Where EMS and education collide

This morning, I read an article with great interest about our local EMS system using a physician assistant who’s also a paramedic to provide enhanced EMS care — both for acute patients and to divert non-acute patients from the emergency room. The truth is that such a program has a ton of merit and would probably benefit a lot of EMS systems. While the funding may not be there, I personally believe that controlling the loss of funds from unreimbursed ambulance transports might be worth the money alone.

But this article illustrates a bigger problem with EMS. Namely, that a paramedic certification leads nowhere, except maybe a paramedic to RN bridge. The truth is that we know a lot of things about emergency medicine — and if you’re a decent provider, a lot of that knowledge carries over into other aspects of medicine. But there’s no recognized mechanism to transfer that knowledge to another discipline. And even if it did transfer over, most people in EMS don’t have the pre-requisites to get into other programs. Me included as my BA was a very studied attempt in avoiding hard science courses at UT because those courses were used to weed out pre-med students.

And the funny thing is that a MD friend of mine said she never uses those courses in her work. The truth is that the health care education field requires the wrong prerequisites. They attract people who do well in science and not necessarily those with the ability to communicate or even those who want to be caregivers. We see the results regularly, especially with physicians, when we see a clinician who can describe lab values to the molecular level but can’t communicate with a patient or their family, let alone show empathy.

We need to address two things as EMS. First, we need to find ways to bring our skillset, clinical knowledge, and life experience into healthcare above and beyond the usual two options of being on the ambulance or being a “tech” in an emergency department. Second, we need to encourage those in health care academia to recognize that alternate pathways to higher education in medical care can and should be recognized. I’d much rather attract clinicians with a proven interest in medical care as well as exposure to medicine than I would people who’ve checked off the right arbitrary coursework and who’ve never seen a sick person, much less talked to one or their family.

The challenge is for us to convince everyone else that an EMS certification brings something to the table when we want to move past working on the ambulance or the emergency department.