Guest guest Posted July 4, 2004 Report Share Posted July 4, 2004 In previous writings I have recognized the dichotomy between the needs of big city fire departments and other situations. If you'll recall, I predicted that the big cities will determine that they do not need many paramedics who can practice advanced care; in fact, big city medics in places like Dallas and San seldom do many of the interventions that non-advanced paramedics are able to do, such as hanging drips and so forth. Even though some services have 12-lead monitors in place, my contacts and inquiries have done little to convince me that many of the medics have a clue about how to interpret a 12-lead, and they rely either on telemetry or simply do not attempt to interpret them. If they can deliver a chest pain patient to a hospital with a cathlab within 30 minutes, then the question is probably moot anyway. So, there is a definite difference in need among services. My complaints are not related to those obvious differences. My complaints are related to the requirements to do advanced practice. My contention is that we do not need to make a jump to rigid education requirements without giving adequate time for people to prepare for those careers, and for a realistic career ladder for advanced paramedics to be established. Let's face it. There is no such thing right now. I think that, as Dr. Bledsoe mentioned with regard to board certifications for ED physicians, there needs to be a period of transition wherein those who are currently practicing can qualify based upon experience and performance rather than possession of a specified degree. I'm willing to be challenged on performance and knowledge at any time, and if I couldn't pass the boards, I would willingly stop until I could. So perhaps there ought to be a board exam for advanced medics that can be challenged, at least for an adequate period of years for the industry to prepare a career ladder and establish a realistic set of expectations for medics who want to stay in Paramedicine as advanced medics. Eventually, I think there should be advanced education requirements, but I'm not at all sure that degrees in EMS are the answer, simply because those degrees have a very narrow application. Why not a degree in science with emphasis on preparation for medical practice that would allow one to then choose EMS, nursing, or another related type of medical practice? Any thoughts about that? GG In a message dated 7/4/2004 7:10:51 PM Central Daylight Time, bbledsoe@... writes: Gene and other have made good points and I stand somewhere in between at this juncture. But, the elephant in the room is the push by the big city fire departments who run EMS to downgrade the paramedic education to " just what we need to know for common things " . The educational demands of the fire service and the increasing demands of EMS make it difficult for firefighter paramedics to stay current in both. Since fire is the primary mission the request is to cut down EMS education. This causes a dichotomy in a system (such as ATC and others) where they want the better trained paramedics who function at a higher level. Is it fair to call a Dallas, Houston or San Fire Recue paramedic the same as a paramedic with an AAS or BS in EMS? Should we have fire paramedics or a level below the current EMT-P/LP that is called (like Canada) a Primary Care Paramedic with the current EMT-P/LP level be called an Advanced Care Paramedic (like Canada). Then, this new animal, currently called Advanced Care Paramedic in the Scope of Practice document can be called something else. E. Bledsoe, DO, FACEP Midlothian, TX Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 4, 2004 Report Share Posted July 4, 2004 In previous writings I have recognized the dichotomy between the needs of big city fire departments and other situations. If you'll recall, I predicted that the big cities will determine that they do not need many paramedics who can practice advanced care; in fact, big city medics in places like Dallas and San seldom do many of the interventions that non-advanced paramedics are able to do, such as hanging drips and so forth. Even though some services have 12-lead monitors in place, my contacts and inquiries have done little to convince me that many of the medics have a clue about how to interpret a 12-lead, and they rely either on telemetry or simply do not attempt to interpret them. If they can deliver a chest pain patient to a hospital with a cathlab within 30 minutes, then the question is probably moot anyway. So, there is a definite difference in need among services. My complaints are not related to those obvious differences. My complaints are related to the requirements to do advanced practice. My contention is that we do not need to make a jump to rigid education requirements without giving adequate time for people to prepare for those careers, and for a realistic career ladder for advanced paramedics to be established. Let's face it. There is no such thing right now. I think that, as Dr. Bledsoe mentioned with regard to board certifications for ED physicians, there needs to be a period of transition wherein those who are currently practicing can qualify based upon experience and performance rather than possession of a specified degree. I'm willing to be challenged on performance and knowledge at any time, and if I couldn't pass the boards, I would willingly stop until I could. So perhaps there ought to be a board exam for advanced medics that can be challenged, at least for an adequate period of years for the industry to prepare a career ladder and establish a realistic set of expectations for medics who want to stay in Paramedicine as advanced medics. Eventually, I think there should be advanced education requirements, but I'm not at all sure that degrees in EMS are the answer, simply because those degrees have a very narrow application. Why not a degree in science with emphasis on preparation for medical practice that would allow one to then choose EMS, nursing, or another related type of medical practice? Any thoughts about that? GG In a message dated 7/4/2004 7:10:51 PM Central Daylight Time, bbledsoe@... writes: Gene and other have made