Professional business ethics

[Flight-LP]

I have always found it very interesting to see how other people at various levels of EMS perform in different geographical locations. I have been very blessed in having opportunities to participate in many great EMS endeavors over the last 18 years and I look forward to new opportunities and growth an upcoming equal amount of time. (Especially one particular opportunity with great pay and an awesome schedule working with some pretty cool cats.......***HINT, HINT***)

I find that many people know the "medicine" of EMS. Many even know the socialistic aspects that enable us to be more efficient communicators and hold an understanding to basic humanistic needs. I know that personnally, my education in EMS came long after completing my college degree and having several years of sound experience under my belt. Having a diverse background in this field has allowed me to learn and understand the business side of the house and how one must exemplify themselves as a business professional in addition to a medical professional.

Yet few understand this concept, nor are afforded the opportunity to learn it. I won't dig deep into the age / maturity issue, but comparatively speaking, we are one of the few careers that affords young adults (and even kids in some area's) the opportunity to participate in a career of this magnitude. One with the level of responsibility that comes with taking an individuals health at a time of crisis into their hands. I've seen young EMT's be proficient, I've seen a few even be mature and responsible, but I have yet to see one carry themself as a business professional. It's not their fault, they have never been educated or acclimated to that persona. So that brings me to my question; What is your opinion of having students take a formal business professional / ethics course? If so, for what levels (B, I, P, ALL OF THEM)? Please try to keep it civil, but honestly I see this as another big brick wall that holds this career field back from where it should be (along with BLS 911, basics working as quasi-paramedics, volunteers, and kids playing on ambulances, but I digress.......thats a topic for another day )

 

[marineman]

Please try to keep it civil, but honestly I see this as another big brick wall that holds this career field back from where it should be (along with BLS 911, basics working as quasi-paramedics, volunteers, and kids playing on ambulances, but I digress.......thats a topic for another day )

haha, you asked to keep it civil then in the next sentence rattled every cage that has a tendency to get out of hand. This will be fun.

To answer the question for our associates degree program one required course is ethics in medicine, is that what you had in mind or am I misguided? I guess I don't entirely understand what you're shooting for and what in your mind the difference is between mature and responsible and being a business professional. Those terms are quite vague and depends on a persons interpretation and understanding of what each means.

 

[triemal04]

An ethics class (and I mean a real class, not a 2 hour lecture) should be a required part of any paramedic program. Although, (and maybe you meant something like this) a buisness ethics, or even generic ethics class wouldn't be as effective as a medical ethics class. Let's face it, most paramedics are not involved in that side, and a class covering medical issues would, I believe, cover the pertinent issues that a class on buisness ethics would.

Really, what are the issues? Looking/acting professional, being honest with pt's about the cost AND NEED of an ambulance ride, only doing the appropriate treatements and not doing something (an IV or ekg) simply to be able to bill at a higher rate, documenting things accurately (if the pt walked to the gurney then they walked, they were not assisted or carried), getting the appropriate info so a pt CAN be billed (whenever possible, even if it means going an extra step). Those are the biggest I can think of off the top of my head, although I'm sure that there are others out there. And most would be covered in a medical ethics class, which is more pertinent to what we do. Actually, most would probably be covered in ANY ethics class, so maybe that's a moot point...

Knowing how your service is run beyond the field is important, regardless of how you come by that info. Knowing just how you will be reimbursed for services rendered is something that should be known by providers, although it shouldn't make a difference in the care given. Knowing how/why decisions are made about where units are posted, contracts with nursing homes/hospitals, how service areas are awarded...definetly worth knowing.

Edit: are you more looking for a way to ensure that people entering this field understand that they must act in a certain manner and not neccasarily act their age or how they do on their days off?

 

[daedalus]

An ethics class (and I mean a real class, not a 2 hour lecture) should be a required part of any paramedic program. Although, (and maybe you meant something like this) a buisness ethics, or even generic ethics class wouldn't be as effective as a medical ethics class. Let's face it, most paramedics are not involved in that side, and a class covering medical issues would, I believe, cover the pertinent issues that a class on buisness ethics would.

