Hey there, it’s The Ambulance Chaser.

Recently, a friend of mine asked why he should renew his NAEMT membership.  I had to think for a minute.  Then I thought for several more minutes. Finally, I told him I maintain my NAEMT membership because I’m affiliate faculty for one of your continuing education programs and because membership provides me a significant discount on EMS Expo (Every other year in Las Vegas – yes please!).   Another person mentioned the 5.11 clothing discount.

What nobody mentioned was NAEMT’s advocacy for the profession.  Why?  Rightly or wrongly, it’s because a lot of us in the field see NAEMT and its leadership as a self-perpetuating good old boys club advocating for its pet causes.

Some of you who know me away from my blog know that I’ve been in state government for over ten years as an attorney and that I’ve previously been legislative staff here in the Lone Star State and have even worked in political campaigns.   When have I seen or met with a representative from NAEMT or any state affiliate (by the way, Texas no longer has a state organization affiliated with NAEMT)?  NEVER.

What do I see from NAEMT for advocacy?  Ham-handed attempts at influencing Congress.  The EMS Field Bill is a useless attempt at finding another source of money for certain EMS agencies that already excel at writing grant applications.  EMS on the Hill Day is, while well-meaning, just another opportunity for certain EMS leaders to wear full dress uniforms that look like a cross between the Knights of Columbus, Captain Crunch, and a Turkish admiral.

Right now, there’s a discussion on the Texas EMS email list about a Texas Board of Nursing administrative rule that’s been interpreted and applied so as to prevent EMS providers from functioning at their certification level in the emergency room.  How does this happen?  Quite simply.  The nursing profession is organized and knows how to get things done politically.  Our supposed “voice for our profession” is way too quiet in the Texas state capitol.  I’m willing to bet you that the other 49 state capitols aren’t being visited by NAEMT either.

So, NAEMT, here’s the deal.  I’m going to keep my membership up.  I want to go to Vegas cheaper (who doesn’t?). I want my continuing education classes, although it’s a damned shame that we have to rely on so much continuing education to make up for the gaps in our initial education.  And yes, I occasionally want some discounted clothing.

But since I’m a member, I’m going to continue to speak out.  And I’m going to keep asking when you’re going to step up for our profession in a meaningful way.  Self congratulatory photos and press releases mentioning the same old names just aren’t going to cut it forever.


  1. State capitals? That’s cute. I’d be surprised if anyone on NAEMT could even find my state on a map, never mind care enough to come and advocate for EMS. You want advocacy? That’s done by the IAFF and, I’m confident in saying that EMS isn’t on the top of their list around here.

    • It’s funny, in the odd sense, that while the NAEMT and many other EMS organizations always kiss up to the fire service lobby, the fire service lobby sees EMS as a second level function of the fire service, and mostly only good for whatever funds it can bring it.

      The NAEMT is the premiere boot licking service for the IAFF and IAFC.

  2. Tony O'Brien says:

    I am an active member of NAEMT. I sent an email asking if we were going to support or oppose the “Field EMS Bill” in October 2011. In that email I asked if the membership would get to vote on support/opposition. I was informed that “The board will be meeting shortly to decide” and that the would “Let you know NAEMT’s official position” once they had decided. I pointed out that would be a violation of the Bylaws (active members will vote on matters properly brought before the Association). This was 3 years ago, since then I have asked repeatedly “How much money have we spent in support of this legislation?” I have never been answered.
    I have asked multiple times who the auditor of NAEMT is? (bylaws state one will be appointed each year, and he/she will give a financial report at the annual membership meeting)
    No response.
    I received an email from my Regional Director telling me that they had “Decided as a board not to respond to you”
    I recently received an email from the President asking me why I don’t just leave NAEMT if I dislike it so much?…
    Another email from my Regional Director told me that he had to tell the President that he had replied to me and that he “Had to as him for forgiveness for what I had done” (violating the gag order)
    Realizing these guys were not going to answer the question, I flew from Boston to Nashville last week to attend the annual membership meeting and hear the auditors report…..there wasn’t one.
    As the meeting was coming to a close and the president was inviting everyone to go drinking, I rose from my chair and said “I rise to a point of order Mr. president” (NAEMT Bylaws state Robert’s Rules of Order will govern all meetings of the association). The President seemed taken aback and asked what I wanted, I said “I was wondering when we were going to get the financial report from our auditor, per our bylaws?” The President said “why don’t you come over here when we are done and we’ll be happy to talk with you about that”. I said “ok, thank you” and sat down.
    Once the meeting had adjourned I walked over to where the Board had gathered to take photos and was attacked by a furious board of directors. “GET OUT OF HERE YOU!”…..”YOUR A DISGRACE TO THAT UNIFORM!”….. “I’M CALLING YOUR CHIEF!” …. YOU WILL NOT DISRESPECT OUR PRESIDENT!”….. and my favorite: “YOUR A PRICK!”
    I was informed that this was not the time, nor the place for this kind of thing. I informed the angry mob that I had been ignored for months, and that as the annual membership meeting this was EXACTLY the time and place for this kind of thing!
    At that stage the President accused me of threatening him. A false claim he could not back up when I challenged him: “Tell these people what I have ever said or done that you consider to be a threat” he was unable to do so. Because it is a lie.
    When I left the meeting, I was greeted by 2 Nashville Police Department cruisers. They told me they had been called because I had caused a disturbance during the meeting. I chatted with the officers for short while, they left with a handshake and one of them telling me to “Keep fighting the good fight”
    This is the behaviour of the people who claim to: “Represent and serve all EMS providers”
    And who according to the website: “shall conduct all NAEMT business with integrity and transparency and adhere to the ethical standards of our profession”
    Yeah, right.

