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.

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