Increasing Education from a perspective of system management

[PRPGfirerescuetech]

Anthony is spot on regarding any shortage being short lived and self limiting. The development of the profession will change the demographics and career patterns in such a way to minimize and/or eliminate shortages. Yes, we are likely to still have a hard time keeping rural EMS well staffed just like we have problems keeping rural hospitals well staffed with nurses. But not nearly as profoundly as the nursing problem.

And of course, another factor that will minimize shortages is the ultimate need to properly define EMS as Emergency Medical Services, and not apply the same entry level standards to horizontal taxi services. They can run their transfers with 120 hour EMTs for all eternity. I don't care. That way they won't have any shortages. Transfer costs won't increase. Wankers will still have jobs. EMS ambulance demand will drop. And EMS will maintain an adequate supply of acceptably educated medical professionals. Everybody wins.

Whoever suggests eliminating I's is out of their minds. It's EMT-B's that need to be eliminated.

So if you eliminate EMT B's, then you need to replace them in "911 EMS" as you term it...therefore still creating a shortage....

[Dustdevil]

So if you eliminate EMT B's, then you need to replace them in "911 EMS" as you term it...therefore still creating a shortage....

Actually, no. This is not a sweeping overnight change. You give people notice of a transitional date by which their personnel must either be trained to the new standard or replaced with those who are. With that warning, you will have a lot of EMTs realizing that it's time to $hit or get off the pot, and making their move back to school. And you will also have plenty of current medics who are stuck on transfer cars who are more than ready to take those EMT's places if they don't make it through medic school. It's all part of the natural selection that will transform the professional ranks.

[PRPGfirerescuetech]

No medics are stuck on transfer cars because they have to be there, many times, its because thats where they end up after a long career in "EMS" as you term it.

Im not sure removing an entire cert level from the system is the answer. Even if you reeducate them, its semantics, because your taking the BLS pool, and renaming them intermediates.

You still need to staff your transfer cars. People need to get them home, so they can call 911 again, and go back. As much as its not "EMS" to you, its still an intregal part of the EMS system. You have to consider that.

[Dustdevil]

No medics are stuck on transfer cars because they have to be there...

I have known many, many, many, many paramedics who were stuck on transfer cars because there simply were no 911 jobs to be had. Especially in places like Dallas County where FDs still rule. It is a very common phenomenon in this country.

Im not sure removing an entire cert level from the system is the answer. Even if you reeducate them, its semantics, because your taking the BLS pool, and renaming them intermediates.

I agree, it really is semantics. And, as I have explained at length in previous threads addressing this topic, I am not actually talking about eliminating PEOPLE with a certain cert level. I am talking about eliminating that level of training. No more people trained to DOT EMT-B standards in EMS. Educate them to the I level from the very beginning without stopping at B. So again, I'm not talking about eliminating PEOPLE. Nobody is out of a job. I am just talking about educating everybody to a higher standard.

You still need to staff your transfer cars. People need to get them home, so they can call 911 again, and go back. As much as its not "EMS" to you, its still an intregal part of the EMS system. You have to consider that.

Sure. Transfer cars still need to be staffed. Their service is critical to the success of EMS, because they take that load off of EMS. But nothing I have suggested would have any effect on transfer services.

[PRPGfirerescuetech]

Then your area is lucky. Most transfer services here cant get a medic to save their a*s, even at astronomical pay rates.

This is also prevelent across the region, from doing staffing models at a previous service.

Relooking at the numbers, your still shorting someone. If you increase the education to I, you lose providers. These are people who had a tough enough time passing B.

You need, at our current staffing models, so much of each provider. If you change the models to increase the education, you will lose providers. (albeit not competent ones, but this is a discussion about handling the workload). The question is, do we shoot ourselves in the proverbial as* by leaving ourselves with not enough people to handle an increasing workload?

[Dustdevil]

Definitely valid points about many of the current crop not being up to the challenge of meeting the increased standards. But again, as others have addressed, market forces will compensate sufficiently, both increasing and improving the next generation of students and medics.

Again, a critical shortage only occurs if you change standards precipitously. With a two year lead in, there is no danger of a shortage.

[PRPGfirerescuetech]

Ill accept that. Just would need to tie in a huge push for more students to accomidate for the downturn and pad the numbers.

[Ridryder 911]

Here in this area, there are so many Paramedic programs that "flood" the market every 16 weeks. Now there is still a shortage & the reason is most that get through the program & yes even pass the NREMT/P exam the first time are basically ...hmmmm shall I say VERY LACKING! No progressive service will hire them, because they do lack initiative and some gray matter. Unfortunately they wind up in the rural areas, where medical decision is more crucial than ever.

Unfortunately, griping & whining here does not change anything. I do wish we had more contact with those involved in legislative and policy changes. I do wonder if any State, National EMS representatives ever bother reading what "real medics" are concerned with. As a former bureaucrat, I know that much are so out of touch with reality, and do not really care what goes on out in the field, only to be concerned what occurs in their ivory towers.

If they read this, I challenge them to speak up!... let us know that they are concerned as much as we are. ... For some reason, I doubt I'll see a response.

Since this will probably not occur I challenge, those on this forum at least e-mail them a link to this site to discuss this... I will. (Mine was my Paramedic preceptor)

Attached is a link of the State EMS Directors... let us put money where our mouth is.. and see how many responses occur, I am sure we can set up a special thread for them.... .

http://www.nasemsd.org/index.php?option=co...&Itemid=101

Good luck,

R/R 911

[PRPGfirerescuetech]

Rid,

I emailed Pennsylvania's EMS director, and the EMS medical director this morning. To everyone. Rid has come up with yet again, a great idea. Use his link, as well as this link to determine their email addresses.

http://www-nrd.nhtsa.dot.gov/departments/n...a/CODESdir.html

Anyone having difficulty locating their State Directors email addresses, please feel free to ask.

I hope each and everyone of you does this. If you even truely have an inkling of desire to make a difference in this service, now is the time to respond.

Also, Im sure some of you will have some uncertainties regarding what to write.

This is what I wrote to PA.

From: "jamesweber@capem.org" <jamesweber@capem.org>

Subject: Upcoming street level provider cyberforum

Sent: 12/19/2005 11:25 AM

To: jschmider@state.pa.us

CC: dkupas@geisinger.edu

Director Schmider, and Medical Director Kupas,

Recently, many street level providers across the country have engaged in several discussions

regarding the current state of affairs of our profession, both in Pennsylvania, and across the

nation. The street level provider in this country has many concerns regarding our profession,

in which we've discussed in these forums at great length. We are extending to both of you,

as well as every EMS state level official across the country an invitation to participate in these

productive discussions. Your imput is welcome, and we look forward to hearing from you.

Discussion Forum: www.EMTcity.com

Regards,

James Weber, AAS, EMT Basic

Founder, Council for the Advancement of Pre hospital Emergency Medicine

Director of Operations, Safety Education Training Associates

215-317-1552 (cell)

215-261-6059 (fax)

jamesweber@capem.org

www.capem.org

Feel free to utilize the body of my email to ease the process. A call to arms, email your directors. Copy and paste your email to this thread after youve sent it. Lets see who from the State Levels steps up to the plate.

Warm Regards and Happy Holidays,

PRPG

[Nate]

You could always pay the quality ones more and toss the bad ones. It won't take long before you have a fax machine turning non-stop with applications and a pool of medics to pick from. Lets face it, money will motivate people...and the more money you offer the more likely your willing to get a quality medic from another service to switch over to yours.