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.