No matter how you look at it, no matter how you say otherwise, the reality is that emergency medical services, whether at the basic life support level or the advanced life support level is, plain and simple, the practice of medicine.
Those of us with a passion for EMS, myself included, regularly dream of what EMS can (and should) be and bemoan our current state. Things I regularly despair over include the lack of professional development, professional identity, and pursuit of excellence. You know, many of the same traits that other health care professions do a much better job of than EMS does.
Sadly, in my mind, the reason that EMS continues to lag behind the rest of the healthcare professions is that we’ve made it too easy to become an EMS provider. The reality is that most health care education programs are degree based and have college entrance requirements at a minimum. EMS – not so much. We all know how hard it is to get into medical school or even nursing school. EMS seems to be the exact opposite. The entrance exam for most EMT programs is a check that clears the bank. The entrance requirements for many paramedic programs are not much more stringent. But that’s to be expected, we define EMT and paramedic by a set of skills rather than a core foundation of knowledge.
So, should it really surprise us that we haven’t progressed any further yet? We’re allowing people who are unprepared for postsecondary education to practice medicine, albeit with a limited scope. To me, it’s little wonder that dogma, anti-intellectualism, and the “meet minimal standards” mindsets pervade so many EMS systems. It’s little wonder that in many (note that I didn’t say all) fire-based EMS systems, the EMS side of the operation is seen as punishment or an assignment to be escaped from eventually.
Heck, to me, the real wonder is why some of us continue to engage in the quixotic pursuit of making EMS a respectable, recognized practice of medicine.
