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    Default EMS Educational Standards

    Question: Are you for or against raising the educational standards of the EMT-P to the EMS-AAS, a two year degree? The degree would be required to recieive the EMT-P cert. Tech school programs would no longer qualify one to be certified as a P. Please include the reasons for your opinion.
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    What would the rationale be for raising the standard to a degree required level?
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    Quote Originally Posted by DeputyMarshal View Post
    What would the rationale be for raising the standard to a degree required level?
    The inconsistency of the various paramedic programs regarding their curriculum and standards. Many programs don't require even a basic college level A&P and pharmacology prior to application. They run a condensed, watered down, in house A&P and pharm for EMS. A paramedic is a medical professional, and needs to understand how the human body works before they Many programs focus on preparing their students to pass the NREMT (or state) exam, not so much for creating strong paramedics. There are programs as short as three months, such as the one that Houston uses for their FF's. This creates a very low barrier for job entry, and also oversaturates the market with medics. Places like FL and OH can demand that every FF be a medic in order to get hired due to the overabundance of medics. If it's easy to get certified as a P, you get individuals who get the P-card just to get a fire job, take an apathetic atitude towards pt care, never strive to improve their clinical knowledge, and drop their cert at the first opportunity.

    If a paramedic were treating your mother or another close family member, would you want someone who wanted to be a medic bad enough that they had to do two years of college to get the position, or the three to six month wonder who rather be anywhere but on the box treating your family member?

    Requiring an EMS degree as a minimum standard would give the medic at least the basics of a medical education; it would reduce the supply of medics allowing the existing ones, the ones who did at least two years of school, to earn higher compensation; it would result in providers that actually have an interest in medicine, or at the least, be proficient in it.

    Edit: Also, with the public looking at our salaries, pensions, etc, it may become evident that we're essentially unskilled labor. By that, I mean that we can get on the job with as little as a GED, and no felonies. We start FF's here at 48k plus night diff, paid holidays, a pension, DROP, etc. Other county positions that pay that well (w/o a DROP and a lower pension multiplier) typically require four year degrees and maybe prior experience. Our medics are making around 70k right out of the academy with the bonuses that come with the position. It would be wise to require applicants to have a job related degree to be able to apply, or at least give hiring preference. If applicants had to have a fire science degree in their possession, that could knock weeks off the academy, saving the dept money. You weed out those that are looking for easy access to a job with a great schedule and benefits. Your people will also have demonstrated the ability to study and retain information by having that degree.
    Last edited by edpmedic; 03-03-2011 at 08:18 PM.
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    There are states that already do require the associates for the paramedic and that still doesn't always solve the problem. A degree has been required in Kansas for a while now and there are programs here that turn out people that have their MICT, but they wouldn't do well on the streets. While there are other programs that produce a competent individual, who fresh out of their program is better prepared for the streets than someone who has been on them for a few years already. The two common denominators for the really good programs in this area are:
    1. Instructors who are there to teach the students and not someone focused on their programs total number of individuals certified.

    2. The programs usually have the ability to weed the individuals that are there just for the pay raise that they'll receive after they complete the program. The most common way is that the instructor assigns the student a daily grade for their personality.

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    I for one would never consider becoming a paramedic a pay raise, But I guess many would which is a shame. I am half way through medic school now and I have to say it is very hard. The program is 14 months and that is after 9 months to become an EMT-I.

    I am just getting into cardiology now.... I think my head is going to explode, So much to learn. Which leads to my next statement, I think a longer program would allow for more complete understanding of the meat and potatoes of being a medic. Not just getting ready for the NREMT exam.


    I think the thing that scares me the most about being a paramedic is when done I will be in charge of the ambulance. How hard was it for you guys to make the transition?
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    Quote Originally Posted by L-Webb View Post
    I think the thing that scares me the most about being a paramedic is when done I will be in charge of the ambulance. How hard was it for you guys to make the transition?
    I was in charge of the ambulance after a one semester ALS course. Becoming a paramedic doesn't necessarily make you a better manager. It does make you more knowledgeable about patient care, which is, of course, a good thing. Hopefully you'll become a good manager as well.

