Hey all—
I know I am about to open up some sore wounds, what I am about to say is a bit controversial and I apologize, I just want to get this out onto the table.
A little background: I am an EMT-B (trained, but not yet certified as an EMT-I) who worked within EMS for some time before starting college. I currently work part time for a private ambulance company in a large urban area. The company I work for does little 911, and many dialysis, discharge and SNF transfers. The following rant and questions emanate from a discussion with a partner last week.
Within our specific company, a nice number of EMTs and Medics tend to have attained or be working towards higher levels of education-- just about all of our Medics have a BA/BS, and are working towards higher degrees, and many of our career EMTs are college graduates, and either cannot find work in their fields of study and have been with the company for a long time or are working towards jobs in other fields and use EMS as a stepping stone.
Many of our part time employees are college students-- more then glad to work nights and weekends for what is considered to be good wages for a college student.
Then we look at the managers and administrators of the company-- all very competent (although generally profit-minded rather then patient-care-minded, but that's a different story). One our of five of the supervisors has a college degree, one of the operations directors has a 2 or 3 year business school certificate, and neither of the owners have any higher education. Specifically, nobody in management (except, of course, for our ALS coordinators) is trained to the paramedic level.
What does this say about our company? About EMS in general? I harbor no hard feelings towards my superiors, and they are all excellent at their jobs. They all have decades of experience in EMS and know the business well.
What does this say in relation to our close cousin, the fire department (service), where in order to be promoted you need to show completion of specific higher education, etc.? Should EMS management require education? Should a private service insist on it? How about a municipal 911 service? Third Service?
What does it say on a global level about the EMTs and Medics? Although much of the staff comes to the company as new EMTs and Medics, they generally have significant life experience. What does it say about the state of the economy that the best job that college graduates can get is on a transfer truck moving dialysis patients around?
What does it say about our promotion possibilities when the company shows they don’t honor education?
I have always thought about the EMS promotional algorithm as a triangle—very wide at the bottom, narrowing towards the top. Location on the triangle is directly related to level of training and amount of experience. EMT-Bs at the bottom, Medics in the middle and top. I recall being told (possibly brainwashed) that in order to move up, one needed medic training, whether you use the skills or not. This is certainly true within fire departments (and we have learned the importance of skill usage recently with the FL firefighters, who, incidentally, have all been reinstated after acing the med test, as of today).
All of this begs the question about long-term solvency for careers in paramedicine. I know we have a whole bunch of wise and experienced medics on this board, and I would love to hear from you. Aside from CC transport, flight medicine, education, nursing school, etc, what should the long-term aspirations of our paramedics be? Looking at the astronomical numbers of burnout, back injury, etc, what does EMS have for their future?
I firmly believe that in order for an individual medical provider (whether it be an EMT, medic, RN, MD, RRT, XRT, etc.) to be their best, they need to constantly be seeking and gaining additional education. With EMT-B classes sitting at as few as 110 hours, often not exceeding advanced first aid, and medic mills churning out medics in just a few months, there is always more knowledge to be gained.
All of this begs me to think about what education is really necessary to run a business or to manage a private ambulance company. Business is certainly crucial, as is knowledge of the local medical world (the state of area hospitals, SNFs, dialysis, 911 contracts, etc.). Does one really need to know acid/base balance in order to determine how many trucks to staff on a given day? How about the importance of ACLS protocols for which contracts to pursue?
I guess what I am asking (apart from reactions to my rant), is what training the administration of your company or service has? What training or education should they have? What should long-term training goals be?
I would really appreciate your comments on this—and I apologize if I have offended anyone.
I know I am about to open up some sore wounds, what I am about to say is a bit controversial and I apologize, I just want to get this out onto the table.
A little background: I am an EMT-B (trained, but not yet certified as an EMT-I) who worked within EMS for some time before starting college. I currently work part time for a private ambulance company in a large urban area. The company I work for does little 911, and many dialysis, discharge and SNF transfers. The following rant and questions emanate from a discussion with a partner last week.
Within our specific company, a nice number of EMTs and Medics tend to have attained or be working towards higher levels of education-- just about all of our Medics have a BA/BS, and are working towards higher degrees, and many of our career EMTs are college graduates, and either cannot find work in their fields of study and have been with the company for a long time or are working towards jobs in other fields and use EMS as a stepping stone.
Many of our part time employees are college students-- more then glad to work nights and weekends for what is considered to be good wages for a college student.
Then we look at the managers and administrators of the company-- all very competent (although generally profit-minded rather then patient-care-minded, but that's a different story). One our of five of the supervisors has a college degree, one of the operations directors has a 2 or 3 year business school certificate, and neither of the owners have any higher education. Specifically, nobody in management (except, of course, for our ALS coordinators) is trained to the paramedic level.
What does this say about our company? About EMS in general? I harbor no hard feelings towards my superiors, and they are all excellent at their jobs. They all have decades of experience in EMS and know the business well.
What does this say in relation to our close cousin, the fire department (service), where in order to be promoted you need to show completion of specific higher education, etc.? Should EMS management require education? Should a private service insist on it? How about a municipal 911 service? Third Service?
What does it say on a global level about the EMTs and Medics? Although much of the staff comes to the company as new EMTs and Medics, they generally have significant life experience. What does it say about the state of the economy that the best job that college graduates can get is on a transfer truck moving dialysis patients around?
What does it say about our promotion possibilities when the company shows they don’t honor education?
I have always thought about the EMS promotional algorithm as a triangle—very wide at the bottom, narrowing towards the top. Location on the triangle is directly related to level of training and amount of experience. EMT-Bs at the bottom, Medics in the middle and top. I recall being told (possibly brainwashed) that in order to move up, one needed medic training, whether you use the skills or not. This is certainly true within fire departments (and we have learned the importance of skill usage recently with the FL firefighters, who, incidentally, have all been reinstated after acing the med test, as of today).
All of this begs the question about long-term solvency for careers in paramedicine. I know we have a whole bunch of wise and experienced medics on this board, and I would love to hear from you. Aside from CC transport, flight medicine, education, nursing school, etc, what should the long-term aspirations of our paramedics be? Looking at the astronomical numbers of burnout, back injury, etc, what does EMS have for their future?
I firmly believe that in order for an individual medical provider (whether it be an EMT, medic, RN, MD, RRT, XRT, etc.) to be their best, they need to constantly be seeking and gaining additional education. With EMT-B classes sitting at as few as 110 hours, often not exceeding advanced first aid, and medic mills churning out medics in just a few months, there is always more knowledge to be gained.
All of this begs me to think about what education is really necessary to run a business or to manage a private ambulance company. Business is certainly crucial, as is knowledge of the local medical world (the state of area hospitals, SNFs, dialysis, 911 contracts, etc.). Does one really need to know acid/base balance in order to determine how many trucks to staff on a given day? How about the importance of ACLS protocols for which contracts to pursue?
I guess what I am asking (apart from reactions to my rant), is what training the administration of your company or service has? What training or education should they have? What should long-term training goals be?
I would really appreciate your comments on this—and I apologize if I have offended anyone.
