Hey there, it’s The Ambulance Chaser.

Recently, a friend of mine asked why he should renew his NAEMT membership.  I had to think for a minute.  Then I thought for several more minutes. Finally, I told him I maintain my NAEMT membership because I’m affiliate faculty for one of your continuing education programs and because membership provides me a significant discount on EMS Expo (Every other year in Las Vegas – yes please!).   Another person mentioned the 5.11 clothing discount.

What nobody mentioned was NAEMT’s advocacy for the profession.  Why?  Rightly or wrongly, it’s because a lot of us in the field see NAEMT and its leadership as a self-perpetuating good old boys club advocating for its pet causes.

Some of you who know me away from my blog know that I’ve been in state government for over ten years as an attorney and that I’ve previously been legislative staff here in the Lone Star State and have even worked in political campaigns.   When have I seen or met with a representative from NAEMT or any state affiliate (by the way, Texas no longer has a state organization affiliated with NAEMT)?  NEVER.

What do I see from NAEMT for advocacy?  Ham-handed attempts at influencing Congress.  The EMS Field Bill is a useless attempt at finding another source of money for certain EMS agencies that already excel at writing grant applications.  EMS on the Hill Day is, while well-meaning, just another opportunity for certain EMS leaders to wear full dress uniforms that look like a cross between the Knights of Columbus, Captain Crunch, and a Turkish admiral.

Right now, there’s a discussion on the Texas EMS email list about a Texas Board of Nursing administrative rule that’s been interpreted and applied so as to prevent EMS providers from functioning at their certification level in the emergency room.  How does this happen?  Quite simply.  The nursing profession is organized and knows how to get things done politically.  Our supposed “voice for our profession” is way too quiet in the Texas state capitol.  I’m willing to bet you that the other 49 state capitols aren’t being visited by NAEMT either.

So, NAEMT, here’s the deal.  I’m going to keep my membership up.  I want to go to Vegas cheaper (who doesn’t?). I want my continuing education classes, although it’s a damned shame that we have to rely on so much continuing education to make up for the gaps in our initial education.  And yes, I occasionally want some discounted clothing.

But since I’m a member, I’m going to continue to speak out.  And I’m going to keep asking when you’re going to step up for our profession in a meaningful way.  Self congratulatory photos and press releases mentioning the same old names just aren’t going to cut it forever.


Butthurt seems to be the dismissive phrase that people use whenever people get offended by their post(s) on social media, especially if the offense is rightly justified.

It takes a lot to make me “butthurt.”  Anyone who knows me in real life knows I don’t have much of a filter and that my humor can occasionally make “Truly Tasteless Jokes” seem like it was written by the Mormon Tabernacle Choir.  I’ve had a few jokes that would make a South Park episode seem like Mister Roger’s Neighborhood.  But I do try (and occasionally fail) to keep said jokes between good friends who appreciate said humor.  And yes, I fully understand and appreciate that such gallows, inappropriate humor is a coping mechanism.  And indeed, in many cases, that’s the only coping mechanism we’ve got.

Here’s what gets me butthurt.  When you don’t have the good sense to keep said humor in private.  When you have the poor judgment to post it on a public Facebook page.  When your Facebook page claims to represent EMS.  When you’ve been an EMT for over ten years doing transfers.  When you embrace burnout.  When you ban any critics by bandying about the words “butthurt” and “free speech.”  When you hide behind anonymity — probably because you know the sentiments that you’re expressing are wrong.

None of this would bother me enough to blog about your butthurt except for one thing — you make your Facebook page a public page.  By banning dissenting voices, you lead the average public to think that the average EMT or paramedic is a monosyllabic, drooling cretin who hates running calls and actively withholds pain medications from patients.  You are what’s wrong with EMS.  You’re why EMS providers are barely paid.  You’re why we’re called ambulance drivers.  You’re why, on average, the best and brightest of EMS reach a level of disgust and become nurses, physician’s assistants, and doctors.

And yes, you’re why I’m butthurt right now.

Not Everyone Gets a Trophy — or a Patch

No matter what your view is on what constitutes a "legitimate" request for an EMS response, we all agree (or in theory, should agree) that a patient calling 911 is experiencing a bad day. Even the lowest acuity call deserves a response from an … [Continue reading]

Ten years in

This month celebrates my tenth year in EMS, first as an EMT and now as a paramedic.  (This doesn't count for the several years I spent as an untrained observer annoying the living daylights out of Lubbock EMS and Austin/Travis County EMS.  Nor does … [Continue reading]

(Another) reason why EMS isn’t taken seriously

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 … [Continue reading]

Things that make no sense in EMS

1) EMTs and paramedics are constantly told "We don't want you to know how billing works because we don't want you to let finances influence a decision to transport a patient."  Makes sense.  But then we're told, "If you don't document this chart … [Continue reading]

Monday morning thoughts

Just a couple of random thoughts to get your Monday morning started.   1) In EMS, we're constantly making noise about going beyond blindly parroting and following protocols, but we continually apply the cookie cutter mindset to any legal … [Continue reading]

Some reasoned justifications in favor of jet fuel and flight suits

In the EMS world, it's become almost fashionable to question the need for helicopter-based EMS (HEMS).   I personally believe that HEMS has been overutilized on occasion, probably even by me.  (I have a lovely snark-gram from the QA gremlin about … [Continue reading]

Ice Buckets

As a conservative/libertarian type, I'm in favor of individual charity rather than the enforced charity that the IRS collects every April 15.   As such, any giving to charity should be encouraged and celebrated, both for individual self-worth and the … [Continue reading]

Core Maxims of EMS

Here are a few of my core observations and beliefs about EMS. 1) You can never go wrong catering to the lowest common denominator of EMS.  The success of Facebook groups like The Most Interesting Ambulance Crew In The World and t-shirts with … [Continue reading]