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In Your Opinion, What Is Holding USA EMS Back?

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How do you figure?

MDs/DOs have a single licence system, yet that doesn't seem to stop them from becoming brain surgeons.

with the notable exception of physicians mosrt health professionals in the USA spend a farir amount opf time saying that either the legislation controlling that profession or another ring fences certain interventions for certain professions rather than the open ended approach to scope of professional practice seen elsewhere

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Private ambulance companies.

AMR just cares about making their shareholders happy. Because they do such a terrible job of serving our community (not staffing units, not trying to retain experienced employees, hiring 19 year olds), they are destroying the image of EMS

You cant blame the destroying of EMS image on the age. I personally study hard and take things seriously when it comes to EMS and so does the rest of my class. It may not be like that everywhere but you really can't blame it on age. I've seen with my own eyes a paramedic forgetting how to take a BP and having an EMT-B do it. It's really has more to do with the dedication the person has to his/her job to be as professional as possible.

If anyone is to blame for this it is the people who made 120 course. Just because we have a short course doesn't mean we can't carry ourselves as professionals. Which brings me to my next point. EMS being recognized as a health care profession doesn't hang on how short our course is. Anyone could make a longer course and just string out what we are already learning to satisfy anyone looking for a time spent in a class. What it really hangs on is the content of what the course offers and what we are allowed to do.

If we could handle smaller calls and not have to bring them to the hospital on ever instances then we would be better off. So in the end it comes down to what we do.

Just look at it we stabilize a patient until the "Doctors and Nurses" can have a look making us look less knowledgeable in a outsider perspective.

Just had to put my 2 cents in here

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with the notable exception of physicians mosrt health professionals in the USA spend a farir amount opf time saying that either the legislation controlling that profession or another ring fences certain interventions for certain professions rather than the open ended approach to scope of professional practice seen elsewhere

Ah, well I agree that is currently the case. My point is that it should not be the case in our future.

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I can only base my opinion on what’s been said by EMS staff on EMS sites like this.

One thing that is blatantly obvious is your attitude. I’ve never seen such negative bunch of people. I found it hard to comprehend why there is a need to state before posting that you shouldn’t ‘bash’ people for expressing there opinion, but now I know why. I could only imagine what would happen if people on this site actually decided to meet.

Really, were to start? You guys have an enormous amount of stuff to sort before thing can run smoothly. Seriously, you guys know what you need; reading through posts there’s been some great suggestions. All that needs to happen now is someone to get of there fat ass and start doing it.

Having not been to America nor have I any urge to go there I can not make any suggestions.

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Education, volunteers, education, no oversight, education, apathy, education

I think if we can correct the education the rest will quickly fall into place.

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If anyone is to blame for this it is the people who made 120 course. Just because we have a short course doesn't mean we can't carry ourselves as professionals. Which brings me to my next point. EMS being recognized as a health care profession doesn't hang on how short our course is. Anyone could make a longer course and just string out what we are already learning to satisfy anyone looking for a time spent in a class. What it really hangs on is the content of what the course offers and what we are allowed to do.

Very good observations. Just one small, but significant correction here. Those who developed the 120 hour EMT course are not the problem. It is those who have fought to keep it that way for the last thirty years that are to blame. 120 hours (actually, it was 80 in the beginning) was perfectly reasonable for the early 1970s. Not anymore. In fact, any education measured in hours is probably inadequate.

Other than that, plus 5 for recognising the important elements of professionalism.

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It’s easier to blame than to fix, isn’t it?

