A Farewell to the NAEMT

Dear Mr. Zavadsky:

First of all, I appreciate your offer to reach out last week after my blog entry regarding my views on what appeared to be NAEMT’s no position of a position statement on the ongoing discussion regarding a degree requirement for paramedics.  Unfortunately, our schedules have yet to match up.  But I did find the explanation provided by one other NAEMT insider to be interesting to say the least – namely that the NAEMT position statement had been in the works for a while and was unrelated to the competing positions from other EMS and fire organizations regarding a paramedic degree requirement.  I might have been willing to believe such a statement had NAEMT (or you) provided such a background statement in conjunction with NAEMT’s position statement. However, such an explanation at this point, when prior opportunities were available, strikes me much more as an attempt at damage control than providing a nuanced policy statement. The fact that NAEMT hasn’t publicly clarified this statement speaks even louder as to the organization’s unwillingness to take a position. I stand by my original position that a degree requirement is worth exploring for paramedics, but will also require significant planning and buy-in from higher education stakeholders.

I was almost willing to view this position statement as merely another failed opportunity for NAEMT to advocate for the EMS profession until today.  As you know, last week, New York City Mayor Bill de Blasio spoke against EMS pay increases for New York City EMS professionals in comparison to Fire Department, Police Department, and Sanitation Department employees claiming, “The work is different.”  EMS social media roared. NAEMT was, once again, silent. Today, however, the National Association of EMS Physicians released a position advocating for EMS pay to be commensurate with the responsibilities of EMS providers. Again, I note – NAEMT, the supposed voice for “advancing the EMS profession,” was silent.

Two such notable flubs in the span of less than two weeks speaks volumes as to the culture and leadership of NAEMT.  I’ve criticized NAEMT before for a variety of issues, namely a focus on quixotic efforts to lobby the Federal government for programs that may not benefit our profession as a whole, a lack of advocacy at the state levels, and an overreliance on revenue from card courses.

More than anything, what I’ve seen from NAEMT is a continued failure to advocate for EMS for fear that it may ruffle some feathers.  What I also see is a culture that has the same usual crowd of EMS insiders and their cronies placed in positions of leadership. (In all fairness, I do have a great deal of respect for you and several of the board members.) This culture has created an organization that is slow to respond to the needs of EMS and to the news cycle as EMS is impacted. When applications for new positions and committee members are sought, it’s always the same names that you always see in EMS.  NAEMT has failed to develop a next generation of EMS leaders and advocates.

Finally, I see an overreliance by NAEMT on revenue from a plethora of card courses. NAEMT’s reliance on said revenue and the partnerships with textbook publishers mean that these largely repetitive card courses are seen as much as a cash cow as they are an actual source of current medical education. I’ve taught Advanced Medical Life Support for years and have even been affiliate faculty for the program.  However, the rise of social media and FOAM efforts means that many continuing education programs on a four-year cycle are, by their very nature, outdated.  Yet, NAEMT produces new courses every year and the publishers produce new updates and required materials on the same basis.

To me, NAEMT’s main benefit consists of the various discounts provided and discounted admission to the EMS World Expo.  While there have been some quality speakers at EMS World Expo, I’d also note that there are many presenters and topics at the conference which do not advance EMS and instead serve the “meets minimum standards” and “lowest common denominator” level of the EMS trade.  Note that I did not say “profession” in this case.

I fully expect that there will be consequences from my communication.  I say this not out of spite, but out of the recognition that my interests as an EMS professional aren’t always recognized by NAEMT.  I will quote another paramedic colleague of mine who says, “I am a member of NAEMSP, but not of NAEMT. I like my money to go someplace useful.”

Accordingly, I choose to speak with a clear action.  I hereby resign my membership in the National Association of Emergency Medical Technicians.



  1. Robin Renfrew says:

    I am also a member of the NAEMT; however, I must say that it’s truly a detriment to those of us (members of said organization) to have the powers that be proclaim that they represent providers at all levels but neglect to actually DO something to promote, protect, and advocate for the providers. I also am second guessing my membership at this point and may not renew once it expires. Color me thoroughly disheartened and disgusted.

