Very, very well said. I am, through a lot of studying and education, well equipped to pick up grandma when her CHF is acting up, or care for her when she is moving from a primary to a tertiary facility during the acute phase being actively medicated, ect. I am ill equipped on the other hand, to take her to dialysis every Monday, Wednesday and Friday simply because NOTHING in my education spoke to this role.
If I were the boss of EMS....
- Thread starter mcdonl
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Very, very well said. I am, through a lot of studying and education, well equipped to pick up grandma when her CHF is acting up, or care for her when she is moving from a primary to a tertiary facility during the acute phase being actively medicated, ect. I am ill equipped on the other hand, to take her to dialysis every Monday, Wednesday and Friday simply because NOTHING in my education spoke to this role.
Flightorbust
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http://www.ppcc.edu/programs/emergency-medical-services/aas-ems-paramedic-degree/
Im sure other Community Colleges have programs as well
Shishkabob
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Though, some could argue that much of 911 IS IFT due to the public at large being uneducated / false ideas about what EMS truly is....
But again, real education could mean treating those folks at the house and getting reimbursed for it instead of being a taxi so the provider gets paid...
JPINFV
Gadfly
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Non-emergent medical taxi service for the general public and non-emergent taxi service for people currently admitted to some sort of health care facility (i.e. hospitals, SNFs, etc) are two completely different things. The average IFT provider needs more education in good body mechanics and transfers, a more nuanced understanding of infection precautions (i.e. the specifics of air born vs contact vs droplet instead of a "put everything on" type training), education on long term care issues like ulcers, and the list goes on. Heck, given the current education, simply giving a CNA a section on transport would probably yield a more appropriate provider for non-emergent IFTs than the standard EMT.
Shishkabob
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Which is why I can spend an hour at a house with a diabetic, yet get "talked to" by El-Kapitan because I "could have been to the hospital and back in that time".
:glare:
That's just it, all I want is the degree. I don't get a degree for myself no sir, I don't need a piece of paper telling me I know what I already know. The sad part is now days without that piece of paper you're at a slight disadvantage in the employment pool against those who have that little piece of paper.
In short I'm going to Medic school but if you wanna take a little more of my money and in exchange let me throw an Associates Degree on my resume I'm OK with that pending the tuition increase merits said degree.
And thank you Flightorbust that's exactly what I'm talking about.
In short I'm going to Medic school but if you wanna take a little more of my money and in exchange let me throw an Associates Degree on my resume I'm OK with that pending the tuition increase merits said degree.
And thank you Flightorbust that's exactly what I'm talking about.
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Where I went you come out with an Associates in Emergency Medical Technologies.
HotelCo
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And did that give you more money when you got hired?
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Regarding a few points:
(1) In US / Canada it typically takes 6-8 years to get an MD, and then another 2-5 years to complete most residencies. A first year resident makes around $35,000 (USD / CAD) in most programs. At least as far as I'm aware. Paramedic pay varies greatly across North America, and across the world. But many medics I know make twice that without working extra shifts. Granted, this pay rate is on the higher end for what most medics make in a global context, but it's still a lot more than a residency. The pay definitely goes up as you complete residency years, and shoots up as soon as you've completed the residency program, but it takes a lot more than 6 years before the physician makes an income that outstrips a paramedic in some places.
(2) BLS pay is bad because the barrier to entry is low. It's too easy to train as a basic EMT. There's too many trained bodies, therefore there's a high demand for work, and a low supply of paid positions. This doesn't provide an incentive for the employer to raise pay. They don't have to to fill positions.
There's definitely a chicken-and-the-egg argument that no one will want to go to a longer EMT program if they can graduate in a shorter time, and few people want to invest more time / expense in their education if the pay is low. But it's hardly likely to go up any time soon if the barrier to entry for a BLS provider is < 6 months in many places, and 100 hours in others.
(3) You can train someone for 2 years just to provide good BLS. I think at this point it would be reasonable to throw in a BIAD, CPAP, 12-lead interpretation and possibly aspirin and IM / SC epinephrine, maybe some ventolin, perhaps entonox. There's no reason why an EMT can't have a decent education in physiology, pharmacology, pathophysiology.
