A Reason a Degree Requirement is Necessary for the Future of EMS.

As a profession, EMS must move forward. Dr. Bledsoe once mentioned that EMS next to being a physician, is the most autonomous profession in healthcare. While it is true that we operate within protocols, we often have the latitude to choose a therapy arm and treat any immediate life threats and consult a physician afterwards. As recent literature is demonstrating, we have more tools available than ever before. But we must decide, based upon evidence based criteria, what is best for the patient. This decision is becoming more complex. Much of the research being conducted today is no longer exclusively from physicians. It now includes many educationally credentialed EMS professionals who are making an impact on moving the profession forward. As a result many wonder if we we are this autonomous, should we be requires associate degrees for entry level paramedics?

There are arguments that the requirement of a degree will impose hardships on a lot of services. True. But so will the proposed federal minimum wage increase to $15/hr. This is horrible to realize that in our profession, and in this time in history, that EMS providers are just making above minimum wage!  As a result this may force the acquisition, merger, or consolidation of ambulance services across the country. This is simply putting a bandaid on the wound but it does not stop the bleeding. To increase the finance arm requires a change to the EMS reimbursement model.

The reimbursement groups still see us as a transport service. Yet EMS still has the dedicated individuals who will say I want to take on extra roles and look at tactical medicine, MIHC, and critical care. Yet, we still do not see the reimbursement in these areas as we have changed within the system. Ground EMS is often treated different than aeromedical. Yet there are more similarities than there are differences. But in a recent job opportunity for a flight paramedic position, it also requires a BS degree. It seems that many providers and groups accept the higher standards for the aeromedical modell and in fact their is a difference in the reimbursement regulations as well. Could this higher standard be one reason why things are different?

By requiring an associate degree for future paramedics, we will meet the vision of many of the documents such as the NASEMSO Instructor Qualifications 2011, the EMS Management education recommendations, the 2050 EMS Agenda. It is also important to recognize that this recommendation is just that, a recommendation. Much like the recommendation made by the IAFC in FireRescue1.com. Tom LaBelle mentions this on the same site in 2011 about the advantage to education in the fire service. It ultimately comes down to the states and the certification testing groups to determine if possessing a degree should be required. While many will admit there will be a decline in supply, the ends should justify the means for reimbursement.

We must prove to the purse string pullers we are no longer ambulance drivers! A way to change reimbursement regulations and rules means we will need to change the system. A degree helps validate that we are dedicated to our profession and leaves little reason for the rule makers to say we are just ambulance drivers.

From a direct patient a degree proves we are invested in the well being of our patients. One can expect verbal and written communication will improve as will personal responsibility. Decision making will become sharper through the development of critical reading and thinking skills. This helps educated providers to make the best clinical choices for their patients often based on some complicated research findings. Finally, with the amount of time it takes to become a paramedic, shouldn’t adding in a few general education classes warrant a degree rather than continue to be recognized as a part of a workforce or vocational program?

We are committed to moving the industry in a direction it has never been in this country. It will not be easy. We will receive bumps and bruises and receive some deeps wounds along the way. No one can predict the future, but there are many strategic plans that exist to improve EMS. Evaluate where we are from the 1966 White Paper, and the 1996 EMS Agenda for the Future. In 10 years, will we have moved the profession forward or just accomplished enough to stay the course?