But aside from that little anecdote, go back to the volunteering scenario. What if you spend 2 years volunteering and only go on 100 calls? Will you know how to deal with people any better than say...the person who works at McDs?
Because they actually lose financially, McDs takes customer service a lot more serious than most EMS or IFT agencies. They actually put you through customer service training. (So does Wendy's for that matter.) So now the McDs grill cook has more customer service training than many EMS providers.
Well, does the person who works at McDonald's have to deal with a critically ill or injured person?
It'd be terrible for a person to take EMT-B then immediately go into Paramedic school only to find out two years later that he or she can't stand the sight of blood and guts. If that person had gotten some experience as an EMT-B first, he or she might not have wasted two years and several thousand dollars.
I believe you both raise very valid points, among other people.
It's true, while EMS is strongly customer service-driven, we are not properly trained to actually serve the patient's needs, only support them medically. As firetender stated later, dealing with humans and keeping order during chaos are the two "basic" skills that a person must know before becoming a fulltime EMT, let alone a Paramedic. The two key things that make a good Medic (or EMT) are being able to deal with things (see above) and solid assessment techniques with knowledge base to back it up. All of the skills we perform could be taught to monkeys. But ABCs, A+P, Pathophys, immunology, and formation of a good DDx are what separate Paramedics from everyone else.
I actually think Basic classes don't screen enough. My fire company CICs the EMT-B class twice a year. Starting in January, they're requiring proven competency of math/reading/english at a high school/GED level. My Medic class requires a college-level math and english class, and some form of prior experience. Though they've waive the "prior experience in EMS" a few times, I've seen what that can produce. "prior experience" is a relative term, as Vene points out. I can think of a few EMT-Bs at my fire company... They've been EMT-Bs for atleast 2 years. They go on a good number of calls. There's almost always a higher level of care, they're NEVER in charge of patient care, and rarely do anything other than ask about allergies, ask for patient info, and maybe do a set of vitals. They know nothing, but technically "have 2 years experience". As JJR touched on, the turnover rate of EMT/Medics within 1 years is pretty high, and even higher within 5 years, due to people finding it wasn't what they thought it would be.
I have to side with Vene also, that outside of the experience dealing with people and chaos and keeping a level head, everything else can/should be taught in the class. My Medic class teaches us everything from the ground up and assumes nothing... We're re-taught CPR, Med/Trauma assessments, re-taught immobilization and KEDs and everything else possible. Because the instructors want to be sure we're all being taught the correct way, and all on the same page. And I gotta say, I enjoy it.
