Why it matters...
Original Post Date:March 24, 2008

Every profession, every career, every passing of time reaches a point in time, probably more than one when it must grow, retreat or die. Baseball did it after the strikes. Great Britian did it each time another piece of the empire dropped out do to it's own thing. The Beatles backed up to punt when that other drummer quit, and that worked out alright. Bottom line, anything worth doing in history had to eventually be done differently, and EMS is no exception.

If someone wasn't willing, nay...inspired to change, we'd still be hauling ass (quite literally) to the hospital in a hearse. But we aren't because we did evelove, proving if nothing else that we knew how if not when. It is my humble opinion that the when is now.

The science of EMS threatens to leave the practitioners behind, giving us an untidy "cart before the horse" appearance that doesn't inspire confidence in anyone. A big part of why other professionals treat us like we cannot understand complicated subjects like physiology is that we often act like we don't care. Instead, we pound our chests and cite all the thing we can do, all the skills we have have that other, more highly paid professionals do not, and say that if they aren't going to pay us then we aren't going to listen. It's the spite nosejob of all time.

This attitude has to go.

A handful of articulate and educated among us speaks for us, or at least they try to. They say "We need this drug to treat our patients...they will likely die without it" Then, the doctor says "You paramedics still give breathing treatments to patients in heart failure, so how will you figure the new stuff out?" Do you know what our advocates say? Nothing. Cant'. The doctor has them dead to rights and they know it. We still do things like that because we don't understand physiology and that's because we don't think it's important to us. Maybe in it's infancy, EMS was best managed on cause & effect relationships, but not anymore.

Science and medicine have advanced to a point where the best interventions are powerful and specific, requiring the clinician to pinpoint the exact pathology because the wrong treatment would be harmful. Our father's EMS, a science of horseshoes and handgrenades is gone. Driving fast and hoping you get it right is not enough anymore.

Anyone who doesn't believe that should start looking for a used hearse. Maybe two.