Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

Drive Like an Egyptian

This week on EMS Garage there are a few topics.[1]

Driving, which is one of the most common causes of LODD (Line Of Duty Death) and a huge source of lawsuits against EMS agencies.

Why are we so bad at coming up with sensible measures to discourage reckless driving?

Why do we take bad driving for granted?

If we assume that bad driving is inevitable, aren’t we encouraging bad driving?

Why do we rely on mindless rules that discourage critical judgment by the driver (such as a red light requires a full stop)?

What should we do to improve EMS driving?

Can we ever expect to have safe drivers, if we discourage critical judgment?

One problem that is mentioned is that management often thinks that they can only change behavior by punishing bad behavior (bad driving, in this case).

Punishment is not essential to behavior modification.

Management needs to focus on demonstrating good behavior, rather than on punishing what we see management getting away with on a regular basis.

Clearly, management that drives bad does not take bad driving seriously.

Why do we pretend that something that kills us and kills our patients is not a problem?

Buck describes the drive cameras that record just before a crash. This is designed for protection in court. Buck does not support this. I point out the obvious problem with that kind of approach –

What’s better protection from going to court, than changing the behavior of your employees who are behaving badly?

We need to change bad behaviors before they become bigger problems.

We need to recognize that we are only encouraging bad behavior when we tolerate bad behavior.

What kind of social media policies should we have in EMS?

As with driving, we seem to avoid allowing any judgment. We act as if blogs are bad. We use the occasional example of misbehavior on the part of a blogger to prejudice all EMS blogs.

Why do we always seem to abandon using critical judgment, when it comes to making decisions?

Are we really incapable of thinking?

If we are incapable of thinking, should anyone trust us to take care of them in an emergency?

Reference is made to a podcast from December 2009, where Dr. Keith Wesley came on and criticized EMS bloggers for poor content and for anonymity.[2]

Yes. There are some bad blogs out there. There is no way to prevent that.

There are also excellent blogs out there.

The presence of the pathetic blogs does not affect the quality of the excellent blogs. Criticizing the excellent blogs for the flaws of the bad blogs is misguided.

Anonymity is similarly a bogus criticism.

Are we smart enough to read something and determine if it is valid?


Are we too stupid to make any decisions without some authority telling us what to think?

Again, if we are incapable of thinking, should anyone trust us to take care of them in an emergency?

Any authority who has to resort to silencing criticism is not an authority we should listen to.

Any authority who discourages thinking is not an authority we should listen to.

An expert is someone who just hasn’t been embarrassed a lot, yet.

Learn from science that you must doubt the experts. As a matter of fact, I can also define science another way:

Science is the belief in the ignorance of experts.

– Richard Feynman.

Trusting experts is only for those of us who are not smart enough to understand what we are reading.

Also on the podcast are:

Chris Montera
Scott Keir
Buck Feris
Russell Stine
David Konig
Chris Kaiser

The articles we started out discussing:

EMS Week. What did you do or what should you do?

Take This Week And Shove It is a blog post that came up in the discussion of what we do wrong when settling for the same old pat on the head for EMS Week.


[1] Drive Like an Egyptian: EMS Garage Episode 134
EMS Garage

[2] Dr. Wesley Versus the Bloggers: EMS Garage Episode 65
EMS Garage



  1. You can criticise me for my anonymity – but it serves multiple purposes:
    1) It protects my patients. Despite the fact that any tale I may tell has had many details changed whilst still conveying the truth, anonymity is an added layer of protection for all concerned.
    2) It protects me from overzealous analysis by management or others who are out to seek an end to EMS blogs.
    3) It allows me greater freedom to express my real feelings in a culture of suspicion…

    I hope it still allows my blog, although it is one meant more as an insider’s look than an educational tool, to be a good blog…