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

- Rogue Medic

When Is It Enough EMS Training? – EMS Office Hours

This week on EMS Office Hours, Jim Hoffman, Josh Knapp, Bob Sullivan, John Broyles, and I discuss how we are perceived outside of EMS.

When Is It Enough EMS Training?

Why do some EMS organizations just throw new medics to the wolves?

Why do the rest of us encourage this?

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We discussed the topic of EMS organizations putting fresh, inexperienced medics out on the street as an example of the organization that try to do everything on the cheap ignoring one important liability that they create.

They whine, We could be sued! for so many less dangerous practices and especially for things that would be good for patients. When it comes to inexperience, all these EMS-on-the-cheap organizations seem to see is lower payrolls.

This is one thing they should be sued for, but lawyers don’t seems to pay attention to the experience of the medics who screw up or to the organizational responsibility for that.

The suggestion is made that there isn’t any money to sue for, as if EMS organizations are not required to carry adequate insurance to cover the damages they may cause. Of course there is money there for legal settlements.

Unfortunately, the topic is diverted into unrelated territory. When companies are sued for malpractice, the lawyers should spend time establishing for the jury the education, or lack of education of the paramedic, as well as the experience, or lack of experience of the paramedic.

For some reason the discussion switched to medics giving testimony in murder trials, where the medic is only there to confirm facts that are not even disputed.

What does the jury think about the experience of the medic in those cases?

Who cares. That has nothing to do with putting inexperienced medics on the street.

Does the lawyer spend time explaining the experience of the medic in those cases?

Of course not. That has nothing to do with putting inexperienced medics on the street.

If a malpractice suit is brought against a company for putting an inexperienced and dangerous medic on the street, the plaintiff’s lawyer should be explaining just how inexperienced the medic is, while the defense lawyer should be making the opposite case. The amount of time spent on this could be extensive. What matters is the way the lawyers are presenting their cases. If experience is relevant to the case, why wouldn’t a lawyer spend hours, days, or even weeks on the topic?

Being a good medic is about making decisions and learning from our mistakes.

A brand new medic has probably not made enough mistakes to learn to be a good medic.

An experienced medic may have made a lot of mistakes, but may not have learned anything from those mistakes.

There is an old saying about the tremendous difference between a 20 year medic having 20 years of experience and a 20 year medic having a year of experience 20 times over (or 6 months of experience 40 times over, or 3 months of experience 80 times over, or . . . ).

We pay attention to standardized tests, rather than assessing the ability to learn and assimilate new knowledge and new experiences. We pay attention to things that do not make a difference in patient outcomes.

We need to change what we pay attention to. How many of our employers track skills and post them publicly?

How good are the medics at intubation?

Is this a secret?

Is it unknown?

If it is not known, that is a sign of organizational incompetence.

We encourage organizational incompetence.


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