Yes, you’re wrong.

Sorry for the interruption in my usual stream of consciousness blogging.  Nothing in particular has been on my mind as of late. (Although I may have to do a post in the near future about finding a potential unicorn.  Namely, a fire department that embraces both volunteers and ALS first response.)

But this morning, I saw a contrast between those who I’d call high speed EMS providers and those who, at best, deserve the title “ambulance driver.”

Example one.  Discussion about the risks and benefits of a particular prehospital intervention.  In this case, it was application of a pelvic binder.  An expert on trauma care provides their opinion and an article that includes citations. Learning and dialogue occur.

Example two. Discussion of prehospital ultrasound on a popular EMS social media page.  Truth be told, I’m still a skeptic on prehospital ultrasound.  I’m not sure what ultrasound can show me that a good patient assessment can AND change my course of care in the prehospital setting. But another EMS provider (and I won’t use the word professional) stated in said discussion, ” I guess when you’re burn out like me, it doesn’t matter any more and you just want to dump the pt in the er. However that’s mine own opinion.”  He then “doubles down on dumb” and goes on to state, “nope it’s my opinion, not ignorance. I jill just don’t care about those devices out in the field. Waste of time and money.”  When he’s challenged on his ignorance, he states, “It’s not an excuse, it’s just how I feel about being burn out. I believe we have differences in opinions and I respect that. I guess opinions are wrong to use. People have different opinions and has nothing to do with education.”

The truth is simple. You can have an opinion. But when your opinion is based upon bad information and beliefs and you refuse to change when given new information, then you are absolutely wrong. And if you’re basing your medicine on bad opinions, then you’re a bad provider.

So long as EMS tolerates those people who refuse to practice good medicine based on current evidence based practice because they “have a different opinion,” we’re going to remain the ambulance drivers.  We won’t be taken as a profession.  And until we step up the standards to be a clinician, regardless of what EMS does for educational standards (which may or may not fix things), we don’t deserve to be called a profession.

You’re entitled to an opinion.  You can be wrong.  But you’re not entitled to harm a patient because you choose to be wrong.  If you are still doing that, that’s why the legal profession exists.

Comments

  1. Cognitive dissonance is a dangerous thing. No, it does not matter how well ‘educated’ you are or are not nor the initials behind your name. The reality is that we have all held onto ‘opionions’ that have been proven empirically wrong or incorrect at some point. using evidence-based practice is a real thing. The sign of a mature and educated provider is one that can take that evidence, digest it and reform their own long-held beliefs and opinions into one that is best practice for our patient and ourselves. Let’s face it MAST trousers did ‘work’, at least short term. Were they effective in improving patient outcomes? No, they were not.

    Are there appropriate places for advanced technology such as prehospital ultrasound in EMS? In the right system, in the right environment quite possibly. Does it make sense in a busy urban system where I can be at an appropriate ED within minutes? Probably not. Will it change my course of treatment or destination? In an urban system, No. In a rural system, yes it may have an impact on my destination choice. Will it affect my treatment? At this stage probably not. Although there is potential for expansion of scope if it does prove effective. Much like prehospital 12 lead EKG, it will take time, practice and research to prove the worth and efficacy of new technology. But if you just want to be an ‘ambulance driver’, well I hear Uber and Lyft pay pretty well and you don’t have to play with patients body fluids. Just my two 1/2 cents.

  2. Jay Cloud says:

    Excellent blog as always.

  3. Skip Kirkwood says:

    Isn’t it sad that somebody so “burned out” continues to work in the field? And inflict his crappy attitude on patients who have no choice about who is sent to care for him? Surely his organization knows about him, but must be more concerned about the “patch and pulse” than anything to do with compassion or quality patient care. Kinda shameful, too!

  4. You aren’t just wrong. You are a threat to the patient’s wellbeing. How can anyone be so callous and still stay in this job? Time to retire or change careers. Stop being “that salty guy” and GTFO of EMS for everyone’s welfare, including your own.

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