I have noticed from time to time that MDs, Nurses, PAs, ER Techs, etc. often look down on us EMTs/ Medics, and view us as the absolute "bottom" of the healthcare totem pole. Yes, we don't go to school for eight years, but we sure do possess advanced skills/ interventions as well as dealing with very difficult situations and patients.
Why are we often looked down upon as a profession?
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NysEms2117
ex-Parole officer/EMT
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If you want my truthful and honest answer. We haven't proven ourselves. And TBH we don't yet deserve it as a community. Are there some medics/EMT's that deserve that level or respect, ABSOLUTELY, but not as a whole yet.
There is a whole thread on this.
Summit
Critical Crazy
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ER Techs are usually EMT/Medics...
It is not just that EMS doesn't go to school for 8 years, but rather EMS has the least education of the healthcare fields.
You can teach a monkey to intubate or start an IV. Of all the aspects that make a healthcare provider, the other professions are least wowed by skills while EMS as a field is most wowed by skills (and blinkies and woo-woos).
That said, if you have a good attitude and provide quality care, nobody should be looking down on you.
We look down on ourselves a lot... but a lot of that is to push progression in the field which is a good thing.
It is not just that EMS doesn't go to school for 8 years, but rather EMS has the least education of the healthcare fields.
You can teach a monkey to intubate or start an IV. Of all the aspects that make a healthcare provider, the other professions are least wowed by skills while EMS as a field is most wowed by skills (and blinkies and woo-woos).
That said, if you have a good attitude and provide quality care, nobody should be looking down on you.
We look down on ourselves a lot... but a lot of that is to push progression in the field which is a good thing.
VentMonkey
Family Guy
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Ugh, not again with this. Doing your research on here OP before creating a redundant thread topic, lawdy lawd
.
.While a good dude, I have a buddy who was excited to finally work as a medic (no 911, only urgent care experience, not that those are bad gigs) because it was "badass" comparatively. While I understand the enthusiasm, and I know everyone here can probably attest to the fact that I was chomping at the bits to finally get released as a medic, I didn't have this vision of being a badass paramedic saving lives every day. I had been working ALS trucks for a while, I knew what to expect in my area. I just wanted my damn pay raise to pay for school.
Just because I have a P in my title though, doesn't mean I deserve respect or am good at this job.
Just because I have a P in my title though, doesn't mean I deserve respect or am good at this job.
hometownmedic5
Forum Asst. Chief
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For perhaps the one millionth time:
We undergo a short, skills based, limited protocol driven training program. The rest of medicine undergoes long, theory based, multi discipline education.
In short, they are professionals and we are skills donkeys. Maybe this is changing, but its going to be many, many years before our certification process is respectable.
We undergo a short, skills based, limited protocol driven training program. The rest of medicine undergoes long, theory based, multi discipline education.
In short, they are professionals and we are skills donkeys. Maybe this is changing, but its going to be many, many years before our certification process is respectable.
VentMonkey
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...gazillionth?
EpiEMS
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When you define yourself by your skills rather than your knowledge, you tend to fall down the professional totem pole rather quickly.
Allow me to expand a little bit: The critical thing we bring to the patient is skills. What incremental "thing" does an ER physician bring over a paramedic? I'll give you a hint - it is not more skills. It is not just more equipment. It is a broader perspective - it is a multiple of years of basic science that layer on top of each other into forming a complete diagnostic picture. Sure, the ER physician might crack a chest or do RSI without a second thought, but he or she sure isn't just doing that "because protocol says so" (not that a good EMS provider is, but, you know, least common denominator and all that).
Allow me to expand a little bit: The critical thing we bring to the patient is skills. What incremental "thing" does an ER physician bring over a paramedic? I'll give you a hint - it is not more skills. It is not just more equipment. It is a broader perspective - it is a multiple of years of basic science that layer on top of each other into forming a complete diagnostic picture. Sure, the ER physician might crack a chest or do RSI without a second thought, but he or she sure isn't just doing that "because protocol says so" (not that a good EMS provider is, but, you know, least common denominator and all that).
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EpiEMS
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And to expand on this expansion, having had a lot of exposure (both personal and secondhand) to other fields that have more of a "professional" cachet, I can tell you this:
No profession - none - says "We can do A, B, and C, thus I should be [pick one: paid more, treated better, etc.]." They either (a) increase barriers to entry (cartelize, say) and/or (b) improve how they generate revenue, and secondarily (tertiarily, if you will) self-govern/discipline/regulate.
Take nurses as an example. Nursing, as we know it, was initially totally unskilled labor. Then, it turned into a skilled (if gendered) trade. Then, college/university level education became de rigueur. Now, nurses are fighting with physicians over who can be called "Doctor." Nurses made it by ratcheting up educational standards and self-regulating so much so that they can fight with the physicians over status. I don't want to be that way - but, boy, would I love to see entry to practice at a higher standard! And professional self regulation like they have elsewhere in the Anglosphere! And billing for what we *do* - not just for transport.
Heck, let's look at a true blue-collar field. Firefighters - what have they done? Hint hint - they have embraced two things: Prevention (let's call it what it is, they have regulated fire out of existence) and unionization/politicizing their message. They don't fight fires much any more, but they make six figures -
Well, if we were as good at saying "You need us", we would be golden. Because, let's face it, we can't stop morbidity due to preventable causes*.
*I'm talking to you, medic with BMI of 35, and you, EMT who smokes, and you, AEMT that drinks too much.
No profession - none - says "We can do A, B, and C, thus I should be [pick one: paid more, treated better, etc.]." They either (a) increase barriers to entry (cartelize, say) and/or (b) improve how they generate revenue, and secondarily (tertiarily, if you will) self-govern/discipline/regulate.