    There are those who complain that EMS providers aren't given any cred, regardless of their level of certification. Moves such as requiring a degree can help deal with that as paramedic moves toward being a profession (like nurses) as opposed to a certification. When paramedics reach that level, you may see more field practice - diagnoses and treatment without transport to a hospital. A little of that occurs now, but not like it does in some places.

    There are advanced practice paramedics these days, just as there are advanced practice nurses.
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    Where I am from most all medic programs are 1 year to a year and a half there are no condensed programs. Most program are competitive to get into and they have an application process. In Missouri you have to do at least 600 Clinical/Ride along Hours and 300 patient contacts so there is no way to do that in 3 months it is pretty much a full time job after class, clinicals, and studying. To touch on what the other guy said no matter if your class is 3 month or 2 years you are not gonna catch all the people that are good at taking test but not a good hands on medic. However most teacher are pretty good at weeding out the s*** bags and graduating sound medics although some do slip through. For this reason though my area is not saturated with medic candidates so you go against a lot less people when testing for a fire/medic job or medic job. I also believe Missouri is going to the degree thing and the programs can only be offered at an institute of higher education and that goes into effect Jan 2012 and all program have to meet a certain criteria otherwise they will not be able to offer a medic program.

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    Personally, I'm mixed on the subject.

    I'm definitely in favor of seeing the Paramedic level be more on par with that of nursing in terms of licensure, compensation and the ability to move state to state without having to "retrain" or "retest" in order to practice. Plus, as more and more is being added to the scope of practice, more upfront education/training will be necessary to adequately cover the material.

    I agree that the training should be such that not every Tom, Dick & Jane can end up on the streets providing care as a Paramedic.

    However, I'm not convinced that a degree program will specifically result in a better end product. In my immediate area there are 2 options for where you can get Paramedic training. The Community College (basically a "Part-time" schooling for the better part of a year) and via a subsidiary of the local major college's medical school and hospital (basically a "Full-time" schooling). This option can be either a Paramedic only training or done as part of a degree program.

    The EMS agency I've worked at the past 9 years is one of a few in the County that does the field precepting for the second option. We typically got a handful of student each semester. We also precepted the other program's students, but not as frequently. Based on my experiences, I'm not convinced that the degree program actually created "better" Paramedics.

    The majority of students we saw tended to have little to no experience as EMTs prior to starting Paramedic training. Several of them had no interest in actually being Paramedics. They wanted to be Doctors and saw the training as a stepping stone towards that end goal. Some never even tested for the actual certification which apparently wasn't required to get the college credit for the course.

    The problem I see (at least in my area) is not one that I think a degree requirement will specifically fix because I've seen numerous good and bad providers come out of both training avenues.

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    Quote Originally Posted by L-Webb View Post
    I for one would never consider becoming a paramedic a pay raise, But I guess many would which is a shame. I am half way through medic school now and I have to say it is very hard. The program is 14 months and that is after 9 months to become an EMT-I.

    I am just getting into cardiology now.... I think my head is going to explode, So much to learn. Which leads to my next statement, I think a longer program would allow for more complete understanding of the meat and potatoes of being a medic. Not just getting ready for the NREMT exam.


    I think the thing that scares me the most about being a paramedic is when done I will be in charge of the ambulance. How hard was it for you guys to make the transition?
    How is it a shame to become a paramedic for a pay raise? I thought about what I would like to do that pays well, and being a paramedic was what fit the bill. If the pay was lousy, I would have had to go into another career, as my family prefers to be clothed and fed.

