Battle EMS techs, nurses and MD's flooding the medical scene?

[mycrofft]

I am finally getting it through my head, we have been at war, in two theaters, since 2002. Many returning veterans have extreme experience, and as time passes, they potentially will rise to positions of influence over practice.

Do our particpants think this is so?

If you are one of these folks, what influence would you like to have? Or HAVE you had already?

 

[John E]

Hmmm...

the admittedly very small sampling I have to work with tells me that a guy or gal coming back from working in a forward area won't have much interest at all schlepping civilians around in an ambulance.

The military training won't get them NREMT certified either so they'll have to take a class first and when they find out how deplorable the wages are, well you can guess the rest I think.

If you're talking about the so called "tactical" side of EMS, I'd expect to see an influx of former military medic types trying to get involved in that over the more mundane civilian side.

In the broader medical arena, the overwhelming number of MD's and others will never need the sort of trauma experience that the military types have received and while it may sound good to have all of that experience in the ER, it won't make for better diagnosticians. There's only so much trauma surgery being performed on a regular basis in the civilian world.

If you're correct the net result simply be more of what's already happening in the job market. Too many EMTs, not enough decent paying jobs. Cue the anti labor union and the now almost mindless, "education is the answer" rants in 3, 2, 1...

 

[usalsfyre]

the admittedly very small sampling I have to work with tells me that a guy or gal coming back from working in a forward area won't have much interest at all schlepping civilians around in an ambulance.

The military training won't get them NREMT certified either so they'll have to take a class first and when they find out how deplorable the wages are, well you can guess the rest I think.

If you're talking about the so called "tactical" side of EMS, I'd expect to see an influx of former military medic types trying to get involved in that over the more mundane civilian side.

In the broader medical arena, the overwhelming number of MD's and others will never need the sort of trauma experience that the military types have received and while it may sound good to have all of that experience in the ER, it won't make for better diagnosticians. There's only so much trauma surgery being performed on a regular basis in the civilian world.

If you're correct the net result simply be more of what's already happening in the job market. Too many EMTs, not enough decent paying jobs. Cue the anti labor union and the now almost mindless, "education is the answer" rants in 3, 2, 1...

I'll bite, what does a union do for the massive oversaturation of EMT's?

 

[usalsfyre]

I am finally getting it through my head, we have been at war, in two theaters, since 2002. Many returning veterans have extreme experience, and as time passes, they potentially will rise to positions of influence over practice.

Do our particpants think this is so?

If you are one of these folks, what influence would you like to have? Or HAVE you had already?

Most of the experience gained in the current theaters of operation has very little applicability to the civilian world, as was noted above. You'll see advances in trauma care, but how much multi-trauma and penetrating trauma do we see anymore compared to other complaints?

 

[John E]

Hmmm...

I give up, what?

The topic at hand is about the influx of former military EMS workers on the civilian medical field.

My comment about unions was simply a bit of tongue in cheek commentary about the nature of how threads like this end up going. If things run their due course, someone will comment about education being the answer to everything, the usual suspects; a few of which are medical students will attempt to share with us all of their vast knowledge on the topic, someone else will make the inevitable comparison between EMS in the U.S. and other countries and then someone else will try to tie union membership into the topic, always have, always will. Come to think about it, that pretty much describes the majority of threads on every topic posted here.

All we need is someone asking about how to obtain a California Ambulance drivers license to make this a complete thread...

 

[usalsfyre]

I give up, what?

The topic at hand is about the influx of former military EMS workers on the civilian medical field.

My comment about unions was simply a bit of tongue in cheek commentary about the nature of how threads like this end up going. If things run their due course, someone will comment about education being the answer to everything, the usual suspects; a few of which are medical students will attempt to share with us all of their vast knowledge on the topic, someone else will make the inevitable comparison between EMS in the U.S. and other countries and then someone else will try to tie union membership into the topic, always have, always will. Come to think about it, that pretty much describes the majority of threads on every topic posted here.

All we need is someone asking about how to obtain a California Ambulance drivers license to make this a complete thread...

Gotcha.

Don't forget what kinda boots and stethoscope do I need?

 

[mycrofft]

Well, I tried.

<_<.........

 

[firetender]

Mine Field Ahead!

Noble try, Mycrofft, but that's not the thing to be concerned about. What should be worrying you is the upcoming onslaught of the Baby Boomer Generation. You think you're getting a lot of IFT's now? This will make worrying about Iraq medics horning in on your territory irrelevant, and probably so discouraging to them, they'll stay out.

 

[Afflixion]

Most of the experience gained in the current theaters of operation has very little applicability to the civilian world, as was noted above. You'll see advances in trauma care, but how much multi-trauma and penetrating trauma do we see anymore compared to other complaints?

