Okay, I am game. Define Paramedic Practioner and contrast that with Paramedic.
Could a Physician Assistant with a Bachelors or Masters fill this role? Or would the Paramedic practioner be a separate role?
As one that has entered both the P.A. and NP route, I can truthfully describe that they could work in the field, with additional education (Paramedic education) but doubt they will. Yes, some will venture into a "house call" arena but truthfully without lab, radiology most are not effective in the diagnosing skills without the luxury. As well, the main point is the financial setting. I know of NO P.A.'s or NP's that are not making at the least a 6 figure salary, to even start out. They are in high demand around in my area, and most prefer NOT to work in emergency departments being stuck in fast track or minor emergency departments, and when a complicated or serious case does arrive they have to immediately turn it over to the physician.
Many years ago, my college attempted to have a P.A. to Paramedic and vice versa but was not successful. Again, most were focused for in hospital care and found they really had no desire to work in a prehospital environment. Again, one needs to be reminded many P.A. attaches themselves (in which they have to be associated with a physician) to surgeons (orthopedic, cardiovascular, etc) to perform pre-physicals, follow up care, write new orders, and many go non-critical for example dermatology, etc. Where as the nurse practitioner in some states operate under their own license and not required to be associated with a physician, most do for admission privileges, etc.. No joking as described, NP's will have to be Doctors by the year 2012, requiring a Doctoral level for license, so yes it will be Dr. Nurse. Like vent described the billing and reimbursement is similar to a physician. The point, I doubt that EMS will be able to compete in salaries. Yes, I feel that the salaries will be much more than field personnel but not in the lower to middle six figure income range in comparison to PA's and NP's.
I do believe that the Paramedic Practitioner will be specialized. Where other medical professions teach basic medicine
then specialize, we will need to teach the basics (bio-chem, micro, general medicine). Yes, alike many other roles or therapist they will have to start out as a minimum undergrad level and finally may move up to a grad level. I do believe they too will have a broad focus of care, similar to nursing role but where nursing lacks to teach emergency care, they will have the expertise. Also, I believe we will start seeing specialty Advanced Paramedics. Alike our counterparts of nursing, why not have someone that is specialized, such as in neonates, or truly critical care? Would it not make sense to have Paramedics that work upon these type of patients, have intense training and education, required work experience, then be formally tested and accredited? This would not be in comparison of the multiple levels of EMT, because they are already at a proficient higher level but are focusing upon one area.
This has many advantages. To keep EMS going, we MUST continue to have a career ladder. These rungs will allow those that have a desire to move upward in education, pay, and actually have long term goals within the system, all in the while providing an essential service. If we do not start creating such positions, we will see an influx of patients that will not be managed, EMS systems that will be financially ruined or out of service, very few that will ever even consider entering EMS as a profession. Why enter and stay in EMS if Paramedic is the most one can be and never to be able to move upward?
I know enrollment in my area has decreased remarkably even though the pay has drastically increased. The reasons most give is EMS is too short of career.. no life after Paramedic. In which is true..either management or education, where the vacancies are limited or pay is poor.. Or to leave and go into another medical profession, then why not just start out and do that in the beginning? Where many have found out they only saved a semester being a Paramedic and have spent additional years, and costs. Fire Service has a lot to offer, but alike many promote past the Paramedic position and then leave that position.
Again, this will not be an easy route. There will be many obstacles and it will not be for every system. I do believe that it will be adventitious for many systems, rural and metro alike. As one that was totally against it in the beginning, I have seen the possibility and potential of such a program.
EMS is in crisis mode folks, either we start developing programs to supplement our profession or watch it die. We can offer a answer to many of the problems in health care, primary to the increasing aging. If we do not do it, someone else will do it for us.
R/r 911
