As a former co worker was fond of saying “The truth only hurts who it is about.”
The post I am commenting on is going to hurt a lot of feelings, but it needed to be said.
I don’t know who this guy is or even if I’ll link to him, but I found this post via Facebook,
I started to write a comment on his blog, but realized that my comment was of blog post length and so decided to get an easy post out of my comments.
I don’t agree with him 100%, but he’s about 80% correct. The part about EBM versus SBM is priceless and will make some EMS heads explode.
Here are my comments,
You bring up some good points, although a couple of your seques are on the head spinning side.
The problem with EMS is that it has not yet decided whether it wants to be a profession, a trade, or a skill set. If it is a profession, then, and I’m sure someone will jump in to object, it has to become a self regulating body that sets and keeps minimum standards. Which might just end volunteer EMS, at least as we know it.
If it’s to be a trade, then volunteers are definitely out, and while it might be self regulating, it will not have the educational requirements to be a profession.
Which leads a skill set. Fire Fighter/Paramedics think of themselves as fire fighters who do EMS on the side. That despite the fact that most of their work load (70-80%) is EMS and not fire suppression. They’ll read all about “fighting the dragon”, but many of them won’t pick up an EMS magazine or book until it’s time to recertify.
It may well come down to paramedicine becoming a profession or trade and EMT being a skill set.
I come from one of “those” systems where we maintain higher standards than the norm. I won’t identify it, but suffice it to say we have a research division, have published studies, our recently retired medical director was well regarded on a national level, etc…
The key to upgrading EMS is not related to some phony baloney EMS degree. It’s related to improving medical education for paramedics, improving pay, benefits, and working conditions to the point that people will stay in the filed for longer than it takes to get hired by a fire department, police department, or admission to a nursing program.
Since there is a seemingly never ending supply of minimally qualified paramedics ready to go to work for chump change, that will likely never change other than in a few systems. The one thing that those systems will share is that their work force is unionized. Which of course most people in EMS that are not working in fire based or third service systems will never do because it’s easy to break the unions in the private sector.
I also agree with you about EBM versus SBM. Although too much of what we do is based on anecdote, too much of what we do is based on the foggy evidence of EBM and not enough is based on SBM. Sadly Emergency Medicine shares that problem as well.