If I was king, 2 years to EMT, 4 years to paramedic, and a real 2 year certification for a higher end critical care level. Someone who can fly or do critical LDT work, who can actually interpret x-rays, reduce dislocations, put in arterial lines, intelligently read bloodwork, manage a vent with ABGs, and manage electrolyte derrangements. You could maybe even make an argument for this type of medic to work in a rural ER, although this is probably starting to overlap the PA role in the states.
There needs to be real EMS research. There's very few programs right now, and very few people producing good data. We need to more critically examine what we're doing well, what we're doing poorly, and how we can improve it. We need to develop treat and refer protocols, and arrange billing in a way that encourages physicians to support this development. There's plenty of patients that could be referred to a family physician, instead of being taken to the ER to wait for 8 hours in the waiting room. It would be great to have a real-time ability to consult with a physician to direct some patients elsewhere.
MPDS needs to go. We need to find a system that works better. We need to stop responding hot to every single abdominal pain just in case one of them is an AMI or a AAA. There needs to be a rational system for dispatching based on clinical priority, instead of liability management. We need to move away from the idea that someone with 24 hours of training and a ring binder is a professional.
There needs to be widespread amalgamation of EMS services and response areas, so that every little town doesn't have it's own service. There needs to be an integration of EMS into healthcare and away from public safety. There needs to be true national licensure and reciprocity.
In my opinion.
(1) In US / Canada it typically takes 6-8 years to get an MD, and then another 2-5 years to complete most residencies. A first year resident makes around $35,000 (USD / CAD) in most programs. At least as far as I'm aware. Paramedic pay varies greatly across North America, and across the world. But many medics I know make twice that without working extra shifts. Granted, this pay rate is on the higher end for what most medics make in a global context, but it's still a lot more than a residency. The pay definitely goes up as you complete residency years, and shoots up as soon as you've completed the residency program, but it takes a lot more than 6 years before the physician makes an income that outstrips a paramedic in some places.
(2) BLS pay is bad because the barrier to entry is low. It's too easy to train as a basic EMT. There's too many trained bodies, therefore there's a high demand for work, and a low supply of paid positions. This doesn't provide an incentive for the employer to raise pay. They don't have to to fill positions.
There's definitely a chicken-and-the-egg argument that no one will want to go to a longer EMT program if they can graduate in a shorter time, and few people want to invest more time / expense in their education if the pay is low. But it's hardly likely to go up any time soon if the barrier to entry for a BLS provider is < 6 months in many places, and 100 hours in others.
(3) You can train someone for 2 years just to provide good BLS. I think at this point it would be reasonable to throw in a BIAD, CPAP, 12-lead interpretation and possibly aspirin and IM / SC epinephrine, maybe some ventolin, perhaps entonox. There's no reason why an EMT can't have a decent education in physiology, pharmacology, pathophysiology.
If I was king, 2 years to EMT, 4 years to paramedic, and a real 2 year certification for a higher end critical care level. Someone who can fly or do critical LDT work, who can actually interpret x-rays, reduce dislocations, put in arterial lines, intelligently read bloodwork, manage a vent with ABGs, and manage electrolyte derrangements. You could maybe even make an argument for this type of medic to work in a rural ER, although this is probably starting to overlap the PA role in the states.
There needs to be real EMS research. There's very few programs right now, and very few people producing good data. We need to more critically examine what we're doing well, what we're doing poorly, and how we can improve it. We need to develop treat and refer protocols, and arrange billing in a way that encourages physicians to support this development. There's plenty of patients that could be referred to a family physician, instead of being taken to the ER to wait for 8 hours in the waiting room. It would be great to have a real-time ability to consult with a physician to direct some patients elsewhere.
MPDS needs to go. We need to find a system that works better. We need to stop responding hot to every single abdominal pain just in case one of them is an AMI or a AAA. There needs to be a rational system for dispatching based on clinical priority, instead of liability management. We need to move away from the idea that someone with 24 hours of training and a ring binder is a professional.
