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Paramedics vs. advanced EMTs: What works best?

It's a costly endeavor to maintain ALS licensure for both providers and departments

Editor's note: With the fire and EMS debate continuing to rage in Naples, Fla., Art Hsieh takes a look at some wider issues the article presents. 

This turf battle has been going on for several years now. The gap between the county and the cities is as wide as the politics are deep.

To date there has been little evidence to show that first responder paramedic response makes a difference in patient outcomes. I'm not saying that it doesn't — but no data supports it.

It's a costly endeavor to maintain ALS licensure for both providers and departments. Moreover, the utilization of an advanced EMT, who is equipped to provide the essential care that has real potential to be life-saving, can be a more cost effective and mission-focused EMS provider in this situation.

In addition, there is evidence to support that increasing the number of paramedics reduces their overall effectiveness.

Experience counts. It refines the practice and increases its accuracy. Like other health care professions, the quality oversight processes are significant in ensuring the safety of the patients.

That level of infrastructure is costly and more effective if spread across a broader population, compared to several smaller ones.

Finally, who will foot the bill for the costs associated with any changes to the system? Eventually it will be taxpayers and those with health insurance premiums.

It would be one thing if it could be demonstrated that more lives would be saved and the overall health of the community improves.

But so far I haven't seen anything in the press that suggests that the care being provided is poor or that gaps exist in service. So really, what are the driving forces?

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