I have been working on SOP for our airport and have met some resistence to change. Being somewhat new to ARFF (Aircraft Rescue / Firefighting) but 34 yrs in fire, I am still abit in the ozone on just how things should work here. I do feel strongly about the following issue and would like feedback. I recently witnessesed what I feel is sub standard patient care when a patient was made to walk down the stairs attached to a regional jet then put on a gurney. This was an in-flight EMS with a 94 yr old male who fell and sustained a head injury. Rather than have the jet connect to the jetway allowing EMS to access with the gurney at cabin floor level, the jet parked short of the jetway and the patient was assisted by EMS as he walked down the aircraft steps onto the concrete apron in 95 deg weather. In my opinion, the jetway should have been connected allowing easy and more direct transport of the pt to the gurney in an air conditioned atmosphere.