https://facebook/paramedic/posts/10152743141613624 The good Doctor asked the question thats asked every year, and heres my take on it. The real answer to this question isnt in the asking, its in the comments. We all know that theres a lot wrong with American EMS from a career perspective, that its a hard job with terrible retention, low pay, nonexistent job security, little respect and disproportionate responsibility thats often interpreted by the wildest, wildest and least-consistent of standards, and we all know that these problems arent getting any better for a lot of reasons. However, I think its more than a degree or any one set of changes can fix. Proponents of college degrees point to nursing as a role model. Thats the crux of their argument- that mandatory educational benchmarks like an Associates or even a Bachelors requirement for paramedics will force change upon the industry, improve our pay and working conditions, give us the unified front we need to lobby effectively and will improve both our delivered care and the possible services we can deliver to the point where those wage increases are justified. Its an attractive claim, and its hard to find fault with it, but its also fairly unrealistic. As more than a few posters pointed out, the degree game has been tried before in EMS, with varying levels of success; and its been tried before in multiple professions, with varying degrees of success. Our comrades in the UK are quite well-educated, but they have the same problems we do; teachers are very well-educated but are treated quite poorly if their payrolls are measured. Those who dont want degree requirements also raise some good points. As dumb as it sounds, theres a lot of good paramedics out there- old and new- that dont have degrees, arent really able to go back to school for whatever reason, and who cant afford the costs that getting their degrees would imply. As ignorant as this sounds, EMS- even good, high-quality EMS- can functionally be delivered by someone with a streak of common sense just as well as someone with a PhD, and critically, its all reimbursed similarly. Moreover, as much as wed all like to believe that a degree will make all the difference, I think we all know that thats not the case. Certainly, current paramedics and future paramedics will benefit in the long run from a degree requirement; a rising tide floats all boats, but how much water is available? By and large, Americans have long demonstrated a shocking apathy towards their public services and dont fund their services terribly well. Their appreciation of our work stops when theyre asked to pay for it. Our reimbursement structure is broken; our legal mandates to provide service regardless of reimbursement shackles us to do the one thing that we can guarantee will pay us something, which it transport; it makes very little sense to educate a profession to do something that is not reimbursed or worth anything if that education is anything more than token.Today, a graduate degree opens doors in administration and leadership in our agencies, but those doors cannot be open for everyone and expecting everyone to enjoy similar promotional opportunities is wildly unrealistic. Should degrees be required, I really dont see it going terribly well- I think that we will find ourselves in the same position as the teachers and lawyers of the world have, chasing ever-inflating educational requirements in pursuit of marginal gains in pay and pushing the limits of what the public is able to pay us. A degree requirement also has the nasty side effect of effectively denying paramedic services to a lot of our most vulnerable citizens, there is effectively no way that most rural counties can afford to staff their first-response infrastructure with well-paid professionals in todays current social climate. Changing that requires either massive expansions of state and federal responsibility or a dramatic shift in how we are perceived. I dont think either is very likely. On the other side of the argument, most of those comments are great reasons to require at least some education. Personally, the thought of my life resting in the hands of someone who measures themselves by the isolated skills they are trained to perform disappoints and scares me; our average paramedic is a walking example of the Dunning-Kruger Effect. Hopefully a mandatory degree would at least cull those too stupid to realize that being able to do something doesnt make you worth any more than the limits of your billing when it comes to money. I think the best answer to our problem is to confront the harsh reality that EMS, particularly ALS 911, is a broken business model unless its directly taxpayer-supported. Private services arent going to pay us more unless they absolutely have to and technology is rapidly advancing to the point where the average paramedics job can be done by a lesser-trained EMT safely and relatively effectively, protocol refinements can cover most patients and our hyper-developed emergency medical system can correct most mistakes. Those who delude themselves by insisting that an EMT with traditional vocational training cannot be trained to follow a protocol flowchart are willfully ignorant of history, and if its cheaper and just as effective, why wouldnt our employers shift the burden of ALS, education and the practice of medicine onto the government? Theres no real great answer to EMS, and quite frankly, theres no huge reason to fix it in most places. I recently left a job where the average paramedic lives, but isnt going to do much else with their life aside from work; most of the other services in my area are effectively identical with a few better and a few worse- and thats not going to change. The average is depressingly mediocre from a lifestyle point of view. For the same money and time Id spend on a degree in paramedicine, I might as well go be a nurse or other allied-health professional and actually enjoy the fruits of my labor. Anon
Posted on: Sun, 05 Oct 2014 19:28:32 +0000
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