Community paramedics- secondary effects

[triemal04]

Community paramedics are the current hot topic in EMS for various reasons, some good, some bad. While these programs can certainly be extremely beneficial, both to patients, and to departments that implement them, there is a side to this that could have some interesting implications for EMS.

At the recent ACEP conference, it sounds like several medical directors had reservations about community paramedics due to the lack of education at the paramedic level; a very valid concern. With EMS now being a subspeciality of EM, the fact that this (if reported accurately) was discussed at the annual ACEP conference should make people take note.

If this type of program continues to be implemented using paramedics, more and more doctors (and not just medical directors and/or EM doctors) will become aware of the lack of education at the paramedic level.

If that's the case, will this have an overall good, bad, or indifferent effect on EMS as a whole?

Edited November 12, 2014 by triemal04

[paramedicmike]

I was the one who reported it as I was there. Several EMS medical directors inferred or said outright that paramedic education is a big hangup when it comes to these programs as it is inadequate for this type of program expansion.

There were a number of factors tied into this. EMS is still a DOT controlled entity and not Health and Human Services (this despite EMS being a subspeciality of EM). Fire Departments have been pushing back against educational expansion (mentioned in discussion without specific mention of any department). Financial constraints and justifying a program that hasn't been shown to be profitable is proving to be a barrier.

The medical directors who spoke said in theory they liked the idea behind it. Making it work has been challenging. There was not a clear consensus across the board about what these programs should even be doing.

To be fair the comments were all made in a day long seminar crammed with a lot of other topics including research, hot topics (i.e. ebola) and coming trends so prolonged discussion was limited.

I'd like to think that increasing awareness of the current state of EMS education would have an overall positive effect in forcing increases and improvements in EMS education. The cynic in me isn't so optimistic, though.

Edited November 12, 2014 by paramedicmike

[treaux]

I also would hope it would increase the demand for more extensive paramedic education. If not for all, than as a certification for community paramedic licensure as required. Anything that raises our education level would benefit the profession as a whole.

Working in the SF Bay Area though, most of what I have seen is negative and reactionary actions by medical direction when it comes to the lack of paramedic education. Notably in my county they removed the needle cricothyrotomy from our scope due to one call where it was performed improperly by a medic. With an ever-shrinking scope in California, it would take some really progressive medical directors to make the community paramedic idea work. I am all for it however, and there have been some cases where similar programs work (I currently am part of a program that has a dedicated paramedic psychiatric/social services unit).

Edited November 12, 2014 by treaux

[zippyRN]

the Commonwealth experience with community paramedicine is generally positive, however the educational stuff was far less of an issue as the development is AFTER education and/or Health Professional registration for paramedics was in place.