What I find funny about this statement is the fact that you automatically assume that the majority of military medicine is traumatic events and we do not know anything in regards to medical events. I assure you servicemen are ill far more often than we have gunshot wounds or shrapnel coming from us. Combat medics have the ability and knowledge to identify and treat a large number of common illnesses. When I was a lowly Private First Class, I could explain to you the differences and treatments from viral and bacterial sinus infections which I doubt many EMTs could do.

 

[Akulahawk]

What I find funny about this statement is the fact that you automatically assume that the majority of military medicine is traumatic events and we do not know anything in regards to medical events. I assure you servicemen are ill far more often than we have gunshot wounds or shrapnel coming from us. Combat medics have the ability and knowledge to identify and treat a large number of common illnesses. When I was a lowly Private First Class, I could explain to you the differences and treatments from viral and bacterial sinus infections which I doubt many EMTs could do.

I'd have to guess that the majority of Combat Medics aren't NREMT-P certified, just NREMT-B certified. They'd be very limited in comparison to what they were able to do in the Military. Shlepping people around as a Basic might not be all that appealing to them.

I'm not knocking their knowledge or their experience. It's that Military combat medics aren't directly comparable to anything that I can think of in the civilian world. Their skill-set evolved to serve that particular population.

Military Docs that know trauma would do well in treating some of the traumatic injuries that are found... but they might not exactly see much use of their knowledge of treating blast injuries, for instance. Overall though, I think their knowledge of treating multi-system trauma and the research lab that battlefields have provided will eventually filter to the civilian world for treating trauma.

 

[Afflixion]

I'd have to guess that the majority of Combat Medics aren't NREMT-P certified, just NREMT-B certified. They'd be very limited in comparison to what they were able to do in the Military. Shlepping people around as a Basic might not be all that appealing to them.

I'm not knocking their knowledge or their experience. It's that Military combat medics aren't directly comparable to anything that I can think of in the civilian world. Their skill-set evolved to serve that particular population.

Military Docs that know trauma would do well in treating some of the traumatic injuries that are found... but they might not exactly see much use of their knowledge of treating blast injuries, for instance. Overall though, I think their knowledge of treating multi-system trauma and the research lab that battlefields have provided will eventually filter to the civilian world for treating trauma.

I'm well aware that most would not be particular enjoy and do not have a comparable civilian, but it seems most people on this forum have this notion that is all military medicine comes too.

 

[usalsfyre]

What I find funny about this statement is the fact that you automatically assume that the majority of military medicine is traumatic events and we do not know anything in regards to medical events. I assure you servicemen are ill far more often than we have gunshot wounds or shrapnel coming from us. Combat medics have the ability and knowledge to identify and treat a large number of common illnesses. When I was a lowly Private First Class, I could explain to you the differences and treatments from viral and bacterial sinus infections which I doubt many EMTs could do.

Please don't take my post as an insult to military medicine, it's not intended to be. However, even the experince gained in medical complaints is only partly applicable. Your still dealing with a basicly healthy patient population who have the normal minor and occasionally major illnesses. I doubt you'll see the military come through with any major advancements in these areas.

The patinet population I see day in and day out are medical trainwrecks waiting to happen. I doubt very seriously your average millitary medic has a lot of exposure to chroinc disease processes, polypharmacy, changes in geriatric physiology or many of the other concerns in the elderly population. It would be a waste of time. This group is who uses EMS in the civilian world however.

The military will continue to be the leader in trauma care of all types, but trauma's a very small part of most EMS providers practice. Dealing with chronic illness on the other hand, is the majority of EMS practice. I would take the average former military medic long before the average just out of school or even two year EMT as a partner. However, to opperate solo in a lead advanced provider role most will need additional education and clinical experince.

Thank you for your service.

 

[emt seeking first job]

this thread made me remember.....

Pardon the thread jack, however, this topic made me rmember my hernia operation in 2001.

My buffy's mom, an OR nurse, gave me a list of surgeons she recommened to use.

I began my phone call to their offices with "Good morning, is your office in the xyz insurance plan."

One office said no, but the surgeon will accept as payment whatever your plan will pay you after you submit his bill. No written agreement, no nothing, just an oral promise to bring the check to his office and sign it over. Then they will stamp the bill PAID IN FULL.

Apparantly, this man was a former field surgeon during the Vietnam War. He would book all four OR rooms at once and schedule four people at once and was known to be very dexterous and quick without sacrificing quality. He would also request certain people in his team(s) that he could rely on to delegate as much as possible. He would go back and forth between the rooms and get his patients in an out to the recovery room ASAP.

