Lead, Follow, or Get the Hell Out of the Way

If you’ve been following any EMS news as of late, you’ve read about the position paper that paramedics should have a minimum of a two year degree. The position paper was issued by the National Association of EMS Educators, the National EMS Management Association, and the International Association of Flight and Critical Care Paramedics. The position paper was peer reviewed and published in the academic journal Prehospital Emergency Care.  Shortly thereafter, what could charitably be called a rebuttal was issued by the International Association of Firefighters and the International Association of Fire Chiefs. Needless to say, the fire service, with some notable exceptions, has little interest in advancing EMS except as a continued source of revenue and mission creep.

So, you ask where our national “voice for EMS” was and what they had to say. Basically, what they said was that there were competing positions worthy of further study. In other words, they took no position.  Regardless of my feelings about the IAFF, the IAFC, and the fire service in general terms, the fire service took a position and they advocated for what they believe to be in the best interest of their members and their trade. I’ll give them respect for that.  And they’ve, by and large, been successful in crafting public policy to their benefit.  The NAEMT?  Not so much.  They took no position. As the famed Texas liberal populist Jim Hightower once said, “There’s nothing in the middle of the road but a yellow stripe and dead armadillos.”

One can argue that by taking no position, the NAEMT took a position in favor of the status quo, which may actually be closer to the IAFC/IAFF position which can be summed up by Pink Floyd, “We don’t need no education.” In all candor, I do think there are significant challenges and hurdles that face EMS if we advance to a degree requirement and that such challenges need to be seriously discussed, especially with higher education leaders.

But NAEMT is an enigma in the world of professional associations.  NAEMT’s primary connection to most members is its development, marketing, and delivery of a plethora of card courses, which are NAEMT’s primary revenue source. NAEMT’s lobbying efforts are primarily directed at the Federal level, while the majority of EMS regulation and legislation happens at the local and state levels. The one clearly identified national level solution, namely a change to how the Centers for Medicare and Medicaid Services (CMS) funds EMS, doesn’t appear to be on NAEMT’s radar. For me, as an EMS provider, the main benefit that NAEMT provides me are member discounts.  NAEMT’s real challenge is that it claims to represent any and all with an EMS certification. As I’ve said before, there’s not a ton of common ground to be found between everyone in EMS.  A flight medic working in rural Nevada has very different needs and wants from their professional association than does a firefighter/EMT who maintains their EMT certification because it’s a condition of employment at their department.

Maybe it is time to realize that NAEMT doesn’t speak for EMS.  And just maybe it’s time for paramedics to demand a separate voice for the advancement of paramedics. After all, the American Bar Association doesn’t represent attorneys, paralegals, law clerks, and legal assistants. The American Bar Association represents lawyers and lawyers alone.

Anyone for a National Association of Paramedics? And the acronym also reminds me of many paramedics’ favorite pastime, me included, namely NAP.

It’s time for paramedics to be our own voice and advocate for ourselves.


  1. Wholeheartedly agree NAEMT should stay the voice of EMT’s. They should not be the voice of paramedics. Not sure another association is needed the IAFCCP seems to fit the space very well for paramedic representation.

  2. *Pulls pin*
    *Throws grenade*

    National Registry of Paramedics?

  3. Bob Kellow says:

    IMHO, yet another “EMS Club” will not work. The historical trail is littered with the bodies of EMS Clubs that wrongly believed at their mission would galvanize one or more constituent components of the “system” into a committed and effective force for reform and change. In that respect, it’s evident that no such marriages could be consumated because their interests were too diverse; their operational settings were too mutually combative; and, no one was ever truly committed to long-range, costly and polymorphous policy objectives that might never be realized in their lifetime. One thing is for certain, until the system finance adequacy issue is finally resolved, nothing, and I mean NOTHING else matters. Until then, all future EMS Clubs will continue to ineffectively ruminate and scratch their bellies, and resonate on a closed frequency that’s undetectable to health care payers.

  4. Hi Wes – thanks for taking my call a few minutes ago. It will be great to visit with you more fully at your convenience to provide some background on the methodology and considerations in preparing the NAEMT position, as well as seek your insight into in what ways the position is different than what you blogged about in September 2018 ==> https://theambulancechaser.com/2018/09/more-on-the-four-year-ems-degree/

    • theambulancechaser says:

      I think the big difference is that I’m saying the degree is a good idea in theory, but will require much more advance work than an aspirational statement saying that everyone should have a degree. It may be merely semantics, but to many of us, including me, the NAEMT position statement read much more like no position at all.

    • I actually think the NAEMT position was very well thought out.

      It was decided not to upset the apple cart by offending the fire associations and throwing a bone to the EMS organizations by saying “Yeah, degrees are nice and all…” The truth is, I find not the thought process but rather the motivation suspect. The NAEMT is selling out to not offend fire associations in order to prevent a loss of membership. It is also looking after its own interests, because a Paramedic with a formal degree education would be less likely to be in need of short, stop-gap educational courses, such as those offered in the NAEMT merit badge courses.

      One has to wonder how much the NAEMT truly advocates for the profession versus how much it actually advocates for itself.

  5. Twenty years ago, the degree was the “next big thing”—at least in our region. I even got paid a stipend for my degree! However, today, employers offer ZERO incentive for a candidate to take speech and PE to get a degree. Due to low output, we had to stop offering our degree. So, yes, pay is an issue.

    What I’ve also learned is that the regulations and requirements placed on higher education (degree structure, hours requirements, etc) need some attention as well. Nobody wants to take courses they deem irrelevant to their field of study…I certainly didn’t.

    So, in the absence of a pay-incentive AND a degree structure that makes sense to the consumer, it is an uphill battle.

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