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Emergency Medicine’s Original Sin

12 Jul 2021 10:39 AM | AIMHI Admin (Administrator)

Atlantic Source Article | Comments Courtesy of Matt Zavadsky

Fantastic article by The Atlantic! 

EMS is facing a staffing crisis not seen in decades.  The EMS staffing crisis has been profiled by several national media outlets.  The latest, here in The Atlantic.

Communities need to get serious about what life would look like if no one responded to EMS calls. 

Among the two most notable quotes:

That medicine treats emergency medics like disposable, low-wage workers instead of the health-care professionals they are isn’t just unfortunate for the workers themselves—it also leads to less than optimal care for the rest of us on the day we may need it most.”

Emergency medics routinely struggle with high rates of burnout and job dissatisfaction, as well as PTSD and other mental illnesses. They are regularly bitten, punched, or otherwise assaulted by their patients, enduring a rate of occupational violence that is about 22 times higher than the average for all other U.S. workers. Altogether, the low pay, the absence of performance feedback, and the chronic mental and emotional toll “sends the message that no one cares about you and your work,” Crowe said.”

The treatment of emergency medics as chauffeurs and not clinicians—as a profession of nonprofessionals—means that not enough Americans choose this career.”

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Emergency Medicine’s Original Sin

The misperception that paramedics are merely ambulance drivers is everyone’s problem.

By Marion Renault

July 12, 2021 

Special Note: The Atlantic interviewed MedStar paramedic Jason Hernandez for their 2016 article “What It’s Like to be a Paramedic”.

Lindsey Kaczmarek gets called an ambulance driver more often than she gets called a paramedic. “That’s absolutely not what I do,” she told me. What she does do is show up when someone needs medical help, figure out what’s wrong with them, and do whatever she can to help them survive the trip to the hospital—in her case, the Mayo Clinic in Rochester, Minnesota. The primary symptom for one in three 911 medical calls is simply “pain,” but during any given shift, Kaczmarek might attend to a heart attack, a stroke, a car crash, a labor and delivery gone wrong, a mental-health crisis, a shooting, or an elderly patient suffering from a severe urinary tract infection. “If they’re not breathing, I will breathe for them,” she said. “If their heart’s not beating, I will be the heartbeat for them.”

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.

The misconception that emergency medics provide transportation, not medicine, leaves them to cope with all sorts of indignities. “They’re used to being second-class citizens,” says Michael Levy, the president of the National Association of EMS Physicians. In one hour—during which they may respond to several 911 calls—the median paramedic or EMT makes a little more than $17. That’s half the hourly pay of registered nurses and less than one-fifth the pay of doctors—if they’re paid at all. During the pandemic, emergency medics were literally enclosed in rolling boxes with COVID-19 patients. But in some states, they were not prioritized alongside other essential health-care workers for the first round of vaccines. After delivering their precious cargo to a hospital, in many cases they don’t learn the final diagnosis, or whether their patient ever makes it back home.

That medicine treats emergency medics like disposable, low-wage workers instead of the health-care professionals they are isn’t just unfortunate for the workers themselves—it also leads to less than optimal care for the rest of us on the day we may need it most.

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