The operation went well. ( I knew someone who dies of a botched hernia repair in 2004). Five weeks later I dropped off my check and there was a flow of people stopping by to sign over the checks.

The point is, this was a close to the battlefield veteran who adapted his skill set to civilian life. He made a living within the "system", worked quickly, and tried to do more with less. And was willing to do soemthing as boring as a hernia repair.

I think it is a diservice to veterans to think that they need some "exciting" job to fit back into civilian life.

 

[Afflixion]

Please don't take my post as an insult to military medicine, it's not intended to be. However, even the experince gained in medical complaints is only partly applicable. Your still dealing with a basicly healthy patient population who have the normal minor and occasionally major illnesses. I doubt you'll see the military come through with any major advancements in these areas.

The patinet population I see day in and day out are medical trainwrecks waiting to happen. I doubt very seriously your average millitary medic has a lot of exposure to chroinc disease processes, polypharmacy, changes in geriatric physiology or many of the other concerns in the elderly population. It would be a waste of time. This group is who uses EMS in the civilian world however.

The military will continue to be the leader in trauma care of all types, but trauma's a very small part of most EMS providers practice. Dealing with chronic illness on the other hand, is the majority of EMS practice. I would take the average former military medic long before the average just out of school or even two year EMT as a partner. However, to opperate solo in a lead advanced provider role most will need additional education and clinical experince.

Thank you for your service.

You have to realize medics do more than work on soldiers, they are often assigned to MEDACs (military hospitals and clinics) which deal with retirees and family members which include pediatrics up to in some cases geriatrics. Medics also treat the local national population such as Iraqi and Afghani citizens, who are far worse than most American citizens. Yes trauma is the main role of the 68W, but they do more than just that.

 

[Veneficus]

When I was in medic school, I was told that the military triage method was to take care of the healthier people who could go back into combat over those who would require more advanced care.

That same text also said that an "assault rifle" produced a higher velocity round than a longarm such as a hunting rifle.

It was BS then, it is BS now.

But it does accurately display the ignorance of military medicine and its benefits.

The military is an awesome testing ground for new treatments. Most of the practicioners have nothing to gain/lose from reporting accurate findings.

New technologies and treatments can be implemented much more quickly than in the civillian world.

As far as practicioners, they understand that the major focus is not "me." Which is something more and more common in society today and consequently in the medical practicioners that same society produces.

There is no substitute for patient contact. seeing a large number of patients of all types in a short amount of time, builds the ability to uniformly and rapidly assess not only severity, but also diversity of illness and injury.

Are there less trauma surgeries in the civillian world now than in the past? Sure, the statistics bear this out. But there is far more to trauma than just surgical intervention. 20 years ago if you sustained a grade I liver laceration, you were going to the OR. Today it might be managed without open surgery. The same with aortic tears being treated endovascularly.

But now in addition to new techniques or managing trauma, there is also realization that the care and rehab after the acute event is just as important and returning people to productive lives.

Those same lessons learned about that in the military are just as applicable to the civillian world. If you or a member of your family lost a limb, do you want the rehab and prosthetic care done by somebody who saw a handful of them or dozens upon dozens?

Another thing combat veterens bring with them is they have actually been outside of the US. Which may not seem like much to people who rarely travel 200 miles outside their home town to anywhere except Las Vegas, but they learn other ways of doing things and how to interact with a variety of people and cultures.

They can make do with shortages of equipment and supply under the most trying of circumstances for the greatest number of people. (that is quite hard to get experience at in the civillian world)

Many military providers practice at levels higher than in the civillian world. But that experience and insight is just as valuable when they are performing as part of a civillian team even at a lower level.

Working with somebody who knows what I need next because they have done it themselves and see things from a similar perspective is definately more valuable than somebody who hasn't.

For the same reasons that employers have always found valuable in military members outside psychomotor skills. The war vets bring considerably more to the table than most, but obviously not all, civillians.

 

[mycrofft]

Thanks for rescuing the thead , especially " emt seeking first job "

One axiom: Since Classic Greek records, about 80% of wartime service casualties can be ascribed to disease and accidents.

As veterans of Korea rose in their civilian associations and facilities, their voice was heard more and more, and probably had much to do with NHTSA's decision to initiate the EMT-A and P system in the first place.

We are already starting to see changes in civilian practice related to the SW Asia conflicts (notably, the use of tourniquets, and chitinous proteins to promote clotting). I only hope we don't burn out so many as to have them leave the field when they return.

 

[Madmedic780]

My department has had a huge increase in vet's wanting to join us for Fire/EMS. I would say they are either just as or better equipped for dealing medical patients as the civilian side.