We Deserve Respect?

At every gathering of EMS providers, whether in person or in the online world, we constantly bemoan the perceived lack of respect that the “ambulance drivers” get from the rest of the medical community, from other public safety providers, and from the public that we serve.  So, to answer the question as to “when will we get the respect that we deserve,” I present the following answers.

When doing the right thing for the patient becomes more important than doing something, no matter what it is.

When we embrace education and science-based medicine rather than dogma because “our instructor said so” or “I’ve seen it work.”

When we work constantly to raise the minimum standards for entry into EMS rather than continually watering down standards while using “the volunteer crisis” as an excuse.

When we spend as much on continuing education and pursuing knowledge as we do on getting another set of LED lights for our personal vehicle.

When we embrace professional self-regulation rather than being an afterthought in most states’ health and human services bureaucracies where the same people inspecting ambulances are inspecting tattoo parlors and tanning beds.

When the term “semester” replaces “clock hours” for ALL levels of EMS education.

When we recognize that patient advocacy and customer service are part of the job rather than something to be ridiculed with a t-shirt slogan.

When we realize that completion of a 120-180 hour EMT course and passing a test of minimal competency is but the beginning rather than the pinnacle of a medical career.

When we recognize that heroism consists of significantly more than merely working in the emergency medical field and doing your job.

When punitive medicine like selecting IV catheter size based on your annoyance factor with the patient or joking about rapid sequence intubation of a patient without adequate sedation is no longer accepted on your ambulance. (At the very least, can we not make these comments in a setting where the public can hear them?)

When shop-worn slogans denigrating advanced practice in favor of “BLS before ALS” are recognized as the anti-intellectual attitudes that they are.

When EMS education reaches a point where one can become a paramedic without first having EMT certification.  Doctors didn’t go to physicians’ assistant school first and lawyers don’t have to become a paralegal first.

When we recognize that “street experience” may actually be meaningless if it was three years of working a BLS transfer truck and learning nothing but bad habits, shortcuts, dogma, and who gives free coffee to EMS.

When we realize that the most important thing that any EMS provider can do is to provide a thorough, competent assessment rather than some “sexy” skill.

When we stop using “the lawyers” as a mythical bogeyman and start understanding the laws and regulations that impact the practice of prehospital medicine.

When we as EMS providers have a voice at both the US Capitol and each and every state capitol.

When our goal is that we leave every patient at least as well as we found them.

When we stop defining EMS by “what we can do.”

When we realize that we DO diagnose and that diagnosis is not illegal, but rather, is expected.

When we recognize that what’s not an emergency to us is still the most important thing that’s happened to the patient today.

When we realize that the most important person in the room is the patient.

When we cease to define clinical competency by parroting a skills sheet.

When EMS managers cease to define success by response time and cardiac arrest survival.

When every EMS provider in every EMS system knows who their medical director is and how to reach them.

When we realize that continuing education is designed to teach new concepts rather than just merely repeating the same dogma on a two year basis.

When we recognize that lowest common denominator medicine means that providers will sink to the lowest common denominator.

When we finally realize that the biggest obstacle to EMS advancement is the average EMS provider.

When we recognize that it’s not our job to judge our patient, but it is our job to treat our patient.


When we can hit even fifty percent of these goals, the respect will be earned.  And so will the salary.

Closing Out EMS Week

As we close out EMS Week 2016, I thought I’d share some more thoughts and observations as you digest your snacks from the break room and enjoy your party favors with the pre-printed motivational saying on it.

Yesterday, on Facebook, a good friend shared a post that I modified and shared.  I think it’s worth sharing here as well.  I’d like to thank the people who’ve made EMS Week possible for me. Thank to the instructors who made it possible for me to get my EMT and then paramedic certification. Thank you to the mentors who’ve inspired me over the years. Thank you to the coworkers who’ve partnered with me over the years. Thank you to the managers, supervisors, and medical directors who’ve put up with way more from me that you should have. Thank you to my family and friends who’ve always supported my passion for EMS. A special thank you to my non-EMS employers who’ve been supportive of my extracurricular EMS activities and given me the time off to pursue them. And finally, thank you to each and every patient who’s trusted me to care for them. There’s too many of you to mention by name and I wouldn’t want to overlook everyone, so please know that each of you has made it possible for me to enjoy both EMS Week and every shift I get to work.

To top yesterday off, I came home and found the latest edition of Dr. Bryan Bledsoe’s paramedic text waiting for me, courtesy of UPS. Spoiler alert: the medical-legal chapter is co-written by yours truly. The biggest thing that we can do in any profession is to pay back the mentoring we’ve received along the way.  I don’t get out on an ambulance nearly as much as I’d like, but I make it a goal to leave EMS better than I found it.  And the biggest impact I can make is to improve EMS education.  In my case in particular, I’d like for EMS students of all levels to have an understanding of the law relating to prehospital care as opposed to myths and urban legends about EMS legal issues.

I’ll leave you with two thoughts as we close out EMS Week 2016. One, the perfect EMS system is much like the Loch Ness Monster. Everyone is looking for it and no one has found it. Strive to make your EMS system the best it can be and find out what you can live with for the pay. (It’s never about the pay.  It’s ALWAYS about what people will put up with for the pay they’re given.)  Thought number two:  If we’d spend 25% of the time that we spend complaining about being called “ambulance drivers” on actually improving EMS, we’d find that, in a very short time, we wouldn’t be called ambulance drivers.

Google Let Me Down.

The following is an email that I sent to Google in response to them choosing artist/activist Yuri Kochiyama for today's Google Doodle on the main Google page. I realize that Google Doodles are sometimes meant to cause us to think.  That's a good … [Continue reading]

Another EMS Week Post

Well, it's Monday and it's the annual commemoration of EMS Week.  This is the week where you'll likely get some sort of junk food at the local ER, assuming the staff doesn't eat it first. Your employer may give you some sort of trinkets and there … [Continue reading]


This is a collaborative post by Too Old To Work, Too Young To Retire (TOTWTYTR) and me. It started from an email exchange and then we decided write a post that will appear on both blogs. I'm not sure exactly how this will work out, but it's worth a … [Continue reading]

What Might Be Wrong With EMS and EMS Education

Earlier this week, I was speaking with someone in the EMS regulatory world and they mentioned having to possibly roll out a class on a new infectious disease concern.  I began to wonder if part of the problem is that many EMS providers are … [Continue reading]

You Get What You Pay For

In Texas, we have a strong tradition of limited government.  In particular, we limit the role of county government.  In most counties, county government provides law enforcement, jails, courts, and roads.  Because of the limits placed on county … [Continue reading]

If We Can’t Take Care Of Our Own

So, yesterday I blogged about the tragedy with the Fairfax County firefighter/paramedic who killed herself.  The suicide is believed to have been connected to multiple workplace climate issues, including bullying. I shared the blog yesterday on … [Continue reading]

A Next Step in EMS Provider Safety and Health

Over the last few years, EMS provider safety and health has come to the forefront.  Rightfully so. Whether unreported, under-reported, or just ignored in the past, we've recently begun to recognize the threats to EMS professionals of all sorts.  … [Continue reading]

It Depends

Anyone who knows me in real life or has heard me talk about the law has heard me say that the lawyer's favorite answer to any question is always, "It depends." In the law, we have a lot of sayings.  "Bad facts make for bad law."  And another … [Continue reading]