Is this the way your medical director, chief, CEO, ALS coordinator treats you?
We do seem to agree that our standards are too low, but we do not agree on what we should do to raise our standards and what are our obstacles to better standards.
We spend a lot of time worrying about the amount of classroom hours to complete each part of a merit badge, rather than how we should assess competence.
We avoid discretion as if it were evil, but we are exercising discretion every time we make any decision.
Every time we drive, we decide when and how hard to press on the throttle, when and how hard to press on the brake pedal, when and how much to turn the wheel, when and for how long to indicate a turn. Rather than assess competence behind the wheel, many organizations just require an EVOC (Emergency Vehicle Operator Course) completion cared.
As with all of the other merit badges that organizations require as an alternative to assessing competence themselves, the quality of these courses varies tremendously. It is like calling medical command for orders – more depends on who answers the phone than on anything else, but we pretend that this is some objective protection for patients.
We tell ourselves what we want to hear.
How much of what is taught in a merit badge course is based on the course materials and how much is based on the instructors opinions?
How much of what is in the course materials is based on good evidence?
We have a bunch of people trying to keep the standards low. Those who think that every seat should be filled with a medics will not have an easy time filling all of those seats with people wearing paramedic medic badge patches if the standards are high.
If being a paramedic is a participation award, will the patients really want the proud owner of a participation prize to be caring for them, or will patients want someone who is being held to standards that matter? Will patients want a paramedic who is treating the serious patients, rather than driving half of the serious patients to the hospital?
If medical directors, chiefs, CEOs, ALS coordinators, and others oppose improvements in standards, we need to ridicule them.
Medical directors who keep standards low do not deserve respect.
Chiefs who keep standards low do not deserve respect.
CEOs who keep standards low do not deserve respect.
ALS coordinators who keep standards low do not deserve respect.
If we are concerned about our image, we need to stop cooperating with the clowns running the circus.
Just because someone has a title does not mean they deserve respect. Leaders need to demonstrate that they deserve respect.
Those who don’t deserve respect should not be defended by us.