    As far as being in charge of the bus, good systems will have an FTO program in place, rather than just throwing you to the wolves. In my old system, NYC, there are always two medics. The senior medic drives, and the junior medic rides as attendant, and writes the reports. The senior medic watches over the junior medic and gives guidance. If the pt's condition is serious, you'll both be in the back anyways.
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    Quote Originally Posted by tree68 View Post
    I was in charge of the ambulance after a one semester ALS course. Becoming a paramedic doesn't necessarily make you a better manager. It does make you more knowledgeable about patient care, which is, of course, a good thing. Hopefully you'll become a good manager as well.

    There are those who complain that EMS providers aren't given any cred, regardless of their level of certification. Moves such as requiring a degree can help deal with that as paramedic moves toward being a profession (like nurses) as opposed to a certification. When paramedics reach that level, you may see more field practice - diagnoses and treatment without transport to a hospital. A little of that occurs now, but not like it does in some places.

    There are advanced practice paramedics these days, just as there are advanced practice nurses.
    Yes, Wake Co. EMS in NC comes to mind.
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    Quote Originally Posted by FireMedic049 View Post
    Personally, I'm mixed on the subject.

    I'm definitely in favor of seeing the Paramedic level be more on par with that of nursing in terms of licensure, compensation and the ability to move state to state without having to "retrain" or "retest" in order to practice. Plus, as more and more is being added to the scope of practice, more upfront education/training will be necessary to adequately cover the material.

    I agree that the training should be such that not every Tom, Dick & Jane can end up on the streets providing care as a Paramedic.

    However, I'm not convinced that a degree program will specifically result in a better end product. In my immediate area there are 2 options for where you can get Paramedic training. The Community College (basically a "Part-time" schooling for the better part of a year) and via a subsidiary of the local major college's medical school and hospital (basically a "Full-time" schooling). This option can be either a Paramedic only training or done as part of a degree program.

    The EMS agency I've worked at the past 9 years is one of a few in the County that does the field precepting for the second option. We typically got a handful of student each semester. We also precepted the other program's students, but not as frequently. Based on my experiences, I'm not convinced that the degree program actually created "better" Paramedics.

    The majority of students we saw tended to have little to no experience as EMTs prior to starting Paramedic training. Several of them had no interest in actually being Paramedics. They wanted to be Doctors and saw the training as a stepping stone towards that end goal. Some never even tested for the actual certification which apparently wasn't required to get the college credit for the course.

    The problem I see (at least in my area) is not one that I think a degree requirement will specifically fix because I've seen numerous good and bad providers come out of both training avenues.
    True, just because it's a college offering the P program doesn't necessarily mean that it's going to be the best program. My program was through a hospital in Brooklyn. I felt it prepared me well. The thing is, there are way too many fly by night medic mills, that run from three to six months, although some are longer. They just seek to pump out as many graduates as they can, and just teach them how to pass the NR-P exam. They don't require any sciences, and generally give a very condensed A&P and pharmacology watered down to just the need to know basics to function as a cookbook medic in a 911 system.

    Making a degree program the minimum standard puts these medic mills out of business. The students are required to have basic English, math, psych, and basic sciences, such as A&P (typically w/lab), and general pharmacology, all taught as college courses. These sciences, along with the ability to do algebra (for drug calculations for starters) and proficiency in a college composition course (business writing typically qualifies as well, and also has direct career applications) are all guaranteed to be part of the paramedic's education. These abilities are the least that should be acceptable to be considered the basics of a medical education; organic chemistry and physics could be validated as well. These medic mills are largely the reason why many systems have strict protocols rather than medical guidelines that allow flexibility in clinical decision making. These medical directors know they're dealing with three and six month wonders. Education alone doesn't produce the best medic, but neither does a poor education base (in the sciences) and good experience, no matter how productive your skills stations and clinical sessions were. There will also be the elimination of cronyism in these programs, such as preceptors falsifying extra ride hours and/or performed skills and pt contacts, and the time spent during skills and classroom sessions will be largely devoid of useless war stories.