Take nurses as an example. Nursing, as we know it, was initially totally unskilled labor. Then, it turned into a skilled (if gendered) trade. Then, college/university level education became de rigueur. Now, nurses are fighting with physicians over who can be called "Doctor." Nurses made it by ratcheting up educational standards and self-regulating so much so that they can fight with the physicians over status. I don't want to be that way - but, boy, would I love to see entry to practice at a higher standard! And professional self regulation like they have elsewhere in the Anglosphere! And billing for what we *do* - not just for transport.
Heck, let's look at a true blue-collar field. Firefighters - what have they done? Hint hint - they have embraced two things: Prevention (let's call it what it is, they have regulated fire out of existence) and unionization/politicizing their message. They don't fight fires much any more, but they make six figures -
Well, if we were as good at saying "You need us", we would be golden. Because, let's face it, we can't stop morbidity due to preventable causes*.
*I'm talking to you, medic with BMI of 35, and you, EMT who smokes, and you, AEMT that drinks too much.
NysEms2117
ex-Parole officer/EMT
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fafillionth mo-millionth
VentMonkey
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Oh sweet baby jesus! Thank you for not leaving me hangin', NYSfafillionth mo-millionth
......carry on.
SandpitMedic
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Millionth thread or not... this post hits the nail squarely on the head.And to expand on this expansion, having had a lot of exposure (both personal and secondhand) to other fields that have more of a "professional" cachet, I can tell you this:
No profession - none - says "We can do A, B, and C, thus I should be [pick one: paid more, treated better, etc.]." They either (a) increase barriers to entry (cartelize, say) and/or (b) improve how they generate revenue, and secondarily (tertiarily, if you will) self-govern/discipline/regulate.
Take nurses as an example. Nursing, as we know it, was initially totally unskilled labor. Then, it turned into a skilled (if gendered) trade. Then, college/university level education became de rigueur. Now, nurses are fighting with physicians over who can be called "Doctor." Nurses made it by ratcheting up educational standards and self-regulating so much so that they can fight with the physicians over status. I don't want to be that way - but, boy, would I love to see entry to practice at a higher standard! And professional self regulation like they have elsewhere in the Anglosphere! And billing for what we *do* - not just for transport.
Heck, let's look at a true blue-collar field. Firefighters - what have they done? Hint hint - they have embraced two things: Prevention (let's call it what it is, they have regulated fire out of existence) and unionization/politicizing their message. They don't fight fires much any more, but they make six figures -
Well, if we were as good at saying "You need us", we would be golden. Because, let's face it, we can't stop morbidity due to preventable causes*.
*I'm talking to you, medic with BMI of 35, and you, EMT who smokes, and you, AEMT that drinks too much.
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Like everything, when you've seen one place, you've seen one place. Paramedics are part of the healthcare system here and are treated well. We have incredible backing from both hospital networks and while our seat at the table is small, EMS's opinion is asked for and respected. We have programs that include AMR, city fire, the local medicaid contractor, and the hospitals all working together to try to find new solutions to age old EMS programs. On a more basic level, the hospitals treat us like they treat their coworkers and we do the same as we respect the different jobs each of us do.
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Yea I'd say it's pretty average. In the city EMS is provided by first response ALS fire (22 stations) and AMR with joint medical direction. The joint medical direction has drug fire out of the dark ages but they are still getting there. I may be biased, but the AMR operation here is very solid. We have a very strong CES program and new hire orientation that leads to some pretty high standards, that the docs back. Since 80% of the transports come from the city and most of the providers are pretty strong, the hospital's generally pro EMS attitude seems to extend by default to the fire protection districts in the county that do their own transport. They have the same medical direction but maybe not the same internal high standards. There are two third services in the region (one is my fulltime job) and I would put our standards as unnecessarily high but if it means trust from the hospitals I am all for it.
Bullets
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So this is ********. I have never seen our ER staff look down on our industry as a whole or with disdain. My agency gets along famously with the staff at the ER, from the Chief of EM to the housekeepers and linen stockers. There are a couple of agencies like this. Are there specific EMTs or agencies that the staff doesnt like? YES! Why? because through the years of them bringing patients, those people/agencies have shown poor clinical judgement, acumen, and attitude. Hell, my department head is HATED (rightfully so) by the ER staff, while the actual line staff regularly get kegs and eggs with night shift.
So the profession isnt looked down on, providers are. If you stumble through a report to an RN over and over and over, activate a specialty team incorrectly multiple times, look or act unprofessional, then the ER staff isnt going to like you...but guess what? I wont like you either.
Make good clinical judgement, learn on your own and understand whats going on with your patient, ASK questions when you dont know something, show engagement, bring a cup of coffee, do the little things that makes ERs life easier, like know who gets an EKG bed right away, slap the ID bracelet on, ect. We are a team! they will help you if you help them!
So the profession isnt looked down on, providers are. If you stumble through a report to an RN over and over and over, activate a specialty team incorrectly multiple times, look or act unprofessional, then the ER staff isnt going to like you...but guess what? I wont like you either.
Make good clinical judgement, learn on your own and understand whats going on with your patient, ASK questions when you dont know something, show engagement, bring a cup of coffee, do the little things that makes ERs life easier, like know who gets an EKG bed right away, slap the ID bracelet on, ect. We are a team! they will help you if you help them!
Reading these kinds of threads makes me want to get out of the profession. It's like I get this feeling that I'm not a "professional" and that the perception of EMS as, poorly trained, certification only, taxi drivers by the health care system is never going to change. I try to stay resilient but part of me really thinks that I am going to fall into that category of medics that leave after less than 5 years for that reason.
epipusher
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Skills donkeys? Nailed it. :endthread:
Summit
Critical Crazy
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It is up to you to be better than that, to encourage others, and push your colleagues and profession to be better.