There needs to be widespread amalgamation of EMS services and response areas, so that every little town doesn't have it's own service. There needs to be an integration of EMS into healthcare and away from public safety. There needs to be true national licensure and reciprocity.
In my opinion.
Regarding a few points:
(1) In US / Canada it typically takes 6-8 years to get an MD, and then another 2-5 years to complete most residencies. A first year resident makes around $35,000 (USD / CAD) in most programs. At least as far as I'm aware. Paramedic pay varies greatly across North America, and across the world. But many medics I know make twice that without working extra shifts. Granted, this pay rate is on the higher end for what most medics make in a global context, but it's still a lot more than a residency. The pay definitely goes up as you complete residency years, and shoots up as soon as you've completed the residency program, but it takes a lot more than 6 years before the physician makes an income that outstrips a paramedic in some places.
(2) BLS pay is bad because the barrier to entry is low. It's too easy to train as a basic EMT. There's too many trained bodies, therefore there's a high demand for work, and a low supply of paid positions. This doesn't provide an incentive for the employer to raise pay. They don't have to to fill positions.
There's definitely a chicken-and-the-egg argument that no one will want to go to a longer EMT program if they can graduate in a shorter time, and few people want to invest more time / expense in their education if the pay is low. But it's hardly likely to go up any time soon if the barrier to entry for a BLS provider is < 6 months in many places, and 100 hours in others.
(3) You can train someone for 2 years just to provide good BLS. I think at this point it would be reasonable to throw in a BIAD, CPAP, 12-lead interpretation and possibly aspirin and IM / SC epinephrine, maybe some ventolin, perhaps entonox. There's no reason why an EMT can't have a decent education in physiology, pharmacology, pathophysiology.
If I was king, 2 years to EMT, 4 years to paramedic, and a real 2 year certification for a higher end critical care level. Someone who can fly or do critical LDT work, who can actually interpret x-rays, reduce dislocations, put in arterial lines, intelligently read bloodwork, manage a vent with ABGs, and manage electrolyte derrangements. You could maybe even make an argument for this type of medic to work in a rural ER, although this is probably starting to overlap the PA role in the states.
There needs to be real EMS research. There's very few programs right now, and very few people producing good data. We need to more critically examine what we're doing well, what we're doing poorly, and how we can improve it. We need to develop treat and refer protocols, and arrange billing in a way that encourages physicians to support this development. There's plenty of patients that could be referred to a family physician, instead of being taken to the ER to wait for 8 hours in the waiting room. It would be great to have a real-time ability to consult with a physician to direct some patients elsewhere.
MPDS needs to go. We need to find a system that works better. We need to stop responding hot to every single abdominal pain just in case one of them is an AMI or a AAA. There needs to be a rational system for dispatching based on clinical priority, instead of liability management. We need to move away from the idea that someone with 24 hours of training and a ring binder is a professional.
There needs to be widespread amalgamation of EMS services and response areas, so that every little town doesn't have it's own service. There needs to be an integration of EMS into healthcare and away from public safety. There needs to be true national licensure and reciprocity.
In my opinion.
(1) In US / Canada it typically takes 6-8 years to get an MD, and then another 2-5 years to complete most residencies. A first year resident makes around $35,000 (USD / CAD) in most programs. At least as far as I'm aware. Paramedic pay varies greatly across North America, and across the world. But many medics I know make twice that without working extra shifts. Granted, this pay rate is on the higher end for what most medics make in a global context, but it's still a lot more than a residency. The pay definitely goes up as you complete residency years, and shoots up as soon as you've completed the residency program, but it takes a lot more than 6 years before the physician makes an income that outstrips a paramedic in some places.
(2) BLS pay is bad because the barrier to entry is low. It's too easy to train as a basic EMT. There's too many trained bodies, therefore there's a high demand for work, and a low supply of paid positions. This doesn't provide an incentive for the employer to raise pay. They don't have to to fill positions.
There's definitely a chicken-and-the-egg argument that no one will want to go to a longer EMT program if they can graduate in a shorter time, and few people want to invest more time / expense in their education if the pay is low. But it's hardly likely to go up any time soon if the barrier to entry for a BLS provider is < 6 months in many places, and 100 hours in others.