Really, what are the issues? Looking/acting professional, being honest with pt's about the cost AND NEED of an ambulance ride, only doing the appropriate treatements and not doing something (an IV or ekg) simply to be able to bill at a higher rate, documenting things accurately (if the pt walked to the gurney then they walked, they were not assisted or carried), getting the appropriate info so a pt CAN be billed (whenever possible, even if it means going an extra step). Those are the biggest I can think of off the top of my head, although I'm sure that there are others out there. And most would be covered in a medical ethics class, which is more pertinent to what we do. Actually, most would probably be covered in ANY ethics class, so maybe that's a moot point...

Knowing how your service is run beyond the field is important, regardless of how you come by that info. Knowing just how you will be reimbursed for services rendered is something that should be known by providers, although it shouldn't make a difference in the care given. Knowing how/why decisions are made about where units are posted, contracts with nursing homes/hospitals, how service areas are awarded...definetly worth knowing.

Edit: are you more looking for a way to ensure that people entering this field understand that they must act in a certain manner and not neccasarily act their age or how they do on their days off?

I agree. A medical ethics class should be part of a comprehensive pre-req program for paramedic students. To include English composition, Ethics, Intro to Chem, Biology, A&P, and psychology.

 

[triemal04]

I agree. A medical ethics class should be part of a comprehensive pre-req program for paramedic students. To include English composition, Ethics, Intro to Chem, Biology, A&P, and psychology.

And pharmacology, algebra, medical terminology, health, basic computer science, public speaking aka speech, medical charting and a few others.

 

[daedalus]

But one step at a time! Right now, some schools require no pre-reqs at the college level :wacko:

Flight, perhaps you are speaking about work ethic? I take pride in my job but not my employer at the present. While I uphold the greatest standard of care, I do not have good things to say about my employer and I do feel bad saying that.

 

[firecoins]

I don't thing a business ethics class will do the trick. It hasn't for business professionals. Look at all the Wall Street professionals and their bonuses after a terrible couple of years of bad decisions. I agree with the general sentiment.

 

[marineman]

At that point let's just go for the gold and make an associates a minimum req in this field.

 

[firecoins]

At that point let's just go for the gold and make an associates a minimum req in this field.

agreed

10 letter requirments.

 

[triemal04]

I don't thing a business ethics class will do the trick. It hasn't for business professionals. Look at all the Wall Street professionals and their bonuses after a terrible couple of years of bad decisions. I agree with the general sentiment.

It could be the start though. Athough I agree, it doesn't matter what you learn if the only things you see are the exact opposite; more than likely those practices will start to rub off on you. Unfortunate fact of human nature.

It would be at least a step in changing certain behaviors and attitudes that some (see, I won't go so far as to say that everyone, or even a majority do some things) have, and a step in the right direction is better than nothing at all.

Edit:

At that point let's just go for the gold and make an associates a minimum req in this field.

That was the point.

 

[lightsandsirens5]

At that point let's just go for the gold and make an associates a minimum req in this field.

NO WAY!! Are you crazy?!? :angry: That just about completely eliminates all volunteers! (Not to mention a lot of paid people too.) You just can't do that. Who is going to want to spend 2 years in college just to volunteer 24 or 48 hours of their week? Maybe EMS needs to work on professionalism a little, but an associates?!?!?

I just hope and pray that this never happens. (Along with doing away with 911-BLS, volunteers, extended care option for basics, and "kids" "playing" on ambulances. You wanna discuss this stuff? Fine make a thread for it! I may be shot down by all of you paid city EMTs/paramedics who think you are some kind of deity, but at least I can have my say!

I'm not saying you guys aren't good at what you do, you are, very good, I'm just saying that it is about time that people stopped acting like children and look at basics and volunteers as something other that a bunch of uneducated monkeys who kill every other patient that they come in contact with.)