good points and I stand somewhere in between at this juncture. But, the elephant in the room is the push by the big city fire departments who run EMS to downgrade the paramedic education to " just what we need to know for common things " . The educational demands of the fire service and the increasing demands of EMS make it difficult for firefighter paramedics to stay current in both. Since fire is the primary mission the request is to cut down EMS education. This causes a dichotomy in a system (such as ATC and others) where they want the better trained paramedics who function at a higher level. Is it fair to call a Dallas, Houston or San Fire Recue paramedic the same as a paramedic with an AAS or BS in EMS? Should we have fire paramedics or a level below the current EMT-P/LP that is called (like Canada) a Primary Care Paramedic with the current EMT-P/LP level be called an Advanced Care Paramedic (like Canada). Then, this new animal, currently called Advanced Care Paramedic in the Scope of Practice document can be called something else. E. Bledsoe, DO, FACEP Midlothian, TX Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 5, 2004 Report Share Posted July 5, 2004 AMEN BRYAN! In a message dated 7/5/04 9:31:57 AM Central Daylight Time, bwiseman@... writes: > Increasing Education requirments is NOT going to lead to more pay. The > majority of the people on this board just told me they would rather have > EMT's on their ambulances then another Paramedic...HELLO!!!! That will drive > your salaries even farther into the poor house. Expectations need to be > raised by the citizens, EMS needs to be a required Public Safety agency, not > just an option. Educate your public, the ones the pay your salaries. They > are willing to give you what you need, they just don't know what you need. > > Education is always great, but don't assume just because you have another > piece of paper on your wall that your agency is going to pay you more, > especially when as a group most of us are willing to do more with less, > willing to be second class Public Safety agencies and willing to let > employers staff ambulance with emt's just to save a few bucks!!! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 5, 2004 Report Share Posted July 5, 2004 AMEN BRYAN! In a message dated 7/5/04 9:31:57 AM Central Daylight Time, bwiseman@... writes: > Increasing Education requirments is NOT going to lead to more pay. The > majority of the people on this board just told me they would rather have > EMT's on their ambulances then another Paramedic...HELLO!!!! That will drive > your salaries even farther into the poor house. Expectations need to be > raised by the citizens, EMS needs to be a required Public Safety agency, not > just an option. Educate your public, the ones the pay your salaries. They > are willing to give you what you need, they just don't know what you need. > > Education is always great, but don't assume just because you have another > piece of paper on your wall that your agency is going to pay you more, > especially when as a group most of us are willing to do more with less, > willing to be second class Public Safety agencies and willing to let > employers staff ambulance with emt's just to save a few bucks!!! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 5, 2004 Report Share Posted July 5, 2004 i am coming in the middle of this conversation. my son will be taking his paramedic classes in jan 05 and will end up with a 2yr Degree in Paramedicine by end 06. should he be doing something else or something extra? thanks for all y'all do. mom Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 5, 2004 Report Share Posted July 5, 2004 If you want money and desire to work in a hospital go R.N. Re: Provider Levels In previous writings I have recognized the dichotomy between the needs of big city fire departments and other situations. If you'll recall, I predicted that the big cities will determine that they do not need many paramedics who can practice advanced care; in fact, big city medics in places like Dallas and San seldom do many of the interventions that non-advanced paramedics are able to do, such as hanging drips and so forth. Even though some services have 12-lead monitors in place, my contacts and inquiries have done little to convince me that many of the medics have a clue about how to interpret a 12-lead, and they rely either on telemetry or simply do not attempt to interpret them. If they can deliver a chest pain patient to a hospital with a cathlab within 30 minutes, then the question is probably moot anyway. So, there is a definite difference in need among services. My complaints are not related to those obvious differences. My complaints are related to the requirements to do advanced practice. My contention is that we do not need to make a jump to rigid education requirements without giving adequate time for people to prepare for those careers, and for a realistic career ladder for advanced paramedics to be established. Let's face it. There is no such thing right now. I think that, as Dr. Bledsoe mentioned with regard to board certifications for ED physicians, there needs to be a period of transition wherein those who are currently practicing can qualify based upon experience and performance rather than possession of a specified degree. I'm willing to be challenged on performance and knowledge at any time, and if I couldn't pass the boards, I would willingly stop until I could. So perhaps there ought to be a board exam for advanced medics that can be challenged, at least for an adequate period of years for the industry to prepare a career ladder and establish a realistic set of expectations for medics who want to stay in Paramedicine as advanced medics. Eventually, I think there should be advanced education requirements, but I'm not at all sure that degrees in EMS are the answer, simply because those degrees have a very narrow application. Why not a degree in science with emphasis on preparation for medical practice that would allow one to then choose EMS, nursing, or another related type of medical practice? Any thoughts about that? GG In a message dated 7/4/2004 7:10:51 PM Central Daylight Time, bbledsoe@... writes: Gene