EMS: Not A True Meritocracy

[thbarnes]

There has been much debate on requiring degrees for EMTs and Paramedics, especially Paramedics. We can look at other allied heath professionals and the 'degree inflation' their professions have seen, but it comes down to the fact that EMS is not a true meritocracy in most cases: degrees don't mean anything in EMS, until they mean something, not many are going to get them.

In medicine, an MSN does not do the work of a CNA. An attending does not have to spend 80 hours at the hospital anymore, that's what residents do. They don't do these things not because of their experience, leadership skills, or other qualities, they do it because the have degrees plain and simple, no question.

Today I worked with a paramedic of twenty years who possess a BSN and is pursuing his MNP, despite pursuing every opportunity afforded him, he's only a lieutenant in our service. Being the best paramedic I know, I don't know why he doesn't have 'chief' in his title. I took a patient to Emory the other day with a Paramedic with twelve years experience and two masters degrees, one in education and one in EMS leadership. He has no rank despite applying at every opportunity. Both of these medics I know make maybe two dollars more an hour than I do, a 21-year-old college student with a Paramedic certificate and not because of their degree, because they've stuck it out longer. It's a shame really that our profession while wanting to advance itself, shortchanges those individuals who take it upon themselves, on their own time and own dollar to do so.

[Asysin2leads]

Today I worked with a paramedic of twenty years who possess a BSN and is pursuing his MNP, despite pursuing every opportunity afforded him, he's only a lieutenant in our service. Being the best paramedic I know, I don't know why he doesn't have 'chief' in his title. I took a patient to Emory the other day with a Paramedic with twelve years experience and two masters degrees, one in education and one in EMS leadership. He has no rank despite applying at every opportunity. Both of these medics I know make maybe two dollars more an hour than I do, a 21-year-old college student with a Paramedic certificate and not because of their degree, because they've stuck it out longer. It's a shame really that our profession while wanting to advance itself, shortchanges those individuals who take it upon themselves, on their own time and own dollar to do so.

Barnes, I fully agree. However, if those of us who care to do so keep up our educational standards, it will in time have an affect on the profession as a whole. A profession can only survive for so long with the ones on the bottom having more education, intelligence, and experience than the ones calling the shots, or at least I like to think so. Welcome to the frontlines in the battle for EMS. Your target is the 34 year old assistant director who's last job was managing a Wal-Mart. Go! Go! Go!

[Ridryder 911]

I can empathize with your partners. As one with nearly 30 years service and having three college degrees and two medical licenses, as well as working a dual graduate degree, I don't make much more than those with only a couple years of experience.

Yes, it sucks.. but the good part is you noticed them. So apparently, something they are doing either being professional, knowledgeable has made the difference.

When nursing started requiring degrees, certificate nurses and as well as many others moaned and groaned loudly. But, common sense and hard work payed off. Compare the salaries, demand, and availability as well as profession from the early eighties. A lot have changed enough that it is a goal to have nursing administration and nurses participation is awarded (Magnet Status). We as well can change with time and persistence.

R/r 911

[vs-eh?]

You simply make new mandatory standardized minimums.

You give a "warning period" of 1-2 years. Following that time, all entry into the field (at said level) requires X education. Period.

This has happened here with the PCP program. In the fall of '99 it was a 1 year college diploma, in '00 a 2-year requirement. Done.

There is no difference in scope of practice, nothing. PCP's here with a 2 year college diploma are at the same scope as their one year counterparts, and as their 25 years on counterparts (with obviously a much different education).

There is no "ranking difference" either for education. It is simply what the requirement is now.

Ontario has a population ~ 40% of Canada's total at ~ 12.5 million. This isn't some small area that is "trialling" something. This is how it is. It also holds some of the largest EMS service's in Canada.

I don't know what sparked the move from 1 to 2 years college. But I can tell you it has not had an ill effect.

The PCP market is FLOODED today. I would say the big influx started about 4 years ago, well after the educational increase. It is extremely competitive and difficult to get a job as PCP today. Two year diploma? Means nothing (and that is mandatory for BLS)...

I truly get the sense that EMS education is somehow feared by the masses in the US. It can work (as shown just 6 years ago here). Start trimming the fat, increase minimal mandatory education and perhaps you will start getting the pay and respect that you desire.

[AnthonyM83]

So, what's the incentive for the guys in management?

Usually it ends up being dollar signs, even if they're not greedy. I know my company's understaffed and they're always recruiting and already have pretty high standards compared to other companies in the area.

I agree with there needing to be rewards and advancement opportunities for those who put more effort into their education, but how do we sell that idea to management?

Only way I've been able to see so far is for physician and EMS organizations to push for it in legislature or with state EMS offices.

[Dustdevil]

Only way I've been able to see so far is for physician and EMS organizations to push for it in legislature or with state EMS offices.

Hmmm... I feel a conversation with Dr. Bledsoe coming on.

[Ridryder 911]

Until we have an incentive for management to recognize education, we will ever progress. Of course many of those in management see education as a risks and conflict of interest.

Like I have discussed, there is no difference in Paramedic to Intermediate reimbursement (ALS is ALS according to Medicare and Insurance Payers). Captivated rates (all inclusive) and there is no challenge to administrators to maintain quality or set standards to obtain insurance benefits payments easier and higher percentage of payments from them.

CoAEMSP appears to have no teeth and progress to establish standards in comparison to other health administrator organizations.

We can discuss until we are cyanotic in the face, and nothing will change until administrators change. State EMS officials pay closer attention to administration groups, than those of the workforce. Unfortunately, they can afford lobbyist and have contacts to assist them legislative.

Again, majority of the medics in the field are apathetic. Only concerned if their check will clear or they will be able to work that second job....

R/r 911

[thbarnes]

Usually it ends up being dollar signs, even if they're not greedy.

Yeah, shift supervisor, lt, or capt...an extra $.25 an hour.

[AnthonyM83]

By management I pretty much mean CEO (in private companies)...at least here, supervisors aren't getting says in that kind of policy making.