Masters of Our Own Destiny

EMS is dependent on others to get what little we do.  Whether it’s getting physician involvement for clinical changes or convincing those with the money that a new ambulance is needed, we have to get others involved in our destiny.

If you listen to the current voices on EMS social media, you’ll hear the lamentations that EMS is broken.  The current consensus, promoted by all self-proclaimed EMS save those in the fire service, is that EMS degrees are what will surely fix EMS and make us respected.  Mind you, the EMS consensus has brought us some other sure-fire winners as system status management, declaring EMS an “essential service” (Hey, where did that go?), and community paramedicine.  We’re on EMS 3.0 or something now and we still haven’t mastered the basics of getting the right patients to the right hospital and treating people right, both as people and as patients.

I agree that more education is needed for EMS. But the last thing we need to do is follow the rest of the healthcare professions and have a solely clinically focused degree.

Too many people in EMS (and the rest of healthcare) think that all you have to understand is the medicine. If you don’t understand (or participate) in the policy and business aspects, others make those decisions for you. If you don’t believe me, look at our modern American healthcare system. For years, physicians refused to be involved in the business of medicine.  As a result, hospital and healthcare administrators developed to handle the business of medicine.  And ultimately, we have ended up where we are currently — where a lot of decisions about medical care are made by the business office rather than by those providing the actual care.

It often seems that there’s a belief in the world of healthcare that being involved in business or policy is somehow “unclean” or beneath the profession.  As a good friend of mine said, “Even if you aren’t interested in politics, politics is interested in you.”

So, in short, I’m not opposed to increasing EMS education.  But what an EMS degree should NOT be is a degree focused solely on the clinical practice of medicine.  Too many of the EMS degree advocates on social media would promote a degree that awards three hours of college credit for a course entitled “Latest Clinical Fads Capstone.”

EMS, like the rest of the healthcare world, does not exist solely in a clinical vacuum. For EMS to advance, we need to understand the business of healthcare.  That means an EMS degree needs to include coursework in the political and regulatory process, finance, personnel management, and the research process.

In other words, it needs to be a well rounded degree as opposed to a narrowly focused clinical pathway that will be doomed to irrelevance with every change in medical practice. But without this kind of education, an EMS degree is doomed to become an expensive addition to the current workplace.  If the current people pushing for a degree requirement better understood the non-clinical aspects of what we do, they’d see the potential pitfalls of an EMS degree such as a lack of buy-in from higher education and the availability of appropriately educated EMS faculty to teach in a college setting. By the way, the same shortage of faculty is partially responsible for the current nursing shortage. This is but one example of why healthcare education (including EMS) needs to understand business and policy. Take ultrasound.  It’s the current EMS clinical fad on social media.  Everyone wants it.  But has anyone developed a position as to how ultrasound saves money, improves care, or how EMS can get paid for ultrasound.  I’ll wait here for that answer.

And if you don’t believe that healthcare providers (including paramedics and EMTs) don’t need to understand the big picture of healthcare outside the actual provision of medicine to patients, then you’ve illustrated exactly why healthcare administrators often make even more money than the doctors do.

Comments

  1. Robert Martin says:

    Hence why I went out and earned undergrad and graduate degrees in healthcare administration.

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