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EMS should all be united under a single professional standard
It shouldn't matter whether the person is a volunteer, career, hospital-based, fire-based or third-party service
By Art Hsieh
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Editor's note: The N.J. Senate Budget and Appropriations Committee has passed a bill that would put all EMS under one professional standard in the control of the state's health commissioner. |
Last I checked, most states have a uniform approach in certifying and/or licensing its EMS providers. "Uniform" is a key term:
Uniform n. 1. having always the same form, manner, or degree : not varying or variable
2. consistent in conduct or opinion
3. of the same form with others : conforming to one rule or mode (Merriam-Webster Dictionary)
It would seem fairly straightforward to create a uniform set of standards for training, accountability and comportment so that citizens and communities could feel confident that the proficiency of care and the moral character of their EMS providers are consistent from one end of the state to another.
It shouldn't matter whether the person is a volunteer, career, hospital-based, fire-based or third-party service — a state-level agency has identified the individual as being capable of rendering emergency care.
I guess some folks in New Jersey don't feel the same way.
Prior columns have spoken to the ways the state's EMS provider leadership wants to preserve its existing EMS system by tying in the cost of background checks with the imminent loss of volunteers. If the system is functioning well, there shouldn't be a worry, right? After all, no one should be upset with a well-run, effective and efficient EMS response, or at least that's how the theory goes.
By my calculations the state's volunteers must be saving the state at least 160 million dollars annually by donating their services. That should be plenty of incentive for the state to provide about a million dollars to fingerprint its EMS providers.
But I am getting off track. Uniform standards for healthcare and public safety providers are a good thing. Whether it's done by a governmental or peer board process is not as critical. Let's not make the issue any bigger than it is.
Skip Kirkwood Thursday, October 25, 2012 6:26:18 PM I think that your estimate of the value of volunteer services is over-stated, Art. In 1986, I did my master's thesis on a cost comparison between the volunteer BLS - hospital ALS system that existed, and what it would cost to provide full-time, all ALS ambulances with 8:59 90% in one county. In the end, it was a wash - there was so much excess capital equipment (buildings, vehicles, etc.) and so much excess operating costs associated with supporting 60 volunteers in a town that needed 6 EMTs or medics. Like 60 ambulances for 425,000 people, 11 rescue trucks, etc. You'd be surprised..... 
Bob Sullivan Thursday, October 25, 2012 7:14:05 PM I'm doing my master's thesis on tiered response systems now, 25 years later. The clinical aspects have changed, but not the money. 
Jeannine Crowfoot-Anglum Thursday, October 25, 2012 8:07:32 PM I agree, should be one standard, but it's the so called professionals who fall short in this regard, I know, having been both and shocked by the attitudes of the so called 'professional' emts. 
Ray Bange Thursday, October 25, 2012 9:44:37 PM I must agree with Skip and many others in terms of having consistent standards - for health care, for benchmarking, for funding for many other reasons. My view is that the regulatory framework should ensure a registered practitioner cohort supported by accredited service providers - there are two sets of criteria to meet and they should go hand in glove,
The question of the employment status of the practitioner is in some respects a red-herring. All parties can be passionate about patients and care and best practice and one needs to look across the board and not just use personal (bad) experiences as the yardstick. State or national registration of the practitioners to operate within defined scopes of practice would do much to create the professionalism being sought. Registration involve fitness-to-practices and other elements that should weed out those unfit to practice in such fields of.
high risk and working with vulnerable patients. 
Steve Cole Friday, October 26, 2012 7:17:43 AM Art,
1- I thought your article was on true riciprocity, not back ground checks... :(
2- Keep in mind there are huge regional variations inthe view of this issue. What seems to be a hot issue on one side of CONUS is an accepted fact of life elsewhere. Same wth random drug tests, etc.
3- I absolutely agree on a uniform standard, and honestly a national data base to prevent problem medics wandering from state to state.
4- And also think annual review is a good idea too. 
