Titles do very much matter in the realm of EMS. For example as a paramedic, I am not legally allowed to intubate a pediatric patient in my state or county. However once I clock in as a flight paramedic, which is just a paramedic with more education, I can now intubate a pediatric patient and it is approved by the state and county. So in this case pediatric intubate is listed as a paramedic skill however it is only authorized for flight medics.