  3. Oh, the replies are delicious. I have never met an NAEMT rep outside a conference unless I already knew them before they held the position. I was a completely unsupported advocate for NAEMT when PPC rolled out and was made National Affiliate Faculty for the program, never receiving any updates or invited to participate in any planning or revisions to the program. I was the only active instructor in all of Nevada and Northern California and I made a dozen new instructors. I never received any support or even a notice of curriculum update (through 3 major revisions) as the only active PHTLS and AMLS instructor in the region. I found out through my textbook publisher’s sales rep. It was all up to me and me alone. Now, I don’t participate in any committee or additional fee groups because all they did for me was take money. I get a pittance of representation at Congress; I get discounts; I just got a free multitool from 5.11; and I get a free AD&D life insurance policy for my membership.

  4. dr-exmedic says:

    How much of their lack of representation is lack of membership? Most of their members are one-year members who get a free membership by taking one of their courses; the number of actual paying members numbers a few thousand. At $35/year/member, that’s hardly enough to hire a secretary, let alone actually do real advocacy. Vicious circle: nobody wants to join because they don’t represent us well, but they *can’t* represent us well because nobody’s joining and paying dues. IAFF has 300k members paying dues every paycheck….

  5. Tony O'Brien says:

    In 2013 NAEMT spent $144,000 on “Recruitment & Retention” with a stated strategic goal of reaching 10,000 dues paying members. I have no idea how they spent that money, but they have nowhere near that many active (dues paying) members currently.
    I tried asking about it on the NAEMT Twitter & FB pages, but I got banned.

  6. My theory: The NAEMT, by trying to be everything to all EMT’s, can’t take a position on any issues that matter. Let’s face it: the goals and priorities of professionals, volunteers, fire, hospital, private, and third service are likely to be completely different. Even if they are the same goals, the direction each group wants to take to reach it is going to be completely different. NAEMT, by wanting to be the big tent for all these groups and not offend any of them, can’t take a position on anything that would take the profession in a single direction. The IAFF and various nursing organizations are strong because they know who they are- firefighters and nurses! NAEMT has no idea. We can say, “we’re EMT’s!” but because EMT’s are such a mishmash of the aforementioned groups all seeking to take the profession in a different direction, we go nowhere.

  7. Like Dr. Ex. pointed out, only 1% of registered EMT’s belong to NAEMT, and most are short timers both with the field and with the organization. With a house divided like ours is, where turf battles stop only long enough for everyone to smile in front of a camera together, I’m not sure its possible for one organization to represent the interests of all the delivery models.

    One thing that all the interest groups seem to have in common is keeping our education standards low. Higher standards would make it take longer for people who sign up for one job to become certified in another, fewer people would be willing to post on street corners making minimum wage, and fewer people would be willing to go on abdominal pain calls from home in the middle of the night.

    On the other hand, Canada has very active national and provincial paramedic advocacy organizations. Their education standards are also much higher (two years full time in college in Ontario, 700 hours in British Columbia to become a BLS primary care paramedic), there are fewer delivery models, EMS is separate from non-emergent transport, and people stay in the profession longer. They are also working towards self regulation, which is a term I have not yet heard mentioned in the US.

