What’s our paradigm?

Fair warning.  I’m going to offend a lot of you.  Hell, I’m expecting a nasty snarky reply or two.

I love the public safety aspects of being a paramedic.  I admit it, I’m enough of a sparky type that I like having a utility belt. I love my duty boots, my radio (which, yes, I leave on “scan”), the 5.11 pants, and the really cool windbreaker with my department patch and my Texas paramedic patch.

Here’s what I don’t love about the public safety paradigm.  The paranoia. The “us versus them” mentality. The culture of fear.  The constant “street survival” mentality.  The belief that every call may be our last.

Now what about medicine?   That model has some flaws too.  So many of us idolize Dr. House and his approach.  You know the mindset.  Nevermind being nice so long as you nail the obscure diagnosis. And it’s never lupus.

Minions, we’re EMS. We adapt.  We adopt the best from every discipline.  It’s time to start living that.  Yes, the public safety mindset protects us,  but it shouldn’t make us paranoid wannabe state troopers.  Yes, we practice medicine (and even diagnose), but it’s not a substitute for warmth.

Whether or not we like it, we are an amalgamation of several different professional disciplines.  I like to say that we practice operational medicine — we deliver acute and urgent care medicine at a mid-level scope using aspects of the public safety professions to help us deliver that care.

In summation, never let being either a clinician or a public safety provider detract you from the main mission — being a caregiver to all of our patients. And yes, the family, friends, and bystanders are part of the care continuum, y’all.

Have a great Friday and an even better weekend.




  1. Robert Ball says:


    I sonetimes (especially when they were still with the DOT) use the Coast Guard as an analogy.

    Similar risks & threats as the “real” (DoD) military. Enough that they are considered a branch of the armed forces; but a substantially different mission.

    Sure, they have machine guns & cannon…but ideally, they’re used to disable an enemy vessel & arrest the crew. Compare that to the standard mission of a Destroyer. Sure, they pick up survivors, but that’s not the primary goal.

    The superstars of the USCG? The toughest group to get in? Rescue Swimmer.

    Yeah, EMS is like the Coast Guard of public safety…but too many people want to be a SEAL instead of a Rescue Swimmer.

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