:angry: :angry: :angry:

 

[firecoins]

, I'm just saying that it is about time that people stopped acting like children and look at basics and volunteers as something other that a bunch of uneducated monkeys who kill every other patient that they come in contact with.)

:angry: :angry: :angry:

If volunteers don't have nenough time to get the proper education, what should we think? The medical community see no difference between a paramedic with an A.A.S or higher and a basic EMT with 120 hours course who volunteers occasionally. You may not see that as a problem. Full timers do.

And yes volunteers and a segment of the paid population would disappear with an associates degree requirment. I am fine with that and I am a volunteer.

 

[Arkymedic]

Several of us are of the opinion that EMT should be a 2 yr program and Medic a 4 yr degree.

NO WAY!! Are you crazy?!? :angry: That just about completely eliminates all volunteers! (Not to mention a lot of paid people too.) You just can't do that. Who is going to want to spend 2 years in college just to volunteer 24 or 48 hours of their week? Maybe EMS needs to work on professionalism a little, but an associates?!?!?

I just hope and pray that this never happens. (Along with doing away with 911-BLS, volunteers, extended care option for basics, and "kids" "playing" on ambulances. You wanna discuss this stuff? Fine make a thread for it! I may be shot down by all of you paid city EMTs/paramedics who think you are some kind of deity, but at least I can have my say!

I'm not saying you guys aren't good at what you do, you are, very good, I'm just saying that it is about time that people stopped acting like children and look at basics and volunteers as something other that a bunch of uneducated monkeys who kill every other patient that they come in contact with.)

:angry: :angry: :angry:

 

[wehttam]

at first i figured arkymedic was being very sarcastic and in my mind i really do hope that he/she is. I think it is time the excuse stop and action is taken i do hope with the new NREMT requirements that more state will adapt that approach and at least eliminate the 3 month programs better yet make the AAS a requirement or at least longer programs

 

[Arkymedic]

Just for clarification I did not write that post about EMTs and Volunteers. I wrote that many of us believe that EMT should be 2 yr and Medic 4 yr and I am one of those of this mindset.

at first i figured arkymedic was being very sarcastic and in my mind i really do hope that he/she is. I think it is time the excuse stop and action is taken i do hope with the new NREMT requirements that more state will adapt that approach and at least eliminate the 3 month programs better yet make the AAS a requirement or at least longer programs

 

[VentMedic]

NO WAY!! Are you crazy?!? :angry: That just about completely eliminates all volunteers! (Not to mention a lot of paid people too.) You just can't do that. Who is going to want to spend 2 years in college just to volunteer 24 or 48 hours of their week? Maybe EMS needs to work on professionalism a little, but an associates?!?!?

I just hope and pray that this never happens. (Along with doing away with 911-BLS, volunteers, extended care option for basics, and "kids" "playing" on ambulances. You wanna discuss this stuff? Fine make a thread for it! I may be shot down by all of you paid city EMTs/paramedics who think you are some kind of deity, but at least I can have my say!

I'm not saying you guys aren't good at what you do, you are, very good, I'm just saying that it is about time that people stopped acting like children and look at basics and volunteers as something other that a bunch of uneducated monkeys who kill every other patient that they come in contact with.)

:angry: :angry: :angry:

Uneducated is a little harsh. Under educated is a better term.

A profession should not have different education standards for entry level just because it is in a different part of the country. No other profession has been able to hold this argument for very long to stop their profession from advancing.

If the EMT was raised to at least a 1 year COLLEGE certificate with the time in COLLEGE credit hours and not clock hours of training, the EMT could be viewed differently than a 110 hour first-aider and better prepared to do an expanded scope if necessary.

The Paramedic should be a 2 year degree.

Also, there might be time to add a course for medical and business ethics or just Principles of the Ambulance business 101. Very few know how contracts between services are negotiated or their state's tax base proportions and tax funding distribution statutes. Few know how vendors are selected when they complain about equipment.

