Why doesn't the US EMS revise their system from the ground up?

[JPINFV]

The current community college paramedic educational model does not "ensure an appropriate command and ability to apply both the foundational sciences and EMS applied science."

...but I have a hard time believing that it doesn't come closer than the 9 month or less medic mill programs. Of course I also think that the entire level design in the US needs an overhaul. The minimum standard for manning an emergency ambulance (EMT level in the US) should have the requite knowledge and scope to handle the vast majority of emergencies. It should be harder to earn an EMT than it is to go from EMT to paramedic. After all, if an EMT is deciding if a paramedic needs to be called, shouldn't the EMT have a firm grasp of anatomy, physiology, clinical prehosptial medicine? Right now we have an oversaturation of providers who can do high risk/low use procedures because the high use, lower risk procedures are also limited to their level. Unfortunately, there's no painless way to remedy that.

Under the old National Standard Curriculum there was barely enough time to met the minimum general education requirements of an associate of applied science or technical degree. These are terminal two-year degrees.

Is part of the problem institutions viewing minimums as the maximum? California only requires medical schools to provide 4,000 hours of instruction. Somehow I doubt that most medical schools in California shoot for as few hours over 4,000 as possible.

Students coming from those programs often need to complete 9 to 12 additional semester hours to meet the general education requirements of a two year associate degree that is aimed at transferring to a bachelor degree program.

Adding Anatomy and Physiology is a help, but if we were to construct a Scope of Practice paramedic degree program to cover the foundamental sciences and EMS applied science it would need to be a four year program. Like the programs run by Pittsburgh and University of Maryland Baltimore County.

Mike

I wouldn't necessarily mind a BS as a requirement for EMS. However, as with my issue with the current setup above, such a move would painful and would require not only overhauling the educational infrastructure of EMS, but a fundamental change in the culture of EMS too.

 

[JPINFV]

But the state BOMs are generally made up of physicians. When was the last time you saw a state board of paramedics? For that matter, when was it you last saw a state EMS agency that had a significant paramedic presence among its policy makers?

I've actually asked that question before. If paramedics want a career latter, why are there so many nurses involved with running EMS in California. As someone who's watched the 3rd season of The Academy (the Orange County Fire Authority season), I've similarly wondered why an RN was providing the EMS evaluation for the academy and not a paramedic? It seems that all too often the lack of a career ladder for paramedics is their own doing as much as it is the lack of a large management overhead in a lot of private services.

 

[the_negro_puppy]

It's not all sunshine and rainbows in other countries. Are you aware that we have socialised medicine in Aus? Everyone pays an approx $100 levy a year in my state on their electricity bill to fund the ambulance service. Residents of my state are not charged for calling and using an ambulance. I could call an ambulance every day for a year and pay nothing and never be prosecuted.

Most family doctors/GP have an out of pocket expensive you have to pay up front ($50) or so which the gov gives a portion back. This dissuades people from going to their doctor and many just present to ED's because they are free.