Four Words: EMS, Apathy, Disgrace, Massachusetts.

By now you’ve all heard of the flap that is happening in Mass. regarding the 200 or so EMTs and Paramedics that had their licenses suspended or revoked for running a non-existent training program or for falsely representing that they attended non-existent training classes. If you haven’t heard about it by now, you’re probably not following EMS news as much as you should.

Here is one of the articles on the subject from JEMS.com

The issue has been discussed quite a bit around the EMS blogosphere. Some big name bloggers have written on it, and I even discussed it a little bit on the EMS Educast the other day.

Here’s TOTWTYTR’s take on this: I’m Not Very Sympathetic

And here’s Rogue Medic’s take on it: (this is a part-2 that reiterates the first)

Here’s the episode of the EMS Educast where we discussed the issue briefly

Other than for speaking about the issue briefly, I’ve been avoiding writing on it. My job is usually to report positive things that are happening in the EMS world and this is definitely not a positive thing. In fact, it’s a disgrace to us all. Rogue Medic has it right when he asks the question “Why do we Encourage such apathy in EMS?”

And that’s what this is. It’s not just that it’s apathy for the boring destruction of brain cells that we call “Continuing Education” in most areas of EMS, it’s the apathy for the whole process. The apathy where we as a profession have let the standards get to this point.

I mean, really. How many of you feel that the continuing education you receive is anything more than something you have to do in order to keep your license up? How many of you feel that your regularly scheduled, mandatory, continuing education classes are of any quality? How many of you feel like they’re actually doing anything good for you?

And that’s the system in which we function. TOTWTYTR made the statement that he sits through boring traning classes all the time because those are the hoops he has to jump through in order to maintain his licensure. I do too, of course. I sit through probably as many or even more classes than anyone reading this article because I am a practicing paramedic with National Registry and licensure in three states. Sometimes the training from one state carries over into the next, and sometimes it doesn’t. At any rate, I get to listen to unmotivated speakers read flat material whilst sitting in an uncomfortable chair on a very regular basis. We all do.

However, I feel that I keep up my continuing education quite well on my own through other means such as extensive self study and non-credit medical education. Keeping my professional skills sharp is very important for me because not only am I proud of my professional skills, but I am well aware of the fact that the quality of my skills translates into the quality of life for my patients. If I keep myself sharp, I’m a better paramedic. If I let them get dull, well then I’m an apathetic paramedic who isn’t doing my duty. Duty is important to me. So are things like Pride, Professionalism, and Honor. In fact, those three words are more than just the slogan for my blog, they are how I think that I and other EMS professionals should live their lives and careers.

Others have been quick to demonize the 200 suspended EMTs. Others have been quick to defend them. The ones defending them have said that these people are apt to lose their incomes, their livelihoods, and that the punishment is unfair. Well, for that part I disagree. The punishment is indeed fair. You could have killed someone by being untrained oafs with lackluster skills. You never proved you were otherwise. However, if you were to ask me if I thought that a state EMS agency – ANY state EMS agency – was competent to manage such a program, I would laugh at you.  Every state has made an attempt to regulate continuing education and I agree that there is a good reason for them to do so. I would also agree that the prospect of regulating a group of EMS people in their continuing education efforts is a daunting task. I would say that the perfect system has yet to be developed and that a good number of the 200 were simply “playing the game” and thought that since their states EMS continuing educational system was a joke that they could make a joke out of it as well.

Here’s the most biting apathy of all to me. If you believe that a system that you work under is a joke. If you believe that there is a better way to do something. If you believe that what you’re made to do is pointless and obsolete… then why the heck haven’t you done anything about it?

I’d like you to look at this issue from this perspective, folks. Sure, not everyone in that group of 200 were caring, competent professionals. I’m sure some of them were jackasses. (And yes, I said “Jackasses). However, I’m also sure that there is a percentage of them in that group that sincerely care about being the best they can be in EMS and they simply got caught up in the mob mentality. I’m sure that some of them had just given up. I’m sure some of them were good people who just became apathetic.

I hate apathy.

If what, say 50% of that group were of the caring kind, that leaves 100 people who thought that the system was broken. Did it not occur to any of those 100 people to try and change it? Did they not try and band together to improve the system? Could one person do it? Could 100 people do it?

If we are to be regulated and controlled by obsolete and ineffective bureaucratic systems, then it is our duty to rise up and change things. Sure, that sounds melodramatic… but how many times have you thought that your state regulations were stupid. One of the defining aspects of a Profession is Self-Regulation. Look at your states “Bar Association” for Lawyers, or the states “Medical Association” for physicians.

Is there any state out there that has a “Paramedic’s Association” that has any teeth to it?

No continuing education system or relicensure processes is even close to perfect. That’s because of a few reasons, not the least of which is because the government is the one running it. The other reason could be because it isn’t being policed by the paramedics who care about it the most.

I’ve said it before, I’ll say it again. It’s time for us to take ownership of our profession. Stand up and make this the profession it deserves to be. Stamp out apathy and band together to let your voices be heard. If you don’t start the process of meaningful change, who do you expect to do so?

