Will EMS evolve?
By Arthur Hsieh
Editor's note: A recent article threw a spotlight on Eagle County, Colo., one of several communities across the U.S. where a select group of paramedics is helping to provide primary health care by making house calls.
The days of lights and sirens, rescuing victims left and right, and providing life-saving care as our primary mission is over. Long over. In fact, it might have never been, save for those who romanticize history and talk about the good ol' days.
Johnny and Roy of the 1970's Emergency! fame never really was. After all, it was a television show, debuting during an era when TVs were transitioning from vacuum tubes to transistors. More importantly, it was fiction. It showed how EMS life might have been like, just like TV "reality shows" depict "real life" today. Meaning, not really. Don't get me wrong; I love that show. Its basic philosophy of providing empathetic, competent care to the sick and injured shaped my childhood and gave me a lifelong career. But reminiscing over it as if it was yesterday would be the wrong way to honor its impact. It was the start, not the end of the modern EMS era.
I think most of us get the concept. We accept the roles of caregiver, rescuer, listener, driver, social worker, dispute resolver, and quicker picker-upper. We know that on any given shift, most of the calls will not require our emergency lifesaving skills. We should be called "Johnny on the spot" for the myriad responsibilities that we are often provided little or no education or training on.
The question is, are we ready to move on? I hope so. Taking care of people "in the streets" requires more than what we are taught today. Several EMS organizations have already recognized that their niche in their local health care and public health systems is broader than the traditional definition of EMS. Their staff are playing key roles in their public safety net, that were either underserved or not done at all.
My point is this: we need to evolve as an industry and a profession. Not doing so will keep us in the dark ages of medicine. Just as importantly, we should not be waiting for someone to tell us what we should or shouldn't do; there are plenty of smart, motivated, and curious folks within our own ranks who can conduct the studies and research to demonstrate real, measurable value of out of hospital medical response systems to their communities.
There is growing interest and development of the advanced practice or community paramedic, being spearheaded by various organizations such as the one in this article. You won't find this in the current national education standards, or in the national EMS scope of practice. Yet the need for their level of practice is evident, as least in the areas being served by these systems. What I would love to see is a concerted effort by the profession to embrace this evolutionary step, and explore its possibilities. Who knows where it might lead us?
Time to move on folks. I'd like to see our profession grow up before I retire. We've been in arrested development for way too long.