It is possible that as some become more knowledgable in these areas, there will be ideas to change the volunteer agencies to paid. Often when an area's EMS providers are under educated, people with their own agendas can quickly turn funds that could go to EMS into pork for their own projects. Few understand that a cost analysis could show a paid agency to be a cost saving for an area in the long run. The volunteers could also get their lives back and no longer have to worry about inconveniencing their families, putting their own cars at risk, the expense for education or finding continuing education classes.

I do give FDs a lot of credit for doing their homework when it comes to how much they can stretch their county, municipal and state's piggy (pork) bank to get what they want. They have researched their statutes and local tax base to gain knowledge for using that information to their advantage. They also hire the most knowledgeable PR people to play on the emotions of the people at election time when they want a raise through taxes. Maybe some of those degrees (business and science) the FDs have been requiring for the past several years to get a promotion are paying off nicely for them.

Even in education and administration, EMS is lacking in leaders that have a strong background in either the basics of medicine or business to effectively provide a direction or be role models for EMS. Those leaders and owners that do have the education know those working for them don't and no one will question some of the things done. The stronger companies with sound business practices do expect their employees to be better educated.

As far as medical ethics, a greater understanding in that area is also needed. Few get much education about DNR or other measures to be within the law to ensure a patient is comfortable when death is near. Few know how some of these decisions are reached and when. Few know about organ procurement.

There is so much that is not covered in the votech style of teaching that has become the "standard" in EMS.

I do worry when some believe a 2 year degree is a lot for a medical profession. It shows that some people, working in EMS, have not been given enough education or insight on their own skills and knowledge to understand what they are missing in the vast world of medicine or even for the specialty of prehospital.

 

[Ridryder911]

NO WAY!! Are you crazy?!? :angry: That just about completely eliminates all volunteers! (Not to mention a lot of paid people too.) You just can't do that. Who is going to want to spend 2 years in college just to volunteer 24 or 48 hours of their week? Maybe EMS needs to work on professionalism a little, but an associates?!?!?

I just hope and pray that this never happens. (Along with doing away with 911-BLS, volunteers, extended care option for basics, and "kids" "playing" on ambulances. You wanna discuss this stuff? Fine make a thread for it! I may be shot down by all of you paid city EMTs/paramedics who think you are some kind of deity, but at least I can have my say!

I'm not saying you guys aren't good at what you do, you are, very good, I'm just saying that it is about time that people stopped acting like children and look at basics and volunteers as something other that a bunch of uneducated monkeys who kill every other patient that they come in contact with.)

:angry: :angry: :angry:

I look at them as what they are. Areas that have no resources for medical care have to rely upon what they can get, but that does not mean they have an excuse not to require the same formal education as those in the city or urban area.

Do we excuse physicians or nurses for not having the proper education because of the region they live or work in? Do we say, oh.. your rural you can by pass four years of college and just go on week ends, when you can.

Sorry, enough excuses already. If the rural area wants healthcare then they need to form alliances to either pay for education and recruitment for medical professionals. Illnesses, diseases and injuries have NO biasis on where they occur. One should expect the same level of educated provider no matter if it is ten buck two or down town metropolis area.

If they cannot provide those levels then provide what they can; first responders but don't disguise yourself as an EMS. There is nothing wrong with that, just don't try to water down the profession just because one is not able to meet the standards.

There is NO excuse for not obtaining a formal education. Again, tired of the whining and boo hooing. Enough with the dribble and excuses. Want to be in EMS, go to school. Don't have the money then get a student loan or an extra job, just like every other medical professional had to. Can't do either of those, then sorry it is not time for you to enter the profession.

Again, medical and health care and the education of those that provide that care SHOULD NEVER BE BASED UPON DEMOGRAPHICS! . Just because one is from rural does not give or allow them to play the poor pity me card. I have primarily worked in rural areas, I assisted developing EMS in communities with < 8000 people with full paid Paramedic care, ED's staffed with board certified emergency nurses. So yes it can be done, determination upon how bad that community wants adequate care.