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For more positive discussion on EMS, check out the comments section in Negativity? You Won’t Find That Here” or for a description of two real-world moral and ethical dilemmas in EMS, check out Two Cases, one letter. From one paramedic’s struggles, change can come”

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  • Ambulance_Driver

    Changing the status quo in EMS continuing education is a Sisyphean task, but it must be done.

    And the main reason it's such a difficult task is because if you polled a representative sample of EMTs on the question, “What is the biggest danger to our profession, ignorance or apathy?”

    90% of them would answer, “I don't know, and I don't care.”

  • http://www.lifeunderthelights.com Ckemtp

    Funny you should bring the old “ignorance or apathy” saying up. I was just thinking about the post, as I do, and I thought I shoulda worked that in there.

    My fear though, is that the real answer might be “I don't care WHAT I don't know”

  • http://grumpydispatcher.blogspot.com/ The Grumpy Dispatcher

    It's not just EMS. Fighting this same battle in power dispatcher circles. Difference is, the CE skills they bore us to death with to keep our certs is generally not stuff that will save lives or keep from blowing stuff up, it's all procedural and ass-covering. AND, there are strong unions and associations.

    EMS CE is far more important, and lacks the industry unity. Indeed, time to step up, pick some leaders (I think this may have already been done but they don't know it yet!), and move forward.

    Great post.

  • Bbrouhard

    I agree and right now CE responsibility is often soley placed on the individual EMS provider. The EMS Agency, Employer and Medical Director have abdigated that responsibility. So unless your ardent in your EMS practice apethy sets in. If all stakeholders in the mission of providing EMS' were held accountable to providing quality EMS CE, the CE system would be better. Yes it is the individual's responsibility to maintain their CE, but would'nt it be nice if everyone contributed?

  • Adam Burgan

    Maybe its just me, but I don't feel at all bad for them. How long is CPR re-cert really, sit through the class you were probably being paid to take. do your job and get over it.

  • annoyed

    Adam,
    One issue with your comment. MA OEMS suspended some people who DID attend a CPR class. They actually went, sat through the program, did the practical test… OEMS' issue: the class was 2 hours! Not enough! Card invalid! WHAT?
    Thankfully the state Administrative Appeals Judge has been reinstating these people as their appeals come before him. The DPH has ZERO authority to do what they did. AND the media, blogs, opinion pages have gone INSANE convicting these people before they even got their day in court.

  • Old_time_EMT

    I am one of those boring people that sits in the uncomfortable chair reading from canned material. I also work in the MA EMS system. As instructors, we have to jump through all kinds of hoops to get OEMS approval for a program….. first region representatives, then it gets to OEMS for “approval”. Any attempt to deviate from their set cirricculum (sp) meets with a rejection stamp. I tried to run a wilderness EMS program and had it rejected because “Massachusetts doesn't have any wilderness.” I'm guessing that someone hasn't been to the 1500 acre land preserve on Cape Cod, or out to the Berkshire Mountains of late. Also, the refreshers are not allowed to deviate from the outline written in 1998 when the last updates were done to the EMT/Medic programs.

    I don't agree with what these 200 EMT's & Paramedics did. However, many of these suspensions are being overturned on appeal. Some on procedural basis, others because OEMS overstepped their authority. I run a paramedic refresher that includes an AHA ACLS refresher. I have approval numbers and have never been questioned. Several of the people suspended were done so because OEMS didn't feel the ACLS refresher was “long enough” so they voided the refresher as not being a complete and “proper” one.

    Yes there was some wrong doing out there. There was also alot of OEMS trying to justify their existence & budget during an election year. I don't think this is over yet. The administrative law judge handling the appeals of many of these EMT's has not been impressed with much of the investigative techniques, ie: phone interviews without telling the emt they were under investigation, some classes voided just based on the instructor who taught it, etc. So, before we send these EMT's and Paramedics to the electric chair, let's see how this all plays out.

    I am hoping that once this is over, we, the instructors, can have more freedom to teach new material

  • Totwtytr

    Annoyed and Old_Time_EMT, those are interesting points. I shouldn't be surprised that OEMS did a half assed investigation, given their reputation for doing things in a half assed manner. Nor should I be surprised that the news coverage was inept because it was based on statements from OEMS and other parties who had a vested interest in making the whole thing go away while pointing fingers.

    I'm sure that some people will have their tickets reinstated and equally sure that OEMS will not publicize the fact.

    I'm also disappointed, but not surprised that OEMS has not taken the opportunity to look inward and re evaluate it's training requirements.

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  • Medic

    To whoever wrote this article,

    Your ignorant to this entire issue and should have kept quiet like you first thought of. Many of the medics had study guides and had to take and hand in tests. What they did was no differant than an online refresher. The argument that was made was that they didnt take a practical at the end. All of this was investigated by someone that held plenty of refreshers without practical. And all the study sheets and test were approved by OEMS, and then magically disappeared after this investigation started. There certainly were some that signed rosters knowing full well that there were no classes or tests. But some people did do what they were supposed to and are still being cruicified.

  • Dan

    Regardless of what has and will go on in MA, I think this is a good time for everyone in the profession to review their own CE efforts, and if found lacking, to do something about it. I enjoyed the article.

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Chris Kaiser aka "Ckemtp"

I am a paramedic trying to advance the idea that the Emergency Medical Services can be made into the profession that we all want it, need it, and know it deserves to be.

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