We don't need "training" in EMS

[VentMedic]

Perhaps some provisions with tort reform could protect us if this additional scope is realized.

Why? Shouldn't the Paramedic be held to the same professional standards as others who treat and release? One can be sued for just about anything but taking away the fear of being sued can make some in this profession even more complacent. As it is now those that do work for a government agency know they have limited liability through the immunity statutes.

 

[medichopeful]

it is possible to be a great provider without a degree.

So is it possible to be a great doctor without pre-med?

 

[46Young]

Why? Shouldn't the Paramedic be held to the same professional standards as others who treat and release? One can be sued for just about anything but taking away the fear of being sued can make some in this profession even more complacent. As it is now those that do work for a government agency know they have limited liability through the immunity statutes.

I don't know of any agencies give their medics autonomy regarding treating and releasing pts. All pt care situations that result in the pt bring released post treatment require refusals. Some areas have protocols to forego spinal motion restriction if the pt falls under certain parameters. Some agencies allow medics to declare a "no need for EMS" if it's warranted after evaluating the situation. I can understand releasing a pt after suturing a lac and giving a tetanus (under protocol) as well as G-tube replacements.

As far as referring pts to urgent care facilities, txp drunks to detox and such would require a true Dx. My understanding is that this right is reserved for doctors only. My understanding is that medics can only offer a "suspected diagnosis", nothing more. When you're on the stand, saying "I diagnosed the pt with APE" will get you jammed up in a hurry. The correct thing to say would be "I treated the pt for rales per protocol". It's not cookbook medicine if you're treating the pt according to guidelines, as you can jump protocols if needed, or deviate within reason based on current validated medical knowledge/practices. You're using the guidelines, essentially the OMD's "rules" to treat the pt based on your findings. You're not actually diagnosing anything.

Now, if we increase the scope (with the requisite education) to allow the medic to diagnose certain conditions, is it worth it in regards to potential liabitily? It only takes one poor pt outcome for you to lose your house and/or license. Do I want to go to school for 4-6 years, MAYBE make 100k or so (not likely by a long shot) and have that much more of a chance to lose my house and my shirt? even PA's operate under an MD's license.

If you're doing treat and release under the OMD's guidelines that's one thing, it's another thing entirely to have the autonomy to make your own Dx and definitively decide on pt tx for certain pt populations.

So, who besides doctors have the autonomy to treat and release pts without protocols or oversight from a higher medical authority?

 

[medic417]

So is it possible to be a great doctor without pre-med?

Actually yes. There have been people that have acted as doctors and only had read books. Yet they were considered by their patients to be very good.

But that would be the rare case.

 

[VentMedic]

We seem to have a serious communication problem here. I did NOT type anything about treating and releasing being okay as education stands now nor did I in anyway promote it.

I was reflecting off your statement that if additional scope was allowed, you wanted tort reform.

I understand that a formal degree should produce the best product, and that even a medic mill graduate can bring themselves up to speed if they put in the work. What I can't grasp is medics doing treat and release, due to the high liability potential. It would require the medic to make a definitive Dx in some cases. Perhaps some provisions with tort reform could protect us if this additional scope is realized.

My statement was that if a Paramedic wants additional scope of practice they should be held accountable and not given a free ride.

Why? Shouldn't the Paramedic be held to the same professional standards as others who treat and release? One can be sued for just about anything but taking away the fear of being sued can make some in this profession even more complacent. As it is now those that do work for a government agency know they have limited liability through the immunity statutes.

 

[Shishkabob]

So is it possible to be a great doctor without pre-med?

A smart person does not a degree make.

 

[JPINFV]

To be fair, in a lot of countries the basic medical degree is an undergraduate degree (e.g. MBBS (Bachelor of Medicine, Bachelor of Surgery). That said, it is still a degree and not a simple certification.

 

[EMSLaw]

So is it possible to be a great doctor without pre-med?

I believe I read somewhere that while a strong sciences backround helps on the MCAT and USMLE Step I, performance in practice (presumably, though I don't recall, meaning your patients think you're a 'good doctor', among other things) is more based on prior education in the humanities.

But I would venture to say there are loads of great doctors who weren't pre-med as undergrads. Of course, if you mean "a great doctor without going to medical school"... well, that's a horse of a different color, but it apparently worked just fine until the early 1900s.

More on topic - medical professionals who engage in even mid-level (pseudo-)independent practice tend to have master's degrees. PAs, NPs, etc. If paramedics were looking for an increased scope of practice, it stands to reason they would need additional education to handle the vastly increased responsiblity. Even assuming you're willing to accept a purely didactic and clinical program on a technician, rather than technologist, level (without any of that fancy book learnin', especially in 'useless' subjects like the liberal arts), maybe, possibly, an associates degree would be sufficient, especially that were the minimum before beginning clinical work.

Anyway, this has been clobbered to death multiple times in this forum, so I'll shush.

 

[VentMedic]

(without any of that fancy book learnin', especially in 'useless' subjects like the liberal arts),

Yeah, nobody needs to waste time with readin', writin' and arithmetic.

These forums are proof of that.

At least lately we have had less "r u an EMT" posts.

