Here’s a great example of what’s wrong with EMS. This morning, I was looking at the webpage for the EMS For Children Improvement and Innovation Center project being administered by Texas Children’s Hospital. The webpage identified twenty-eight staff members assigned to the project.
Of these staff members, only one of them is identified as a paramedic and he’s actually a full-time employee of the state EMS office. The majority of those identified with healthcare backgrounds were either physicians or nurses. We need to quit letting EMS be defined and controlled by people who aren’t in EMS. This is the equivalent of having a bunch of paramedics define oncology care because they do transports.
The truth is that there are EMS professionals with the educational background to be involved in developing the future of EMS and determining our professional identity. There are paramedics with master’s degrees in a variety of fields ranging from the hard sciences to education to public health to administrative fields like business administration, public administration, and healthcare administration. The National Registry even funds two EMS professionals per year to get a graduate degree in an EMS related field. There is NO reason not to have more than a token EMS presence on committees that define who we are and what we do as a profession.
Instead, through a combination of our own apathy and aggressive encroachment by other fields (cough, nursing, cough), we allow our profession’s path to be charted by those without a real stake in EMS and not necessarily with EMS’s best interests in the forefront. The nursing advocates regularly say that EMS providers shouldn’t do anything that approaches nursing and believe that nursing represents a higher level of education and skill sets. However, these same nurses readily encroach on the EMS field and insert themselves on almost every committee that determines EMS education and practice. Try advocating for an EMS professional to even have a seat on a committee regarding the hospital emergency department or the ICU and prepare for the wailing and gnashing of teeth.
A lot of really smart people in EMS regularly advocate for EMS being represented within the US Department of Health and Human Services. Personally, I believe this will continue the trend of EMS having little, if any, voice of its own. After many years as a government lawyer, I’ve realized that those who call the shots in the health and human services bureaucracies usually have a nursing and/or a public health background. I can virtually guarantee that putting EMS in the health and human services system will ensure that nursing and public health controls who we are and what we do. An EMS office within the HHS bureaucracy will be little more than a token voice that will be run over roughshod by the nurses, public health professionals, and various other “stakeholders” that truly have no stake in EMS.
We have got to control our professional identity and that begins with paramedics being involved in the administration and development of our profession. It’s time to demand that those that define and determine what EMS is at least have an idea of what happens on an ambulance.