(3) You can train someone for 2 years just to provide good BLS. I think at this point it would be reasonable to throw in a BIAD, CPAP, 12-lead interpretation and possibly aspirin and IM / SC epinephrine, maybe some ventolin, perhaps entonox. There's no reason why an EMT can't have a decent education in physiology, pharmacology, pathophysiology.
If I was king, 2 years to EMT, 4 years to paramedic, and a real 2 year certification for a higher end critical care level. Someone who can fly or do critical LDT work, who can actually interpret x-rays, reduce dislocations, put in arterial lines, intelligently read bloodwork, manage a vent with ABGs, and manage electrolyte derrangements. You could maybe even make an argument for this type of medic to work in a rural ER, although this is probably starting to overlap the PA role in the states.
There needs to be real EMS research. There's very few programs right now, and very few people producing good data. We need to more critically examine what we're doing well, what we're doing poorly, and how we can improve it. We need to develop treat and refer protocols, and arrange billing in a way that encourages physicians to support this development. There's plenty of patients that could be referred to a family physician, instead of being taken to the ER to wait for 8 hours in the waiting room. It would be great to have a real-time ability to consult with a physician to direct some patients elsewhere.
MPDS needs to go. We need to find a system that works better. We need to stop responding hot to every single abdominal pain just in case one of them is an AMI or a AAA. There needs to be a rational system for dispatching based on clinical priority, instead of liability management. We need to move away from the idea that someone with 24 hours of training and a ring binder is a professional.
There needs to be widespread amalgamation of EMS services and response areas, so that every little town doesn't have it's own service. There needs to be an integration of EMS into healthcare and away from public safety. There needs to be true national licensure and reciprocity.
In my opinion.
Flightorbust
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No prob. I like that its only 3 extra classes and they are ones that make sence to get your AAS
RocketMedic
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Increases in our scope of practice and salaries justify higher education. It also provides better care. However, it also shrinks the pool of providers. Good for us, bad for grandma when fher local agency can't keep a crew employed. The national EMS system would have to be able to afford commisurate wages, which is not a sure thing. Additionally, we need to keep our students in the field and learning. Anyone can be good in school, but in the fields a different world.
1 year of education for emt, 2 for intermediate with pharmacy and a&p, 4 for this proposed 'supermedic'. 3-4 is what most paramedics have invested now anyways from the word 'go'.
Usaffyre, there's no reason I need to sit through art or psych to know that Grandma is poor and lonely. Common sense and autonomy are prerequisites for EMS and what seperates us from nursing. Forcing employees to redundant education is only going to make them more expensive.
1 year of education for emt, 2 for intermediate with pharmacy and a&p, 4 for this proposed 'supermedic'. 3-4 is what most paramedics have invested now anyways from the word 'go'.
Usaffyre, there's no reason I need to sit through art or psych to know that Grandma is poor and lonely. Common sense and autonomy are prerequisites for EMS and what seperates us from nursing. Forcing employees to redundant education is only going to make them more expensive.
Did going to EMT school make you a worse EMT? Did going to medic school make you a worse medic?
Would you have been a better medic if your program was half the time?
So why would going to school longer make a worse medic?
Are you sure? Because I've witnessed a lot of behaviour from EMS providers that falls well outside of the boundaries of what most people would consider "common sense".
I also don't remember ever being tested for "common sense", or for "autonomy". It's true that a paramedic has more autonomy than the average nurse, but can we really claim to have a monopoly on "common sense"? I think a lot of RNs might take issue with that.
Probably. But isn't one of the biggest complaints on this site that basic EMTs don't get paid enough? Or that it's too hard to find a job? Or even that in many places medics make much much less than RNs? Don't we all want to get paid more?
Isn't more education a good way to get there? And improve the care that we deliver?
adamjh3
Forum Culinary Powerhouse
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What can be changed without first addressing those issues?
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I agree. It is a major issue.
Shishkabob
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JPINFV
Gadfly
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How can we address supply of supply/demand with what is virtually no barrier to entry without addressing education?
Shishkabob
Forum Chief
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Up your pay, up your standards of who you hire.
Basic business management 101.
Basic business management 101.