 

[medichopeful]

Actually yes. There have been people that have acted as doctors and only had read books. Yet they were considered by their patients to be very good.

But that would be the rare case.

Thanks for the help medic417 <_<

 

[atropine]

r99, don't worry about it, the day the us require all paramedic providers to have an AA degree, is the day that system status will be no more. Look ems is not going to change, because politicians want the cheapist labor as possible.^_^

 

[medic417]

Thanks for the help medic417 <_<

Your welcome.

 

[medichopeful]

A smart person does not a degree make.

No, but it does make an educated one.

 

[medichopeful]

I believe I read somewhere that while a strong sciences backround helps on the MCAT and USMLE Step I, performance in practice (presumably, though I don't recall, meaning your patients think you're a 'good doctor', among other things) is more based on prior education in the humanities.

But I would venture to say there are loads of great doctors who weren't pre-med as undergrads. Of course, if you mean "a great doctor without going to medical school"... well, that's a horse of a different color, but it apparently worked just fine until the early 1900s.

More on topic - medical professionals who engage in even mid-level (pseudo-)independent practice tend to have master's degrees. PAs, NPs, etc. If paramedics were looking for an increased scope of practice, it stands to reason they would need additional education to handle the vastly increased responsiblity. Even assuming you're willing to accept a purely didactic and clinical program on a technician, rather than technologist, level (without any of that fancy book learnin', especially in 'useless' subjects like the liberal arts), maybe, possibly, an associates degree would be sufficient, especially that were the minimum before beginning clinical work.

Anyway, this has been clobbered to death multiple times in this forum, so I'll shush.

You're right, I should have been more clear. Let's clarify. The question should have read like this:

"So is it possible to have a good doctor who didn't have any training before medical school?"

:wacko:B)

 

[medic417]

No, but it does make an educated one.

Sadly in many peoples cases it just means a piece of paper. Many people get degrees and never put any effort. So hard to say they are educated.

Sorry it seem I keep helping the anti education crowd today.

 

[medichopeful]

Sadly in many peoples cases it just means a piece of paper. Many people get degrees and never put any effort. So hard to say they are educated.

Sorry it seem I keep helping the anti education crowd today.

Stop doing that!

 

[VentMedic]

Sadly in many peoples cases it just means a piece of paper. Many people get degrees and never put any effort. So hard to say they are educated.

It doesn't mean they don't have the potential to reconnect with their education. Many young and immature people are sent to 4 years of college by their parents. Many may not realize the value of that education until a few years after they graduate. Was that education wasted? Absolutely not.

There are also doctors who have been sent to school because their parents expected it of them. Some are well educated but unhappy. However, since they do have an education, they now have choices.

Now take EMS. So many complain about the Liberal Arts classes if they go for a degree. Few realize the benefit of being able to read, write and do math.

The one thing about an education is that it gives you more choices and opens up many more doors somewhere down the road. Some may think getting a two year degree is a waste but may regret not getting one when another opportunity comes along with higher education standards. Regardless of what one thinks of that piece of paper or why they got it, you still have it. For that reason your education is usually the first letters placed after your name when listing your alphabet soup in the signature. The reasoning behind that is your education can not be taken away from you. Certs and licenses can lapse or be revoked.

 

[ResTech]

your education can not be taken away from you. Certs and licenses can lapse or be revoked.

That's a very good point....

 

[medic417]

It doesn't mean they don't have the potential to reconnect with their education. Many young and immature people are sent to 4 years of college by their parents. Many may not realize the value of that education until a few years after they graduate. Was that education wasted? Absolutely not.

There are also doctors who have been sent to school because their parents expected it of them. Some are well educated but unhappy. However, since they do have an education, they now have choices.

Now take EMS. So many complain about the Liberal Arts classes if they go for a degree. Few realize the benefit of being able to read, write and do math.

The one thing about an education is that it gives you more choices and opens up many more doors somewhere down the road. Some may think getting a two year degree is a waste but may regret not getting one when another opportunity comes along with higher education standards. Regardless of what one thinks of that piece of paper or why they got it, you still have it. For that reason your education is usually the first letters placed after your name when listing your alphabet soup in the signature. The reasoning behind that is your education can not be taken away from you. Certs and licenses can lapse or be revoked.

But with no effort comes no education thus it is just a piece of paper. Later in life they can return to school for an advanced degree and then get educated but that paper is just paper, an education it does not make.

 

[VentMedic]

But with no effort comes no education thus it is just a piece of paper. Later in life they can return to school for an advanced degree and then get educated but that paper is just paper, an education it does not make.

So you really do believe education is a waste.

No. Even if you only learned to type a full sentence that is readable it is not a waste. You would be surprised what the brain retains even if very little effort is put into it.

Education is a choice. The fact that one does stick it out through a college degree shows they know a little about the benefits of an education even if they don't admit it or appear disinterested. They could easily leave the college.

Do you know how many Art History or some other Liberal Arts majors get well paying jobs with major companies or government agencies just because of that piece of paper? It didn't matter what they had the degree in. It just mattered that regardless of their opinion about education they still FINISHED what they started. I am of course talking about a 4 year degree but even a 2 year degree is an accomplishment or at least an initial step.