Most of the medics I know here in Texas have one of the three things from Warren Zevon’s song — guns. Money is something that most of them are in short supply of. Another thing that EMS is in short supply of would be a friendly political and regulatory climate.
And that’s where lawyers come in. While everyone screams, moans, and gripes about damned lawyers, everyone loves their lawyer. Unfortunately, we in the EMS world have darned few of our own lawyers. And nope, I’m not nominating myself. I’m perfectly happy in my current job. I’m paid well, work with intelligent colleagues, and have interesting work most days.
But back to EMS…. Lawyers are paid advocates, both in and out of the courtroom. And God forbid, some even lawyers are even lobbyists, advocating for a client with government agencies and/or elected officials. EMS needs advocates. Not the “so-called” self-appointed advocates for EMS who have a self-interested agenda, yet manage to be on every blue-ribbon panel for EMS or serve as a “stakeholder” on committees.
In fact, the preamble for the Texas Disciplinary Rules of Professional Conduct for lawyers starts with “A lawyer is a representative of clients.” EMS needs representation. Federal, state, and local regulations impact what EMS does. In most cases, only a lawyer can provide legal representation before a court or in an administrative hearing. Only a lawyer has the skills, knowledge, and abilities to help EMS providers and organizations understand and comply with these laws and regulations. Perhaps most importantly, some lawyers also serve as lobbyists, helping to craft good legislation and regulations for EMS — and stopping bad ideas before they make it into law or regulation.
While I still have my doubts about community paramedicine, imagine how much more successful the initiatives would be if the Center for Medicare and Medicaid Services’ initial regulations and policies had been written from the get-go to pay for EMS services based on treatments rather than on transports. A lawyer or lobbyist knowledgeable about EMS could have recognized this issue and influenced policy.
Many of my EMS friends, particularly the Ambulance Driver and Mr. Too Old To Work, are strong advocates of the Second Amendment and remind us that a gun is a tool. Whether or not a gun harms others is up to who’s using the tool. We in EMS need to recognize that lawyers and lobbyists are just like firearms — a tool to be utilized and respected. Sadly, in the world of law and politics, there is often a limited pool of money. Without a place at the table and advocacy, EMS will continue to suffer from, at best, benign neglect.
There’s been a lot of talk about EMS 2.0 in the blogosphere. Without lawyers – advocates – EMS 2.0 will look a lot like EMS 1.0.
