Last Month, the Canadian Government took the first step towards what they refer to as an increase in Labor Mobility: they are going to be standardizing the certification, assessment and recertification of Paramedics on a national level.According to the Canadian Government this is being done to make it easier for Paramedics to move throughout the country, and work acrossProvidencelines.Canadaestimates that more than 200,000 of its citizens relocate to a differentProvidenceeach year.These actions will make it easier for Paramedics to move around, and seamlessly transition from job to job.
You can read the whole article here:
http://news.gc.ca/web/article-eng.do?nid=511429
What was probably looked at by the Canadian population as a small step towards improving the country’s economy, it should be looked at by theEMScommunity as a big move towards unification of our industry.
The EMS Leaders and Lawmakers in our country should take a good hard look at what is taking place north of the boarder and take notes.Our community has numbers, in the Public market, the Private market and still in parts of the country in the Volunteer market and uniting those people could be what propelsEMSas a whole to the next level.
The things I need to practice medicine in my urban setting might not exactly fit what is needed by a rural Paramedic in the far reaches ofMontana, potentially an hour or more from the care that is needed.So how should a unified National EMS Front work?Well, from a regulatory standpoint, this is how I see it:
The National EMS System would be broken up into four levels, National, Regional, State, and System.Providers would be governed by the National, Regional and System levels, and services would be monitored and dictated by the National, Regional, and State levels.
1.Certification, recertification, and core training should be standardized on a national level.The didactic, field and clinical portions of EMT and Paramedic training should be the same inArizonaas it is inMaine.This would, in theory, give every provider the same base education.
2.System qualifications should be determined by the system’s Medical Director.You are, after all, working under their license.They can determine required training needed above and beyond the CEU requirements setup nationally.
3.Protocols should have a set core at the National level, but Regional Medical Directors would figure in add-on protocols to meet the requirements of their unique environment.
4.A series of Optional Skills should be developed.Medical Directors can pick from these skills in an ala carte fashion to tailor their providers to the needs of their particular system.Examples would be I/O, Needle Decompression or CPAP at the Paramedic Level, and IVs, Intubations and assisting with Meds at a BLS level.Like I said, these are only examples.We could come up with hundreds of examples to fit into these categories.
This all seems REALLY logical to me, but I think we can all relate to how much fun bureaucratic red tape can be.So what does everyone else think?Would a National EMS Model work in theUnited States?And more importantly, can we put our differences aside long enough to make it possible?I was reading some posts on the National EMS Management Association ListServ on a completely unrelated topic and someone posted this:
“. . .we can’t even agree that someone else’s model for providing service in another jurisdiction no where near ours is appropriate or acceptable compared to our own, or what is a paramedic or what skills can an EMT vs. Paramedic can do…we have a long way to come as an industry. . .”
Now, remember, like I said, that quote was plucked from a discussion about a completely unrelated topic, but I really think it gets right to the heart of the problem, and defines our first step.Before we can accomplish anything, we need to put aside our petty differences, and keep an open mind, so we can decide what is right for the providers as well as our patients.
EMSis still a very young field, and it’s not going anywhere.People are always going to be getting sick and accidents are going to happen.They’re going to pick up the phone and call9-1-1looking for help, and we are going to be there.It’s up to all of us to be leaders and to steer it in the right direction.
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Congratulations to Sebastian Wong and the entire San Francisco Fire Department.For the first time their more than 25 years, the Ambulance Service responding to emergencies in the City of San Francisco met their response time criteria in every single district in the City.
I don’t want to steal Sebastian’s thunder, so you can read more about his Department’s accomplishments at his blog located here:
http://sebandhismusings.blogspot.com/2010/02/ive-waited-28-years-for-this.html
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Finally, I want to thank many of the people out there in theEMSblogging community who have added me to their Twitter, helped me promote my blog, and sent me words of encouragement.Much like my time on the ambulance, there is no way I can do this all by myself.
If you want to read some other great blogs, check out some of these links (listed in no particular order):
http://sebandhismusings.blogspot.com
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That’s going to do it for this week.As always, feel free to comment below, and follow me on Twitter at www.twitter.com/medicsbk.I’m still learning the ins and outs of the Twitter Universe, but I’m sure the training wheels will be off soon enough.
So for me, it’s back to the drawing board, as I decide which topic to tackle next week.In the meantime, watch out for each other out there, and be safe!