    So Mr. Ambulance Chaser, what is your alternative to NAEMT? I paid dues to join the American College of Paramedicine (which I believe you are involved with), and have offered to help with their projects. I believe we need to raise our standards for both provider education an patient care, and for those standards to be based on evidence instead of political noise. I was optimistic that they would be the organization to drive those things, but have not hear much from them lately.

  8. Daniel R. Gerard says:

    NAEMT is an alumni association for the continuing education programs they provide.



    Everything contained in the Field EMS Bill is already in place…Field EMS is meant to subjugate you…make you sheep…

    Don’t believe me?

    This is what PPACA says under sections 3504 and section 1204:




    “SEC. 1281. <> GRANTS TO STATES.

    “(a) Establishment.–To promote universal access to trauma care
    services provided by trauma centers and trauma-related physician
    specialties, the Secretary shall provide funding to States to enable
    such States to award grants to eligible entities for the purposes
    described in this section.

    ‘‘(a) EMERGENCY MEDICAL RESEARCH.—The Secretary shall support
    Federal programs administered by the National Institutes
    of Health, the Agency for Healthcare Research and Quality, the
    Health Resources and Services Administration, the Centers for
    Disease Control and Prevention, and other agencies involved in
    improving the emergency care system to expand and accelerate
    research in emergency medical care systems and emergency medicine,

    SEC. 5102. STATE HEALTH CARE WORKFORCE DEVELOPMENT GRANTS to develop educational programs etc., for the healthcare workforce, which includes the definition of EMT’s and paramedics in the law.


    Here is the kicker…there already is an office for EMS under Health Affairs in DHS…and a paramedic is in charge of it!!!

    All of these already funded…you don’t need this BS ‘oh I have a little check box on my tax form…lets fund the ambulance corps this year so they don’t have to stand with a tin can and collect money…’

    What the hell is the Field EMS Act? Who the hell was Field???

    You know what the law should be?

    It should be the ‘Jim Page Emergency Medical Services Act’

    It should say:

    That the lead federal agency for EMS will reside in the Health Affairs Office in the Department of Homeland Security.

    This office will coordinate all activities for policy on a federal level. This office will work with HHS to make sure funds and programs allocated under the Affordable Care Act are accessed and implemented to improve the quality of care and drive system development. The DHS Office of Health Affairs, as the lead federal agency will coordinate the activities of FICEMS and all federal agencies that have input into emergency medical services.”

    You already have funding under the ACA…and you have an office already in DHS for EMS.

    Field EMS is a joke, it is a distracition to the profession. Why ins’t NAEMT taking about the grants that are available under the Affordable Care Act? Why don’t they want you to have that money?

    Why doesn’t NAEMT talk about the EMS Office that ALREADY EXISTS IN DHS?

    Either they do not have a clue, or they are just trying to undermine EMS. Why would I support a law that gives us MAYBE $90 million as a best guess from Field EMS, when I can access billions for true integrated systems of care under the Affordable Care Act?

    NAEMT is selling you out, they are holding back information, because information is power, and they are not interested in advancing the profession, they are interested in maintaining the status quo.

    Now read the Affordable Care Act and about the EMS Office in Health Affairs in DHS…and you find out if I am wrong.

    And when they raise $90 million dollars…and that works out to about a million and change to every state, you tell me how much get…while the doctors in the emergency rooms and trauma centers are getting the rest of the money…and then ask yourself why did I support Field EMS and why no one told me about the ACA…

  9. The NAEMT is as much an advocacy group for EMTs as AARP is for senior citizens.

    Which is to say none.

    NAEMT made the decision back in the early 1980s not to get involved in politics or union activities. As a result, it’s been ineffective during it’s entire existence.

  10. I really wish we could get a national strongly led organization together to represent us and advocate for advancing EMS. Unfortunately, EMS right now and historically is full of lowest common denominator tradesmen instead of health professionals, so we can’t find sufficiently educated people to lead.

    So, every effort, because it has to be staffed with EMTs for buy-in, ends up chaotically ineffective because the leaders do not have a sufficient education to argue for their cause effectively, unlike other organizations that represent nursing, PAs, and emergency medicine physicians, which are usually led by people with doctoral-level degrees.

    Compare JEMS to legitimate medical journals for physicians and nurses and note the difference in scholarship.

    Field medical care, whether definitive or pre-hospital is a critical subject, but few are researching and advocating for it.