Your arguments for doctors vs Paramedics are not valid in that many services did (and do) HAVE physicians on the ambulances at one time but with proper education and training, Paramedics were allow to perform just as well.
I'm pretty sure there are still treatments that MD's perform that Paramedics cannot. The educational requirement aren't even close, and to suggest otherwise is laughable. A more accurate statement would be "paramedics were able to provide care that was more cost effective and was a good enough analogue of MD care." BLS is another iteration of that, simply at a lower level on the "sliding scale" of care.
Physicians ARE STILL used on some transports if the patient warrants a higher level. How about 911 calls? Those exist, but are few and far between. for example, Pittsburgh has "doc in a box"s, but they are a tiered response anywyas, like many BLS services are with tiered ALS
They are also on the ambulances that provide EM residencies.
That is for the benefit of the residents, not generally because the ambulances feel the need to have doctors
We are talking about services that have not been ALS and some do not want to be ALS, not just because of money, but because of the additional responsibiliies of what a higher education and certification might bring in terms of liability and accountibility.
I've seen no evidence of this "fear of liabillity." Where are you getting this? Especially using Bossy Cow's system as a case study, it is pretty clear that money and availablity of ALS providers is the problem
The money thing should not be used as an excuse for not providing medical services. Sure it should. We aren't commies, you have to pay for things in this country. The sad fact is that some area's can't. I think capatilism is a pretty good system, despite its flaws. One of those flaws is that sometimes there is uneven allocation of goods (or care). Cost-effectiveness is extremely important in the provision of medicine, especially as technology exponentially increases the treatment and assessment options but at extreme financial cost. ALS is simply not cost effective in some areas
Poor people are just as entitled to medical care as the rich and can use that card to make a play for additional grants and adjustment in their state's tax distribution funding. HA! What "Card?" Poor places generaly have less effective representation in state governments. They'd be very lucky to get additional funds. And really, why should some people be forced to pay for other's medical care?
So your arguement that because healthcare sucks in the U.S. in general, EMS should remain at a lower standard also? I'd call that a misrepresentation. My argument is : Many areas suffer from a limited amount of money and access to medical providers. Those areas should determine on their own the best way to allocate their limited resources, be that in providing ALS care or in trying to keep a local clinic open, or simply to put food on their table. While it would be nice to live in a utopia where there was good free medical care available to everyone who needs it, that is a fantasy, and while it may be a good goal, it is silly to pretend that is how things work now What about all the areas that have managed to provide quality EMS? Maybe they should lower their standards so those that make all the excuses will feel justified in their lower level of care?They should do whatever they think best. They should also restrain themselves from telling everyone else to do things as they have. Circumstances are different in differnet places...that should be obvious