  2. Jay Cloud says:

    Bravo Wes. I am in total agreement.

  3. Tony O’Brien says:

    At least you got to resign! I was kicked out, they called the police on me for asking a financial question at the general membership meeting, (claimed I was “causing a disturbance”) and later Matt Zavadaski himself called my employer in an attempt to have me fired.
    The ‘leadership’ of NAEMT has been grotesque for years.

  4. Gene Gandy says:

    Well stated, Wes. You have summed up some of the problems with NAEMT quite well. I ceased being a member a number years ago because of the same issues and inability to make any progress in changing things.

    As for the card courses. At one time they served a very important purpose, that of adding information and practices to the pool of EMS knowledge not covered in initial courses. Today, however, card courses as traditionally taught are obsolete because of the expansion of social media and online programs that offer instant access to the latest information and practices in EMS and emergency medicine.

    Having taught all of them in the past, I found them useful at one time, but today they simply are not the best way to keep up with current thinking. Just as textbooks are obsolete the minute they hit the shelves, so are card courses because they can’t be updated at the rate that knowledge is expanding.

    NAEMT can save itself by becoming an advocate for working medics, but so far it has not shown the ability or propensity to do so. And that is in spite of the efforts of a lot of good people. Will we see any changes? I hope so, but I fear not.

  5. Bob Kellow says:

    Perhaps it’s better to understand what NAEMT is, and more importantly what it is not. NAEMT is a non-profit trade association, which upon its founding was designed to represent and be all things to all EMS people. It was much easier back then because the emerging industry was much more closely integrated and single-minded in purpose. As industry interests fragmented and spun out of control during the early-80’s, NAEMT’s philosophy of member aggregation became increasingly threatened by the emergence of secular EMS groups, who were promoting their “unique identities” and subsequent territorial imperatives. That’s when NAEMT began to unravel as the sole collection point for all EMS-related interests, which it remains to this date.

    Given the diversity of its membership and their particular secular beliefs, NAEMT’s position statements and health policy initiatives are very non-specific and broad. Narrowing their policy beliefs to favor one membership faction over other’s would be economically and existentially suicidal. In the context of degreed paramedics, why would NAEMT advance such a policy, when the majority of their membership does not possess, nor want to pursue college degrees, and would clearly oppose it — even with the unfounded “promise” of improved annual incomes?

    More importantly, I believe it’s best to understand what NAEMT is not. NAEMT is a voluntary trade association that competes for dues-paying members from a pool of providers who still consider purchasing a 12-pack of beer a better discretionary spending investment. It is not a trade union that can compel membership and mandate confiscatory dues payments. For example, consider NAEMT’s competitive effectiveness when weighed against that of the IAFF, which will always oppose degree requirements. NAEMT has an annual budget of $2.6 million, of which $1.6 million is spent on administration and membership promotion. Compare that to the IAFF’s $67 million annual budget, along with their ability to contribute millions in political campaign contributions. Hell, even ACEP has a $38 million annual budget, with a small army of highly-educated and paid professional staff members.

    For those who believe that NAEMT has committed policy treason by the issuance of a broad and non-committal position statement on degree requirements for paramedics, I urge you to start your own national association that advocates that very point. Then, see how long you last. As a former executive staff member at national ACEP throughout the 1980’s, it’s my belief that NAEMT’s interests, given its broad membership mix, are best served by avoiding being the tip of the spear, and focusing on manipulating the internal components of such an initiative at the secondary level. From almost every perspective relating to money muscle, political influence and inter-organizational stature, prestige and competitiveness, NAEMT could never outlast a serious national challenge to a claim of singular authority on this matter.

  6. Jules Scadden says:

    I was a board member several years ago and can tell you this statement is spot on and terminally sad. NAEMT has had the opportunity for years and under some past leadership made strides in representing EMS but the past 5+ years they have not been productive for the profession as a whole. I am holding out some hope this new leadership under Matt will do better, but if January is an example, they need to step up their game

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