So, I recently read an article online in Fire Apparatus Magazine bemoaning the state of EMS. Because, as we all know, the most current information on emergency medicine comes from a magazine that shows pictures of big red shiny trucks.
When you go through the article (I’m not going to link it because I don’t want to give this guy any more legitimacy), he raises the standard argument that fire chiefs and large EMS system managers always use as their stalking horse in their arguments to keep EMS educational standards low — or even lower them. Yep, that’s right. The mythical rural EMS volunteer who will disappear if we change the science and/or add one more bit of knowledge to their already overflowing brain.
I feel more than qualified to address this issue. I’ve spent the majority of my EMS career as a volunteer at both the EMT and paramedic levels with both fire-based systems and third service models. I’ve worked urban, suburban, and rural. The majority of my experience has been in combination departments where paid and volunteer medics work side-by-side. And to the premise of this article, I say, “BULL.” Well, I said more, but this is a family-friendly blog.
I’m more than tired of using the overworked rural volunteer provider as a straw man. First, regardless of whether you draw a paycheck or not, an EMT or paramedic certification is the same. In many states, you can’t say the same for a paid versus unpaid firefighter. Second, in my experience, volunteers are some of the most motivated people out there when it comes to seeking continuing education and opportunities to advance their medicine. In the rural service where I currently volunteer, we have an active continuing education program consisting of monthly online classes as well as a full panoply of “card courses” covering resuscitation, cardiac care, medicine, trauma, pediatrics, and tactical medicine. Our medics, at all levels, routinely exceed state mandated training requirements. I’d further note that several of our paramedics are volunteers who work in outside professions and maintain licensure in those professions as well. Furthermore, come to any of the big EMS conferences. There, you’ll notice a disproportionate number of volunteer providers, especially compared to those employed in large EMS systems.
In short, Chief Haddon of the North Fork, Idaho Fire Department is wrong. Volunteer EMS providers can, will, and do exceed educational requirements and expectations. Give them a chance and you’ll find out. And if you don’t believe me, I’m extending a personal invitation to come down to Texas. I’d be happy to introduce you to some volunteers who actively seek to improve themselves professionally for the benefit of their patient. Heck, I’ll even treat to BBQ.
I’m not expecting a visit, though. It’s a lot easier to use the myth of the overworked, overwhelmed volunteer EMS provider who will go away if we add one more class. Sadly, this “don’t need to know it mentality” usually only benefits the “mongo mentality” of “you call, we haul” that seems to hold back EMS. The worst part is that the same departments and administrators who bemoan increased EMS education can be seen at all of the structural fire conferences. Maybe its time to have more volunteer EMS systems and less volunteer fire systems?