RE: Re: Returning to my soapbox

[Guest guest]

My perspective:

The 1,300 or so people on this list are here because they have a passion for

EMS (or they are in management and want to read what their employees are

saying. The three largest EMS providers in Texas are the Houston, Dallas and

San Fire Departments. How many people from these organizations are

on this list? Few, if any! EMS is the step child in the fire department and

the culture ostracizes anybody who embraces EMS. Now, there are FD EMS

operations that do a great job (primarily the suburbs) and have a culture

that supports EMS. However, for the most part FDs see EMS as a necessary

evil. Interestingly, here in Australia the Fire Rescue people and ambulance

rarely interact. The FD, for the most part, does not first respond. In most

states, ambulance people are paid better or the same as fire. The ambulance

crewes here interact more and are friendlier with the police. I had dinner

with several paramedics and they are making between AUD 55,000 and AUD

100,000 a year (USD 47,000 to USD 85,000). All have been on the job for

10-20 years. All services are unionized and the union is a powerful force.

People join EMS here as a career. I met a dispatcher last week in Queensland

who has spent 34 years at the same station.

EMS in the US, and Texas especially, will never grow until we have an EMS

culture that is like the culture of the fire service or even the police. As

long as EMS remains the stepchild of other disciplines (including medicine),

it is doomed to failure. It would be good for Texas EMS providers to do what

is common here in commonwealth countries. Do an exchange visit with Canada,

Australia, South Africa or England. The only problem is that US EMTs and

paramedics do not have the educational background (and in some cases

experience) to pass the necessary qualification tests to do this. Almost all

ambulance personnel in the countries listed have AAS degrees (or the similar

Diploma in Ambulance Studies) and many have BS and Masters degrees. The few

times US EMTs and paramedics have applied they failed the necessary

qualification exams and had to repeat initial training. Again, our culture

in the US is to go to an 80 hour EMT school, get no significant experience,

and then go to a 700 hour paramedic school and a 20 hour CCT school and then

expect parity with the world and nursing. What a provincial belief. Here,

people often wait 10 years for an opportunity to go to paramedic school.

They only educate for what they need. The unions keep from flooding the

market with paramedics (only 1-2 EMS schools in the country admit students

to EMS education who are not affiliated with the ambulance service [i.e.,

Park Rangers, Surf Lifesavers]). Also, most paramedic programs are arduous

with long periods of field education.

I am off to do a site visit for the Monash University College of Ambulance

Profession Studies (MUCAPS) as they are expanding their BS program and

offering graduate degrees in ambulance studies. Ambulance studies at Monash

have full parity with medicine and nursing. In the US, most of our EMS

programs are delegated to vocational schools or community colleges. They do

a good job-but the academic resources available in a medical school and a

community college are quite different.

Basically, what I have done here is repeat Bob Kellow's email from another

perspective.

Just my thoughts-your mileage may vary.

BEB

[Guest guest]

EMS in the US, and Texas especially, will never grow until we have an

EMS

culture that is like the culture of the fire service or even the police.

As

long as EMS remains the stepchild of other disciplines (including

medicine),

it is doomed to failure.

Both the fire and police service with very few exceptions are

governmental services. I'm not trying to bring the public vs. private

debate back, but how do we create a culture like the fire or police

service in an industry that is a mix of governmental and for profit

services?

Another issue is funding. Both the fire and police services are mostly

dependent on direct public funding. EMS is dependent on funding from

different sources. Does this impede the creation of a similar culture

to the other two services?

In my opinion the Canadian and the Australian systems have a unique

culture because of their funding mechanism. Take out the concerns for

billing and tort issues and I think that you would have a much different

system here in the US.

Just my opinion.

AJL

________________________________

From: [mailto: ] On

Behalf Of Bledsoe

Sent: Sunday, October 09, 2005 5:03 PM

To:

Subject: RE: Re: Returning to my soapbox

My perspective:

The 1,300 or so people on this list are here because they have a passion

for

EMS (or they are in management and want to read what their employees are

saying. The three largest EMS providers in Texas are the Houston, Dallas

and

San Fire Departments. How many people from these organizations

are

on this list? Few, if any! EMS is the step child in the fire department

and

the culture ostracizes anybody who embraces EMS. Now, there are FD EMS

operations that do a great job (primarily the suburbs) and have a

culture

that supports EMS. However, for the most part FDs see EMS as a necessary

evil. Interestingly, here in Australia the Fire Rescue people and

ambulance

rarely interact. The FD, for the most part, does not first respond. In

most

states, ambulance people are paid better or the same as fire. The

ambulance

crewes here interact more and are friendlier with the police. I had

dinner

with several paramedics and they are making between AUD 55,000 and AUD

100,000 a year (USD 47,000 to USD 85,000). All have been on the job for

10-20 years. All services are unionized and the union is a powerful

force.

People join EMS here as a career. I met a dispatcher last week in

Queensland

who has spent 34 years at the same station.

EMS in the US, and Texas especially, will never grow until we have an

EMS

culture that is like the culture of the fire service or even the police.