    Edit: It doesn't take all that much to become proficient as an EMT-B. It certainly doesn't take two or three years. It's not very difficult to perform spinal motion restriction, take a BP, pump and blow, apply a swing and swathe, etc. The better medic programs address the student's lack of experience as a basic. As far as students using the education as a stepping stone, well, I would too if I could only make 15 bucks an hour if I'm lucky in some places. But, if there were only degrees, the laws of supply and demand would raise salary and benefits, and it would eliminate many of the Ricky Rescues and whackers who just want to do it for the lights and sirens and adrenaline rush. Look on any EMS forum and there are many threads on what lights they should get for their POV, what they should carry on their belt, where they can get EMS vanity license plates, etc.
    Last edited by edpmedic; 03-07-2011 at 04:37 PM.
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    Quote Originally Posted by edpmedic View Post
    Edit: It doesn't take all that much to become proficient as an EMT-B. It certainly doesn't take two or three years. It's not very difficult to perform spinal motion restriction, take a BP, pump and blow, apply a swing and swathe, etc.
    Right it doesn't, but it's been our experience with the students that came to our service to precept, a lot were not proficient at all with their BLS skills.

    The better medic programs address the student's lack of experience as a basic.
    Unfortunately, not enough address it by requiring the students to actually demonstrate proficiency with BLS skills before being enrolled in the class.

    As far as students using the education as a stepping stone, well, I would too if I could only make 15 bucks an hour if I'm lucky in some places.
    I think you misunderstood something. It wasn't about working as a Paramedic while working towards something else, like MD. The ones I referred to were taking the Paramedic class for the course credits instead of taking a semester or two of regular college courses. They never actually tested for the Paramedic certification.

    [/quote] But, if there were only degrees, the laws of supply and demand would raise salary and benefits, and it would eliminate many of the Ricky Rescues and whackers who just want to do it for the lights and sirens and adrenaline rush. Look on any EMS forum and there are many threads on what lights they should get for their POV, what they should carry on their belt, where they can get EMS vanity license plates, etc.[/QUOTE]

    It may not reduce the number of Ricky Rescues, they just might stay EMTs.

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    A Canadian Primary Care Paramedic, which is the minimum level required to transport a patient, take a 2-year degree to get, and they don't even have as many meds or procedures as a 6-month American medic mill grad. Going to the ALS level requires another year of school depending on where you are.

    I've been told that in the Netherlands, Paramedic school is a Graduate-level course only available to experienced ICU nurses (which of course takes a degree itself).

    Are Canadians sicker than Americans? Are the Dutch? Or do they just know something that we don't? Or, is it because they don't have national-level special interest groups with a vested interest in keeping standards as low as possible and a lot of money to be spent making that happen?

    One thing I do know, you won't find a paramedic working for $10 an hour in Canada or the Netherlands.

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    [QUOTE=edpmedic;1253745]How is it a shame to become a paramedic for a pay raise? I thought about what I would like to do that pays well, and being a paramedic was what fit the bill. If the pay was lousy, I would have had to go into another career, as my family prefers to be clothed and fed.

    If you like doing it and it pays better... That's good. Thats not quite what I meant.

    There are 2 students in my class that have openly stated that the only reason that they are here is that they will get 5-6000 more a year and just want to get enough to pass the test.
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    Quote Originally Posted by FireMedic049 View Post
    Right it doesn't, but it's been our experience with the students that came to our service to precept, a lot were not proficient at all with their BLS skills.

    Unfortunately, not enough address it by requiring the students to actually demonstrate proficiency with BLS skills before being enrolled in the class.

    I think you misunderstood something. It wasn't about working as a Paramedic while working towards something else, like MD. The ones I referred to were taking the Paramedic class for the course credits instead of taking a semester or two of regular college courses. They never actually tested for the Paramedic certification.
    But, if there were only degrees, the laws of supply and demand would raise salary and benefits, and it would eliminate many of the Ricky Rescues and whackers who just want to do it for the lights and sirens and adrenaline rush. Look on any EMS forum and there are many threads on what lights they should get for their POV, what they should carry on their belt, where they can get EMS vanity license plates, etc.[/QUOTE]

    It may not reduce the number of Ricky Rescues, they just might stay EMTs.[/QUOTE]

    I was under the impression that the core courses within the EMS AAS curriculum could only be taken if you're in the program, similar to the RN classes.