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aussiephil, that was a very good "keep it real" response. Although, I do hold a degree, that is business related, and not in science, I keep seeing post after post about higher and higher education levels. While I do agree, that there should be a high standard of training, and that's what it is "training", I find that some people are taking it too far. Based on "some" of the posts I've read, some medics seem to have a feeling that they should have the ultimate power in decision making healthcare providing. If this would be the case, why call a report to the ER, why not call directly to the floor and admit your own patients. Why would I want a Bachelor's Degree in Science, to memorize dosages, or to calculate drip rates? If you don't know it when you come out of medic school, you've got issues. We are not doctors. Yep, the degree helps pay in "some" agencies, but until there is more governmental influence at the Federal level, the pay can only go so far. And, until you put M.D. after your paramedic title, med control physicians are only gonna allow so much, to be put in a paramedic's standing orders. So, at least for now I wished we could focus on the issue of applying pressure on our governments to bring a "standard" to the business. EMS is a really simple process, treat life threatening, and transport. All the in between is ok to further your assessment skills, and to gain a further knowledge of the medical conditions that some individuals face. We are forever preached to about ABCs, that's because this is the "primary" issue for EMS providers. Some where along the lines, some people lose sight of our objective, and try to be field doctors. Remember, that no matter the condition of the patient, we are only equipped to treat so much. And, trying to "overdiagnose" certain conditions, may make you look good in front of the doc while you're giving a report, but you as the medic did not intervene on the treatment required. That's because your truck is not equipped (and never will be) for conditions that are gonna require long term care for the patient in most cases. I do also believe in the fact that the different levels, such as basic and intermediate have their place, as does voluteers in "certain" remote locations, and certain conditions. There will "never" be a situation that we as paid medics will ever be able to be everywhere all of the time. Citizens in this country and abroad need to have someone that can be there for them in their time of crisis. We as EMS, would love for that to be us, but it just can't be that way. They could never manufacture enough ambulances, or hire enough people. As long as we are in healthcare, we must have help from somewhere. Please don't misunderstand me. I would never belittle our profession. But, I assure the answers we're looking for is not in eliminating EMTs or volunteers, or even higher education. If, and I do say "if" that were the case, our problems would have already been solved.

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aussiephil, that was a very good "keep it real" response.

Yeah, all except for this stinker:

I am also a firm believer that while ems crosses both the health field & emergency services fields, it should not be run on a 'for profit' basis. Same for all healthcare. Health & Primary Emergency services should be a function of Government, with paid providors used as an adjunct for things such as sporting events with licensing controlled by the government to enforce regulations. This should be a state, not federal function & would allow for the use of statewide protocols etc.

There is not a single thing right in that paragraph. While I accept that it might make some sense from an Australian perspective, from an American perspective, everything in that paragraph is just dead wrong. There is not a single government agency in this country that is a model of efficiency and professonalism. The federal government has farked up every piece of healthcare that they have touched, including EMS. The government is the medical insurer (Medicare, Medicaid, Medical, etc...) that fails to pay upwards of eighty percent of the ambulance bills it receives. It's not time for them to take over. It's time for them to get the hell out.

As for "for profit" private providers, they are the best of the best in American healthcare. In fact, they are the best of the best of Europaean healthcare too. Nobody in this country looks forward to being a patient in a government run healthcare facility. Anybody who can afford to do so chooses a private hospital. That's where the best care is available. Most any aspiring physician would rather get accepted to Harvard, Yale, Johns Hopkins, Duke, Stanford, Case Western, Vanderbilt, Loma Linda, Cornell, Washington, or Boston University (all private medical colleges) than the State University of Southern North Dakota - Bumfuck Campus (a government run college). My mother's health insurance (and other benefits) from her private industry job beat the hell out of the health insurance and benefits my step-dad gets from 30 years at his government job. The most clinically sophisticated EMS systems I have seen in the United States were mostly either private or hospital based. Things may be a lot different in your society, but there is nothing positive to come from government control of EMS in the U.S. Simply put, our government sucks at running anything but their mouths. They damn sure aren't the people who ought to be setting statewide protocols that would lower us all to the level of the lowest common denominator, resulting in every system turning into another Detroit or D.C. FD EMS, with nobody having any ability or motivation to excel. If firemonkey EMS is your golden standard, then you'll love the EMS set up by the government.

But, I assure the answers we're looking for is not in eliminating EMTs or volunteers, or even higher education. If, and I do say "if" that were the case, our problems would have already been solved.

^ Quite possibly the most ignorant statement ever made at EMT City.

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