and other have made good points and I stand somewhere in between at this juncture. But, the elephant in the room is the push by the big city fire departments who run EMS to downgrade the paramedic education to " just what we need to know for common things " . The educational demands of the fire service and the increasing demands of EMS make it difficult for firefighter paramedics to stay current in both. Since fire is the primary mission the request is to cut down EMS education. This causes a dichotomy in a system (such as ATC and others) where they want the better trained paramedics who function at a higher level. Is it fair to call a Dallas, Houston or San Fire Recue paramedic the same as a paramedic with an AAS or BS in EMS? Should we have fire paramedics or a level below the current EMT-P/LP that is called (like Canada) a Primary Care Paramedic with the current EMT-P/LP level be called an Advanced Care Paramedic (like Canada). Then, this new animal, currently called Advanced Care Paramedic in the Scope of Practice document can be called something else. E. Bledsoe, DO, FACEP Midlothian, TX Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 5, 2004 Report Share Posted July 5, 2004 If you want money and desire to work in a hospital go R.N. Re: Provider Levels In previous writings I have recognized the dichotomy between the needs of big city fire departments and other situations. If you'll recall, I predicted that the big cities will determine that they do not need many paramedics who can practice advanced care; in fact, big city medics in places like Dallas and San seldom do many of the interventions that non-advanced paramedics are able to do, such as hanging drips and so forth. Even though some services have 12-lead monitors in place, my contacts and inquiries have done little to convince me that many of the medics have a clue about how to interpret a 12-lead, and they rely either on telemetry or simply do not attempt to interpret them. If they can deliver a chest pain patient to a hospital with a cathlab within 30 minutes, then the question is probably moot anyway. So, there is a definite difference in need among services. My complaints are not related to those obvious differences. My complaints are related to the requirements to do advanced practice. My contention is that we do not need to make a jump to rigid education requirements without giving adequate time for people to prepare for those careers, and for a realistic career ladder for advanced paramedics to be established. Let's face it. There is no such thing right now. I think that, as Dr. Bledsoe mentioned with regard to board certifications for ED physicians, there needs to be a period of transition wherein those who are currently practicing can qualify based upon experience and performance rather than possession of a specified degree. I'm willing to be challenged on performance and knowledge at any time, and if I couldn't pass the boards, I would willingly stop until I could. So perhaps there ought to be a board exam for advanced medics that can be challenged, at least for an adequate period of years for the industry to prepare a career ladder and establish a realistic set of expectations for medics who want to stay in Paramedicine as advanced medics. Eventually, I think there should be advanced education requirements, but I'm not at all sure that degrees in EMS are the answer, simply because those degrees have a very narrow application. Why not a degree in science with emphasis on preparation for medical practice that would allow one to then choose EMS, nursing, or another related type of medical practice? Any thoughts about that? GG In a message dated 7/4/2004 7:10:51 PM Central Daylight Time, bbledsoe@... writes: Gene and other have made good points and I stand somewhere in between at this juncture. But, the elephant in the room is the push by the big city fire departments who run EMS to downgrade the paramedic education to " just what we need to know for common things " . The educational demands of the fire service and the increasing demands of EMS make it difficult for firefighter paramedics to stay current in both. Since fire is the primary mission the request is to cut down EMS education. This causes a dichotomy in a system (such as ATC and others) where they want the better trained paramedics who function at a higher level. Is it fair to call a Dallas, Houston or San Fire Recue paramedic the same as a paramedic with an AAS or BS in EMS? Should we have fire paramedics or a level below the current EMT-P/LP that is called (like Canada) a Primary Care Paramedic with the current EMT-P/LP level be called an Advanced Care Paramedic (like Canada). Then, this new animal, currently called Advanced Care Paramedic in the Scope of Practice document can be called something else. E. Bledsoe, DO, FACEP Midlothian, TX Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2004 Report Share Posted July 6, 2004 Hello Everyone, I'm making an attempt to read all of your comments to get an understanding of what your positions are concerning Provider Levels. I recognize many of you from previous comments however it would help me if you all would identify the type of system you are employeed, rural, urban, fire base, private etc. I would like to have and idea of who is/isnot being represented. Let me also say that personal attacks are not necessary, we have an open forum and will not rush to make any changes concerning this issue. Your input is very important to me and I appreciate you all voicing your opinions. I would invite all of you to attend the committee meetings and GETAC to make your position known. However, if you can't make it to Austin e-mails are welcomed, I actually attempt to read your comments on the list server. I don't usually comment but I don't listen. For those of you who don't know me, I am Maxie Bishop, GETAC Education Committee Chair. I am a paramedic with Dallas Fire Rescue. Together we will build a strong EMS system in Texas, but we must work together and make sure everyone is represented. Thanks again for your comments, Maxie Quote Link to comment Share on other sites More sharing options...
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