R/r 911

 

[41 Duck]

NO WAY!! Are you crazy?!? :angry: That just about completely eliminates all volunteers! (Not to mention a lot of paid people too.) You just can't do that. Who is going to want to spend 2 years in college just to volunteer 24 or 48 hours of their week? Maybe EMS needs to work on professionalism a little, but an associates?!?!?

I just hope and pray that this never happens. (Along with doing away with 911-BLS, volunteers, extended care option for basics, and "kids" "playing" on ambulances. You wanna discuss this stuff? Fine make a thread for it! I may be shot down by all of you paid city EMTs/paramedics who think you are some kind of deity, but at least I can have my say!

I'm not saying you guys aren't good at what you do, you are, very good, I'm just saying that it is about time that people stopped acting like children and look at basics and volunteers as something other that a bunch of uneducated monkeys who kill every other patient that they come in contact with.)

:angry: :angry: :angry:

Okay.

I'm a volley 911 BLS provider. Why? Because working as a B, here, is silly: 48+ hours a week doing transports and wheelchairs to make less money than I would pay out in day-care costs. Last I checked, the object of working was to make money, not lose it. That's why I'm going through medic school... as a medic, I have half a chance of coming out ahead at the end of a pay period.

I enjoy volunteering, and will probably still do so --though to a lesser extent-- after graduation. I mean... that's why it's done, ain't it? For the enjoyment of giving your time and expertise? If you volunteer, and have a higher level of expertise, where's the problem?

If advanced education scares off people from getting into this...

...well, maybe they shouldn't be doing it in the first place. If that's what it takes to get into EMS, then those that wish to pursue this will do so.

Current volunteers who have their EMT just to run the occasional shift but make their living in another field, should, of course, be given an incentive to still volunteer. I'm sure some will bail, but I don't think that many will go if they're given the opportunity to meet the requirements--because this is what they WANT to do. Will they :censored::censored::censored::censored::censored: about it while doing it? Sure. But that's merely a side-effect of the archetypical personality attracted to EMS.

Requiring a degree of any type will put the burden on the municipalities and organizations to attract, educate, and provide incentives to get this done. They'll either pay for the education to retain volunteers, or compensate for it through a paycheck for paid providers. Either way, it's not a bad thing.



Later!

--Coop

 

[lightsandsirens5]

I look at them as what they are. Areas that have no resources for medical care have to rely upon what they can get, but that does not mean they have an excuse not to require the same formal education as those in the city or urban area.

If they cannot provide those levels then provide what they can; first responders but don't disguise yourself as an EMS. There is nothing wrong with that, just don't try to water down the profession just because one is not able to meet the standards.

Again, medical and health care and the education of those that provide that care SHOULD NEVER BE BASED UPON DEMOGRAPHICS! . Just because one is from rural does not give or allow them to play the poor pity me card. I have primarily worked in rural areas, I assisted developing EMS in communities with < 8000 people with full paid Paramedic care, ED's staffed with board certified emergency nurses. So yes it can be done, determination upon how bad that community wants adequate care.

R/r 911

First, at least for now rural and urban EMS providers are educated in the same basic way to the same basic standard.

Second, we in rural areas are providing what we can. A rural Basic or Intermediate is not just a first responder! They are trained to the same standard as any other B or I in their state.

I completely agree that care should not be based on demographics. However, what people are trying to do is base EMS on the demography of an urban setting. There has to be some compromise. You cannot just force what all the city EMTs want on the rural ones just because the city is always going to be more “advanced” in just about everything (from EMS to waste management). Maybe we need to find some kind of common denominator that allows some advancement for the urban and suburban settings but that doesn’t eliminate the rural guys. I’m all for providing the best care that can be given, but it is a whole lot easier to do in an urban setting. (At least I think it is.)

 

[medic417]

But rural should have the highest educated because they actually have time to provide medical care during their long transports. If anybody was to fight for less education should be city people because they have a patient for 5 minutes, 15 minutes on a long call. So actually they could argue more education is a waste as they are just driving not doing medicine. Not my opinion just showing why makes no sense for rural people with a whole lot more time with each patient to be fighting requiring more education.