That is the startling title of a recent article in the Atlantic, https://www.theatlantic.com/health/archive/2021/07/paramedics-not-just-ambulance-drivers/619395/. The subtitle is, “The misperception that paramedics are merely ambulance drivers is everyone’s problem.” Key excerpts are below, but the whole article is well worth reading. The Atlantic is paywalled, but nonsubscribers get three free articles a month, so you should be able to access it. And remember, if you need an EMS expert, Vident Partners is your best source.
The job of providing emergency medical services, or EMS, often resembles medical detective work, with limited clues, no specialists to consult, and very little, if any, of the sophisticated equipment available to doctors and nurses. But even though emergency medics – a catchall term used throughout this story for paramedics, emergency medical technicians, and emergency medical responders – handle tens of millions of calls in the United States each year and make life-altering decisions for their patients every day, they remain all but excluded from institutional medicine. “You’re basically like a glorified taxi,” says Sarayna McGuire, a Mayo Clinic emergency physician who has studied pre-hospital health care….
For the most part, EMS providers don’t learn whether the split-second decisions they make – say, whether to intubate someone – ultimately help their patients. Only about one in three EMS agencies reports having any access to electronic, patient-specific medical information. Many hospitals refuse to share any outcome data with EMS, claiming it’s a HIPAA violation (legally, it’s not). Ultimately, even in the most clear-cut of cases, if a patient dies in the ambulance, an emergency medic may not learn the cause of death, or whether there was anything they could have done differently to change the outcome….
Leaving emergency medics out of the loop doesn’t only turn their jobs into repeated chronic cliff-hangers. It also keeps them from improving the care they give to their patients, experts told me, robbing them of the opportunity to learn which of their instincts are correct and which to avoid. “Without creating this feedback loop, you really can’t get better,” Sayre says. “Of course medical errors happen because of that. You didn’t have enough of the puzzle pieces.” Few other fields, especially in the world of medicine, demand that its professionals tolerate working in a feedback-free environment. What if a chef never tasted a final dish? What if a teacher wasn’t allowed to grade tests? Would a lawyer be okay with never hearing a verdict?....
The treatment of emergency medics as chauffeurs and not clinicians – as a profession of nonprofessionals – means that not enough Americans choose this career. While nurses and doctors generally stick around in the field for decades, the average age for an emergency medic is just 34, and about 80 percent leave the job after seven years or less. This affects the quality of medical care provided: Data suggest that more experienced EMS clinicians save more patients and lead to better health outcomes. Retention issues in EMS are so widespread that some states and counties are plagued by staffing shortages and, in turn, delayed emergency care….
As emergency medics continue to be undervalued, their work has never been more valuable. We needed them, and badly, during the pandemic, as 911 call volumes skyrocketed. We need them to respond to the urgent health needs of the country’s growing population of elderly people…. We need them on the scene of mass shootings and drug overdoses. We need them [for] natural disasters, bouts of extreme weather, and infrastructure collapses. America’s health-care system ignores emergency medics at its own risk – and all of ours.