    At least the Ricky Rescues could be kept in check by the medics.
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    [QUOTE=L-Webb;1254166]
    Quote Originally Posted by edpmedic View Post
    How is it a shame to become a paramedic for a pay raise? I thought about what I would like to do that pays well, and being a paramedic was what fit the bill. If the pay was lousy, I would have had to go into another career, as my family prefers to be clothed and fed.

    If you like doing it and it pays better... That's good. Thats not quite what I meant.

    There are 2 students in my class that have openly stated that the only reason that they are here is that they will get 5-6000 more a year and just want to get enough to pass the test.
    There are two things that are beyond me:

    First, why do certain depts insist on making everyone become a medic? It costs for the class, the increased compensation, and also for CME's and such. ALS isn't for everyone, either. Pushing drugs and providing electrical therapy, and the education that comes with that is serious business. If you carry an apathetic attitude toward that side of the job, people are going to get hurt and killed.

    Second, in medic saturated regions such as FL and OH, why don't these depts require that their applicants, who typically have to be medics to even apply, have EMS degrees as a hiring condition? In these regions, the competition for fire jobs are like the competition for non-ALS fire positions elsewhere. If the applicant has the EMS degree, that would imply a certain amount of proficiency in EMS, and they'll be less likely to drop their cert after getting on as well.
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    Quote Originally Posted by emt161 View Post
    Are Canadians sicker than Americans? Are the Dutch? Or do they just know something that we don't? Or, is it because they don't have national-level special interest groups with a vested interest in keeping standards as low as possible and a lot of money to be spent making that happen?
    Can you expand on your meaning of the above statement?

    I come from a state that doesn't have medic mills either - our programs are no less than a year, generally 18+ months. The programs are associated with a college (generally a community college), so the student is eligible for a AAS in EMS at the end of the program should so they so choose. A&P? You're getting two full semesters of it.

    However, I don't care what country you're in, taking actions to restrict paramedicine to someone with ICU experience is a bit extreme. While I don't condone a 6-month EMT-P canned program, I don't see that getting a graduate-level education is paramount to treatment & diagnosis of what we encounter daily.
    Last edited by BoxAlarm187; 03-12-2011 at 07:58 PM.
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    Quote Originally Posted by BoxAlarm187 View Post
    Can you expand on your meaning of the above statement?
    What emt161 is getting at is that some blame the IAFF for keeping EMS educational standards low, the reason being that it would lower the supply of medics. In reality, we can blame most private, hospital based, and third service EMS employers of the same thing. How many of these employers require degrees to apply? How many even give preference to someone with a degree? Usually to get hired it's just a P-card or I-card, a pulse, a couple of alphabet cards, a good driving record, no felonies, and you're good. These non fire based EMS employers far outnumber the fire based services. I don't see them making any noticeable push for increasing EMS educational standards.

    Edit: Who either requires or gives weight towards promotional scores for having degrees? The fire service does. What's the easiest degree for a medic to get? The EMS AAS. It only takes a year if you have the P-card. Who sends their medic students to college (NVCC)? Fairfax County does. Just sayin'
    Last edited by edpmedic; 03-12-2011 at 09:43 PM.
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    In our area there aren't enough P's that a degree makes a big difference. In fact, most of the P's are working at several agencies, because there is the need.
    Opinions my own. Standard disclaimers apply.

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    Quote Originally Posted by edpmedic View Post
    I was under the impression that the core courses within the EMS AAS curriculum could only be taken if you're in the program, similar to the RN classes.
    Can't speak to that in general, nor what the exact degree discipline that is offered. I just know that this particular has long offered a stand-alone paramedic program that was very highly regarded in the industry. This program is integrated into the degree program such that you spend a year doing the paramedic program, then the next finishing the other requirements for the degree, however you are able to practice as a paramedic upon completion of that portion and the applicable certification hoops.

