The Bravest, the Finest, and the Forgotten

We’ve gone ’round the sun again, and 2019 EMS Week has come and gone. I must say I’m grateful to ACEP for taking the lead in honoring emergency medical services. Every year it provides a logo and great marketing materials. Thank you!

I’m also grateful to NAEMSP for sticking up for us. We certainly don’t do it for ourselves. Where was our uproar when the mayor of New York City took a position that his EMS shouldn’t get equal pay to other services? It was NAEMSP President David Tan, MD (from Missouri), who spoke up and stood with the EMTs and paramedics of New York City.

Ironically, the silence from our own advocacy organizations was deafening. I guess they were busy doing something else. Well, I’m glad somebody spoke up. But it’s time our occupation stood up and advocated for ourselves.

Some communities have done a good job of recognizing EMS for what it is: critical community infrastructure! EMS is a critical component of community public safety response. However, we have some problems. For almost 50 years our evolving occupation has let everyone speak for us…except us. We’ve failed to stick together and speak with a unified voice. While police and fire are legally required services, EMS usually isn’t, despite the fact most true emergencies in the community are medical in nature.

We also have a “branding” problem. How would it work if fire and police services had as many confusing titles as we do? We have so many confusing titles, the public and media struggle with what to call us. While firefighters are referred to as “the bravest” and police as the “the finest,” EMS is just forgotten. Watch almost any media account of a community incident—journalists don’t know what to call us. We often get referred to as “emergency workers” or even just “ambulance drivers.” While police and fire are an identifiable “brand,” EMS is not.

Recently there was a national meeting on nomenclature for our occupation. The matter being discussed was rebranding the occupation as “paramedicine” and doing what most other countries have done: Use the base title of paramedic for those in the occupation, just like nursing has done. Guess what? We stuck with the status quo.

No big surprise. We let regulators and other special-interest groups define our occupation at every level. Who drives nursing practice in most states? It’s not nursing regulators, it’s nurses! They have an identifiable brand, too. They lobby and stick together as an occupation. Get the picture?

We face many issues, but there are two foundational ones:

• EMS must be an “essential public service” in every state in the USA. EMS is critical public safety infrastructure and must not be overlooked. Who provides it is a local issue, but it needs to be funded and provided, just like police and fire services.
• We must solidify our “brand” just like police, fire, and nursing. The term paramedic should be our base all-encompassing title, like our Canadian, Australian, and U.K. colleagues. There are many different levels of paramedic, just like there are many levels in nursing. We need to lobby in every state to make this happen. I know—you worked hard for that title. So did I, and I’ve held it for 40 years. But it’s time to do what’s good for the occupation, not just ourselves. Let’s get behind this.

Are you a member of a national advocacy organization like NAEMT, NAEMSE, or the new American Paramedic Association? It’s time to get involved and let your voice be heard. Decisions are made by occupations that speak with one voice and show up. I’m grateful our medical directors (ACEP and NAEMSP) have continued to advocate for us. But it’s time the occupation of paramedicine grows up and starts to help itself.

Jonathan Politis, MPA, NRP, is retired chief of the Colonie EMS Department, a combination career and volunteer service in upstate New York. Active as an EMT since 1971, he has been a career firefighter, state EMS training coordinator for two states (Vermont and New York), and a paramedic training program coordinator. He is the author of numerous publications and stays active in the field as a paramedic, ski patroller, EMS and rescue instructor, and volunteer fire chief for the Verdoy (N.Y.) Fire District. He is also the owner of an EMS leadership consulting company.