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 technicians who are taught to “fix” a patient’s “condition.” Every so often, the latest buzz hits EMS and we all roll out something “new” to address this.

Some years, the EMS flavor du jour is anaphylaxis.  Some years, it’s been cardiac arrest.  Some years, it’s been acute coronary syndrome.  Yet other years, stroke becomes a focus. Currently, we seem to be torn between sepsis and emerging tropical infectious diseases (Ebola and now Zika).  All of these are important topics and something that any EMS provider should be capable of at least beginning to address. Meanwhile, we have all of the various factions advocating that EMS will get the respect it deserves if we go into “community paramedicine,” “tactical medicine,” or “critical care paramedicine.”  Then factor in the various advocates pushing differing models of EMS, whether private, third-service, or fire-based.

Yet, what everyone is overlooking is simple. We’re teaching EMS providers the recipes for cooking, but not how to actually cook.  Every one of these new ideas that rolls out fails to address the simple fact that EMS providers aren’t taught the fundamentals of medicine.   Teach anatomy, physiology, pathophysiology, pharmacology, assessment, and skills appropriate to the provider level.  If you taught the core fundamentals of medicine rather than flowcharts and protocols, you’d have an educated provider who, at any level, is capable of adapting and providing clinically appropriate to almost any patient.

If you teach a chef, you teach them their way around the kitchen.  If you train a cook, you teach them how to make things from the recipe.  In EMS, we’re turning out short order cooks who need a new recipe anytime the clinical tastes change as opposed to professional chefs who know how to make a recipe of their own and can vary that recipe for their patient/customer. And until we fix that, all of the latest card courses and “urgent” continuing education modules to address the latest problem won’t fix the real problem with EMS.



  1. It is far easier and cheaper to teach one what to think than how to think. Besides, those who have learned how to think demand higher wages and better working conditions.