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    Quote Originally Posted by edpmedic View Post
    What emt161 is getting at is that some blame the IAFF for keeping EMS educational standards low, the reason being that it would lower the supply of medics.
    I assumed that what he was getting at, as I known he's had issues with the IAFF in the past. However, I've yet to hear any IAFF-based rhetoric about EMS education standards. Perhaps in collective bargaining states this has been brought up? I don't know, but I've personally never heard of the IAFF seeking to lower educational standards.

    Edit: Who either requires or gives weight towards promotional scores for having degrees? The fire service does. What's the easiest degree for a medic to get? The EMS AAS. It only takes a year if you have the P-card. Who sends their medic students to college (NVCC)? Fairfax County does. Just sayin'
    I can see where you're drawing a parallel, but as a line officer who has been intimately involved in training and education in a progressive department I can confidently say that I don't know ANY of our employees that have sought an EMS AAS degree for the purposes of promotion. Perhaps there's someone out there that has, but it would certainly be the exception, not the norm.

    The previous discussion about pay incentives is interesting. I work with some excellent medics that I would want treating my family if they were ever sick. However, some of them have clearly stated that if they lost their 15% pay incentive tomorrow, they'd give up their ALS certification. The blurred line between "doing it for the money" and "doing it because you want to" blurs a little more....
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    Quote Originally Posted by edpmedic View Post
    What emt161 is getting at is that some blame the IAFF for keeping EMS educational standards low, the reason being that it would lower the supply of medics. In reality, we can blame most private, hospital based, and third service EMS employers of the same thing. How many of these employers require degrees to apply? How many even give preference to someone with a degree? Usually to get hired it's just a P-card or I-card, a pulse, a couple of alphabet cards, a good driving record, no felonies, and you're good. These non fire based EMS employers far outnumber the fire based services. I don't see them making any noticeable push for increasing EMS educational standards.
    You probably won't and for many of the very reasons you favor it. Most of the EMS agencies in my area (and probably a lot more across the country) are pretty much hanging on by a thread to break even every year and keep operating. A lot of them pay pretty crappy for their medics, have fair to average benefits at best (EE only) and for the most part no retirement benefits or true career ladder.

    The theory that increased educational requirements will drive down the supply and drive up the wages isn't very a very attractive prospect for these employers. It's tough enough finding employees now plus economically they aren't in a position to support any significant wage increases a degree paramedic would theoretically command. So why would they push for something like this even if it could be "better" clinically?

    Until the overall funding issue for EMS is fixed or the non-degree paramedic is legislated into extinction, you likely won't see a significant movement towards degree paramedics outside the larger systems that are already at the forefront of EMS delivery now.

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    Quote Originally Posted by edpmedic View Post
    What emt161 is getting at is that some blame the IAFF for keeping EMS educational standards low, the reason being that it would lower the supply of medics.
    I said "groups," as in plural, and I meant it. The IAFF is only one leg of the IAFF/IAFC/NVFC triangle that have played a huge role in preventing EMS from progressing.

    However, I've yet to hear any IAFF-based rhetoric about EMS education standards.
    The Interational's role is a little more indirect, or was at least until the last National Convention. The usual agenda is to promote all-ALS systems, the theory being that if two paramedics on an ambulance at an EMS call are good, 4 more on a fire truck must be better. This leads to paramedic requirements for hire, which induces young people looking for work as firefighters to want a Paramedic card not for the love of pre-hospital care, but for the dream of riding a big red truck. If given the option, most of them will take the path of least resistance towards this goal, like 6 and 9-month patch factories whose owners are only too happy to supply the demand.

    At the 2010 Convention, a resolution was passed calling for the International to seek two seats on the board of CAAHEP, which is the body whose accreditation will be required for the program's graduates to test at the NREMT. The purpose of these members, per the Resolution, would be to ensure that fire departments who run their own in-house programs would be accredited. Hmm, instead of just encouraging these department to meet the CAAHEP requirements for the good of the program, its students, and their patients, we'll just take a slot on the board and vote to keep the status quo. Nice.