As

long as EMS remains the stepchild of other disciplines (including

medicine),

it is doomed to failure. It would be good for Texas EMS providers to do

what

is common here in commonwealth countries. Do an exchange visit with

Canada,

Australia, South Africa or England. The only problem is that US EMTs and

paramedics do not have the educational background (and in some cases

experience) to pass the necessary qualification tests to do this. Almost

all

ambulance personnel in the countries listed have AAS degrees (or the

similar

Diploma in Ambulance Studies) and many have BS and Masters degrees. The

few

times US EMTs and paramedics have applied they failed the necessary

qualification exams and had to repeat initial training. Again, our

culture

in the US is to go to an 80 hour EMT school, get no significant

experience,

and then go to a 700 hour paramedic school and a 20 hour CCT school and

then

expect parity with the world and nursing. What a provincial belief.

Here,

people often wait 10 years for an opportunity to go to paramedic school.

They only educate for what they need. The unions keep from flooding the

market with paramedics (only 1-2 EMS schools in the country admit

students

to EMS education who are not affiliated with the ambulance service

[i.e.,

Park Rangers, Surf Lifesavers]). Also, most paramedic programs are

arduous

with long periods of field education.

I am off to do a site visit for the Monash University College of

Ambulance

Profession Studies (MUCAPS) as they are expanding their BS program and

offering graduate degrees in ambulance studies. Ambulance studies at

Monash

have full parity with medicine and nursing. In the US, most of our EMS

programs are delegated to vocational schools or community colleges. They

do

a good job-but the academic resources available in a medical school and

a

community college are quite different.

Basically, what I have done here is repeat Bob Kellow's email from

another

perspective.

Just my thoughts-your mileage may vary.

BEB

[Guest guest]

EMS in the US, and Texas especially, will never grow until we have an

EMS

culture that is like the culture of the fire service or even the police.

As

long as EMS remains the stepchild of other disciplines (including

medicine),

it is doomed to failure.

Both the fire and police service with very few exceptions are

governmental services. I'm not trying to bring the public vs. private

debate back, but how do we create a culture like the fire or police

service in an industry that is a mix of governmental and for profit

services?

Another issue is funding. Both the fire and police services are mostly

dependent on direct public funding. EMS is dependent on funding from

different sources. Does this impede the creation of a similar culture

to the other two services?

In my opinion the Canadian and the Australian systems have a unique

culture because of their funding mechanism. Take out the concerns for

billing and tort issues and I think that you would have a much different

system here in the US.

Just my opinion.

AJL

________________________________

From: [mailto: ] On

Behalf Of Bledsoe

Sent: Sunday, October 09, 2005 5:03 PM

To:

Subject: RE: Re: Returning to my soapbox

My perspective:

The 1,300 or so people on this list are here because they have a passion

for

EMS (or they are in management and want to read what their employees are

saying. The three largest EMS providers in Texas are the Houston, Dallas

and

San Fire Departments. How many people from these organizations

are

on this list? Few, if any! EMS is the step child in the fire department

and

the culture ostracizes anybody who embraces EMS. Now, there are FD EMS

operations that do a great job (primarily the suburbs) and have a

culture

that supports EMS. However, for the most part FDs see EMS as a necessary

evil. Interestingly, here in Australia the Fire Rescue people and

ambulance

rarely interact. The FD, for the most part, does not first respond. In

most

states, ambulance people are paid better or the same as fire. The

ambulance

crewes here interact more and are friendlier with the police. I had

dinner

with several paramedics and they are making between AUD 55,000 and AUD

100,000 a year (USD 47,000 to USD 85,000). All have been on the job for

10-20 years. All services are unionized and the union is a powerful

force.

People join EMS here as a career. I met a dispatcher last week in

Queensland

who has spent 34 years at the same station.

EMS in the US, and Texas especially, will never grow until we have an

EMS

culture that is like the culture of the fire service or even the police.

As

long as EMS remains the stepchild of other disciplines (including

medicine),

it is doomed to failure. It would be good for Texas EMS providers to do

what

is common here in commonwealth countries. Do an exchange visit with

Canada,

Australia, South Africa or England. The only problem is that US EMTs and

paramedics do not have the educational background (and in some cases

experience) to pass the necessary qualification tests to do this. Almost

all

ambulance personnel in the countries listed have AAS degrees (or the

similar

Diploma in Ambulance Studies) and many have BS and Masters degrees. The

few

times US EMTs and paramedics have applied they failed the necessary

qualification exams and had to repeat initial training. Again, our

culture

in the US is to go to an 80 hour EMT school, get no significant

experience,

and then go to a 700 hour paramedic school and a 20 hour CCT school and

then

expect parity with the world and nursing. What a provincial belief.

Here,

people often wait 10 years for an opportunity to go to paramedic school.

They only educate for what they need. The unions keep from flooding the

market with paramedics (only 1-2 EMS schools in the country admit

students

to EMS education who are not affiliated with the ambulance service

[i.e.,

Park Rangers, Surf Lifesavers]). Also, most paramedic programs are

arduous

with long periods of field education.

I am off to do a site visit for the Monash University College of

Ambulance

Profession Studies (MUCAPS) as they are expanding their BS program and

offering graduate degrees in ambulance studies. Ambulance studies at

Monash

have full parity with medicine and nursing. In the US, most of our EMS

programs are delegated to vocational schools or community colleges. They

do

a good job-but the academic resources available in a medical school and

a

community college are quite different.

Basically, what I have done here is repeat Bob Kellow's email from

another

perspective.

Just my thoughts-your mileage may vary.

BEB