EMS the Health Care Arm of Public Safety?

[Ridryder 911]

Ditto to Dust's responses. I have as of yet had any formal "safety" classes as a Paramedic. (Albeit, I do have a degree in Fire Science and Safety Engineering) I can assure you, we are not Public Safety officers.

This is why I do not understand why we ever wanted to be removed from hospital based systems. We should be considered mobile health care. Even labeling ourselves as Public Health Care is incorrect, in regards to what is defined as Public Health Care at this time. Well, at the least every one would have to have a bachelor's degree to be perfoming in that field.....Yet, then maybe we should attempt to go that route, it would mean increasing our minimal educational level... !

[Asysin2leads]

I'm on the fence with it, and I'll explain why. First off, I have always believed that EMS should be primarily viewed as an extension of the hospital, paramedics are classified as "physician extenders" and training, ethics, and deployment should be viewed as such. My main arguement against volunteer based EMS systems comes back to this; when you go to the emergency room, you are not descended upon by well meaning unpaid people of varying degrees of skill, you are treated by people who are trained, certified, and compensated based on their competence and skill set. This is how it shoud be for EMS as well.

That being said, I don't think the public safety/public service aspects of

EMS can be denied. Of particular concern to me is that I know that both hospitals and municipalities will get away with as much as you let them, which includes denying extra benefits to cover the increased risks of working 911 EMS. If, say legislation was passed classifying paid EMS as simply physician extenders working outside of the hospital, you can bet that any service would look to align injury criteria and other benefits to the environments usually encountered by other medical providers.

In other words, at the end of the day, if I had to be classified as a public safety provider and have a little extra coverage on my cute little tuckus, or be viewed as a health care provider and have the powers that be give no more thought to my risk for injury than a lab technician, I'll go with the public safety angle.

Now, one could argue "Okay, well if you want to be a paramedic, than you just have to buck up and accept the risk," but, I say that if this is your philosophy, than you will only attract those in the population who don't care if they get hurt on the job, and you'll find usually they are the ones who have the 1200 bumperstickers and the stethescope on the rearview mirror.

(Now we might have a problem, because as we all know that Dustdevil is always right, it is equally common knowledge that I am never wrong. )

[Dustdevil]

Excellent points and explanations.

This, my friends, is why Asys is "The Dean." :thumbleft:

You bring up a point that I have neglected in the past, and that is definitely to be considered. As we are expected to respond in a public service role, outside the comfort and safety that most Americans work in, recognition of such is important when it comes to compensation for those risks. But I tend to just roll my eyes when I hear EMTs whining that they want that extra $100k in death benefits from the federal government like cops and firemen. If we were medical professionals, making what medical professionals should make, then the amount of money we could afford to leave behind to our families wouldn't be such an issue. Once we are educated professionals who are not immediately replaceable by next week's class of 120 hour first aiders, the glut of providers disappears, and employers will be forced to provide a benefits package that attracts and keeps professionals. That would include a comprehensive, double-indemnity, accidental death and dismemberment policy, as well as the usual health and disability benefits. It doesn't take the federal government to achieve that.

Other than the federal public safety death benefit, are there other public safety benefits that you are talking about that I am not addressing?

[Niftymedi911]

I would strongly disagree. This silly "public safety" notion is one of the primary factors holding EMS in the 1970s and preventing professional growth.

I am correct, and all who disagree are wrong. Period.

Thanks for asking!

What a narrow minded comment. But never the less it is your opinion and I respect that.

EMS I personally believe should be part of public safety. I personally believe in order for EMS to grow out of its dark ages it has to start looking into morphing into different aspects of the field. Tactical, Hazmat, Confined space, extrication the usual. But like with the FD, what about active seminars for public education? Not just for simple bullcrap, this is what we do and this is our truck. No, No, what about injury prevention with elderly, active seat belt awareness drives, (LEO does this with tickets, why not try doing it with some of the stuff we deal with everyday? Photos and the like) the Hang up and drive campaign thats going on down here. How about check ups with previous patients etc. I'm sure this has been argued before so I won't go very much further. Yes, our job is written in everything as treat and transport to hospital. But thats why we're in the predicament that we're in now. Just like the FD morphed, so EMS needs to.

[JPINFV]

^

Sounds more public health than public safety.

[Dustdevil]

^

Sounds more public health than public safety.

Sounds more like duplicating the efforts that others are already doing than setting us apart from the rest.

In order to set ourselves apart as a profession, narrow minded is the ONLY thing we can be. I prefer to call it focused. Broad-mindedness like you suggest, is a lack of focus that only perpetuates the idea that we are just somebody else's bastard step-child, and that anybody else could easily do our job just as well as we can. And Nifty's failure to grasp what is really such a simple concept is in itself very narrow minded.

The difference between you and me, Nifty...? You want a cool job for yourself. I want a secure profession for all of us.

[Niftymedi911]

Have you missed me yet Dust?

It's been a while since I've been on the boards. I must advise I do not have the experience or the knowledge that most of you on here have so I apologize if I might also seem narrow minded. Getting back to the replies, Dust isn't the number 1 priority in anything we do is ourselves? Securing scene safety (to make sure we don't get shot at?), BSI, CISD, and the like. Scold me if I am wrong but I though that was everyone was taught?

Thank You

[Rescue0ne]

EMS isn't exxactly a public safety service, although close...but neither is it a health-care profession. While I am an advocate of education vs training, and support a 4 year paramedic program...I've yet to see anywhere in VA where EMS isn't a semi-public safety service. My agency operates like one, and does so with large success, as do many others throughout the state.

While I'm certainly not an opponent of hospital-based EMS, currently they'd not be able to keep up with us out in the rural areas.

Good thread, I'm looking forward to hearing more.

[Richard B the EMT]

When EMS in NYC was still part of the New York City Health and Hospitals Corporation, we were lobbying to become an independent "Mayoral Emergency" agency, like the NYPD and the FDNY. This would have meant we would have had our own commissioner who would report to the Mayor, instead of reporting to a third VP of NYC-HHC, who might refer our vital information to the mayor. We wanted "Third Service" status.

When we were "merged" into the FDNY, the EMS Chief of Operations then started reporting to the FDNY Deputy Chief of Operations, and through channels to the Fire Commissioner. At least it is one less step to the Mayor.

After many years of legal infighting through the NY State Court of Appeals, The EMTs and Paramedics union, and the Supervisor's union, got what is called "Uniform" status. This means we are now allowed, when in contract negotiations, to negotiate alongside the UFA, UFOA, and the PBA, and to be separated from other locals in the District Council, who might be either "paper-pushers" or floor cleaners (no insult intended to either of these needed professions), within DC 37, of the American Federation of State County and Municipal Employees (AFSCME).

FYI, the city considers the Sanitation Department as the Third Mayoral Emergency Agency. Could this be because they plow the streets clear during and after snowfalls?

[frontcrawl]

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