    The previous discussion about pay incentives is interesting. I work with some excellent medics that I would want treating my family if they were ever sick. However, some of them have clearly stated that if they lost their 15% pay incentive tomorrow, they'd give up their ALS certification. The blurred line between "doing it for the money" and "doing it because you want to" blurs a little more....
    Happened at a department near me, almost to the T. Department was shorthanded, and was (and still is) running half as many transport units as they needed. They began taking ALS-licensed guys off their fire companies for months-long details to the EMS side.

    What happened next? Dozens and dozens fewer ALS-licensed firefighters- they can't go to the EMS division as Basics.

    Next contract comes up, the stipend for an ALS license was increased significantly.

    What happened next? Dozens of formerly ALS-licensed firefighters recerting.

    Blurred? Damn near opaque.
    Last edited by emt161; 03-13-2011 at 05:53 PM.

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    Quote Originally Posted by FireMedic049 View Post
    You probably won't and for many of the very reasons you favor it. Most of the EMS agencies in my area (and probably a lot more across the country) are pretty much hanging on by a thread to break even every year and keep operating. A lot of them pay pretty crappy for their medics, have fair to average benefits at best (EE only) and for the most part no retirement benefits or true career ladder.

    The theory that increased educational requirements will drive down the supply and drive up the wages isn't very a very attractive prospect for these employers. It's tough enough finding employees now plus economically they aren't in a position to support any significant wage increases a degree paramedic would theoretically command. So why would they push for something like this even if it could be "better" clinically?

    Until the overall funding issue for EMS is fixed or the non-degree paramedic is legislated into extinction, you likely won't see a significant movement towards degree paramedics outside the larger systems that are already at the forefront of EMS delivery now.
    I agree. These agencies and companies thrive on the plentiful supply of medics. They hire new medics with little experience for the bare minimum (because they're happy just to get the work experience until they get a better job) work them to the bone, and then replace them with other new medics for the same low salary. It's even better if it's for a municipal employer. You get a lot of 1-3 year people who leave before they're vested for defined benefit. You can tell which places just want bodies to staff their rigs - they typically have just a one day orientation, maybe three ride alongs, and then you're thrown to the wolves. It costs them very little to hire and train, as opposed to companies and depts that run academies, or at least have FTO programs that may last months.
    "The democracy will cease to exist when you take away from those willing to work and give to those who are not." Thomas Jefferson

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    Quote Originally Posted by emt161 View Post
    I said "groups," as in plural, and I meant it. The IAFF is only one leg of the IAFF/IAFC/NVFC triangle that have played a huge role in preventing EMS from progressing.



    The Interational's role is a little more indirect, or was at least until the last National Convention. The usual agenda is to promote all-ALS systems, the theory being that if two paramedics on an ambulance at an EMS call are good, 4 more on a fire truck must be better. This leads to paramedic requirements for hire, which induces young people looking for work as firefighters to want a Paramedic card not for the love of pre-hospital care, but for the dream of riding a big red truck. If given the option, most of them will take the path of least resistance towards this goal, like 6 and 9-month patch factories whose owners are only too happy to supply the demand.

    At the 2010 Convention, a resolution was passed calling for the International to seek two seats on the board of CAAHEP, which is the body whose accreditation will be required for the program's graduates to test at the NREMT. The purpose of these members, per the Resolution, would be to ensure that fire departments who run their own in-house programs would be accredited. Hmm, instead of just encouraging these department to meet the CAAHEP requirements for the good of the program, its students, and their patients, we'll just take a slot on the board and vote to keep the status quo. Nice.



    Happened at a department near me, almost to the T. Department was shorthanded, and was (and still is) running half as many transport units as they needed. They began taking ALS-licensed guys off their fire companies for months-long details to the EMS side.

