “Racing the Reaper” and “Doing Everything That a Doctor Does at 80 miles per hour.)
But today, I stumbled on another reason why we shouldn’t be taken seriously. EMS professionals of all levels fail to grasp the science behind what we do. I’m not talking about an EMT being unfamiliar with the Krebs cycle or even a paramedic not being able to explain why Trendelenburg is bunk.
What I’m talking about is more fundamental. It’s about a failure to understand the scientific method, which subsequently adds to the continued issues with medics lacking critical thinking skills or understanding research. This morning, I saw at least two experienced paramedics on Facebook hawking pseudoscientific woo as diet/health supplements. Either they’re con artists or they lack the basic scientific literacy to understand that there’s ZERO science or evidence behind the overwhelming majority of these products. Let’s not even discuss the amount of EMS providers who are vaccine deniers. I won’t even give them the courtesy of invalidating their beliefs. To me, vaccine deniers are the medical version of Holocaust deniers.
And then, there’s the other extreme in EMS. We have the pedants who claim to be advocates of science and “evidence based medicine.” All too often, though, these “experts” will immediately advocate massive changes in medical practice based on one journal article. Sometimes, these experts don’t even critically analyze the article. Patient who receive morphine in acute coronary events have worse outcomes? Their solution? Ban morphine administration. Critical takeaway — most patients who receive morphine in acute coronary events receive morphine only because the nitroglycerine failed to relieve their chest pain. Did it ever occur that the patients with more acute pain might be having a more extensive event? Nope. To the nattering nabobs of negativity who self-appoint themselves as “EMS research experts,” one journal article is enough to limit the EMS skills arsenal or drug formulary. Yet, these same experts usually want multiple studies to enhance EMS skills or drugs because “the science hasn’t been proven yet.” Folks, it’s a rare case when one journal article should change your practice.
I’ve blogged before about the shameful state of EMS legal education. It’s somewhat understandable as EMS isn’t run by attorneys. (And that’s probably a good thing, excluding your favorite blogger not named Kelly Grayson….) But EMS is medical practice. And medical practice is supposed to based upon science. For EMS providers of any level to not understand the scientific method and inject a healthy dose of skepticism to most claims is to fail as medical providers. And that, my dear minions, is yet another reason why we’re ambulance drivers and not healthcare professionals.