    What happened next? Dozens and dozens fewer ALS-licensed firefighters- they can't go to the EMS division as Basics.

    Next contract comes up, the stipend for an ALS license was increased significantly.

    What happened next? Dozens of formerly ALS-licensed firefighters recerting.

    Blurred? Damn near opaque.
    Okay, I'll change "IAFF" to "Fire Service" in general.

    See my above reply to FM049. The numerous private companies, hospital based EMS depts, and municipal/PUM EMS agencies have a vested interest in keeping the supply of medics high to keep payroll down. They also benefit from the 6-9 month patch factories. I've interviewed for one FD, two municipal third service agencies, four hospital based systems, and four privates throughout my career. I've spoken to others that have also applied to different types of EMS delivery systems. None of these places cared if you had an EMS degree or just a card. Go on to any paremedic job posting, fire based or not. They only ask that you have a GED, a valid cert, no felonies, a decent driving record, your alphabet cards, or the ability to get them, and to between 18-21 y/o depending.

    You can say that it's the fire service's fault directly or inderectly for keeping EMS educational standards down, but the non fire based employers have the power to change that. For the most part, they choose not to. Key word "choose." They could collectively choose to only hire medics with EMS degrees, give hiring preference to them, or at least compensate at a significantly higher rate than cert only medics. But they don't. That's for the same reasons that you say the FD seeks to keep the standards down - cheap, replaceable, abundant labor. Let's not single out the fire service when there are other major players in EMS employment that have just as much of a part in the big picture of EMS educational standards. If these non fire based employers required degrees for employment, or at least compensated significantly higher for one, you would see the medic mills go out of business, and more colege EMS programs open up.

    I don't blame the IAFF for seeking out seats on the board of the CAAHEP. The fire service is a large enough employer of EMS professionals, so they ought to seek positions of influence, rather than have others make their decisions for them. They don't run the board, but their opinions can be voiced.

    I don't see the point of having an all ALS FD, either. That seems to be a FL thing, though. I haven't seen that from the NE down to SC as far as I know.

    Speaking from experience, I can't say I blame medics for dropping their cert if they're made to ride the box all the time. I know FF's that have no interest in EMS, I also know many who enjoy the EMS side. That's was the half the appeal for me applying to a FD with ALS txp. The other half was the salary and benefits. The typical burnout in EMS is 5-7 years, or maybe 7-10 depending on who you talk to. I don't know many 25-30 year street medics or EMT's. With a FD, you can move from a suppression assignment on one day, and ride the box the next. It keeps you fresh, and it definitely keeps me interested in EMS. I don't blame those for dropping their certs in the example you gave because they're probably running a high call call volume, missing drills, PT, meals, sleep, etc. They may also enjoy fire suppression, and are being deprived of that. They don't get that break from the EMS volume and time consumption. It's nice to get back to dinner or PT 20 minutes after a call in many cases, instead of an hour to two hours each run, if you don't get hit for another while going back to the station. If they did EMS only, they would also be subject to that 5-10 year burnout range.

    Edit: Opaque: Hell yeah! I left a decent paying, urban hospital based EMS system to go fire based. My family and I would never have been able to own a home, have a secure retirement, and have a sustainable career if I didn't make the move to the fire service. Why would these FF/medics stay on the box 100% of the time and be out of the station all day and night running skells? How long do you want to do that before you burn out? If you pay well enough, the call volume, along with the drama in EMS becomes worth it. Where I work, I'm getting at least $25k more than a basic FF to also be a medic. I think I can do this 30+ years w/o a problem. I've been in EMS for nine years - 6 outside of the FD, and three in the fire service. I sure as hell wouldn't be in EMS FT any more had I stayed. I'd be an RN/BSN, and maybe be a per diem medic for that hospital (too old for FDNY).
    Last edited by edpmedic; 03-14-2011 at 02:51 PM.
    "The democracy will cease to exist when you take away from those willing to work and give to those who are not." Thomas Jefferson

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